Effectiveness of the CDC HEADS UP online training on healthcare providers’ mTBI knowledge and self-efficacy

Background: Many healthcare providers do not consistently implement recommendations contained in clinical guidelines on mild traumatic brain injury (mTBI). As such, the Centers for Disease Control and Prevention (CDC) created the HEADS UP to Healthcare Providers online training to promote uptake of five key recommendations in the CDC Pediatric mTBI Guideline. Methods: Using data from modules in the CDC HEADS UP to Healthcare Providers online training, healthcare providers’ self-reported knowledge and self-efficacy prior to and immediately following completion of the training was analyzed. Results: Improvements for 8 out of the 10 knowledge questions had a high level of practical significance. The knowledge question with the highest level of practical significance pre- to post-test improvement was for the key guideline recommendation on neuroimaging (pre-test correct: 70.2%; post-test correct: 87.8%; (p < 0.0001, Cohen’s g = 0.39). Four out of the six questions had a self-efficacy level increase of a high level of practical significance (r > 0.50) between the pre- and post-tests. The self-efficacy question with pre- to post-test improvement with the highest level of practical significance was “I am confident in my ability to manage the return to sports progression for my patients” (p < 0.001; r = 0.54). Conclusions: The HEADS UP to Healthcare Providers online training led to significant improvements in knowledge and self-efficacy related to mTBI diagnosis and management. Expanded use of this training among healthcare providers who commonly provide care for pediatric patients with mTBI may be beneficial. Practical Applications: This study highlights several factors guideline developers may take into consideration when creating an implementation tool, such as using health behavior theories, working with partners and key stakeholders, and focusing on digital-based tools.     

Factors associated with concussion symptom knowledge and attitudes towards concussion care-seeking among parents of children aged 5–10 years

Background: Understanding parents’ concussion-related knowledge and attitudes will contribute to the development of strategies that aim to improve concussion prevention and sport safety for elementary school children. This study investigated the association between parent- and child-related factors and concussion symptom knowledge and care-seeking attitudes among parents of elementary school children (aged 5–10 years). Methods: Four hundred parents of elementary school children completed an online questionnaire capturing parental and child characteristics; concussion symptom knowledge (25 items, range = 0–50; higher = better knowledge); and concussion care-seeking attitudes (five 7-point scale items, range = 5–35; higher = more positive attitudes). Multivariable ordinal logistic regression models identified predictors of higher score levels. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) excluding 1.00 were deemed statistically significant. Results: Select parent and child characteristics were associated with higher score levels for both outcomes. For example, odds of better knowledge level in parents were higher with increased age (10-year increase aOR = 1.59; 95% CI = 1.10–2.28), among females (aOR = 3.90; 95% CI = 2.27–6.70), and among white/non-Hispanics (aOR = 1.79; 95%CI = 1.07–2.99). Odds of more positive concussion care-seeking attitude levels were higher among parents with a college degree (aOR = 1.98; 95%CI = 1.09–3.60). Child sports participation was not associated with higher score levels for either outcome. Conclusions: Certain elementary school parent characteristics were associated with parents’ concussion symptom knowledge and care-seeking attitudes. While the findings suggest providing parents with culturally and demographically relevant concussion education might be helpful, they also emphasize the importance of ensuring education/prevention regardless of their children’s sports participation. Practical Applications: Pediatric healthcare providers and elementary schools offer an optimal community-centered location to reach parents with this information within various communities.     

Racial disparities in parent knowledge of concussion and recognition of signs and symptoms

Introduction: Concussion is a type of traumatic brain injury that can be sustained through participation in different sports. It is important that a parent be able to identify common and uncommon symptoms of a concussion to ensure the safety and good health of their child. The purpose of this study was to compare knowledge of concussion scores among White and African American parents and guardians. Methodology: This cross-sectional study consisted of a single survey of 53 questions that was given to parents/guardians of high school athletes at a preseason parent meeting. Parent and guardian knowledge of concussion was assessed through a series of 45 questions. Participants were asked to correctly identify signs and symptoms of concussion, answer questions regarding the anatomy of a concussion (i.e. a concussion is an injury to the brain), answer true/false questions about general concussion knowledge, select from a list the consequences of multiple concussions and select from a list the consequences of returning to play too soon from a concussion. Knowledge of concussion was calculated by summing correct responses for the 45 knowledge questions. Racial differences were calculated using an ANCOVA, controlling for socioeconomic school type. The statistical significance level was set a priori p ≤ 0.05 for all analyses. Results: Participants of this study consisted of 176 [115 (65.3%) White, 61 (34.7%) African American] parents/guardians of high school athletes. Significant differences in knowledge of concussion scores between White parents/guardians [38.50 ± 4.55 (85.6% correct)], and African American parents/guardians [35.15 ± 4.97, 78.1% correct)] were identified (F_(1,172) = 4.82, p = 0.03). Conclusion: Knowledge of concussion disparities exist between African American and White parents/guardians. This disparity could cause complications from concussion to surface among children and adolescents participating in sport as their parents/guardians may not be able to correctly identify the signs and symptoms in order to seek proper medical care. Practical Application: Findings from this study highlight quantitative differences in concussion knowledge of parents from different demographics. These findings underline disparities and inequities in access to concussion-health resources that need to be addressed.     

Soccer,concussions, and safety: Perceptions of parents of youth soccer participants

Introduction: The rate of concussions in youth soccer is among the highest of all youth sports. Parents play an important role in caring for their children and making decisions regarding whether they should participate in a sport, such as soccer, where concussions are well known. This study examined parental perceptions regarding: (a) coaches’ role in concussion management, (b) heading restriction policies, and (c) overall concussion risk and participation issues. Method: Online surveys were completed by 419 parents of youth soccer players who participated in the largest U.S. youth soccer programs nationwide. Results: Findings indicated 44.5% of the respondents had considered keeping their children from playing organized soccer and 47.2% were concerned about a potential decline in youth soccer participation due to concussions. Nearly 69% of responding parents agreed that heading should be banned for participants 10 years old or younger, while 56.5% thought heading should not be limited for participants 13 or older. Only 35% of parents were very confident about their child’s coach’s ability to properly identify concussions and remove those suspected of a concussion from play. Parents’ socioeconomic status (SES), soccer coaching and playing experience, and previous history of concussion(s) were key predictors of greater perceived risk about concussions. Conclusions: Findings from this study shed light on parents’ perceptions about concussions and related safety issues in youth soccer. Understanding what parents believe about concussions is vital to preserve youth soccer participation and can be used to strengthen education and policies that promote a safer environment for youth sport participants. Practical Applications: Youth soccer coaches can benefit from stronger, comprehensive educational efforts at the league/club level. Additionally, parents of youth athletes who are in the lower SES communities should be targeted to receive concussion safety information and/or interventions that would improve their knowledge, attitude, and practices regarding concussion safety.     

Parental knowledge of concussion: Evaluation of the CDC's “Heads up to parents” educational initiative

Background: Potential negative outcomes associated with sport-related concussion drive the need for resources to educate parents about prevention, recognition, and management of concussion in the youth athlete. Parents play a critical role in the recognition and management of concussion for their child. Purpose: This study aims to (a) investigate current knowledge of concussion among parents whose children age 5–18 years play a club sport and (b) identify effects of an online video versus online print educational intervention on concussion knowledge change and learning. Methods: 140 parents whose children played a club sport answered questions regarding their knowledge of sport-related concussion pre- and post-random assignment to an educational intervention: CDC Concussion Awareness video or CDC Concussion Fact Sheet for Parents. Results: Participating parents demonstrated a moderate level of pre-intervention knowledge, but critical gaps in knowledge were identified. Knowledge of concussion improved slightly following intervention regardless of intervention type. Conclusions: This study confirms the presence of gaps in knowledge of concussion in parents whose children play club sports. Without the protection of concussion legislation, those athletes who participate in club sports are at particular risk due to lack of concussion knowledge and education. This study confirms that education can have a positive impact on parental knowledge of concussion. Practical applications: Pre-knowledge of concussion is the greatest predictor of post-knowledge of concussion, therefore pre-assessment of target audience knowledge followed by a custom educational intervention taking into account principles of adult learning, would be the most beneficial to increasing concussion knowledge.     

Users’ acceptance of private automated vehicles: A systematic review and meta-analysis

Introduction: This research systematically reviewed relevant studies on users’ acceptance of conditional (Level 3) to full (Level 5) automated vehicles when such vehicles are to be used privately (herein referred to as ‘private automated vehicles or private AVs). Method: The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, and was undertaken in three databases: APA PsycINFO, Transport Research International Documentation, and Web of Science. Articles were required to focus on individuals’ acceptance of private SAE Level 3–5 AVs. Acceptance was defined as individuals’ attitudes towards or intentions and/or willingness to use AVs in the future. A total of 2,354 articles were identified in the database search. Thirty-five articles were included in the review, six of which included multiple studies and/or comparison groups. Results: Most studies (n = 31) applied self-reported measures to assess user acceptance together with a range of psychosocial factors predicting such acceptance. The meta-analytic correlations revealed that perceived behavioral control, perceived benefits/usefulness, perceived ease of use, and subjective/social norms had significant positive pooled relationships with attitudes and intentions. Trust and sensation seeking also had significant positive pooled correlations with intentions, while knowledge of AVs had a significant and negative pooled correlation with intentions. Age did not show any significant pooled relationship with attitudes, intentions, or willingness. Conclusions: The findings obtained from the systematic review and meta-analysis provide support for psychosocial models to aid understanding of users’ acceptance of private AVs. Practical applications: Examining acceptance of AVs after participants have experienced these vehicles on closed tracks or open roads would advance contemporary knowledge of users’ intentions to use these vehicles in the future. Further, experiencing these vehicles firsthand may also help with addressing any perceived barriers reducing acceptance of future use of private AVs.     

Concussion attitudes,behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

IntroductionThis study assessed young athletes' (ages 12 to 17) concussion attitudes and behaviors, particularly their self-reported experience learning about concussion and intentions to report a concussion and disparities in these experiences.MethodsWe used data from Porter Novelli's 2014 YouthStyles survey that is conducted each year to gather insights about American consumers.ResultsOf the 1,005 respondents, 57% reported sports participation. Fourteen percent reported they may have had a previous concussion, and among them 41% reported having a concussion more than once while playing sports. Males (17.7%) were significantly more likely to report having a concussion than females (10.0%; χ² (1) = 7.01, p = 0.008). Fifty-five percent of respondents reported having learned about what to do if they think they may have a concussion, and 92% reported that they would tell their coach if they thought they sustained a concussion while playing youth or high school sports. Youth from higher income families ($75,000–$124,999) were significantly more likely than youth from lower income families (less than $35,000) to report that they learned about what do if they suspected that they had a concussion.ConclusionAge of athlete, parental income level, athlete's sex, and living in a metro versus non-metro area led to disparities in athletes' concussion education. There is a need for increased access to concussion education and an emphasis on customizing concussion education efforts to meet the needs of different groups.Practical applicationWe identified athletes' self-reported previously sustained concussions and predictors of education related to concussion. Further research is needed to explore the age, gender and income gaps in concussion education among athletes.     

Predicting pool safety habits and intentions of Australian parents and carers for their young children

Introduction: Children under five years are most at risk of experiencing fatal and nonfatal drowning. The highest proportion of drowning incidents occur in private swimming pools. Lapses in adult supervision and failures in pool barriers are leading contributory factors for pool drowning in this age group. Methods: We investigated the role of the theory of planned behavior social cognitions (attitude, subjective norm, and perceived behavioral control) as well as perceived barriers, planning, role construction, and anticipated regret on parents’ and carers’ intentions and habits toward two pool safety behaviors: restricting access and supervising children around private swimming pools. The study adopted a cross-sectional correlational design. Participants (N = 509) comprised Australian parents or caregivers with children aged under five years and access to a swimming pool at their residence. Participants completed a battery of self-report measures of social cognitive variables with respect to the swimming pool safety behaviors for their children. Results: Path analytic models controlling for past behavior indicated that subjective norm, planning, anticipated regret, and role construction were important predictors of habit, and subjective norm was a consistent predictor of intentions, for both behaviors. Planning predicted intentions in the restricting access sample, while attitudes, barriers, and role construction also predicted intentions in the supervising sample. Both models controlled for past behavior. Conclusion: Current findings indicate the importance of psychological factors for restricting access and supervising behaviors, with normative factors prominent for both reasoned (intentions) and non-conscious (habits) behavioral antecedents. It seems factors guiding restricting access, which likely require regular enactment of routine behaviors (e.g., ensuring gate is not propped open, pool fence meets standards), may be governed by more habitual than intentional processes.     

Making safety training stickier: A richer model of safety training engagement and transfer

Introduction: Compared to other types of occupational training, safety training suffers from several unique challenges that potentially impair the engagement of learners and their subsequent application or “transfer” of knowledge and skills upon returning to the job. However, existing research on safety training tends to focus on specific factors in isolation, such as design features and social support. The aim of this research is to develop an overarching theoretical framework that integrates factors contributing to training engagement and transfer. Method: We conducted a comprehensive qualitative review of safety training research that was published between 2010 and 2020. We searched Web of Science, Scopus, and Google Scholar, yielding 147 articles, and 38 were included. We content analyzed article summaries to arrive at core themes and combined them with contemporary models of general occupational training to develop a rich model of safety training engagement and transfer. Results: We propose that training engagement is a combination of pre-training factors such as individual, organizational, and contextual factors, that interact with design and delivery factors. Safety training engagement is conceptualized as a three-component psychological state: affective, cognitive, and behavioral. Organizations should prioritize pre-training readiness modules to address existing attitudes and beliefs, optimize the safety training transfer climate, and critically reflect on their strategy to design and deliver safety training so that engagement is maximized. Conclusions: There are practical factors that organizations can use before training (e.g., tailoring training to employees’ characteristics), during training (e.g., ensuring trainer credibility and use of adult learning principles), and after training (e.g., integrating learned concepts into systems). Practical Applications: For safety training to ‘stick,’ workers should be affectively, cognitively, and behaviorally engaged in learning, which will result in new knowledge and skills, improvements in attitudes, and new safety behaviors in the workplace. To enable engagement, practitioners must apply adult learning principles, make the training relevant, and tailor the training to the job and individual needs. After training, ensure concepts are embedded and aligned with existing systems and routines to promote transfer.     

What the research says about concussion risk factors and prevention strategies for youth sports: A scoping review of six commonly played sports

Introduction: Given the growing research on potential adverse outcomes related to concussion and other serious brain injuries and the increased susceptibility for concussion among youth athletes, primary prevention is vital to protect the health and safety of this population. The purpose of this study is to summarize the current research on risk factors and primary concussion prevention strategies focused on specific youth sports, and to identify research gaps. Methods: A literature search was conducted using six electronic databases. A scoping review method was used to identify studies that addressed risk factors or primary concussion prevention strategies focused on youth athletes (ages 5–18 years) in six sports (football, ice hockey, soccer, lacrosse, basketball, and wrestling). Results: Of the 18 publications identified, the publications focused on risk factors (N = 11), policy (N = 1), rule changes (N = 3), education (N = 2), equipment (N = 2), and playing technique (N = 0). Some articles had information related to multiple topics. Conclusions: Current research on concussion prevention has primarily been focused on risk factors. There are a dearth of studies that examine primary concussion prevention in sports. When studies do exist, most focus on football and ice hockey. Only a small number of studies focus solely on risk factors or primary prevention in soccer, lacrosse, basketball, and wrestling—all sports in which concussions are common. Practical applications: This scoping review summarizes current research on concussion risk factors and primary prevention strategies in specific sports focused on youth athletes and identifies research gaps to help inform future efforts.     

Antecedents of intention to help mitigate wildfire: Implications for campaigns promoting wildfire mitigation to the general public in the wildland–urban interface

The current investigation sought to examine the association between knowledge of the causes of wildfire in the wildland–urban interface (WUI) and intentions on the part of members of the public to help mitigate wildfire. In doing so, antecedents from the theory of planned behavior were employed to enhance our understanding of the relationships among wildfire knowledge, attitudes, subjective norms, perceived behavioral control, and intention to help mitigate wildfire in the WUI. Participants (N = 408) living in the WUI in Appalachian Ohio were sampled as a means of conducting formative research prior to developing messages promoting wildfire mitigation. Our results reveal that, among the variables in the theory of planned behavior, the only paths that consistently explain individual’s intention to help mitigate wildland fire in the WUI in protecting both homes and the environment are associations between knowledge about wildfire and perceived behavioral control and between perceived behavioral control and intention. Our findings are discussed with a focus on message design for wildland fire mitigation professionals and a focus on implications for the theory of planned behaviors for academics with interests in wildland fire and other environmental issues.     

Leadership skills for strengthening jobsite safety climate

Introduction: Construction foremen may lack the leadership skills needed to create a strong jobsite safety climate. Many construction companies address this by sending their lead workers to the OSHA 30-h course; however the course does not include a leadership training module. This article describes the development and pilot testing of such a module and evaluation surveys designed to address this training gap. Methods: A 17-member curriculum development team, numerous subject matter experts, and an instructional design company helped us develop a comprehensive set of teaching resources and a set of survey instruments for evaluating the materials' effectiveness on improving safety leadership and safety climate. All materials and surveys were pilot tested with representative members of the target population. Results: Pilot surveys showed high reliability and data collected on the resulting Foundations for Safety Leadership (FSL) module indicated that the majority of foremen thought the training was helpful or valuable, particularly the discussion questions. The majority said they intended to use the skills on the jobsite. With the exception of the role-play activities, the trainers rated highly all other components, especially the videos and discussion questions. Modifications were made to the training materials and surveys based on pilot test findings. The most important result of the development and pilot testing efforts is that the OSHA Training Institute (OTI) included the FSL as an elective in the OSHA 30-h course. Conclusions: The FSL module fills a needed skills gap by providing safety leadership training to all foremen who might otherwise not have access to it through their company or union. The continued success of the FSL training will be ensured by dissemination via the OSHA 30-h course, an established nationwide safety training program. Practical applications: The FSL training module has already been widely accepted by the construction industry as a useful approach for providing construction foremen/See new abstract lead workers with the knowledge and skills they need to become more effective jobsite safety leaders.     

From the CDC: A qualitative study of middle and high school professionals' experiences and views on concussion: Identifying opportunities to support the return to school process

Introduction: Current research recommends that students returning to school after a concussion should receive a return to school plan that is tailored to their individual symptoms. School professionals play important roles in designing and implementing the supports outlined in return to school plans. Methods: This qualitative study explored middle and high school professionals' experiences with concussion, particularly their knowledge and perceptions of the injury and their experience with supporting students with concussion. Six focus groups were conducted with two to four school professionals per group, including two groups of teachers, two groups of school psychologists and counselors, and two groups of school nurses. Findings were coded into four categories: (a) challenges with identifying a concussion; (b) strategies for communicating with students about concussion; (c) barriers to implementing return to learn plans; and (d) establishing a collaborative school support team. Results: School professionals who participated in the focus groups were knowledgeable about concussion and the importance of helping their student recover. Participants also understood the importance of recognizing the signs and symptoms of concussion and communicating with students and parents about this injury. However, the study participants reported various challenges related to concussion identification and management, including the perceived validity of concussion symptom reporting by students. A team-based approach was mentioned across all groups as the preferred method for school-based concussion management for students. Conclusion: School professionals in this study were eager to address concussion in their schools, but desire guidance on how to overcome social norms around concussion identification and reporting. In addition, there is a need for consistent use of written instructions from healthcare providers to help guide return to learn (RTL) accommodations. Practical applications: The findings from this study can help inform the integration of concussion, and other health, management plans in schools.     

An application of a modified theory of planned behavior model to investigate adolescents’ job safety knowledge,norms, attitude and intention to enact workplace safety and health skills

Introduction: For many reasons, including a lack of adequate safety training and education, U.S. adolescents experience a higher rate of job-related injury compared to adult workers. Widely used social-psychological theories in public health research and practice, such as the theory of planned behavior, may provide guidance for developing and evaluating school-based interventions to prepare adolescents for workplace hazards and risks. Method: Using a structural equation modeling approach, the current study explores whether a modified theory of planned behavior model provides insight on 1,748 eighth graders’ occupational safety and health (OSH) attitude, subjective norm, self-efficacy and behavioral intention, before and after receiving instruction on a free, national young worker safety and health curriculum. Reliability estimates for the measures were produced and direct and indirect associations between knowledge and other model constructs assessed. Results: Overall, the findings align with the theory of planned behavior. The structural equation model adequately fit the data; most path coefficients are statistically significant and knowledge has indirect effects on behavioral intention. Confirmatory factor analyses suggest that the knowledge, attitude, self-efficacy, and behavioral intention measures each reflect a unique dimension (reliability estimates ≥0.86), while the subjective norm measure did not perform adequately. Conclusion: The findings presented provide support for using behavioral theory (specifically a modified theory of planned behavior) to investigate adolescents’ knowledge, perceptions, and behavioral intention to engage in safe and healthful activities at work, an understanding of which may contribute to reducing the downstream burden of injury on this vulnerable population—the future workforce. Practical application: Health behavior theories, commonly used in the social and behavioral sciences, have utility and provide guidance for developing and evaluating OSH interventions, including those aimed at preventing injuries and promoting the health and safety of adolescent workers in the U.S., who are injured at higher rates than are adults.     

An evaluation of a college campus emergency preparedness intervention

IntroductionGiven the range of emergencies that beset postsecondary institutions, university administrators must take a multimodal approach to prepare campus stakeholders for safety threats. One such strategy is emergency preparedness communication.MethodsIn the present investigation, we tested the efficacy of a professionally produced video that uses the federally endorsed slogan, Run-Hide-Fight(r). Undergraduate students participated in a quasi-experiment with a pretest-posttest-delayed posttest control group design.ResultsUsing the theory of planned behavior as our guiding framework, we found that video exposure increased attitudes, perceived norms, perceived behavioral control, intentions, as well as knowledge of recommended behavioral responses. Favorable attitudes and injunctive norms positively predicted intentions at the initial and delayed posttests. Importantly, the video's effects on most of the outcomes endured two weeks after video exposure.ConclusionsA brief emergency preparedness video using the Run-Hide-Fight(r) theme can have immediate and lingering effects on psychosocial predictors of appropriate emergency response behaviors.Practical ApplicationsAdministrators at higher education institutions should consider showing emergency preparedness messages to increase the likelihood that stakeholders will take appropriate action in case of a campus threat. In particular, these messages should aim to promote favorable attitudes toward appropriate response behaviors and instill beliefs that appropriate responses ought to be performed.     

An examination of antecedents to coal miners' hearing protection behaviors: a test of the theory of planned behavior

PROBLEM: The National Institute for Occupational Safety and Health's [NIOSH] National Occupational Research Agenda (DHHS Publication No. 96-115) reports that approximately 50% of miners will experience hearing loss by age 50, compared to only 9% of the general population. The present investigation examines three antecedents believed to be associated with miner's use of hearing protection. METHOD: A posttest-delayed-posttest-control group field research design was employed to assess antecedents toward wearing hearing protection. RESULTS: Following the initial posttest, miners' attitudes and subjective norms were antecedents to intentions to wear hearing protection devices. Also, intentions toward wearing hearing protection predicted hearing protection behaviors. Approximately six weeks later, miners' attitudes and perceived behavioral control were each significant predictors of intentions to wear hearing protection and again, intentions were positively associated with hearing protection behaviors. IMPACT ON INDUSTRY: Our results indicate that appeals to normative influences may be the most effective antecedent to employ when persuading coal miners to wear hearing protection. However, messages designed to impact attitudes and perceived behavioral control were also effective.     

Risky business: Investigating influences on large truck drivers' safety attitudes and intentions

Introduction: Safety research in the U.S. motor carrier context remains important, as the trucking industry employs approximately 1.7 million large truck drivers. Drivers face many competing pressures in this unique high risk, high regulation, and low direct supervision context. They represent the cornerstone of safe carrier operations. Methods: Using a multi-theoretical approach, this study investigates how drivers' perceptions of carrier safety climate influence their safety-related attitudes and intentions. Results: Responses from nearly 1500 over the road drivers provide evidence that safety climate directly influences drivers' attitudes toward safety, safety norms, and driver risk avoidance, and indirectly influences drivers' intentions to commit unsafe acts. These findings replicate previous findings and also extend the nomological network of theory in this context, adding driver risk avoidance as a central factor to the driver safety theoretical framework. Additionally, carrier managers are encouraged to reflect on the study's evidence and pursue a better understanding of their drivers' risk perceptions and tolerance, while minimizing avoidable risk through prudent safety and operational policies, procedures, and processes. Future research in this area is highly encouraged.     

Nursing student evaluation of NIOSH workplace violence prevention for nurses online course

Introduction: As primary targets of workplace violence in health care settings, nurses may suffer negative physical and psychological consequences. NIOSH created an online course to educate nurses about violence prevention techniques. Method: A mixed-methods approach assessed workplace violence awareness and knowledge among nursing students. A pre/post/post-test survey and focus group discussions evaluated participant awareness and knowledge, assessed course design, and solicited recommendations for increasing participation and strategies for improving message retention. Results: The mean awareness scores differed significantly between pre-course and both post-course time points (Wilk's λ = 0.319, F(2, 46) = 49.01, p < 0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased awareness of workplace violence from pre-course scores (M = 0.75, SD = 0.438) to immediate post-course (M = 2.13, SD = 0.789) and four-week post-course (M = 1.96, SD = 0.771) scores on a 3-item measure. Similarly, mean knowledge scores increased between pre-course and both post-course time points (Wilk's λ = 0.495, F(1.57, 73.66) = 37.26, p < 0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased knowledge of workplace violence from pre-course scores (M = 6.65, SD = 1.45) to immediate post-course (M = 8.56, SD = 1.32) and four-week post-course (M = 8.19, SD = 1.42) scores on a 10-item measure. Qualitative data from the focus groups reinforced the quantitative findings. Participants citing benefits from the content strongly recommended including the course in nursing curriculums. Incorporating the course early in the nursing educational experience will better prepare students to deal with workplace violence when they enter health care professions. Conclusions: The results indicate that NIOSH and its partners created an effective online workplace violence awareness and prevention course. Practical applications: Nursing students and professionals can be effectively educated about workplace violence using an online format.     

Automated vehicles and older drivers in Canada

Introduction: As seniors represent a growing proportion of the driving population, research about how automated vehicles can help improve older driver safety and mobility is highly relevant. This paper examines the knowledge, attitudes and perceptions of older drivers towards limited self-driving vehicles (LSDVs), and how these variables can influence the likelihood that they will rely on this technology. Method: The study includes data from a previous national survey (N = 2662) about automated vehicle technology, with new analyses to test hypothetical models using structural equation modeling. Results of the first model were confirmed and built upon with a second more complex model that incorporated the construct “behavioral adaptation.” Focus groups with older drivers were also conducted (N = 38) to help reveal nuances in older drivers' knowledge, attitudes, perceptions, and behaviors regarding this technology. Results: Survey results demonstrated that feelings of safety and knowledge about LSDVs are positively related to perceived ease of use and adoption of the technology. The positive association between safety and perceived ease of use was further highlighted when comparing responses of older drivers to those of younger age groups, as older drivers were significantly less likely to agree that LSDVs were easy to use and were significantly less agreeable about feeling safe using them. Focus groups results confirmed that safety and knowledge of LSDVs are essential to the likelihood of adopting this technology, and revealed a high receptivity among older drivers to educational strategies and tools to increase their knowledge of LSDVs. Implications for educational strategies and safety benefits for older drivers are discussed. Practical applications: Results provide insight into strategies to encourage the early adoption of automated vehicles by older drivers and facilitate a safer transition towards automated vehicles that is lead by a cohort of safety-conscious drivers.