Background Child safety seats are known to reduce the risk of death from motor vehicle crashes by... more Background Child safety seats are known to reduce the risk of death from motor vehicle crashes by between 50%-80%. CSS use among younger children is common, use for older children is low, and CSS misuse is widespread. We developed a smart phone app to promote correct CSS use among children younger than 8 years old and tested it with parents of children who presented in one urban and one rural paediatric emergency department in 2 US states. Methods Research staff helped enrolled parents download the Safety in Seconds app to their smart phone. Parents completed a series of assessment items about their CSS knowledge and beliefs. Intervention group parents reported in more detail about their CSS beliefs and practices with all age-eligible children while control parents answered a similar number of items about another safety topic. Both groups received an electronic report from the app in real time that offered recommendations for improving their health behaviour of interest. All parents received periodic text messages and completed follow up reports through the app at 3 and 6 months. Study enrollment is expected to end in January 2016 and follow ups by July 2016. Results To date, 761 parents completed baseline surveys (32% rural; 68% urban). Study parents, on average, are black (65.6%), employed (65.8%), with more than a high school education (60.0%), with no differences between study groups. Index child is 5.2 years old. At 6 month follow up, more intervention group parents had gotten their child's safety seat inspected by a car seat technician (34% vs 24%) and properly identified that children should ride in the back seat of the car until at least age 13 (35% vs 27%). Additional CSS knowledge, beliefs and practices will be explored when the final data set is ready. Conclusions Child passenger safety remains an important public health problem. Programs are needed to correct widespread misuse and to promote CSS use among older children.
The mean duration of stay at the burn centre was higher for females (19.17 ± 23.27) compared to m... more The mean duration of stay at the burn centre was higher for females (19.17 ± 23.27) compared to males (13.85 ± 15.29) (p-value 0.0001). Conclusions Compared to males, females with burn injuries are older and married and likely to have burn injury at home. Males are more likely to have burns at work. Females suffered from higher percentage of surface area of burn. There were more deaths in females.
Background Tap water burns result in an estimated 1500 hospital admissions and 50 deaths in the U... more Background Tap water burns result in an estimated 1500 hospital admissions and 50 deaths in the USA annually despite national efforts to preset water heaters at the factory. Aims/Objectives/Purpose This study reports on observed water temperature, water heater characteristics (age, size, capacity, gauge setting) knowledge and reported testing behaviours in a sample of 1033 urban homes. Methods Data on knowledge, self-reported testing behaviours, observed water temperature, heater characteristics and demographics were recorded as part of a home observation in a randomised community trial which aimed to improve home safety behaviours.
African American infants from low-income families remain at high risk for sleep-related deaths de... more African American infants from low-income families remain at high risk for sleep-related deaths despite the reduction in infant sleep deaths in the general population. As part of a larger research study, 2 46 African American mothers were asked about their infants' sleep practices during 3 separate encounters on the same day: a survey administered by a research assistant (RA), a well-baby visit with the pediatrician, and a safe sleep discussion with a health educator (HE). Based on the mothers' responses during each encounter, this study assesses the disclosure rates for unsafe sleep practices.
The objective of this study was to describe changes in carbon monoxide (CO) safety knowledge and ... more The objective of this study was to describe changes in carbon monoxide (CO) safety knowledge and observed CO detector use following distribution of a CO detector use intervention in two environments, a pediatric emergency department (Ohio) and an urban community (Maryland). A total of 301 participants completed the 6-month follow up (Ohio: n = 125; Maryland: n = 176). The majority of participants was female, 25–34 years of age, and employed (full or part time). We found that CO safety knowledge did not differ between settings at enrollment, but significantly improved at the follow-up visits. The majority of CO detectors observed were functional and installed in the correct location. Of those with CO detectors at follow up, the majority had not replaced the battery. The success of the intervention varied between settings and distribution methods. The majority of participants showed improved knowledge and behaviors. Improved device technology may be needed to eliminate the need for battery replacement.
This study assesses parents&a... more This study assesses parents' literacy skills and evaluates how literacy levels influenced the effectiveness of a health communication intervention designed to improve safety knowledge in low-income, urban families. A total of n = 450 parents of children aged 4 to 66 months completed the Rapid Estimate of Adult Literacy in Medicine (REALM) and participated in a randomized trial of an injury prevention intervention delivered via computer kiosk in a pediatric emergency department. A safety knowledge test was administered by telephone 2 to 4 weeks later. More than one-third of parents were assessed by the REALM to have marginal (30%) or inadequate (8%) reading levels; the remaining 62% of parents had adequate reading levels. REALM scores were independently associated with knowledge gains for poison storage and smoke alarms. Participants reading level had an independent and significant effect on safety knowledge outcomes. Literacy level should be considered in all patient education efforts.
Child passenger safety remains an important public health problem because motor vehicle crashes a... more Child passenger safety remains an important public health problem because motor vehicle crashes are the leading cause of death for children, and the majority of children ride improperly restrained. Using a mobile app to communicate with parents about injury prevention offers promise but little information is available on how to create such a tool. The purpose of this article is to illustrate a theorybased approach to developing a tailored, smartphone app for communicating child passenger safety information to parents. The theoretical basis for the tailoring is the elaboration likelihood model, and we utilized the precaution adoption process model (PAPM) to reflect the stage-based nature of behavior change. We created assessment items (written at 6th grade reading level) to determine the child's proper type of car seat, the parent's PAPM stage and beliefs on selected constructs designed to facilitate stage movement according to the theory. A message library and template were created to provide a uniform structure for the tailored feedback. We demonstrate how messages derived in this way can be delivered through new m-health technology and conclude with recommendations for the utility of the methods used here for other m-health, patient education interventions.
Objectives-This study focuses on parental report of exposure to dogs and highlights the potential... more Objectives-This study focuses on parental report of exposure to dogs and highlights the potential for using a computer kiosk to increase knowledge around dog bite safety in an urban pediatric emergency department. Methods-901 parents of young children completed a kiosk assessment and received a report which contained information aimed at increasing knowledge about either dog bite prevention (PAR-DB n=453) or other safety behaviors (PAR-S n=448). The participants who received the dog bite prevention report (PAR-DB) were asked questions about exposure to dogs as part of the baseline assessment. All participants were telephoned 2-4 weeks later for a follow-up interview to measure knowledge differences. Results-The majority of respondents who answered the exposure questions reported seeing stray dogs (53%) and having dangerous dogs (43%) in their neighborhood. Few respondents reported that their child had been bitten by a dog (1%), but the majority (56%) reported having knowledge of another child having been bitten. Few respondents reported having a dog in their home (11%) and only one reported that her dog had bitten a child. A majority (56%) of dogs had not been spayed or neutered. Of families with dogs in the home, 20% reported leaving their child unattended with the dog. A minority (45%) of dogs left alone with children had been spayed or neutered. PAR-DB parents achieved knowledge gains as a result of the parent action report generated by the kiosk, demonstrating the potential to improve knowledge via a computer kiosk in a busy pediatric emergency department.
Journal of Urban Health-bulletin of The New York Academy of Medicine, Apr 3, 2009
This paper presents a cross-sectional study examining the influence of neighborhood violence on m... more This paper presents a cross-sectional study examining the influence of neighborhood violence on multiple aspects of mothers' health. While the influence of neighborhood violence on health is important to understand for all populations, mothers are especially important as they play a key role in protecting their children from the consequences of violence. Three hundred and ninety-two Baltimore City mothers of children 5 years and younger completed a self-administered survey that included questions about perceptions of their safety as well as their personal experiences with neighborhood violence. Separate models were run to compare the relationship between each measurement of neighborhood violence and five diverse health-related determinants and outcomes: self-reported health status, smoking, exercise, average hours of sleep a night, and sleep interruption. Controlling for mother's age, child's age, maternal education, and marital status, mothers with high exposure to neighborhood violence were twice as likely to report poorer health, smoking, never exercising, and poor sleep habits. Maternal perception of neighborhood safety was not related to any of the assessed health-related determinants and outcomes. This study emphasizes the importance of measuring exposure to neighborhood violence rather than solely assessing perceived safety. Neighborhood violence was a common experience for mothers in this urban sample, and should be considered by health professionals in trying to understand and intervene to improve the health of mothers and their children.
Journal of Urban Health-bulletin of The New York Academy of Medicine, Feb 9, 2006
Controlling residential lead hazards is critical for case management of lead poisoned children. T... more Controlling residential lead hazards is critical for case management of lead poisoned children. To attain this goal, permanent relocation of the family is sometimes necessary or advisable for many reasons, including poor housing conditions; extensive lead hazards; lack of abatement resources, landlord compliance and local enforcement capacity; and family eviction. During 1996-1998, the Kennedy Krieger Institute implemented a unique capitated Program for case management of Baltimore City children with blood lead concentrations (PbB) 919 2g/dL. The Program provided financial, housing, and social work assistance to facilitate relocation as a means of providing safer housing. Nearly half of the Program families relocated with direct assistance, and 28% relocated on their own. The Program evaluation examined the costs and benefits of relocation. Average relocation cost per child was relatively inexpensive (G$1,500). Average relocation time of 5 months (range G2 months to 912 months) was less than the 8-month average time to complete lead hazard control work in 14 city and state programs funded by U.S. HUD. Relocation was associated with (1) a statistically significant decrease in dust lead loadings on floors, windowsills and window troughs that persisted for one year, and (2) statistically significantly greater decreases in children_s PbB compared to children who did not relocate from untreated homes. Children relocated to housing that met current Federal residential dust lead standards had statistically significant decreases in blood lead levels. Visual inspection did not consistently identify relocation houses with dust lead levels below current Federal standards, indicating that dust testing should be an essential component of future programs. This will require additional resources for dust testing and possibly cleaning and repairs but is expected to yield additional benefits for children. The findings support recent U.S. CDC case management recommendations suggesting that permanent relocation to safer housing is a viable means to reduce children_s lead exposure. The benefits of relocation notwithstanding, 40% of families moved at least twice. Research is needed to better understand how to expedite relocation and encourage families to remain in safe housing. Relocation does not negate owners_ and health authorities' responsibilities to address lead hazards in the child's original house in order to protect future occupants.
ObjectivesTo identify, describe and critique state and local policies related to child passenger ... more ObjectivesTo identify, describe and critique state and local policies related to child passenger safety in for-hire motor vehicles including ridesharing and taxis.MethodsWe used standard legal research methods to collect policies governing the use of child restraint systems (CRS) in rideshare and taxi vehicles for all 50 states and the 50 largest cities in the USA. We abstracted the collected policies to determine whether the policy applies to specific vehicles, requires specific safety restraints in those vehicles, lists specific requirements for use of those safety restraints, seeks to enhance compliance and punishes noncompliance.ResultsAll 50 states have policies that require the use of CRS for children under a certain age, weight or height. Seven states exempt rideshare vehicles and 28 states exempt taxis from their CRS requirements. Twelve cities have relevant policies with eight requiring CRS in rideshare vehicles, but not taxis, and two cities requiring CRS use in both rides...
ObjectiveTo develop a tool to assess the safety of the home environment that could produce valid ... more ObjectiveTo develop a tool to assess the safety of the home environment that could produce valid measures of a child’s risk of suffering an injury.MethodsTool development: A four-step process was used to develop the CHASE (Child Housing Assessment for a Safe Environment) tool, including (1) a literature scan, (2) reviewing of existing housing inspection tools, (3) key informants interviews, and (4) reviewing the National Electronic Injury Surveillance System to determine the leading housing elements associated with paediatric injury. Retrospective case–control study to validate the CHASE tool: Recruitment included case (injured) and control (sick but not injured) children and their families from a large, urban paediatric emergency department in Baltimore, Maryland in 2012. Trained inspectors applied both the well-known Home Quality Standard (HQS) and the CHASE tool to each enrollee’s home, and we compared scores on individual and summary items between cases and controls.ResultsTwent...
Journal of public health management and practice : JPHMP, Jan 17, 2018
Innovative strategies are needed to improve the prevalence of working smoke alarms in homes. To o... more Innovative strategies are needed to improve the prevalence of working smoke alarms in homes. To our knowledge, this is the first study to report on the effectiveness of Facebook advertising and automated telephone calls as population-level strategies to encourage an injury prevention behavior. We examine the effectiveness of Facebook advertising and automated telephone calls as strategies to enroll individuals in Baltimore City's Fire Department's free smoke alarm installation program. We directed our advertising efforts toward Facebook users eligible for the Baltimore City Fire Department's free smoke alarm installation program and all homes with a residential phone line included in Baltimore City's automated call system. The Facebook campaign targeted Baltimore City residents 18 years of age and older. In total, an estimated 300 000 Facebook users met the eligibility criteria. Facebook advertisements were delivered to users' desktop and mobile device newsfeeds....
Background/Purpose: Formative evaluation is critical to developing engaging and effective health ... more Background/Purpose: Formative evaluation is critical to developing engaging and effective health promotion programs, but many programs struggle to secure the resources needed to support this process. An innovative partnership among a public health school, an art institute, and several local organizations is using formative and qualitative strategies to inform a community intervention trial of fire prevention services. Methods: Two rounds of focus groups will be held in April 2008 with approximately 20 East Baltimore residents to solicit information about: their exposure to a smoke alarm promotion program, barriers and facilitators to participation, and ideas for improving it. Public health professionals designed the focus group protocol which will be used by the local organizations to conduct the focus groups. Graphic design students will observe to learn about residents' perspectives which will inform development of prototype communication materials for the intervention. Local ...
The authors conducted a household survey and observation to assess carbon monoxide (CO) knowledge... more The authors conducted a household survey and observation to assess carbon monoxide (CO) knowledge and risks as well as prevalence of CO alarms in an urban community prior to the enactment of a mandatory ordinance requiring CO alarms in one U.S. city. From July to December 2009, household surveys and observations were completed in 603 residences. Participants were mostly African-American (61%), women (70%), 25-54 years in age (66%), and with a high school education or less (51%). Most homes visited contained CO-producing appliances, including gas stoves (86%), gas furnaces (82%), and gas water heaters (79%). Participants' overall mean percentage correct knowledge score was 57%. CO alarms were reported by 33% of participants and observed among 28% of households. Low rates of CO knowledge and CO alarm ownership, combined with high rates of CO-producing sources in homes, suggests the need for widespread campaigns to promote CO alarms. Recommendations are also made to integrate the l...
Objectives-This study focuses on parental report of exposure to dogs and highlights the potential... more Objectives-This study focuses on parental report of exposure to dogs and highlights the potential for using a computer kiosk to increase knowledge around dog bite safety in an urban pediatric emergency department. Methods-901 parents of young children completed a kiosk assessment and received a report which contained information aimed at increasing knowledge about either dog bite prevention (PAR-DB n=453) or other safety behaviors (PAR-S n=448). The participants who received the dog bite prevention report (PAR-DB) were asked questions about exposure to dogs as part of the baseline assessment. All participants were telephoned 2-4 weeks later for a follow-up interview to measure knowledge differences. Results-The majority of respondents who answered the exposure questions reported seeing stray dogs (53%) and having dangerous dogs (43%) in their neighborhood. Few respondents reported that their child had been bitten by a dog (1%), but the majority (56%) reported having knowledge of another child having been bitten. Few respondents reported having a dog in their home (11%) and only one reported that her dog had bitten a child. A majority (56%) of dogs had not been spayed or neutered. Of families with dogs in the home, 20% reported leaving their child unattended with the dog. A minority (45%) of dogs left alone with children had been spayed or neutered. PAR-DB parents achieved knowledge gains as a result of the parent action report generated by the kiosk, demonstrating the potential to improve knowledge via a computer kiosk in a busy pediatric emergency department.
Background Child safety seats are known to reduce the risk of death from motor vehicle crashes by... more Background Child safety seats are known to reduce the risk of death from motor vehicle crashes by between 50%-80%. CSS use among younger children is common, use for older children is low, and CSS misuse is widespread. We developed a smart phone app to promote correct CSS use among children younger than 8 years old and tested it with parents of children who presented in one urban and one rural paediatric emergency department in 2 US states. Methods Research staff helped enrolled parents download the Safety in Seconds app to their smart phone. Parents completed a series of assessment items about their CSS knowledge and beliefs. Intervention group parents reported in more detail about their CSS beliefs and practices with all age-eligible children while control parents answered a similar number of items about another safety topic. Both groups received an electronic report from the app in real time that offered recommendations for improving their health behaviour of interest. All parents received periodic text messages and completed follow up reports through the app at 3 and 6 months. Study enrollment is expected to end in January 2016 and follow ups by July 2016. Results To date, 761 parents completed baseline surveys (32% rural; 68% urban). Study parents, on average, are black (65.6%), employed (65.8%), with more than a high school education (60.0%), with no differences between study groups. Index child is 5.2 years old. At 6 month follow up, more intervention group parents had gotten their child's safety seat inspected by a car seat technician (34% vs 24%) and properly identified that children should ride in the back seat of the car until at least age 13 (35% vs 27%). Additional CSS knowledge, beliefs and practices will be explored when the final data set is ready. Conclusions Child passenger safety remains an important public health problem. Programs are needed to correct widespread misuse and to promote CSS use among older children.
The mean duration of stay at the burn centre was higher for females (19.17 ± 23.27) compared to m... more The mean duration of stay at the burn centre was higher for females (19.17 ± 23.27) compared to males (13.85 ± 15.29) (p-value 0.0001). Conclusions Compared to males, females with burn injuries are older and married and likely to have burn injury at home. Males are more likely to have burns at work. Females suffered from higher percentage of surface area of burn. There were more deaths in females.
Background Tap water burns result in an estimated 1500 hospital admissions and 50 deaths in the U... more Background Tap water burns result in an estimated 1500 hospital admissions and 50 deaths in the USA annually despite national efforts to preset water heaters at the factory. Aims/Objectives/Purpose This study reports on observed water temperature, water heater characteristics (age, size, capacity, gauge setting) knowledge and reported testing behaviours in a sample of 1033 urban homes. Methods Data on knowledge, self-reported testing behaviours, observed water temperature, heater characteristics and demographics were recorded as part of a home observation in a randomised community trial which aimed to improve home safety behaviours.
African American infants from low-income families remain at high risk for sleep-related deaths de... more African American infants from low-income families remain at high risk for sleep-related deaths despite the reduction in infant sleep deaths in the general population. As part of a larger research study, 2 46 African American mothers were asked about their infants' sleep practices during 3 separate encounters on the same day: a survey administered by a research assistant (RA), a well-baby visit with the pediatrician, and a safe sleep discussion with a health educator (HE). Based on the mothers' responses during each encounter, this study assesses the disclosure rates for unsafe sleep practices.
The objective of this study was to describe changes in carbon monoxide (CO) safety knowledge and ... more The objective of this study was to describe changes in carbon monoxide (CO) safety knowledge and observed CO detector use following distribution of a CO detector use intervention in two environments, a pediatric emergency department (Ohio) and an urban community (Maryland). A total of 301 participants completed the 6-month follow up (Ohio: n = 125; Maryland: n = 176). The majority of participants was female, 25–34 years of age, and employed (full or part time). We found that CO safety knowledge did not differ between settings at enrollment, but significantly improved at the follow-up visits. The majority of CO detectors observed were functional and installed in the correct location. Of those with CO detectors at follow up, the majority had not replaced the battery. The success of the intervention varied between settings and distribution methods. The majority of participants showed improved knowledge and behaviors. Improved device technology may be needed to eliminate the need for battery replacement.
This study assesses parents&a... more This study assesses parents' literacy skills and evaluates how literacy levels influenced the effectiveness of a health communication intervention designed to improve safety knowledge in low-income, urban families. A total of n = 450 parents of children aged 4 to 66 months completed the Rapid Estimate of Adult Literacy in Medicine (REALM) and participated in a randomized trial of an injury prevention intervention delivered via computer kiosk in a pediatric emergency department. A safety knowledge test was administered by telephone 2 to 4 weeks later. More than one-third of parents were assessed by the REALM to have marginal (30%) or inadequate (8%) reading levels; the remaining 62% of parents had adequate reading levels. REALM scores were independently associated with knowledge gains for poison storage and smoke alarms. Participants reading level had an independent and significant effect on safety knowledge outcomes. Literacy level should be considered in all patient education efforts.
Child passenger safety remains an important public health problem because motor vehicle crashes a... more Child passenger safety remains an important public health problem because motor vehicle crashes are the leading cause of death for children, and the majority of children ride improperly restrained. Using a mobile app to communicate with parents about injury prevention offers promise but little information is available on how to create such a tool. The purpose of this article is to illustrate a theorybased approach to developing a tailored, smartphone app for communicating child passenger safety information to parents. The theoretical basis for the tailoring is the elaboration likelihood model, and we utilized the precaution adoption process model (PAPM) to reflect the stage-based nature of behavior change. We created assessment items (written at 6th grade reading level) to determine the child's proper type of car seat, the parent's PAPM stage and beliefs on selected constructs designed to facilitate stage movement according to the theory. A message library and template were created to provide a uniform structure for the tailored feedback. We demonstrate how messages derived in this way can be delivered through new m-health technology and conclude with recommendations for the utility of the methods used here for other m-health, patient education interventions.
Objectives-This study focuses on parental report of exposure to dogs and highlights the potential... more Objectives-This study focuses on parental report of exposure to dogs and highlights the potential for using a computer kiosk to increase knowledge around dog bite safety in an urban pediatric emergency department. Methods-901 parents of young children completed a kiosk assessment and received a report which contained information aimed at increasing knowledge about either dog bite prevention (PAR-DB n=453) or other safety behaviors (PAR-S n=448). The participants who received the dog bite prevention report (PAR-DB) were asked questions about exposure to dogs as part of the baseline assessment. All participants were telephoned 2-4 weeks later for a follow-up interview to measure knowledge differences. Results-The majority of respondents who answered the exposure questions reported seeing stray dogs (53%) and having dangerous dogs (43%) in their neighborhood. Few respondents reported that their child had been bitten by a dog (1%), but the majority (56%) reported having knowledge of another child having been bitten. Few respondents reported having a dog in their home (11%) and only one reported that her dog had bitten a child. A majority (56%) of dogs had not been spayed or neutered. Of families with dogs in the home, 20% reported leaving their child unattended with the dog. A minority (45%) of dogs left alone with children had been spayed or neutered. PAR-DB parents achieved knowledge gains as a result of the parent action report generated by the kiosk, demonstrating the potential to improve knowledge via a computer kiosk in a busy pediatric emergency department.
Journal of Urban Health-bulletin of The New York Academy of Medicine, Apr 3, 2009
This paper presents a cross-sectional study examining the influence of neighborhood violence on m... more This paper presents a cross-sectional study examining the influence of neighborhood violence on multiple aspects of mothers' health. While the influence of neighborhood violence on health is important to understand for all populations, mothers are especially important as they play a key role in protecting their children from the consequences of violence. Three hundred and ninety-two Baltimore City mothers of children 5 years and younger completed a self-administered survey that included questions about perceptions of their safety as well as their personal experiences with neighborhood violence. Separate models were run to compare the relationship between each measurement of neighborhood violence and five diverse health-related determinants and outcomes: self-reported health status, smoking, exercise, average hours of sleep a night, and sleep interruption. Controlling for mother's age, child's age, maternal education, and marital status, mothers with high exposure to neighborhood violence were twice as likely to report poorer health, smoking, never exercising, and poor sleep habits. Maternal perception of neighborhood safety was not related to any of the assessed health-related determinants and outcomes. This study emphasizes the importance of measuring exposure to neighborhood violence rather than solely assessing perceived safety. Neighborhood violence was a common experience for mothers in this urban sample, and should be considered by health professionals in trying to understand and intervene to improve the health of mothers and their children.
Journal of Urban Health-bulletin of The New York Academy of Medicine, Feb 9, 2006
Controlling residential lead hazards is critical for case management of lead poisoned children. T... more Controlling residential lead hazards is critical for case management of lead poisoned children. To attain this goal, permanent relocation of the family is sometimes necessary or advisable for many reasons, including poor housing conditions; extensive lead hazards; lack of abatement resources, landlord compliance and local enforcement capacity; and family eviction. During 1996-1998, the Kennedy Krieger Institute implemented a unique capitated Program for case management of Baltimore City children with blood lead concentrations (PbB) 919 2g/dL. The Program provided financial, housing, and social work assistance to facilitate relocation as a means of providing safer housing. Nearly half of the Program families relocated with direct assistance, and 28% relocated on their own. The Program evaluation examined the costs and benefits of relocation. Average relocation cost per child was relatively inexpensive (G$1,500). Average relocation time of 5 months (range G2 months to 912 months) was less than the 8-month average time to complete lead hazard control work in 14 city and state programs funded by U.S. HUD. Relocation was associated with (1) a statistically significant decrease in dust lead loadings on floors, windowsills and window troughs that persisted for one year, and (2) statistically significantly greater decreases in children_s PbB compared to children who did not relocate from untreated homes. Children relocated to housing that met current Federal residential dust lead standards had statistically significant decreases in blood lead levels. Visual inspection did not consistently identify relocation houses with dust lead levels below current Federal standards, indicating that dust testing should be an essential component of future programs. This will require additional resources for dust testing and possibly cleaning and repairs but is expected to yield additional benefits for children. The findings support recent U.S. CDC case management recommendations suggesting that permanent relocation to safer housing is a viable means to reduce children_s lead exposure. The benefits of relocation notwithstanding, 40% of families moved at least twice. Research is needed to better understand how to expedite relocation and encourage families to remain in safe housing. Relocation does not negate owners_ and health authorities' responsibilities to address lead hazards in the child's original house in order to protect future occupants.
ObjectivesTo identify, describe and critique state and local policies related to child passenger ... more ObjectivesTo identify, describe and critique state and local policies related to child passenger safety in for-hire motor vehicles including ridesharing and taxis.MethodsWe used standard legal research methods to collect policies governing the use of child restraint systems (CRS) in rideshare and taxi vehicles for all 50 states and the 50 largest cities in the USA. We abstracted the collected policies to determine whether the policy applies to specific vehicles, requires specific safety restraints in those vehicles, lists specific requirements for use of those safety restraints, seeks to enhance compliance and punishes noncompliance.ResultsAll 50 states have policies that require the use of CRS for children under a certain age, weight or height. Seven states exempt rideshare vehicles and 28 states exempt taxis from their CRS requirements. Twelve cities have relevant policies with eight requiring CRS in rideshare vehicles, but not taxis, and two cities requiring CRS use in both rides...
ObjectiveTo develop a tool to assess the safety of the home environment that could produce valid ... more ObjectiveTo develop a tool to assess the safety of the home environment that could produce valid measures of a child’s risk of suffering an injury.MethodsTool development: A four-step process was used to develop the CHASE (Child Housing Assessment for a Safe Environment) tool, including (1) a literature scan, (2) reviewing of existing housing inspection tools, (3) key informants interviews, and (4) reviewing the National Electronic Injury Surveillance System to determine the leading housing elements associated with paediatric injury. Retrospective case–control study to validate the CHASE tool: Recruitment included case (injured) and control (sick but not injured) children and their families from a large, urban paediatric emergency department in Baltimore, Maryland in 2012. Trained inspectors applied both the well-known Home Quality Standard (HQS) and the CHASE tool to each enrollee’s home, and we compared scores on individual and summary items between cases and controls.ResultsTwent...
Journal of public health management and practice : JPHMP, Jan 17, 2018
Innovative strategies are needed to improve the prevalence of working smoke alarms in homes. To o... more Innovative strategies are needed to improve the prevalence of working smoke alarms in homes. To our knowledge, this is the first study to report on the effectiveness of Facebook advertising and automated telephone calls as population-level strategies to encourage an injury prevention behavior. We examine the effectiveness of Facebook advertising and automated telephone calls as strategies to enroll individuals in Baltimore City's Fire Department's free smoke alarm installation program. We directed our advertising efforts toward Facebook users eligible for the Baltimore City Fire Department's free smoke alarm installation program and all homes with a residential phone line included in Baltimore City's automated call system. The Facebook campaign targeted Baltimore City residents 18 years of age and older. In total, an estimated 300 000 Facebook users met the eligibility criteria. Facebook advertisements were delivered to users' desktop and mobile device newsfeeds....
Background/Purpose: Formative evaluation is critical to developing engaging and effective health ... more Background/Purpose: Formative evaluation is critical to developing engaging and effective health promotion programs, but many programs struggle to secure the resources needed to support this process. An innovative partnership among a public health school, an art institute, and several local organizations is using formative and qualitative strategies to inform a community intervention trial of fire prevention services. Methods: Two rounds of focus groups will be held in April 2008 with approximately 20 East Baltimore residents to solicit information about: their exposure to a smoke alarm promotion program, barriers and facilitators to participation, and ideas for improving it. Public health professionals designed the focus group protocol which will be used by the local organizations to conduct the focus groups. Graphic design students will observe to learn about residents' perspectives which will inform development of prototype communication materials for the intervention. Local ...
The authors conducted a household survey and observation to assess carbon monoxide (CO) knowledge... more The authors conducted a household survey and observation to assess carbon monoxide (CO) knowledge and risks as well as prevalence of CO alarms in an urban community prior to the enactment of a mandatory ordinance requiring CO alarms in one U.S. city. From July to December 2009, household surveys and observations were completed in 603 residences. Participants were mostly African-American (61%), women (70%), 25-54 years in age (66%), and with a high school education or less (51%). Most homes visited contained CO-producing appliances, including gas stoves (86%), gas furnaces (82%), and gas water heaters (79%). Participants' overall mean percentage correct knowledge score was 57%. CO alarms were reported by 33% of participants and observed among 28% of households. Low rates of CO knowledge and CO alarm ownership, combined with high rates of CO-producing sources in homes, suggests the need for widespread campaigns to promote CO alarms. Recommendations are also made to integrate the l...
Objectives-This study focuses on parental report of exposure to dogs and highlights the potential... more Objectives-This study focuses on parental report of exposure to dogs and highlights the potential for using a computer kiosk to increase knowledge around dog bite safety in an urban pediatric emergency department. Methods-901 parents of young children completed a kiosk assessment and received a report which contained information aimed at increasing knowledge about either dog bite prevention (PAR-DB n=453) or other safety behaviors (PAR-S n=448). The participants who received the dog bite prevention report (PAR-DB) were asked questions about exposure to dogs as part of the baseline assessment. All participants were telephoned 2-4 weeks later for a follow-up interview to measure knowledge differences. Results-The majority of respondents who answered the exposure questions reported seeing stray dogs (53%) and having dangerous dogs (43%) in their neighborhood. Few respondents reported that their child had been bitten by a dog (1%), but the majority (56%) reported having knowledge of another child having been bitten. Few respondents reported having a dog in their home (11%) and only one reported that her dog had bitten a child. A majority (56%) of dogs had not been spayed or neutered. Of families with dogs in the home, 20% reported leaving their child unattended with the dog. A minority (45%) of dogs left alone with children had been spayed or neutered. PAR-DB parents achieved knowledge gains as a result of the parent action report generated by the kiosk, demonstrating the potential to improve knowledge via a computer kiosk in a busy pediatric emergency department.
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Papers by Wendy Shields