Trial Outcomes & Findings for Randomized Control Trial of Booster Seat Education Material to Increase Perceived Benefit Among Parents (NCT NCT03573830)

Last Updated: 2020-11-24

Results Overview

Assessed with the Perceived Benefit sub-scale of the BSASabb (an abridged version of the Booster Seat Attitudes Scale, Cunningham et al., 2011). The Perceived Benefit subscale evaluates parents' perception of the general safety afforded by booster seats (e.g., prevents children from being injured during normal driving). The Perceived Benefit sub-scale of the BSASabb ranges from 1 to 5, and higher scores mean better outcome.

Recruitment status

COMPLETED

Study phase

Target enrollment

731 participants

Primary outcome timeframe

Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

Results posted on

2020-11-24

Participant Flow

Participants were recruited online, between the 10th and the 27th of December 2018, through a market research service, Maru Blue, which keeps a database of 130,000 individuals who have consented to receive invitations to online surveys. Individuals registered in the database were sent an email invitation, which included a link to our online survey.

Our target sample size was 606, as stated in the protocol. However, we were able to enroll more than our target: 731

Participant milestones

Participant milestones
Measure	Current Material Participants in this arm were shown the online Transport Canada Material that is was available at the time: https://tc.canada.ca/en/road-transportation/child-car-seat-safety/stage-3-booster-seats Transport Canada material: The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).	Enhanced Material Participants in this arm were shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts. Enhanced material: Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).
Overall Study STARTED	364	367
Overall Study Reviewed Assigned Material	364	360
Overall Study COMPLETED	360	360
Overall Study NOT COMPLETED	4	7

Reasons for withdrawal

Reasons for withdrawal
Measure	Current Material Participants in this arm were shown the online Transport Canada Material that is was available at the time: https://tc.canada.ca/en/road-transportation/child-car-seat-safety/stage-3-booster-seats Transport Canada material: The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).	Enhanced Material Participants in this arm were shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts. Enhanced material: Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).
Overall Study Dropped without completing treatment	0	7
Overall Study Lost to Follow-up	4	0

Baseline Characteristics

Race and Ethnicity were not collected from any participant.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure	Current Material n=364 Participants Participants in this arm were shown the online Transport Canada Material that is was available at the time: https://tc.canada.ca/en/road-transportation/child-car-seat-safety/stage-3-booster-seats Transport Canada material: The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).	Enhanced Material n=367 Participants Participants in this arm were shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts. Enhanced material: Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).	Total n=731 Participants Total of all reporting groups
Age, Continuous	38.40 Years STANDARD_DEVIATION 6.98 • n=364 Participants	39.16 Years STANDARD_DEVIATION 7.10 • n=367 Participants	38.78 Years STANDARD_DEVIATION 7.04 • n=731 Participants
Sex/Gender, Customized Mothers	191 Participants n=364 Participants	199 Participants n=367 Participants	390 Participants n=731 Participants
Sex/Gender, Customized Fathers	173 Participants n=364 Participants	168 Participants n=367 Participants	341 Participants n=731 Participants
Race and Ethnicity Not Collected	—	—	0 Participants Race and Ethnicity were not collected from any participant.
Education No certificate, diploma or degree	14 Participants n=364 Participants	18 Participants n=367 Participants	32 Participants n=731 Participants
Education High school certificate or equivalent	40 Participants n=364 Participants	36 Participants n=367 Participants	76 Participants n=731 Participants
Education Apprenticeship or trades	55 Participants n=364 Participants	52 Participants n=367 Participants	107 Participants n=731 Participants
Education University certificate or diploma	38 Participants n=364 Participants	38 Participants n=367 Participants	76 Participants n=731 Participants
Education College, CEGEP or equivalent	84 Participants n=364 Participants	68 Participants n=367 Participants	152 Participants n=731 Participants
Education Bachelor's degree	62 Participants n=364 Participants	89 Participants n=367 Participants	151 Participants n=731 Participants
Education Master's degree	59 Participants n=364 Participants	54 Participants n=367 Participants	113 Participants n=731 Participants
Education PhD, MD, Dentist, or equivalent	12 Participants n=364 Participants	12 Participants n=367 Participants	24 Participants n=731 Participants
Number of children One child	74 Participants n=364 Participants	81 Participants n=367 Participants	155 Participants n=731 Participants
Number of children Two children	186 Participants n=364 Participants	166 Participants n=367 Participants	352 Participants n=731 Participants
Number of children Three children	62 Participants n=364 Participants	83 Participants n=367 Participants	145 Participants n=731 Participants
Number of children Four or more	42 Participants n=364 Participants	37 Participants n=367 Participants	79 Participants n=731 Participants
Language spoken at home English	343 Participants n=364 Participants	339 Participants n=367 Participants	682 Participants n=731 Participants
Language spoken at home Other language	21 Participants n=364 Participants	28 Participants n=367 Participants	49 Participants n=731 Participants
Perceived Benefit of Booster Seats	4.31 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.69 • n=364 Participants	4.31 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.70 • n=367 Participants	4.31 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.69 • n=731 Participants
Perceived key benefit of booster seats	4.45 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.68 • n=364 Participants	4.45 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.64 • n=367 Participants	4.45 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.66 • n=731 Participants
Intent to use booster seats	4.73 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.50 • n=364 Participants	4.69 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.52 • n=367 Participants	4.71 Scores on a scale from 1 to 5 STANDARD_DEVIATION 0.51 • n=731 Participants
Intent to Learn about booster seats	3.63 Scores on a scale from 1 to 5 STANDARD_DEVIATION 1.09 • n=364 Participants	3.65 Scores on a scale from 1 to 5 STANDARD_DEVIATION 1.02 • n=367 Participants	3.64 Scores on a scale from 1 to 5 STANDARD_DEVIATION 1.05 • n=731 Participants

PRIMARY outcome

Timeframe: Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

Population: Only participants with complete data in the Perceived Benefit sub-scale of the BSASabb were included.

Outcome measures

Outcome measures
Measure	Current Material n=360 Participants Participants in this arm were shown the online Transport Canada Material that is was available at the time: https://tc.canada.ca/en/road-transportation/child-car-seat-safety/stage-3-booster-seats Transport Canada material: The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).	Enhanced Material n=357 Participants Participants in this arm were shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts. Enhanced material: Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).
Change in Perceived Safety Benefit of Booster Seats	0.27 Scores on a scale from 1 to 5 Standard Deviation 0.53	0.15 Scores on a scale from 1 to 5 Standard Deviation 0.53

PRIMARY outcome

Timeframe: Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

Population: Only participants with complete data in Key Benefit sub-scale of the BSASabb were included.

Change in key safety was measured as the difference between post- and pre-intervention scores assessed with the Key Benefit sub-scale of the BSASabb (an abridged version of the Booster Seat Attitudes Scale, Cunningham et al., 2011). The Key Benefit sub-scale evaluates parents' perception of the safety afforded by booster seats in relation to potentially fatal injuries to the spine and neck, a key feature of booster seats. The Key Benefit sub-scale of the BSASabb ranges from 1 to 5 and higher scores mean better outcome.

Outcome measures

Outcome measures
Measure	Current Material n=360 Participants Participants in this arm were shown the online Transport Canada Material that is was available at the time: https://tc.canada.ca/en/road-transportation/child-car-seat-safety/stage-3-booster-seats Transport Canada material: The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).	Enhanced Material n=356 Participants Participants in this arm were shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts. Enhanced material: Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).
Change in Key Benefit of Booster Seats	0.29 Scores on a scale from 1 to 5 Standard Deviation 0.54	0.15 Scores on a scale from 1 to 5 Standard Deviation 0.50

SECONDARY outcome

Timeframe: Immediately before intervention; immediately after intervention (the mean duration of the intervention was 3 minutes)

Population: Only participants with complete data in the Intent to Use sub-scale of the BSASabb were included.

Change in intention to use booster seats was measured as the difference between post- and pre-intervention scores in the Intent to Use sub-scale of the BSASabb (an abridged version of the Booster Seat Attitudes Scale, Cunningham et al., 2011). Intent to Use sub-scale evaluates parents' willingness to purchase and ensuring their child always rides on a booster seat. The Intention to Use of the BSASabb ranges from 1 to 5 and higher scores mean better outcome.

Outcome measures

Outcome measures
Measure	Current Material n=360 Participants Participants in this arm were shown the online Transport Canada Material that is was available at the time: https://tc.canada.ca/en/road-transportation/child-car-seat-safety/stage-3-booster-seats Transport Canada material: The current Transport Canada booster seat education material focuses on imparting guidelines; that is, it describes, in plain language, the minimum and maximum ages, heights, and weights to determine when a child should use a booster seat, and when it is safe for a child to use only the seat belt. This material does not describe the principle of operation of seat belts (i.e., redirecting crash forces to the rib cage and pelvis), nor the principle of operation of booster seats (i.e., ensuring the seat belt is placed correctly across the chest and hips).	Enhanced Material n=360 Participants Participants in this arm were shown an enhanced version of the online Transport Canada Material, which includes an introduction explaining how booster seats prevent injuries caused by seat belts. Enhanced material: Enhancements to the booster seat education material were developed based on the hypothesis that parents would better appreciate the additional injury risk reduction afforded by booster seats, if they understand that: (1) seat belts prevent injuries by redirecting crash forces to stronger parts of the body (i.e., rib cage and pelvis); and (2), without booster seats, children would wear the seat belt on their abdomen and neck, which directs crash forces to more vulnerable anatomical structures (i.e., internal organs and spine).
Change in Intention to Use Booster Seats	0.03 Scores on a scale from 1 to 5 Standard Deviation 0.38	0.01 Scores on a scale from 1 to 5 Standard Deviation 0.32

SECONDARY outcome

Timeframe: immediately after intervention (the mean duration of the intervention was 3 minutes)

Population: Only participants with complete data on general knowledge of booster seats were included.

Participants were asked questions to assess how much general information about booster seats they retained: how booster seats prevent injuries as well as guidelines and recommendations. Scores ranges from 0 to 2 and higher scores mean better outcome.