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Injury is the leading cause of death for children but little is known about what types of injury prevention messages are communicated on Instagram. Conducted in the United States, the aim of this study was to better understand child injury prevention messages on Instagram to develop recommendations for the future. Informed by Social Cognitive Theory, a quantitative content analysis was conducted on all Instagram posts from selected organizations from May 2018 through April 2019. Of the 818 injury prevention posts, almost all included an image (575, 70%) or video (211, 26%). Of the 575 images, 245 (42.46%) had in image that did not match the topic of the post. Regarding injury prevention recommendations, 579 posts (71%) provided a clear action that parents should take. For these posts, 115 (20%) had an image that communicated the desired safety recommendation, but many more (285, 50%) did not; in 23 cases it was not clear if there was a match or not. There are missed opportunities for child health and injury organizations to reach parents and caregivers through Instagram. Posts made during the study period often lacked specificity about action-oriented measures and failed to utilize images that demonstrated the recommended practices. Organizations posting on Instagram and other social media platforms should provide clear action tips and utilize images that depict child injury prevention recommendations.

Introduction: Golf cart-related injuries constitute a substantial source of morbidity, most notably in pediatric populations. Despite the high rate of injuries, there have been no meaningful changes in golf cart design or legislation to reduce the overall burden of these injuries. This study sought to characterize the epidemiology of golf cart-related injuries treated in United States hospital emergency departments. Method: A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for patients of all ages who were treated in emergency departments (EDs) (2007–2017) for a golf cart-related injury. Results: From 2007 through 2017, an estimated 156,040 (95% CI = 102,402–209,679) patients were treated in U.S. EDs for golf cart-related injuries. The average rate of traumatic brain injuries (TBIs) in children (1.62 per 100,000 children) was more than three times that of TBIs in adults (0.52 per 100,000 adults; rate ratio = 2.38; 95% CI = 2.36–2.41) and nearly twice that of TBIs in seniors (1.11 per 100,000 seniors; rate ratio = 1.21; 95% CI = 1.19–1.22). The rate of injuries in seniors increased significantly by 67.6% from 4.81 per 100,000 seniors in 2007 to 8.06 per 100,000 seniors in 2017 (slope = 0.096; p = 0.041). Conclusions: Golf cart use remains an important source of injury for people of all ages, especially in children. As use continues to increase, it is unlikely that golf cart-related injuries will decrease without substantial changes to product design, regulation, and/or legislation. Practical Applications: Use of golf carts pose a considerable risk of injury and morbidity; safety recommendations should be followed.

Breastfeeding benefits infants, but support is often needed to meet breastfeeding goals. Social media may help disseminate infant feeding information to caregivers. The relationship between parents’ health information-seeking behaviors (HISB) on social media and infant feeding practices remains understudied. Based on social cognitive theory (SCT), parents’ self-efficacy and outcome expectations are two potential factors for improving online HISB. We aimed to use SCT to describe associations between outcome expectations, self-efficacy (eHealth literacy), and online HISB across infant feeding groups among a nationally representative sample of U.S. parents. Eligible participants (N = 580) completed a cross-sectional online survey assessing infant feeding practices (never breastfed, only pumped, only fed-at-the-breast, and both pumped and fed-at-the-breast), self-efficacy (using eHealth literacy as a proxy), outcome expectations in online HISB, parents’ online HISB on social media, and demographic information. Survey weighted linear and logistic regression models were constructed. No online activities differed by infant feeding practices. Parents who pumped only had significantly lower eHealth literacy than parents who never breastfed (adjusted β = -2.63, 95% CI: -4.73, -0.53). Parents who used both methods had 1.78 times greater odds of considering online tools useful for making health-related decisions (95% CI: 0.96, 3.28) and 1.49 times greater odds of considering online tools important for accessing health information (95% Cl: 0.70, 3.15) than parents who never breastfed, though neither association was statistically significant. Understanding these associations between infant feeding practices and online HISB, as well as the two potential factors of parents’ self-efficacy and outcome expectations, may offer implications for tailoring online social media resources to promote breastfeeding outcomes.

Statement of purpose Social media (SM) is ubiquitous and offers an opportunity to disseminate reliable and accurate safety recommendations to parents who are frequent social media users, yet little is known about the reach and impact of these messages on safety knowledge and behavior adoption. Methods/Approach Parents of children ( Results A total of 580 parents completed the survey. Most were female (58.6%) with high eHealth literacy (84.5%). Low eHealth literate parents used SM more frequently than high eHealth literate parents for safety information (p Conclusion Injury professionals can use SM to create and share reliable and accurate injury prevention information to large, global audiences. Using matching imagery and text helps to facilitate parental understanding of safety recommendations, regardless of eHealth literacy level of the audience. Identifying gaps in the content of SM messaging and parental understanding of messages will allow injury professionals to create and disseminate safety information to more effectively facilitate parental understanding of recommendations.

Health organizations can use visuals that support observational learning in social media. The social cognitive theory construct of observational learning illustrates how social media messages can inform health-related behavior change. In a within-subjects design, parents (n = 150) were exposed to real-world social media posts where safety recommendation text and imagery was matched (n = 3) or unmatched (n = 3). Safety topics were relevant to children age seven and younger: infant sleep, poisoning prevention, and bicycling safety. Eye tracking software captured visual attention (in milliseconds) on visual imagery and a post-experiment survey recorded correct answers to safety recommendations. Analyses examined the relationship between the match between text and imagery and visual attention. Participants spent more time on the matched image posts compared to mismatched image posts (5.3 versus 3.3 seconds

Purpose Lacrosse is one of the fastest growing sports in the United States (US). Research is limited, and there are no known studies utilizing a nationally representative data set to analyze lacrosse injury patterns in the youth population over several years. This study sought to describe the epidemiology of lacrosse-related injuries treated in United States (US) hospital emergency departments (EDs). Methods/Approach We conducted retrospective analysis using the National Electronic Injury Surveillance System data for youth aged 11–18 years who were treated for lacrosse-related injuries in US EDs from 2000–2016. Based on review of the case narratives, we created and coded a new injury mechanism variable. We generated national estimates from 6,408 cases. Results An estimated 206 274 lacrosse-related injuries to youths aged 11–18 years were treated in US EDs from 2000–2016. The rate of injuries per 10,000 youths significantly increased from 1.9 in 2000 to 5.3 in 2012 (p Conclusions Despite additional protective regulations in the sport, injuries still occur and differ by the sex and age of the athlete. This study supports the continuation, modification, and addition of rules aimed to reduce lacrosse injury risk. Significant and contribution to the field Understanding lacrosse-related injuries is critical as lacrosse-related injuries are a significant source of pediatric injury and ED utilization.

Statement of purpose We will provide information on two study branches: content analysis, showing the frequency and content of injury prevention social posts from key disseminating organizations, and eye tracking experiment, examining the textual and pictorial factors of social posts that influence visual attention and safety behaviors among parents of young children. Methods/Approach First, we conducted a quantitative content analysis (May 2018-April 2019) of Instagram posts from 22 key pediatric injury organizations. Next, parents (n=150) of young children ( Results A total of 4,598 posts were analyzed, of which 754 had a pediatric injury focus. Pediatric injury content was posted in 54% of posts from pediatric injury organizations. More posts had images than videos, but videos were more likely to show safety recommendations. Participants spent an average of 5.3 seconds on the concordant image posts compared to 3.3 seconds on the discordant image posts (p Conclusion Visual attention to posts with recommended safety behaviors attracted significantly higher visual attention and resulted in an increased recognition/identification of the optimal safety actions. Significance Identifying gaps in social media messaging and understanding how parents view these messages allows us to provide recommendations for injury prevention organizations to more effectively design and disseminate child injury prevention messages to local and global audiences.

Purpose Golf cart-related injuries are a source of morbitiy for people of all ages, especially children, and their use has increased in recent years. However, design modifications or legislation to reduce the overall burden of these injuries have been nonexistent. This study sought to characterize the epidemiology of golf cart-related injuries treated in United States (U.S.) hospital emergency departments (EDs). Methods/Approach We performed a retrospective analysis by using the National Electronic Injury Surveillance System data for patients of all ages treated in EDs (2007–2017) for a golf cart-related injury. Bivariate comparisons were conducted by using design-adjusted chi-square tests, and the strength of association was assessed by relative risks (RR) with corresponding 95% confidence intervals (CIs). Injury rates over time were analyzed by using linear regression. We generated national estimates from 3567 cases. Results From 2007–2017, an estimated 156 040 (95% CI=102 402–209 679) patients were treated in U.S. EDs for golf cart-related injuries. The average rate of traumatic brain injuries (TBIs) in children (1.62 per 100 000 children) was more than three times that of TBIs in adults (0.52 per 100 000 adults; rate ratio=3.12; 95% CI=3.05–3.20) 1.46 times that of TBIs in seniors (1.11 per 100 000 seniors; 95% CI=1.42–1.51). The injury rate in seniors increased significantly by 67.6% from 4.81 per 100 000 seniors in 2007 to 8.06 per 100 000 seniors in 2017 (slope=0.096; p=0.041). Conclusions Golf cart use remains an important source of injury for people of all ages, especially children. As use continues to increase, it is unlikely that golf cart-related injuries will decrease without substantial changes to product design, regulation, and/or legislation. Significance and Contribution to the Field Understanding the patterns of golf cart-related injuries, especially to children and seniors, is critical as their use and injuries are increasing.

Background Many unintentional injuries that occur in and around the home can be prevented through the use of safety equipment and by consistently following existing safety recommendations. Unfortunately, uptake of these safety behaviors is unacceptably low. This paper describes the design of the Make Safe Happen® smartphone application evaluation study, which aims to evaluate a mobile technology-based safety behavior change intervention on parents’ safety knowledge and actions. Methods Make Safe Happen® app evaluation study is a randomized controlled trial. Participants will be parents of children aged 0–12 years who are recruited from national consumer online survey panels. Parents will complete a pretest survey, and will be randomized to receive the Make Safe Happen® app or a non-injury-related app, and then complete a posttest follow-up survey after 1 week. Primary outcomes are: (1) safety knowledge; (2) safety behaviors; (3) safety device acquisition and use, and (4) behavioral intention to take safety actions. Results Anticipated study results are presented. Conclusions Wide-reaching interventions, to reach substantial parent and caregiver audiences, to effectively reduce childhood injuries are needed. This study will contribute to the evidence-base about how to increase safety knowledge and actions to prevent home-related injuries in children. Trial registration number NCT02751203; Pre-results. Electronic supplementary material The online version of this article (10.1186/s40621-018-0133-3) contains supplementary material, which is available to authorized users.

A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for children

OBJECTIVES:To describe the epidemiology of foreign-body ingestions (FBIs) of children METHODS:We performed a retrospective analysis using data from the National Electronic Injury Surveillance System for children RESULTS:On the basis of those cases, 759 074 children CONCLUSIONS:FBIs remain common in children

BACKGROUND Nearly half of the unintentional injuries in children happen in and around the home; many of these injuries are preventable. Providing parents and caregivers with proper injury prevention information that is easily accessible may help them make their homes safer for children. OBJECTIVE The aim of this study was to evaluate parental injury prevention awareness and home safety behaviors, motivations for and challenges to taking injury prevention and safety actions for parents as well as user experience following the use of the Make Safe Happen mobile app. METHODS A total of 40 parents with children aged 0-12 years living in Columbus, Ohio, participated in 1 of 5 focus group discussions following the completion of (1) a pretest survey, (2) use of the Make Safe Happen app, and (3) a posttest survey. RESULTS Following the use of the Make Safe Happen app, parents reported a significant increase in injury prevention awareness and completed 45% more home safety behaviors in and around their homes. Nearly all of the parents felt the app provided them with the information needed to make their home safer for their children; the great majority of parents intended to make such changes in the future. CONCLUSIONS The combination of qualitative and quantitative data collection allowed for rich data capture and provided a deeper understanding of parents’ safety knowledge, behaviors, app use, and decision making regarding child injury prevention in and around the home. The Make Safe Happen app provides the information and motivation parents and caregivers need to help them take steps to prevent child injuries that may occur in and around their homes.

Purpose To describe the epidemiology of baseball- and softball-related injuries to the wrist, hand, and fingers among children aged 5–18 years in the United States. Methods A retrospective analysis was performed by using data from the National Electronic Injury Surveillance System for children aged 5–18 years treated in emergency departments (EDs) for a baseball- or softball-related injury to the wrist, hand, or finger (2009–2015). Cases where the patient was injured playing baseball or softball were analysed (n=8,947). Player action at time of injury was coded by reviewing case narratives. Sample weights were used to calculate national estimates and rates of injuries over time were analysed using linear regression. Results An estimated 3 57 784 (95% CI: 297,464–418,104) children aged 5–18 years were treated in EDs for baseball- or softball-related injuries to the wrist, hand, or finger during the eleven-year study period. Most patients were injured playing baseball (63.8%) and were 13–15 years old (37.0%). Injuries most often occurred to fingers (54.7%) and fractures (34.4%) were the most common diagnosis. Children aged 5–9 years were 2.05 times (95% CI: 1.17–2.48) as likely to be injured while batting compared to those aged 10–18 years. Children aged 13–18 years were 1.79 times (95% CI: 1.54–2.09) as likely to be injured while sliding compared to other age groups. Injury rates significantly increased from 2005 through 2010 (p Conclusions Differences in injuries by age groups may be due to varying skill level and increased competitive play. Long-term surveillance of injuries is needed after a bat regulation change in baseball in 2011. Significance Investigating the epidemiology of baseball and softball injuries is critical in preventing sports-related injuries. Preliminary findings show that a bat regulation change in baseball has reduced injuries to the hand area and warrants continued investigation.

Purpose To describe the epidemiology of injuries associated with cribs, playpens, and bassinets among children Methods A retrospective analysis was performed by using data from the National Electronic Injury Surveillance System for children Results An estimated 90 490 (95% CI: 63,068–117,911) children Conclusions These findings demonstrate that crib-, playpen-, and bassinet-related injuries remain an important source of injury for children. The high frequency of falls highlights the potential hazards of products that children use daily. Significance Investigating the epidemiology of injuries associated with cribs, playpens, and bassinets is critical as parents rely on these products for safe sleep areas for infants and young children. Long-term surveillance of injuries is needed after crib safety standards were updated in 2011.

Background Nearly half of the unintentional injuries in children happen in and around the home; many of these injuries are preventable. Providing parents and caregivers with proper injury prevention information that is easily accessible may help them make their homes safer for children. Objective The aim of this study was to evaluate parental injury prevention awareness and home safety behaviors, motivations for and challenges to taking injury prevention and safety actions for parents as well as user experience following the use of the Make Safe Happen mobile app. Methods A total of 40 parents with children aged 0-12 years living in Columbus, Ohio, participated in 1 of 5 focus group discussions following the completion of (1) a pretest survey, (2) use of the Make Safe Happen app, and (3) a posttest survey. Results Following the use of the Make Safe Happen app, parents reported a significant increase in injury prevention awareness and completed 45% more home safety behaviors in and around their homes. Nearly all of the parents felt the app provided them with the information needed to make their home safer for their children; the great majority of parents intended to make such changes in the future. Conclusions The combination of qualitative and quantitative data collection allowed for rich data capture and provided a deeper understanding of parents' safety knowledge, behaviors, app use, and decision making regarding child injury prevention in and around the home. The Make Safe Happen app provides the information and motivation parents and caregivers need to help them take steps to prevent child injuries that may occur in and around their homes.