Assessment of Safe Sleep: Validation of the Parent Newborn Sleep Safety Survey.

PURPOSE: Sudden Infant Death Syndrome (SIDS) and suffocation account for more than half of all Sudden Unexpected Infant Deaths (SUID). The American Academy of Pediatrics (AAP) recommendations describe the safest environments to protect infants. This study compared parent responses on the Newborn Sleep Safety Survey and observational assessments (N=72) of infant sleep environments in families thought to be at high-risk for non-compliance with AAP recommendations. DESIGN AND METHODS: A naturalistic study of participants enrolled in two home visitation support programs was used. Observed risks ranged from 36.6% (never use pacifier) to 4.3% (never use firm mattress). RESULTS: Results comparing report to observation demonstrated acceptable concordance. Five items had fair concordance (Kappa>.4), four showed moderate concordance (Kappa>.6), and one excellent concordance (Kappa>.8). Although direct observation of safety behaviors is the gold standard in the injury prevention field, direct observation is logistically difficult, time consuming, and costly. CONCLUSIONS: Research and interventions aimed at a reduction of Sudden Infant Death Syndrome (SIDS) and suffocation require accurate assessment of the infant sleep environment. This study provides acceptable evidence for the use of the Newborn Sleep Safety Survey as an alternative to direct observation to assess parent adherence to recommendations. Limitations are discussed. PRACTICAL IMPLICATIONS: This study provided evidence of the usefulness of the Newborn Sleep Safety Survey, a parent survey of infant sleep environments. This tool will provide medical and research professionals a reliable, inexpensive tool to evaluation of the quality of sleep environments using a standard definition.

Making the message meaningful: a qualitative assessment of media promoting all-terrain vehicle safety.

BACKGROUND: Millions of all-terrain vehicles (ATV) are used around the world for recreation by both adults and youth. This increase in use has led to a substantial increase in the number of injuries and fatalities each year. Effective strategies for reducing this incidence are clearly needed; however, minimal research exists regarding effective educational interventions. OBJECTIVE: This study was designed to assess rural ATV riders' preferences for and assessment of safety messages. METHODS: 13 focus group discussions with youth and adult ATV riders were conducted. 88 formative research participants provided feedback on existing ATV safety materials, which was used to develop more useful ATV safety messages. 60 evaluative focus group participants critiqued the materials developed for this project. RESULTS: Existing ATV safety materials have limited effectiveness, in part because they may not address the content or design needs of the target population. ATV riders want educational and action-oriented safety messages that inform youth and adult riders about their responsibilities to learn, educate and implement safety behaviours (eg, appropriate-sized ATV, safety gear, solo riding, speed limits, riding locations). In addition, messages should be clear, realistic, visually appealing and easily accessible. Newly designed ATV safety materials using the acronym TRIPSS (training, ride off-road, impairment, plan ahead, safety gear, single rider) meet ATV riders' safety messaging needs. CONCLUSIONS: To reach a target population, it is crucial to include them in the development and assessment of safety messages. Germane to this particular study, ATV riders provided essential information for creating useful ATV safety materials.

Barriers and facilitators to all-terrain vehicle helmet use.

BACKGROUND: The burden of all-terrain vehicle (ATV)-related injuries and deaths in the pediatric population has increased dramatically during the past decade. Brain injuries represent a large proportion of these injuries and are the leading cause of death among those injured. Despite the risk involved in operating these vehicles, helmet use remains low. The aim of this study was to identify and understand common barriers and facilitators to helmet use among ATV users. METHODS: Focus groups were conducted in Arkansas with adolescent and adult ATV users to discuss ATV and safety equipment use. Standard methods of qualitative research were used to interpret focus group data. Moderator guides were framed using the Health Belief Model of behavior change. Transcript-based analysis was used, and data were managed using HyperRESEARCH (version 2.8.3). The transcribed data were coded to identify important themes. RESULTS: Eleven focus groups were conducted with 58 participants, who discussed ATV use patterns, current safety practices, and barriers to helmet use. Major themes were a lack of perceived risk with operating an ATV and lack of perceived severity of injury resulting from ATV crashes. Participants discussed other barriers to helmet use including helmet discomfort and inconvenience. Suggested solutions included passage of helmet laws for riders younger than 18 years, helmet redesign, and development of visual aids/crash simulations to convey the dangers of ATV use. CONCLUSION: This study identifies a gap in risk perception among ATV users. Injury prevention should focus on education about risks of engaging in unsafe ATV behaviors and the danger of the vehicles themselves.