Pediatric injury prevention counseling: an observational study of process and content

Objectives: To describe routine injury prevention counseling; to observe how three visit components - printed prompts. parent remarks, and parent behaviors - affect such counseling to describe the process and content of discussions about car seats as an example of routine injury prevention. Methods: A total of 128 well-child visits of children under 7 months of age to a university pediatric clinic were videotaped (76% of eligible visits). Results: Three injury topics were mentioned, on an average, per visit. Parents or caregivers rarely introduced injury topics (5%). Physicians frequently introduced those topics listed on age-specific prompting sheets (73%). Car seat counseling typically began with a physician's question (82%). Most asked simply about ownership or use (93%). Few addressed difficult issues. such as consistency of use (11%). Conclusions: Physicians bring up the injury topics that are prompted. However, most discussion is superficial, Printed prompts that address counseling process as well as content might be beneficial. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.