Promoting booster seat use for young children: A school-based intervention pilot study.

PURPOSE: Misuse and/or lack of booster seat use are often associated with high rates of injury and death among school-aged children. This pilot study examined the efficacy and the potential effectiveness of a booster seat intervention in the classroom. METHODS: Two elementary schools participated (randomly assigned as one intervention school and one control school). At the intervention school, a certified car seat specialist and a police officer held an interactive booster seat session. The height and age for each child were recorded. Children received a certificate indicating whether they met the requirements for booster seat use and a postcard with car seat restraint specifications. Children in the control school received a brochure on car seat safety. Pre- and post-intervention self-reports were collected and booster seat use was observed. RESULTS: Observational findings showed a decline in booster seat use at the control school and an increase in use at the intervention school. Self-reports of booster seat use indicated a decline at both schools; however, cell sizes were too small to permit statistical analyses. CONCLUSION: Anecdotally researchers found the sessions were easy to conduct and were well received by the children and could be easily integrated into programming in schools. Classroom sessions may have the potential to positively influence booster seat use among 6- to 8-year-olds.

Achieving all-age helmet use compliance for snow sports: strategic use of education, legislation and enforcement.

BACKGROUND: Nova Scotia is the first jurisdiction in the world to mandate ski and snowboard helmet use for all ages at ski hills in the province. This study represents a longitudinal examination of the effects of social marketing, educational campaigns and the introduction of helmet legislation on all-age snow sport helmet use in Nova Scotia. METHODS: A baseline observational study was conducted to establish the threshold of ski and snowboarding helmet use. Based on focus groups and interviews, a social marketing campaign was designed and implemented to address factors influencing helmet use. A prelegislation observational study assessed the effects of social marketing and educational promotion on helmet use. After all-age snow sport helmet legislation was enacted and enforced, a postlegislation observational study was conducted to determine helmet use prevalence. RESULTS: Baseline data revealed that 74% of skiers and snowboarders were using helmets, of which 80% were females and 70% were males. Helmet use was high in children (96%), but decreased with increasing age. Following educational and social marketing campaigns, overall helmet use increased to 90%. After helmet legislation was enacted, 100% compliance was observed at ski hills in Nova Scotia. CONCLUSIONS: Results from this study demonstrate that a multifaceted approach, including education, legislation and enforcement, was effective in achieving full helmet compliance among all ages of skiers and snowboarders.

Predicting parents' use of booster seats.

OBJECTIVE: To examine the simultaneous contribution of multiple factors associated with parents' use of booster seats. METHODS: Using the theory of planned behaviour framework, constructs of the theory were tested for usefulness in predicting self-reported intent and behaviour with respect to parents' use of booster seats. Through the use of structural equation modelling, the study demonstrated the most significant predictors of the intent to use a booster seat and reported use of booster seats in a Canadian sample (n=1480) of parents of school-aged children, 4-9 years. RESULTS: The strongest predictors of intent to use booster seats were attitudes (benefits of booster seat use) and second, subjective norms (perceived booster seat use in the community). Parent barriers were inversely associated with intent and use of booster seats and child barriers with use. Intent and norms had the greatest effect on use, both positive and equally influential. The final model explains 30% of the variance in booster seat use. CONCLUSION: Messages that address the benefit to the child in preventing injury could be beneficial if spread more diversely, establishing a social norm. Legislation, enforcement and local policy could positively influence the perceived culture that supports and expects booster seat use for school-aged children.

Overestimation of Physical Abilities Among Boys With and Without ADHD.

OBJECTIVE: Children with ADHD have been widely reported to overestimate their abilities in social and academic domains, but a similar overestimation of physical abilities has not been examined. METHOD: Twenty-four elementary school-age boys with ADHD and fifteen boys without ADHD were compared on their ability to accurately estimate their ability to complete four lab-based physical tasks, varying on three levels of difficulty: (a) within their ability, (b) 8% beyond their ability, and (c) 13% beyond their ability. RESULTS: Children with ADHD were significantly more likely than controls to overestimate their physical ability at difficult levels of the task. CONCLUSION: Implications of these results for preventing risky behaviors in children with ADHD are discussed.

Helmets for skiing and snowboarding: who is using them and why.

BACKGROUND: In Canada, winter sports injuries are responsible for significant health care burden, with estimates of $400 million in direct and indirect annual health care costs. For ski-related injuries, helmets have been shown to provide significant protection. Current common practice in Canada, including the Province of Nova Scotia, is to leave the decision of whether to wear a helmet to the individual. The purposes of this study were to document skiers' and snowboarders' use of helmets and to isolate factors associated with helmet use and nonuse. METHODS: A mixed methods approach was used to collect data during a 2-month period at the province's three ski hills. Naturalistic observations documented helmet use and falls, whereas interviews identified factors influencing helmet use or nonuse. RESULTS: Helmets were used by most skiers (74%) and snowboarders (72%); the use varied significantly between ski hills, ranging from 69% to 79%. Females were more likely to wear helmets compare with males (80% vs. 70%). The highest rates of use were found among 4-year-old to 12-year-old children, with helmet use declining as age increases. Qualitative data revealed that helmet users were most influenced by the protective benefits of helmets (77%), personal choice (46%), family (44%), and rules (44%), while non-helmet users cited personal choice (29%), comfort (26%), rules (14%), and cost (11%) as reasons for nonuse. CONCLUSION: More than 25% of skiers and snowboarders remain at increased risk of a serious brain injury by not wearing a helmet. Changes in regulations may be required to ensure widespread use of helmets on ski hills. LEVEL OF EVIDENCE: Prognostic study, level II.

School liaison program for children with brain tumors.

A school liaison program that familiarized teachers with the implications of each child's brain tumor treatment with respect to learning, behavior, and socialization was implemented. The study explored the experiences of nine families and their teachers and health staff who participated in the program. The successes and challenges of the program were captured through interviews that were audio-taped and transcribed verbatim for data analysis. Individualized programs were negotiated between families and education staff to address behavioral, academic, and social needs of each child. Children were able to learn to their ability rather than be judged on the achievements of their respective grade levels. Parents reported that the program strengthened their advocacy skills and improved the children's social and learning achievements. Teachers reported an improved ability to provide more comprehensive educational programming suited to the child's needs. Overall, most children in the program achieved or exceeded their initial academic, social, and behavioral expectations. The school liaison program demonstrated significant potential to enhance the learning experience for children with brain tumors.

Modeling improvements in booster seat use: a discrete choice conjoint experiment.

Automobile crashes are the leading cause of death in children aged 1-14 years. Many children, however, are not properly restrained in safety seats that reduce serious injury and death. This study used a discrete choice conjoint experiment to study factors influencing the decision to use booster seats. Parents of 1714 children aged 4-9 years from nine Canadian provinces completed choice tasks presenting experimentally varied combinations of 15 4-level booster seat promotion attributes. Latent class analysis yielded three segments of parents. The choices of the Benefit Sensitive segment (50%) were most sensitive to the injury prevention benefits of booster seats. The choices of parents in the Context Sensitive segment (33.5%) were more likely to be influenced by installation complexity, oppositional behavior, and the prospect that their child may be teased for riding in booster seats. Parents in the High Risk segment (16.5%) were younger, less educated, and less knowledgeable about vehicle safety legislation. They anticipated fewer benefits, expected more barriers and were less likely to use booster seats. Simulations suggest that consistent enforcement coupled with advertising focusing on injury prevention and the use of booster seats by other parents would increase adoption.

School experiences of families of children with brain tumors.

Families and children often report a diverse range of academic achievements and challenges after undergoing treatment for a brain tumor. This study explores the experiences of children, youth, and their families as they seek to reintegrate into mainstream educational systems. Despite the variable experiences, there are many common strategies that could positively influence the child's success in school. Strong communication between parents, school, and health professionals is paramount. Preparing parents to advocate for their children's academic and social needs and developing an awareness of the challenges among school staff has potential to improve outcomes for these children. Equipping the children with the social skills needed to manage social situations will strengthen their ability to overcome the challenges that they face. These study findings shed light on the academic experiences of these children and can lead to the development of strategies to support families facing similar challenges.

Children at risk of injury.

This study examined the relationships between two groups of Canadian preschool children (injured and noninjured) and their parents' risk perceptions, safety behaviors, parenting stress, and children's risk behaviors. Data analysis revealed significantly higher numbers of injury behaviors in the group of injured children (t = -2.46, p =.015). Contrary to the investigators' hypothesis, parents' perceptions of risk and hazard were not found to be significantly less among those parents of injured children. However, the parents of injured children had a higher score for perceived dangers for their children (t = -2.38, p =.01) and less parent stress (t = 3.38, p =.001).