Evaluation of a Culturally Tailored Educational Video Intervention to Promote Bike Helmet Safety for Urban Children: A Pilot Study

Abstract

Bicycle-related falls are a significant cause of mortality and morbidity. Use of bicycle helmets substantially reduces risk of severe traumatic brain injury but compliance with this safety practice is particularly low in urban children. Given the lack of educational interventions for urban youth, our research team created a youth-informed, culturally relevant educational video on bike helmet safety, which was informed by focus groups with Baltimore City youth. This video, You Make the Call, linked the concept of use of cases to protect phones to use of helmets to protect heads and can be viewed at http://bit.ly/2Kr7UCN . The impact of the video as part of an intervention (coupled with a free helmet, fit instructions, and a parent guidance document) was tested with 20 parent–child dyads. The majority (80%) of youth (mean age 9.9 ± 1.8 years) reported not owning or wearing a helmet. At 1-month follow-up (n = 12, 60% response rate), helmet use was higher in the five youth reporting bike-riding after the intervention; 100% “always” used helmets compared to 0% preintervention. There were increases in youth reporting that parents required helmet use (35% pre vs. 67% post) and that is was possible to fall when bike-riding (60% pre vs. 92% post). These pilot results support the use of this video and educational intervention along with further evaluation in a larger sample size. This youth-informed and culturally tailored approach could be explored as a strategy to address other pediatric injury topics.

Culturally Sensitive Interventions in Pediatric Primary Care Settings: A Systematic Review

“…27,30,33,38,42,43,45 Two (8%) conducted fully powered RCTs, 30,43 3 (12%) were pilot RCTs, 38,42,45 and 2 (8%) RCTs were underpowered. 27,33 Four (16%) studies used cross-sectional designs, 34,36,46,50 1 (4%) used an adaptation scoring design, 29 * Refs 28,32,35,37,[39][40][41]44,47,48,and 51. used an intervention arm with a historical control, 31 and 1 (4%) used retrospective chart reviews. 49 Per the description in each study's methods section, 16 (64%) used primarily quantitative methods, † 1 (4%) was primarily qualitative, 34 and 8 (32%) used mixed methods 29,31,32,40,46,47,49,50 (Table 3).…”

“…Ten (43%) were focused on obesity prevention ‡ and 4 (17%) on depression. 32,39,40,51 One (4%) each was focused on asthma, 38 sexual health, 35 smoking cessation, 47 parental education for prevention of infant musculoskeletal disorders, 44 bicycle helmet safety, 48 child behavior, 41 provision of familycentered primary care, 50 care coordination, 36 and development of a cultural health advisor position within a clinical practice. 46 All interventions took place in primary care centers or clinics, with some including components located online, 30 at schools, 47,49 or at local community centers.…”

“…46 All interventions took place in primary care centers or clinics, with some including components located online, 30 at schools, 47,49 or at local community centers. 31,49 For longitudinal interventions, session length ranged from 20 minutes 50 to 2 hours, 33,34,40,41,46 and intervention length ranged from a single session 36,44,48 to sessions spread over 2 years 43 (Table 2).…”

“…The 2 most frequent terms, "culturally sensitive" § and "culturally appropriate," k were each used in 12 (52%) interventions. Eight (35%) interventions used "culturally tailored," [28][29][30][31]33,34,37,41,44,48 8 (35%) used "culturally adapted," 28,29,32,40,41,[43][44][45]51 7 (30%) used "culturally relevant," [27][28][29][32][33][34]39,41,48 7 (30%) used "culturally competent," 28,29,36,38,41,43,46,50 and 4 (17%) used "culturally specific." 31,33,34,41,51 Other terms included the following: culturally centered, 45,51 culturally accepted or acceptable, 35,44 culturally safe, 46 culturally congruent, 33,34 culturally aware, …”

“…31,33,34,41,51 Other terms included the following: culturally centered, 45,51 culturally accepted or acceptable, 35,44 culturally safe, 46 culturally congruent, 33,34 culturally aware, 32 culturally inclusive, 50 culturally familiar, 31 culturally equivalent, 51 culturally representative, 51 culturally suitable, 28,29 culturally modified, 28,29 culturally effective, 36 culturally respectful, 33,34 culturally based, 35 culturally targeted, 44 and culturally accurate. 49 37,38,40,48 income, 28,29,37,40 adolescence, 30,35,39,47,50 language proficiency, 44 refugee status, 46 and special health care needs. 36…”