Six-month Follow-up of a Brief Intervention on Self-reported Safety Belt Use Among Emergency Department Patients.

Author(s): Fernandez WG, Winter MR, Mitchell PM, Bullock H, Donovan J, George JS, Feldman JA, Gallagher SS, McKay MP, Bernstein E, Colton T

Affiliation(s): From the Department of Emergency Medicine (WGF, PMM, HB, JD, JS, JAF, EB), the Data Coordinating Center (MRW), and the Department of Epidemiology (TC), Boston University School of Medicine, Boston, MA; the Program in Health Communication, Department of Public Health and Family Medicine, Tufts University School of Medicine (SSG), Boston, MA; and the Center for Injury Prevention and Control, Department of Emergency Medicine, George Washington University School of Medicine (MPM), Washington, DC.

Publication date & source: 2009-10-08, Acad Emerg Med., [Epub ahead of print]

Publication type:

Abstract Objectives: Safety belt use (SBU) reduces motor vehicle deaths by 45%. We previously reported that a brief intervention improved self-reported SBU among emergency department (ED) patients at 3 months. We sought to determine if these effects were sustained at 6 months postenrollment. Methods: This was a prospective, randomized controlled trial of adult patients (age >/= 21 years) at an academic medical center ED from February 2006 to May 2006. Patients were systematically sampled for self-reported SBU. Those with self-reported SBU less than "always" were asked to participate. Subjects were surveyed at baseline with a nine-item series of situational SBU questions scored on a five-point Likert scale (e.g., 5 = always, 1 = never). This nine-item average comprised the mean SBU score. Subjects were randomized to a control group (CG) and an intervention group (IG). The CG received an injury prevention brochure; the IG received a brief motivation interview by a trained interventionist and the brochure. Subjects were phoned at 3 and 6 months to determine interval change in SBU scores via a standard script. Repeated-measures analysis of covariance and t-tests were used to analyze trends in mean SBU scores between groups, as well as to test mean changes in SBU scores from the 3- to 6-month intervals. Results: Of 432 eligible patients, 292 enrolled (mean age = 35 years, SD +/- 11.2 years; 61% male). At baseline, there were no significant demographic differences; the IG (n = 147) and CG (n = 145) had similar mean SBU scores (2.8 vs. 2.6, p = 0.31), and 66% (n = 96 in each) completed both 3- and 6-month follow-up. The mean SBU score at 6 months in the IG was greater than in the CG group (3.6 vs. 2.9, p < 0.001), as were the mean SBU score differences from baseline (IG = 0.84 vs. CG = 0.29, p < 0.001). These differences were sustained from the 3-month interval (IG = -0.02 vs. CG = -0.06, p > 0.05). Conclusions: The previously reported finding that ED patients who received a brief motivation interview reported higher SBU scores at 3 months compared to a CG was sustained at 6-month follow-up. Although limited by self-report, a brief intervention may enhance lasting SBU behavior among high-risk ED patients. ACADEMIC EMERGENCY MEDICINE 2009; 16:1-4 (c) 2009 by the Society for Academic Emergency Medicine.