Evaluating a Website to Teach Children Safety with Dogs: A Randomized Controlled Trial.

David Schwebel,Joan Severson,Leslie Mcclure,Peng Li

doi:10.3390/ijerph13121198

Abstract

Dog bites represent a significant threat to child health. Theory-driven interventions scalable for broad dissemination are sparse. A website was developed to teach children dog safety via increased knowledge, improved cognitive skills in relevant domains, and increased perception of vulnerability to bites. A randomized controlled trial was conducted with 69 children aged 4–5 randomly assigned to use the dog safety website or a control transportation safety website for ~3 weeks. Assessment of dog safety knowledge and behavior plus skill in three relevant cognitive constructs (impulse control, noticing details, and perspective-taking) was conducted both at baseline and following website use. The dog safety website incorporated interactive games, instructional videos including testimonials, a motivational rewards system, and messaging to parents concerning child lessons. Our results showed that about two-thirds of the intervention sample was not adherent to website use at home, so both intent-to-treat and per-protocol analyses were conducted. Intent-to-treat analyses yielded mostly null results. Per-protocol analyses suggested children compliant to the intervention protocol scored higher on knowledge and recognition of safe behavior with dogs following the intervention compared to the control group. Adherent children also had improved scores post-intervention on the cognitive skill of noticing details compared to the control group. We concluded that young children’s immature cognition can lead to dog bites. Interactive eHealth training on websites shows potential to teach children relevant cognitive and safety skills to reduce risk. Compliance to website use is a challenge, and some relevant cognitive skills (e.g., noticing details) may be more amenable to computer-based training than others (e.g., impulse control).

Highlights

Pediatric dog bites are a significant public health problem
The present study developed and evaluated a child-focused website to reduce pediatric dog bite risk by addressing the first two factors, children’s behavior near dogs and their cognitive skills that influence those behaviors
Statistical tests of differences between the groups yielded a significant result for gender; despite randomization, the transportation safety group was 61.8% male and the dog safety group was 34.3%

Summary

Introduction

Pediatric dog bites are a significant public health problem. The Centers for Disease Control (CDC) estimate that about 4.5 million dog bites occur annually in the US [1]. Dog bites affect people at all ages, children suffer the highest risk by a large margin [1,2]. The precise reason for elevated risk to children is unknown, but experts attribute it to at least three factors: (a) children behave in unpredictable and active ways [3], stressing dogs and sometimes causing animal aggression;. (b) children lacking cognitive skills needed to recognize, understand, and behave appropriately near dogs; and (c) children, and especially younger children, are shorter than adults, leading to increased prevalence of bites to the head/neck region, which involves greater injury and more substantial. Res. Public Health 2016, 13, 1198; doi:10.3390/ijerph13121198 www.mdpi.com/journal/ijerph

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