Bishai David, Qureshi Asma, Cantu Noelia, Parks Cheryl
Department of Population and Family Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21030, USA.
Acad Emerg Med. 2003 Dec;10(12):1371-7. doi: 10.1111/j.1553-2712.2003.tb00012.x.
To determine whether injury prevention counseling and behavioral counseling delivered in the emergency department (ED) could result in increases in self-reported bicycle helmet use.
The authors undertook a trial of counseling in 222 children recruited in an urban ED between August 2000 and October 2001. All consenting patients in the ED aged 5 to 15 years who did not have life-threatening conditions were eligible. One hundred nine children were assigned to the control group on the basis of attendance on an odd-numbered day, and they received a photocopied photograph of the hospital. One hundred thirteen children were assigned to the intervention group, and they received a personal counseling session and signed a contract promising to wear their bicycle helmets. In addition, 57 of the intervention children were assigned (based on having an even-numbered birthday) to be fitted with helmets if they did not already own them. Parents were telephoned four weeks after the ED encounter for follow-up.
Follow-up data were obtained for 148 children (67% follow-up rate), of whom only 69 reported riding a bicycle in the four weeks after their ED visit. Of the final sample of 69 children, 38 belonged to one of the intervention groups, and 25 of these (66%) reported always wearing a helmet while cycling during the four weeks after their ED visit, versus 13 of 31 (42%) in the control group (odds ratio, 2.66; p < 0.05). The effect of the intervention was independent of whether the children owned a helmet at baseline.
Injury prevention counseling in the ED using "The Injury Prevention Program" (TIPP) sheet, behavioral contracting, and helmet distribution may have a significant effect on reports of subsequent bike helmet use.
确定在急诊科（ED）提供的伤害预防咨询和行为咨询是否能提高自我报告的自行车头盔使用率。
作者对2000年8月至2001年10月在城市急诊科招募的222名儿童进行了咨询试验。急诊科所有年龄在5至15岁、无危及生命状况且同意参与的患者均符合条件。109名儿童根据奇数日就诊被分配到对照组，他们收到一张医院的影印照片。113名儿童被分配到干预组，他们接受了个人咨询并签署了一份承诺佩戴自行车头盔的合同。此外，57名干预组儿童（根据生日为偶数）如果没有自己的头盔，将被分配配备头盔。在急诊科就诊四周后给家长打电话进行随访。
获得了148名儿童（随访率67%）的随访数据，其中只有69名报告在急诊科就诊后的四周内骑自行车。在最终的69名儿童样本中，38名属于其中一个干预组，其中25名（66%）报告在急诊科就诊后的四周内骑自行车时总是佩戴头盔，而对照组31名中有13名（42%）（优势比为2.66；p<0.05）。干预的效果与儿童在基线时是否拥有头盔无关。
在急诊科使用“伤害预防计划”（TIPP）表、行为契约和头盔分发进行伤害预防咨询，可能对随后自行车头盔使用的报告有显著影响。
