Objectives To determine the efficacy of a video-based dog bite prevention intervention at increasing child knowledge and describe any associated factors; and to assess the acceptability of providing this intervention in a pediatric emergency department (PED). Methods This cross-sectional, quasi experimental study enrolled a convenience sample of 5–9 year old patients and their parents, presenting to a PED with non-urgent complaints or dog bites. Children completed a 14-point simulated scenario test used to measure knowledge about safe dog interactions pre-/post- a video intervention. Based on previous research, a passing score (≥11/14) was defined a priori. Parents completed surveys regarding sociodemographics, dog-related experiential history and the intervention. Results There were 120 child/parent pairs. Mean child age was 7 (SD 1) and 55% were male. Of parents, 70% were white, 2/3 had more than high school education, and half had incomes <$40,000. Current dog ownership was 77%; only 6% of children had received prior dog bite prevention education. Test pass rate was 58% pre-intervention; 90% post-intervention. Knowledge score increased in 83% of children; greatest increases were in questions involving stray dogs or dogs that were fenced or eating. Younger child age was the only predictor of failing the post-test (p<0.001). Nearly all parents found the intervention informative; 93% supported providing the intervention in the PED. Conclusions Child knowledge of dog bite prevention is poor. The video-based intervention we tested appears efficacious at increasing short-term knowledge in 5–9 year old children and is acceptable to parents. Parents strongly supported providing this education.
Objective Hospital-based data reveal that children who have secondhand smoke exposure (SHSe) experience severe respiratory illnesses and greater resource utilization. Our objective was to assess the relationship between SHSe and illness severity/resource utilization among children presenting to the pediatric emergency department (PED) with three common respiratory conditions—asthma, bronchiolitis, and pneumonia. Methods A retrospective review of a yearlong consecutive sample of PED patients with SHSe status documentation and asthma, bronchiolitis, or pneumonia diagnoses was performed. PED illness severity/resource utilization variables included triage categorization, initial oxygen saturation, evaluation/testing (influenza A & B, respiratory syncytial virus, chest X-ray), procedures/interventions performed (supplemental oxygen, suctioning, intubation), medications administered, and disposition. Logistic and linear regression models were conducted to determine differences in each diagnosis group while controlling for sociodemographics, medical history, seasonality, and insurance type. Results There were 3,229 children with documentation of SHSe status and an asthma (41%), bronchiolitis (36%), or pneumonia (23%) diagnosis. Across diagnosis groups, approximately 1/4 had positive documentation of SHSe. Asthmatic children with SHSe were more likely to receive corticosteroids (odds ratio (OR) = 1.71, 95% confidence interval (CI) = 1.19, 2.44) and/or magnesium sulfate (OR = 1.66, 95% CI = 1.14, 2.40). Children with SHSe and bronchiolitis were more likely to receive racemic epinephrine (OR = 2.48, 95% CI = 1.21, 5.08), have a chest X-ray (OR = 1.36, 95% CI = 1.00, 1.85), and/or be admitted (OR = 1.46, 95% CI = 1.09, 1.95). No differences in illness severity/resource utilization were identified for children with pneumonia. Conclusions SHS-exposed children with asthma or bronchiolitis have greater illness severity/resource utilization. Our findings highlight the importance of SHSe assessment, cessation, and research efforts in the PED setting.
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