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Paediatric emergency department-based carbon monoxide detector intervention: a randomised trial
  1. Lara B McKenzie1,2,3,
  2. Kristin J Roberts1,
  3. Roxanne M Kaercher1,
  4. Christy L Collins4,
  5. R Dawn Comstock5,
  6. Soledad Fernandez6,
  7. Mahmoud Abdel-Rasoul6,
  8. Marcel J Casavant2,7,
  9. Leslie Mihalov8
  1. 1Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
  2. 2Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio, USA
  3. 3Division of Epidemiology, College of Public Health, The Ohio State University, Columbus, Ohio, USA
  4. 4OhioHealth Research & Innovations Institute, Columbus, Ohio, USA
  5. 5Dept. of Epidemiology, Colorado School of Public Health and Dept. of Pediatrics, Emergency Medicine, School of Medicine, University of Colorado Anschutz, Aurora, Colorado, USA
  6. 6Center for Biostatistics, The Ohio State University, Columbus, Ohio, USA
  7. 7Central Ohio Poison Center, Nationwide Children's Hospital, Columbus, Ohio, USA
  8. 8Emergency Medicine, Nationwide Children's Hospital, Columbus, Ohio, USA
  1. Correspondence to Lara B McKenzie, Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205, USA; Lara.McKenzie{at}nationwidechildrens.org

Abstract

Background Although non-fire-related carbon monoxide (CO) poisoning is almost entirely preventable, over 400 people die and 20 000 people are injured each year in the USA from unintentional CO poisoning. Thus, there is a critical need for evidence-based interventions for preventing CO poisoning and increasing the proper use and installation of CO detectors.

Methods A randomised, controlled trial (Project CODE, a Carbon Monoxide Detector Education intervention) with 2-week and 6-month follow-up home observations was conducted in 299 parents of children aged ≤18 years recruited in the emergency department of a level 1 paediatric trauma centre. The intervention group received an educational tool, a spiral-bound, laminated booklet that resembled a CO detector containing theory-based safety messages based on the precaution adoption process model, a plug-in CO detector and 9 V battery. The control group received a one page flyer on CO poisoning prevention.

Results Although the difference was not statistically significant, mean CO knowledge score increased at a greater rate for the intervention group than the control group. Intervention group parents were more likely to exhibit ‘safe’ CO detector use than control group parents at the 2-week follow-up (RR: 2.75; 95% CI 2.06 to 3.69) and 6-month follow-up (RR: 2.78; 95% CI 2.06 to 3.76), after adjusting for self-reported CO detector use behaviour at enrolment and annual per capita income.

Conclusions An emergency department-delivered intervention containing a theory-based educational tool paired with a CO detector can be an effective method for increasing knowledge about CO poisoning, for prevention and for appropriate use of a CO detector.

Trial registration number NCT00959478.

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Footnotes

  • Contributors LBM: conceptualised and designed the study and drafted the initial manuscript. KJR: analysed the data, reviewed the results, helped to draft the initial manuscript and reviewed drafts of the manuscript. RMK and CLC: reviewed the results and helped to draft the initial manuscript. RDC: participated in the design of the study, reviewed the results and reviewed drafts of the manuscript. SF: participated in the design of the study, analysed the data and reviewed the results. MA-R: analysed the data and reviewed the results. MJC and LM: participated in the design of the study. All authors approved the final manuscript as submitted.

  • Funding NICHD (R01HD057155).

  • Competing interests The contents of this publication are solely the responsibility of the authors and do not necessarily represent the official views of the NICHD. The authors have no financial relationships or competing interests relevant to this article to disclose.

  • Ethics approval Institutional review board at the study institution.

  • Provenance and peer review Not commissioned; externally peer reviewed.