Child Dog Bite Prevention
Conditions
Brief summary
Dog bites result in over 800,000 doctor/ER visits, 6000 hospitalizations, and a dozen deaths each year in the United States. By a large margin, children suffer the highest risk - and children typically are bitten by familiar dogs in familiar places. Several programs exist to reduce pediatric dog bite risk, but few are empirically-supported or theoretically-motivated. None are widely disseminated. This study builds from existing child dog bite prevention programs to develop and then evaluate a website to teach children safe interactions with dogs. The website will be interactive, entertaining, and engaging, allowing children (target ages 4-6) to learn in a technologically-sophisticated and interactive environment. It will be developed based in behavioral theory. Hearkening child development theory, it will teach and permit practice of cognitive skills that develop in early childhood and are critical to safety with dogs: impulse control, perspective taking, and attention to details. Hearkening health behavior change theory, the website will help children and their parents perceive personal vulnerability to bites, recognize normative behavior to protect themselves, and have personal motivation to change previous habits. Overarching the website design will be goals to create an engaging and entertaining environment, and to facilitate cognitive and behavioral change on the part of both child and parent via multiple mechanisms. Besides teaching children, the website will educate parents via an innovative messaging system triggered by child attainment of points and skill levels. Following website development, an evaluation study will investigate usability and efficacy of the website using a repeated measures pre-test, post-test experimental design. 68 children ages 4-6 will be recruited, complete a pre-intervention assessment evaluating knowledge and behavior relevant to dog safety via multiple methods, and then be randomly assigned to use either the newly-developed dog safety website or a control pedestrian safety website at home over the subsequent 2 weeks. Frequent reminders will encourage website use. Following the 2-week period, all children will return for a post-intervention assessment battery to evaluate knowledge and behavior change. Data will be analyzed using descriptive and inferential statistics, with primary hypotheses tested using linear mixed models.
Interventions
BEHAVIORALdog safety
use of dog safety website at home for about 2 weeks
BEHAVIORALtransportation safety
use of transportation safety website at home for about 2 weeks
Sponsors
University of Alabama at Birmingham
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
4 Years to 6 Years
Healthy volunteers
Yes
Inclusion criteria
* parent and child speak English, * exposure to dogs with some frequency, * internet access at home
Exclusion criteria
* physical or disability preventing valid participation in study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Children's Behavior With Dogs on Standardized Objective Scale | post-intervention (about 2 weeks after pre-intervention assessment) | Coded behavior using objective criteria during a semi-structured interaction with a live therapy dog. Specifically, we examined behavioral patterns for 15 tasks/activities/decisions the child made with the live dog. Sample tasks were when and how the child touched the dog, the extent to which the child was close or intimate to the dog, whether the child handled the dog's toys, and whether the child interrupted the dog during its rest time. 7 of those hung together in factor analysis. Those 7 were standardized and then averaged to create the scale. It was transformed with linear transformation so all values are positive. Higher numbers indicate higher risk-taking. Theoretically the scale is 0-infinity; in practice most children scored between 0-4. The individual items had an average intercorrelation of .50 and Cronbach's alpha of .65. |
| Simulated Behavior With Dogs on Standardized Objective Scale | post-intervention (about 2 weeks after pre-intervention assessment) | Coded behavior in dollhouse simulation. Specifically, in 7 simulated scenarios using a dollhouse that included child and dog characters, furniture, yard, etc., children heard a scene and explained/used the dolls to act what would happen next. For example, the experimenter acted a child doll playing in the kitchen near dog food and the doll dog entered, saw the child, and approached the food bowl. The experimenter said, \[Child's Name\] is playing around in the kitchen near \[Dog name's\] food. \[Dog's name\] comes into the kitchen and sees \[Child's Name\] near his/her food bowl making him/her upset and start to growl. What will happen next? The task was coded using objective coding criteria to score the child's response as safe (1 point), safe but not optimal (0.5 points), or unsafe (0 points). Scores across the 7 scenarios were summed to yield a single score; possible range = 0=7. Higher scores indicate better safety. Inter-rater reliability on 30% of the sample was good; kappa = .90. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Dog Safety 2 weeks of regular use of website on child dog safety developed for this research
dog safety: use of dog safety website at home for about 2 weeks | 35 |
| Transportation Safety 2 weeks of regular use of publicly-available website on child transportation safety
transportation safety: use of transportation safety website at home for about 2 weeks | 34 |
| Total | 69 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 1 | 3 |
| Overall Study | not adherent to dog website use | 21 | 0 |
| Overall Study | Withdrawal by Subject | 1 | 0 |
Baseline characteristics
| Characteristic | Dog Safety | Transportation Safety | Total |
|---|---|---|---|
| Age, Continuous | 5.0 years STANDARD_DEVIATION 0.6 | 5.1 years STANDARD_DEVIATION 0.6 | 5.1 years STANDARD_DEVIATION 0.6 |
| Gender Female | 14 Participants | 22 Participants | 36 Participants |
| Gender Male | 21 Participants | 12 Participants | 33 Participants |
| Race/Ethnicity, Customized African American | 6 participants | 10 participants | 16 participants |
| Race/Ethnicity, Customized Caucasian | 27 participants | 19 participants | 46 participants |
| Race/Ethnicity, Customized Other | 2 participants | 5 participants | 7 participants |
| Region of Enrollment United States | 35 participants | 34 participants | 69 participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — |
| other Total, other adverse events | 0 / 35 | 0 / 34 |
| serious Total, serious adverse events | 0 / 35 | 0 / 34 |
Outcome results
Primary
Children's Behavior With Dogs on Standardized Objective Scale
Coded behavior using objective criteria during a semi-structured interaction with a live therapy dog. Specifically, we examined behavioral patterns for 15 tasks/activities/decisions the child made with the live dog. Sample tasks were when and how the child touched the dog, the extent to which the child was close or intimate to the dog, whether the child handled the dog's toys, and whether the child interrupted the dog during its rest time. 7 of those hung together in factor analysis. Those 7 were standardized and then averaged to create the scale. It was transformed with linear transformation so all values are positive. Higher numbers indicate higher risk-taking. Theoretically the scale is 0-infinity; in practice most children scored between 0-4. The individual items had an average intercorrelation of .50 and Cronbach's alpha of .65.
Time frame: post-intervention (about 2 weeks after pre-intervention assessment)
Population: In the dog safety group, only children with known noncompliance were analyzed for this measure
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dog Safety | Children's Behavior With Dogs on Standardized Objective Scale | 1.4 units on a scale | Standard Deviation 0.5 |
| Transportation Safety | Children's Behavior With Dogs on Standardized Objective Scale | 1.6 units on a scale | Standard Deviation 0.8 |
Primary
Simulated Behavior With Dogs on Standardized Objective Scale
Coded behavior in dollhouse simulation. Specifically, in 7 simulated scenarios using a dollhouse that included child and dog characters, furniture, yard, etc., children heard a scene and explained/used the dolls to act what would happen next. For example, the experimenter acted a child doll playing in the kitchen near dog food and the doll dog entered, saw the child, and approached the food bowl. The experimenter said, \[Child's Name\] is playing around in the kitchen near \[Dog name's\] food. \[Dog's name\] comes into the kitchen and sees \[Child's Name\] near his/her food bowl making him/her upset and start to growl. What will happen next? The task was coded using objective coding criteria to score the child's response as safe (1 point), safe but not optimal (0.5 points), or unsafe (0 points). Scores across the 7 scenarios were summed to yield a single score; possible range = 0=7. Higher scores indicate better safety. Inter-rater reliability on 30% of the sample was good; kappa = .90.
Time frame: post-intervention (about 2 weeks after pre-intervention assessment)
Population: In the dog safety group, only children with known noncompliance were analyzed for this measure
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dog Safety | Simulated Behavior With Dogs on Standardized Objective Scale | 3.0 units on a scale | Standard Deviation 2 |
| Transportation Safety | Simulated Behavior With Dogs on Standardized Objective Scale | 3.6 units on a scale | Standard Deviation 2.1 |