ABSTRACT. Background. Written materials used in pediatric public health settings often exceed the reading skills of caretakers.Objective. To compare a pictorial anticipatory guidance (PAG) sheet requiring limited reading skills to a TIPP (The Injury Prevention Program) sheet for providing injury prevention information to low-income urban families.Design and Setting. A convenience sample of families with children treated at an urban pediatric clinic affiliated with a teaching hospital.Methods. Parents of children <6 years old received either a PAG sheet or a TIPP sheet during a well-child care clinic visit; parents of children seen in the morning clinic received a PAG sheet and those seen during the afternoon clinic a TIPP sheet. All also received injury prevention counseling by a clinic nurse. The recall of injury prevention information was assessed by telephone questionnaire 14 to 28 days after the clinic encounter.Results. We interviewed 66 parents (57% of families enrolled): 46 were in the PAG group and 20 in the TIPP group. There were no differences between groups in mean parent age, percent minority race, or percent public aid. Eighty-seven percent of PAG and 100% of TIPP parents recalled receiving an information sheet; 17% of PAG and 20% of TIPP parents could recall no specific injury topics. The mean number of topics recalled was 2.1 ؎ 1.5 from parents in the PAG group and 1.6 ؎ 1.1 from those in the TIPP group. No specific injury topic was recalled by more than half the parents in either group.Conclusions. Recall of injury information several weeks after a clinic visit is limited. The use of PAG sheets did not improve recall; lack of literacy is not the sole cause of poor recall. Successful injury prevention counseling in this population may require comprehensive and repetitive efforts. I njuries are the leading cause of death and disability during childhood. Each year, an estimated 600 000 children are hospitalized because of injuries, and an estimated 16 million more are treated in emergency departments.1 In Chicago, among children Յ14 years old, unintentional injuries, homicides, and motor vehicle injuries are the 3 leading causes of death.2 Childhood injuries disproportionately affect low-income and minority children. The injury death rates for black children for homicide, fires and burns, drowning, and pedestrian injury range from 1.5 to 5 times those for white children. [3][4][5][6] There is a clear need to target injury prevention efforts to these children.The American Academy of Pediatrics developed TIPP (The Injury Prevention Program) to prevent injuries. TIPP consists of a childhood safety counseling schedule and safety information sheets to be used in providing anticipatory guidance to parents. Using TIPP anticipatory guidance sheets helps to focus counseling on selected important injury topics with proven interventions. Most significant safety topics are reviewed at several clinic visits.
7The TIPP program meets the needs of many families. However, we were concerned that the parents of the ch...