Gerald McGwin, Jr., M.S., Ph.D.

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Gerald McGwin, Jr., M.S., Ph.D.

• Associate Professor
• Departments of Epidemiology, Surgery, and
  Ophthalmology
• University of Alabama at Birmingham

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An Educational Intervention to Promote Proper
Seat Belt Use During Pregnancy
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Background

• Restraint use during pregnancy contributes to
  improved maternal and fetal survival after MVCs.
• Research suggests 25 to 50 do not follow
  guidelines for seatbelt use during pregnancy.
• Discomfort and concerns about harm to themselves
  or fetus common reasons for lack of restraint.
• Few interventions to improve seat belt knowledge
  and practices during pregnancy.

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Purpose

• To evaluate an education intervention focused on
  increasing the proper use and knowledge regarding
  seat belt use during pregnancy.

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Methods

• Phase I Collect baseline information regarding
  seat belt use knowledge and behaviors
• Phase II Developing and implementing
  educational intervention
• Phase III Evaluating impact of educational
  intervention

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Methods Phase I III

• The Jefferson County Alabama Department of Health
  operates nine health centers distributed
  throughout the county seven of these centers
  provide prenatal care.
• To qualify for services at the County health
  centers, patients need to be residents of
  Jefferson County, Alabama or have Medicaid
  indigent patients also qualify for services.

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Methods Phase I III

• Research team visited County health centers and
  approached all pregnant women for participation
  in the study (Phase I 6-8/2001 Phase III
  10-12/2002)
• Staff members rotated among all seven centers in
  a manner that provided a random sample of all
  women seeking prenatal care.
• Patients given description of study and asked if
  they were willing to participate.

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Methods Phase I III

• Self-administered questionnaire collected
  demographic and pregnancy information and
  restraint use characteristics.
• Information on restraint use in previous
  pregnancies and under different driving
  situations also collected.
• Patients asked whether they had received any
  information regarding restraint use from a
  variety of sources.
• Survey available in both English and Spanish.

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Methods Phase II

• Data from Phase 1 identified gaps in knowledge
  and behavior as targets for educational material.
• Focus groups conducted with clinic patients and
  staff to identify barriers regarding proper seat
  belt use during pregnancy and techniques for
  addressing these issues.
• Collectively, this information was used to create
  a variety of material for distribution to
  prenatal care clinics, patients, and staff.

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Methods Phase II

• Posters depicting proper seat belt placement
  created and installed at prenatal care clinics.
• All patients given gift bag containing brochure
  explaining benefits and correct use of seat
  belts.
• Clinic staff provided buttons encouraging proper
  seat belt use.
• All material was available in both English and
  Spanish.

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Methods Summary
Baseline Intervention Intervention
Post-Invention Survey Development
Dissemination Survey
6/2001 1/2002 3/2002
10/2002
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FIGURE 2A. Knowledge of seat belt effectiveness
for a non- pregnant woman among pre- and
post-intervention groups.
(p0.005)
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FIGURE 2B. Knowledge of seat belt effectiveness
for a pregnant woman among pre- and
post-intervention groups.
(plt0.0001)
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FIGURE 2C. Knowledge of seat belt effectiveness
for a baby among pre- and post-intervention
groups.
(p0.0009)
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Conclusions

• Although frequency of seat belt use high, many
  not wearing seat belts properly.
• This study demonstrated potential for educational
  tools to change knowledge and behavior.
• Education regarding proper seat belt use is now a
  regular component of pre-natal care at county
  health department pre-natal care clinics.

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An Educational Intervention to Promote Proper
Seat Belt Use During Pregnancy