PEDIATRICS Vol. 105 No. 1 January 2000, p. e16

ELECTRONIC ARTICLE:
Injury Prevention Education Using Pictorial Information

Received May 25, 1999; accepted Aug 23, 1999.

Elizabeth C. Powell^*, Robert R. Tanz, Andrew Uyeda^§, Mary Beth Gaffney, and Karen M. Sheehan^*

From the ^* Divisions of Pediatric Emergency Medicine and  General Academic Pediatrics, Children's Memorial Hospital, and Department of Pediatrics, Northwestern University Medical School, ^§ Northwestern University Medical School, and  Children's Memorial Hospital, Chicago, Illinois.

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.  Key words:  injury prevention, counseling, primary care.

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