Good intentions are not enough: An analysis of child injury prevention materials

This study is late-breaking, because it began in January 2007 and ended in June. Background: From 1997 to 2006, 306 young children died in the US from heat stroke while unattended in vehicles. The number of deaths each year has not declined appreciably, despite increased attention in recent years. Many materials aimed at education and prevention have been created, but there has been no systematic review of their effectiveness or the processes used to create them. Objective: This study sought to describe the current practices used to develop print materials addressing heat-related injuries to young children unattended in vehicles and to provide guidelines for future material development. Method: Print materials created between 2003 and April 2007 were collected through a snowball technique that solicited relevant national listservs and organizations. Content analyses were performed to discern what health communication strategies were employed and what risks were identified. Twenty-two materials developers were surveyed. Survey items included: target audience, content development processes, dissemination methods, and evaluation practices. Results: Fifty percent of materials employed both fear- and action-based communication strategies and many (22%) did not employ any strategy. No materials attempted to change behavior by mentioning the legal ramifications of leaving a child alone in the car. Among the risks identified, heat injury was the most common (27%), followed by the child putting the vehicle in motion (15%), or being abducted (12%); several materials did not identify any specific risk. The most common source for content was parent advocacy groups (68%), with few respondents consulting the published/scientific literature. Only four of 22 respondents had evaluated their materials. Conclusions: Effective health communication strategies and behavioral theories were not employed in the development of educational materials related to injury prevention. Developers should engage in formative, process, and outcome evaluations to ensure that communication objectives are met.