Does office-based counseling of adolescents and young adults improve self-reported safety habits? A randomized controlled effectiveness trial

Purpose: The purpose of this study was to evaluate brief physician advice regarding seatbelt and bicycle helmet use in adolescents and young adults. Methods: We recruited 200 patients ages 11-24 years presenting for all visits to a primary care clinic in the Southwestern United States from January 2000 to March 2001. Patients were randomized to control or a single 2- to 3-minute scripted motivational counseling intervention delivered by physicians with an educational brochure and discount helmet coupon. We conducted telephone follow-up evaluation at 3 months. Main outcome measures were self-reported seatbelt and bicycle helmet use assessed on a 4-point Likert scale and attitudes toward these behaviors assessed on a 5-point Likert scale and analyzed by the Wilcoxon signed-rank test. Results: For the intervention group, mean Likert scores precounseling and postcounseling for self-reported seatbelt use were 1.3 and 1.4, respectively, with a mean difference of. 04 (95% confidence interval [CI], -.1 to. 2). For self-reported bicycle helmet use, scores were 3.1 and 3.0, respectively, with a mean difference of. 1 (95% CI, -.3 to. 2). Combined mean Likert scores measuring subject's attitudes about seat belt use were 13.8 and 14.0, respectively, with a mean difference of. 2 (95% CI, -.3 to. 6). For bicycle helmet use, scores were 20.0 and 20.9, respectively, with a mean difference of. 9 (95% CI, -1.4 to 3.3). Conclusion: We were unable to detect a significant improvement in safety behaviors or attitudes by adolescents and young adults after a brief intervention by physicians during routine office visits.