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Original research
User-driven instructions reduce errors in child restraint use: a randomised controlled trial in Sydney, Australia
  1. Julie Brown1,2,3,
  2. Lisa Keay1,3,
  3. Jane Elkington1,
  4. Wennie Dai1,
  5. Catherine Ho1,
  6. Judith Charlton4,
  7. Sjaan Koppel4,
  8. Kirsten McCaffery5,
  9. Andrew Hayen6,
  10. Lynne E Bilston2
  1. 1The George Institute for Global Health, UNSW, Sydney, New South Wales, Australia
  2. 2Neuroscience Research Australia, Randwick, New South Wales, Australia
  3. 3The University of New South Wales, Sydney, New South Wales, Australia
  4. 4Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
  5. 5The University of Sydney, Sydney, New South Wales, Australia
  6. 6University of Technology, Sydney, New South Wales, Australia
  1. Correspondence to Professor Julie Brown; j.brown{at}neura.edu.au

Abstract

Background and objectives Crash injury risk is reduced when a child correctly uses an appropriate restraint; however, incorrect restraint use remains widespread. The aim of this study was to determine whether product information developed using a user-driven approach increases correct child restraint use.

Methods We conducted a two-arm double-blinded parallel randomised controlled trial in New South Wales, Australia 2019–2021. Participants were current drivers who were either an expectant parent or a parent of at least one child residing in the greater Sydney metropolitan area who were interested in purchasing a new child restraint. The intervention was user-driven product information consisting of instructions printed on an A3 sheet of paper, swing tags with key reminders and a video accessed via Quick Response codes printed on the materials. The control group received a postcard summarising legal child restraint requirements. The primary outcome was the correctness of child restraint use observed during home visit approximately 6 months after restraint purchase. Correct use was defined as no serious error or <2 minor errors. The secondary outcome was a count of observed errors.

Results 427 participants were recruited. Home visits were conducted for 372 (190 intervention and 182 control). Correct use was more common in the intervention group (37.4%) compared with the control group (24.2%, p=0.006). Participants receiving the intervention were 1.87 times more likely to correctly use their restraint than those in the control group (95% CI 1.19 to 2.93).

Conclusions The results provide evidence for the effectiveness of user-driven instructions as a countermeasure to restraint misuse.

Trial registration number ACTRN12617001252303.

  • Restraints
  • Child
  • Passenger
  • Randomized Trial

Data availability statement

Data are available on reasonable request.

https://doi.org/10.1136/ip-2023-045213

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    Data availability statement

    Data are available on reasonable request.

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    Footnotes

    • LK and JE contributed equally.

    • Contributors JB conceptualised and designed the study, designed the data collection methods and instruments, carried out the initial analyses, drafted the initial manuscript and critically reviewed and revised the manuscript and is responsible for the overall content as guarantor. LK, JC, SK, KM and LEB conceptualised and designed the study and critically reviewed and revised the manuscript for important intellectual content. AH conceptualised and designed the study, guided analysis and critically reviewed and revised the manuscript. JE, WD and CH designed the data collection methods and instruments, coordinated and supervised data collection, collected, managed and cleaned data and critically reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

    • Funding This work was funded by the Australian National Health and Medical Research Council (NHMRC APP 1124981).

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.