Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107901

Robert J. Letourneau, MPH, Department of Health Behavior and Health Education, University of North Carolina-Chapel Hill, CB#7506, Chapel Hill, NC 27599-7506, 919-966-3920, Robert_Letourneau@unc.edu, Carolyn E. Crump, PhD, Department of Health Behavior & Health Education, University of North Carolina-Chapel Hill, CB#7506, Chapel Hill, NC 27599-7506, J. Michael Bowling, PhD, Health Behavior and Health Education, The University of North Carolina at Chapel Hill, CB 7440, Chapel Hill, NC 27599, Christopher W. Allen, MS, PHS Indian Health Center, White Earth Enviornmental Health Officer, 25519 State Highway 224, Ogema, MN 56569, and Diana Kuklinski, MS, RS, Environmental Health/Injury Prevention, Bemidji Area Indian Health Service, 522 Minnesota Avenue, NW, Bemidji, MN 56601.

Background: Motor vehicle crashes (MVCs) are the leading cause of death for American Indian/Alaska Native (AI/AN) children. The use of child safety seats (CSSs) reduces MVC-related mortality, however, AI/AN CSS usage rates are often less than 20% in pre-school aged children. This presentation describes the development of a child passenger safety (CPS) program, which uses community-based participatory research methods, to increase CSS use among Tribal Head Start families.

Methods: Formative evaluation (e.g., focus groups, technical review) was conducted to develop the program, which includes: tailored curriculum for Head Start; community-based CPS educational activities; CPS training; CSS distribution; and observational surveys/follow up home visits. Process (e.g., surveys, interviews) and impact (pre/post child safety seat observations at 11 sites) have been conducted.

Results: Focus groups identified barriers to CSS use (e.g., uncooperative children, CSS availability). Expert technical review informed curriculum/evaluation activity development. Coordinator surveys/interviews in Years I-II identified program implementation challenges and streamlined educational/evaluation activities. From 2002-2005, 14 Tribal Head Start sites in six states participated. Head Start Center staff (n=41) obtained CPS Practitioner/Technician training. Over 1,600 families were reached with educational materials and 1,100 CSSs were distributed. Pre/post CSS observational surveys showed an average increase in CSS usage from 37.8 to 69.0 percent; adjusted odds ratio was 4.2 (p<.001). Infants were more likely to be restrained than toddlers.

Conclusions: Adapting an evidence-based effective strategy for Tribal Head Start Centers is an appropriate approach for use in AI/AN communities. Diffusion of this program to other Tribes/Tribal entities and non-Tribal groups is underway.

Learning Objectives: