Have injury prevention strategies, will travel: Assessing dissemination of the CARES mobile safety center

Background: To assess how to disseminate injury prevention strategies to a low-income urban population we assessed how CARES, a 40-foot “house on wheels” designed to disseminate safety products and educate visitors about injury prevention, was incorporated into anticipatory guidance by a pediatric practice and used by parents attending well-child visits. The purposes of this work are to describe the implementation of an innovative approach to disseminating child injury prevention interventions and draw lessons from this experience for similar efforts.

Methods: We collected implementation data through in-depth interviews with clinic partners and CARES health educators, surveyed parents, and analyzed operations data to assess parent uptake.

Results: Clinic partners expressed support for CARES, and described it as a valuable addition to clinical services. However, staff adoption of CARES into the clinical routine was limited (28% of patients reported being referred to CARES). Clinic staff cited time constraints as the main barrier, and noted that long clinic waits likely affected parents' willingness to visit CARES. They also offered suggestions for how to better engage the staff as disseminators. Despite these challenges, almost 1,000 people visited CARES during the 119 6-hour days CARES was at the clinic. Visitors reported high levels of satisfaction (98% reported they would refer a friend), purchased 259 products, and bought and/or had 235 car seats installed.

Conclusion: CARES is a promising vehicle for disseminating injury prevention information and products. This work documents the extent of dissemination, and provides insight into how to better engage clinic staff in dissemination efforts.