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Original article
User-driven design of child restraint information to reduce errors in use: a pilot randomised controlled trial
  1. Alexandra B Hall1,
  2. Catherine Ho1,
  3. Bianca Albanese1,
  4. Lisa Keay2,
  5. Kate Hunter2,
  6. Judith Charlton3,
  7. Andrew Hayen4,
  8. Lynne E Bilston1,
  9. Julie Brown1,2
  1. 1Neuroscience Research Australia, University of New South Wales, Sydney, New South Wales, Australia
  2. 2The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
  3. 3Accident Research Centre, Monash University, Clayton, Victoria, Australia
  4. 4Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
  1. Correspondence to Dr Julie Brown, Neuroscience Research Australia, Randwick, NSW 2193, Australia; j.brown{at}neura.edu.au

Abstract

Background Incorrect use of child restraints is a long-standing problem that increases the risk of injury in crashes. We used user-centred design to develop prototype child restraint instructional materials. The objective of this study was to evaluate these materials in terms of comprehension and errors in the use of child restraints. The relationship between comprehension and errors in use was also explored.

Methods We used a parallel-group randomised controlled trial in a laboratory setting. The intervention group (n=22) were provided with prototype materials and the control group (n=22) with existing instructional materials for the same restraint. Participants installed the restraint in a vehicle buck, secured an appropriately sized mannequin in the restraint and underwent a comprehension test. Our primary outcome was overall correct use, and our secondary outcomes were (1) comprehension score and (2) percent errors in the installation trial.

Results There was 27% more overall correct use (p=0.042) and a higher mean comprehension score in the intervention group (mean 17, 95% CI 16 to 18) compared with the control group (mean 12, 95% CI 10 to 14, p<0.001). The mean error percentage in the control group was 23% (95% CI 16% to 31%) compared with 14% in the intervention group (95% CI 8% to 20%, p=0.056). For every one point increase in comprehension, there was an almost 2% (95% CI −2.7% to −1.0%) reduction in errors (y=45.5–1.87x, p value for slope <0.001).

Conclusions Consumer-driven design of informational materials can increase the correct use of child restraints. Targeting improved comprehension of informational materials may be an effective mechanism for reducing child restraint misuse.

  • restraints
  • motor vehicle occupant
  • child
  • randomised trial
  • interventions
  • product modification

https://doi.org/10.1136/injuryprev-2019-043380

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    Footnotes

    • Contributors ABH conceptualised the intervention, developed the intervention, conceptualised and designed the trial, designed data collection tools, coordinated data collection, collected data, carried out the initial analyses, drafted the initial manuscript, and reviewed and revised the manuscript. CH developed the intervention, collected data, carried out initial analyses, reviewed and revised the manuscript. BA developed the intervention, designed data collection tools, collected data, reviewed and revised the manuscript. LK conceptualised and developed the intervention, conceptualised and designed the trial, provided intellectual input into analyses, reviewed and revised the manuscript. KH developed the intervention, provided intellectual input into data collection tools and analyses, reviewed and revised the manuscript. JC conceptualised the intervention, developed the intervention, conceptualised and designed the trial, reviewed and revised the manuscript. AH conceptualised the intervention, conceptualised and designed the trial, provided expert oversight of analyses, reviewed and revised the manuscript. LEB conceptualised the intervention, developed the intervention, conceptualised and designed the trial, provided intellectual input into data collection tools, reviewed and revised the manuscript. JB conceptualised the intervention, developed the intervention, conceptualised and designed the trial, supervised design of data collection tools and data collection, carried out final analyses, drafted the initial manuscript, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

    • Funding This study was funded by the Australian National Health and Medical Research Council (APP1124981).

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study was approved by the University of New South Wales’ Human Research Ethics Committee (HC17273).

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

    • Data availability statement Data are available on reasonable request.