DO THE FRAMINGHAM SAFETY SURVEYS IMPROVE INJURY PREVENTION COUNSELINGDURING PEDIATRIC HEALTH SUPERVISION VISITS

Background. Previous studies suggest that injury prevention counseling by pediatricians is effective but accomplished infrequently. The Fram ingham Safety Surveys (FSS) are brief questionnaires designed to facil itate physician education of parents regarding injury prevention. Obje ctive: To determine whether the FSS improve pediatricians' injury prev ention counseling. Design: Nonrandomized comparison of a 4-week baseli ne period and subsequent intervention periods. Settings: Private pract ice; university hospital clinic. Patients: Patients coming for health supervision visits. Intervention: Provision to the physician of one of the FSS, completed by the parent just before the health supervision v isit. Outcome measures: (1) After each visit parents completed a check list of safety issues discussed by the pediatrician, Injury prevention was compared for the two periods by means of three criteria: number o f issues discussed (quantity), identification and discussion of specif ic high-risk behaviors (efficiency), and recognition of high-risk fami lies (targeting), (2) Each physician's assessment of the value of the FSS was obtained by questionnaire. Results: A total of 144 parents (50 from the private practice, 94 from the clinic) completed checklists d uring the baseline period, and 168 (38 from the private practice, 130 from the clinic) during the intervention period. Use of the FSS produc ed no detectable improvement in any of the three measures. Seventy-sev en percent of the physicians indicated that the FSS were helpful in ed ucating families about safety, 38% thought that the FSS helped identif y high-risk families, and 54% said they would use it again. Conclusion s: Although most physicians believed the FSS were useful, introduction of the surveys as employed in this study did not improve injury preve ntion counseling.