Abstract
BackgroundLeading causes of unintentional child injury such as poisoning and falls are preventable, and the majority occur in the home. Numerous home safety interventions have been developed and tested to increase safety behaviors; however, no smart phone-based applications (apps) have been developed and evaluated for this purpose. The objective of this study was to evaluate whether a mobile technology-based health behavior change intervention, the Make Safe Happen® app, was an effective tool to increase safety knowledge and safety actions/behaviors for the prevention of child unintentional injuries in and around the home.MethodsData were collected in pretest and posttest online surveys from an existing nationwide population-based survey panel. Intervention subjects were randomized to organically (participant-driven) use the Make Safe Happen® app for 1 week, which provided home safety information and the ability to purchase safety products, while control participants were assigned to download and use an app about a topic other than home safety. The primary outcomes of safety knowledge and home safety actions were assessed by using linear mixed model regressions with intention-to-treat analyses.ResultsA total of 5032 participants were randomized to either the intervention (n = 4182) or control (n = 850) group, with 2055 intervention participants downloading and entering their participant IDs into the Make Safe Happen® app. The online posttest survey was completed by 770 intervention and 283 control subjects. Mean knowledge parent safety score increased at a greater rate for intervention than control subjects (p < 0.0001), and at posttest was significantly higher for intervention than control subjects (p < 0.0001). The percentage of intervention subjects who reported doing all one-time and repeated safety actions significantly increased from pretest to posttest (p < 0.0001 and p = 0.0001, respectively), but there was no change among the control subjects (p = 0.1041 and p = 0.9755, respectively). At posttest, this percentage was larger for intervention than control subjects only for repeated safety actions (p = 0.0340).ConclusionsThe mobile application significantly improved safety knowledge and safety actions for participants using the Make Safe Happen® app, although loss to follow-up was a limitation. The results of this study indicate the usefulness of widespread distribution and use of the Make Safe Happen® app.Trial registration numberNCT02751203; Registered April 26, 2016.
Highlights
Leading causes of unintentional child injury such as poisoning and falls are preventable, and the majority occur in the home
The results of this study indicate the usefulness of widespread distribution and use of the Make Safe Happen® app
The intention of the app was to increase safety knowledge and the number of safety actions, reducing the number of deaths and injuries sustained by children in and around the home
Summary
Leading causes of unintentional child injury such as poisoning and falls are preventable, and the majority occur in the home. A 2015 survey of more than 1000 parents of children ≤ 12 years of age found that 30% kept medicines and cleaning products in an area accessible to their toddler, 14% had never checked their smoke alarm batteries, 13% had left their young child in a bathtub for at least 5 min without supervision, and 48% had not secured their televisions and furniture with anti-tip straps (Safe Kids Worldwide 2015) These low rates of safety behaviors may be explained by the lack of a centralized and accessible platform to access information on “child proofing” the home, or the perception that these actions are cumbersome, difficult, confusing, and time-consuming. Parents and caregivers often have difficulty identifying hazards in their home (Gaines et al 2009), finding credible information and recommendations, and obtaining the safety products bestsuited to their home
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