Injury prevention education using pictorial information

Background. Written materials used in pediatric public health settings ofte n exceed the reading skills of caretakers. Objective. To compare a pictorial anticipatory guidance (PAG) sheet requiri ng limited reading skills to a TIPP (The Injury Prevention Program) sheet f or 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 less than or equal to 6 years old received eit her a PAG sheet or a TIPP sheet during a well-child care clinic visit; pare nts of children seen in the morning clinic received a PAG sheet and those s een during the afternoon clinic a TIPP sheet. All also received injury prev ention counseling by a clinic nurse. The recall of injury prevention inform ation was assessed by telephone questionnaire 14 to 28 days after the clini c encounter. Results. We interviewed 66 parents (57% of families enrolled): 46 were in t he PAG group and 20 in the TIPP group. There were no differences between gr oups in mean parent age, percent minority race, or percent public aid. Eigh ty-seven percent of PAG and 100% of TIPP parents recalled receiving an info rmation 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 pare nts in the PAG group and 1.6 +/- 1.1 from those in the TIPP group. No speci fic injury topic was recalled by more than half the parents in either group . Conclusions. Recall of injury information several weeks after a clinic visi t is limited. The use of PAG sheets did not improve recall; lack of literac y is not the sole cause of poor recall. Successful injury prevention counse ling in this population may require comprehensive and repetitive efforts.