Skip to main content
SpringerLink
Log in

An Evaluation of the Cool 2 Be Safe Program: An Evidence-Based Community-Disseminated Program to Positively Impact Children’s Beliefs About Injury Risk on Playgrounds

  • Published:
Prevention Science Aims and scope Submit manuscript

Abstract

Falls from playground equipment during play are a leading cause of injury for elementary school children. Changes to playground design and surfacing materials can reduce injury risk. However, there is also a need for intervention programs to reduce risky play behaviors by children that are associated with falls. The Cool 2 Be Safe program was developed based on past research that identified effective strategies for targeting injury beliefs that predict risk behaviors on playgrounds among individually tested elementary school children. The current study evaluated the effectiveness of delivering these activities as an integrated program and in a group format in after school programs organized by Boys and Girls Clubs of Canada. The clubs were provided all program and extensive training materials, and a webinar training session was conducted for facilitators. Observations of sessions provided data on fidelity of program delivery. Pre- and post-intervention data assessing children’s injury beliefs were collected via survey, with children participating in four structured activity sessions in small groups between premeasures and post-measures. The training materials proved to be quite effective; observational data indicated 88 % compliance with the procedures. Comparing children’s pre- and post-responses revealed positive changes in injury-risk beliefs that have been shown to predict reduced risk taking on playgrounds. This initial evaluation suggests that the Cool 2 Be Safe community program holds much promise as a means for addressing the issue of fall-risk behaviors by elementary school children on playgrounds.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Campbell, R., Starkey, F., Holliday, J., Audrey, S., Bloor, M., & Parry-Langdon, N. (2008). An informal school-based peer-led intervention for smoking prevention in adolescence (ASSIST): A cluster randomized trial. Lancet, 371, 1595–1602.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Canadian Standards Association (CSA). (2007). Children’s playspaces and equipment, CAN/CSA-Z614-07. Rexdale: CSA.

    Google Scholar 

  • Carey, M. P., Carey, K. B., Maisto, S. A., Gordon, C. M., Schroder, K. E. E., & Vanable, P. A. (2004). Reducing HIV-risk behavior among adults receiving outpatient psychiatric treatment: Results from a randomized controlled trial. Journal of Consulting and Clinical Psychology, 27, 252–268.

    Article  Google Scholar 

  • Christensen, S., & Morrongiello, B. A. (1997). The influence of peers on children’s judgments about engaging in behavior that threatens their safety. Journal of Applied Developmental Psychology, 18, 547–562.

    Article  Google Scholar 

  • Conner, M., & Norman, P. (2005). Predicting health behavior (2nd ed.). Buckingham: Open University Press.

    Google Scholar 

  • Fiissel, D., Pattison, G., & Howard, A. (2005). Severity of playground fractures: Play equipment versus standing height falls. Injury Prevention, 11, 337–339.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Friedman, R. S., & Arndt, J. (2005). Reexploring the connection between Terror Management Theory and Dissonance Theory. Personality and Social Psychology Bulletin, 31, 1217–1225.

    Article  PubMed  Google Scholar 

  • Gardner, M., & Steinberg, L. (2005). Peer influence on risk taking, risk preference, and risky decision making in adolescence and adulthood: An experimental study. Developmental Psychology, 41, 623–635.

    Article  Google Scholar 

  • Gerrard, M., Gibbons, F. X., Houlihan, A. E., Stock, M. L., & Pomery, E. A. (2008). A dual-process approach to health risk decision making: The prototype willingness model. Developmental Review, 28, 29–61.

    Article  Google Scholar 

  • Gielen, A. C., & Sleet, D. (2003). Application of behavior-change theories and methods to injury prevention. Epidemiologic Reviews, 25, 65–76.

    Article  PubMed  Google Scholar 

  • Hammond, D., Fong, G. T., McDonald, P. W., Brown, S., & Cameron, R. (2004). Graphic Canadian cigarette warning labels and adverse outcomes: Evidence from Canadian smokers. American Journal of Public Health, 94, 1442–1445.

    Article  PubMed Central  PubMed  Google Scholar 

  • Harré, N., & Coveney, A. (2000). School-based scalds prevention: Reaching children and their families. Health Education Research, 15, 191–202.

    Article  PubMed  Google Scholar 

  • Howard, A. W., MacArthur, C., Willan, A., Rothman, L., Moses-McKeag, A., & MacPherson, A. K. (2005). The effect of safer play equipment on playground injury rates among school children. Canadian Medical Association Journal, 172, 1443–1446.

    Article  PubMed Central  PubMed  Google Scholar 

  • Huchcroft, S. A., McGowan, C. R., & Mo, F. (2013). Injuries related to consumer products in Canada - a systematic literature review. Chronic Diseases and Injuries in Canada, 33(3), 175–187.

    Google Scholar 

  • Kaderavek, J. N., & Justice, L. M. (2010). Fidelity: An essential component of evidence-based practice in speech-language pathology. American Journal of Speech-Language Pathology, 19, 369–379.

    Article  PubMed  Google Scholar 

  • Kochanek, K. D., Kirmeyer, S. E., Martin, J. A., Strobino, D. M., & Guyer, B. (2012). Annual summary of vital statistics: 2009. Pediatrics, 129, 338–348.

    Article  PubMed Central  PubMed  Google Scholar 

  • La Greca, A. M., Prinstein, M. J., & Fetter, M. D. (2001). Adolescent peer crowd affiliation: Linkages with health-risk behaviors and close friendships. Journal of Pediatric Psychology, 26, 131–143.

    Article  PubMed  Google Scholar 

  • Laforest, S., Robitaille, Y., Lesage, D., & Dorval, D. (2001). Surface characteristics, equipment height, and the occurrence and severity of playground injuries. Injury Prevention, 7, 35–40.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Leitch, K. K. (2007). Reaching for the top: A report by the advisor on healthy children & youth. Retrieved from http://www.hc-sc.gc.ca/hl-vs/alt_formats/hpb-dgps/pdf/child-enfant/2007-advisor-conseillere/advisor-conseillere-eng.pdf.

  • Lesage, D., Robitaille, Y., Dorval, D., & Beaulne, G. (1995). Does play equipment conform to the Canadian standard? Canadian Journal of Public Health, 86, 279–283.

    CAS  PubMed  Google Scholar 

  • MacArthur, C., Hu, X., Wesson, D. E., & Parkin, P. C. (2000). Risk factors for severe injuries associated with falls from playground equipment. Accident Analysis and Prevention, 32, 377–382.

    Article  CAS  PubMed  Google Scholar 

  • Mack, M. G., Hudson, S., & Thompson, D. (1997). A descriptive analysis of children’s playground injuries in the United States 1990-4. Injury Prevention, 3, 100–103.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Morrongiello, B. A. (1997). Children’s perspectives on injury and close-call experiences: Sex differences in injury-outcome processes. Journal of Pediatric Psychology, 22, 499–512.

    Article  CAS  PubMed  Google Scholar 

  • Morrongiello, B. A. (2004). Do children’s intentions to risk take relate to actual risk taking? Injury Prevention, 10, 62–64.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Morrongiello, B. A., & Dawber, T. (2004). Identifying factors that relate to children’s risk-taking decisions. Canadian Journal of Behaviour Science, 36, 255–266.

    Article  Google Scholar 

  • Morrongiello, B. A., & Kiriakou, S. (2004). Mothers’ home-safety practices for preventing six types of childhood injuries: What do they do, and why? Journal of Pediatric Psychology, 20, 285–297.

    Article  Google Scholar 

  • Morrongiello, B. A., & Mark, L. (2008). “Practice what you preach”: Induced hypocrisy as an intervention strategy to reduce children’s intentions to risk take on playgrounds. Journal of Pediatric Psychology, 33, 1117–1128.

    Article  PubMed  Google Scholar 

  • Morrongiello, B. A., & Matheis, S. (2004). Determinants of children’s risk-taking in different social-situational contexts: The role of cognitions and emotions in predicting children’s decisions. Journal of Applied Developmental Psychology, 25, 303–326.

    Article  Google Scholar 

  • Morrongiello, B. A., & Matheis, S. (2007). Addressing the issue of falls off playground equipment: An empirically-based intervention to reduce fall-risk behaviors on playgrounds. Journal of Pediatric Psychology, 32, 819–830.

    Article  PubMed  Google Scholar 

  • Morrongiello, B. A., & Rennie, H. (1998). Why do boys engage in more risk taking than girls? The role of attributions, beliefs, and risk appraisals. Journal of Pediatric Psychology, 23, 33–43.

    Article  CAS  PubMed  Google Scholar 

  • Morrongiello, B. A., McArthur, B. A., Kane, A., & Fleury, R. (2013). “Only kids who are fools would do that!” Peer social norms influence children’s risk taking. Journal of Pediatric Psychology, 38, 744–755.

    Article  PubMed  Google Scholar 

  • Mott, A., Evans, R., Rolfe, K., Potter, D., Kemp, K. W., & Sibert, J. R. (1994). Patterns of injuries to children on public playgrounds. Archives of Disease in Childhood, 71, 328–330.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Mowat, D. L., Wang, F., Pickett, W., & Brison, R. J. (1998). A case-control study of risk factors for playground injuries among children in Kingston and area. Injury Prevention, 4, 39–43.

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • National Center for Injury Prevention and Control. (2001). Injury fact book 2001–2002. Atlanta: Centers for Disease Control and Prevention.

    Google Scholar 

  • National Center for Injury Prevention and Control. (2007). Web-based Injury Statistics Query Reporting System. Retrieved from http://www.cdc.gov/ncipc/wisqars.

  • O’Donnell, C. L. (2008). Defining, conceptualizing, and measuring fidelity of implementation and its relationship to outcomes in K-12 curriculum intervention research. Review of Educational Research, 78, 33–84.

    Article  Google Scholar 

  • Peterson, L., Farmer, J., & Kashani, J. H. (1990). Parental injury prevention endeavors: A function of health beliefs? Health Psychology, 9, 177–191.

    Article  CAS  PubMed  Google Scholar 

  • Peterson, L., Oliver, K. K., Brazeal, T. J., & Bull, C. A. (1995). A developmental exploration of expectations for and beliefs about preventing bicycle collision injuries. Journal of Pediatric Psychology, 20, 13–22.

    Article  CAS  PubMed  Google Scholar 

  • Phelan, K., Khoury, J., Kalkward, H., & Lamphear, B. (2001). Trends and patterns of playground injuries in United States. Ambulatory Pediatrics, 1, 227–233.

    Article  CAS  PubMed  Google Scholar 

  • Pickett, W., Carr, P. A., Mowat, D. L., & Chui, A. (1996). Playground equipment hazards and associated injuries in Kingston and area. Canadian Journal of Public Health, 87, 237–239.

    CAS  PubMed  Google Scholar 

  • Potts, R., & Swisher, L. (1998). Effects of televised safety models on children’s risk taking and hazard identification. Journal of Pediatric Psychology, 23, 157–163.

    Article  CAS  PubMed  Google Scholar 

  • Public Health Agency of Canada (2000). Summary statistics-CHIRPP database for the year 1999. Retrieved from http://www.collectionscanada.gc.ca/webarchives/20071207020413/ http://www.phac-aspc.gc.ca/injury-bles/pdf/sum1999e.pdf.

  • Safe Kids Canada. (2004). Playground safety fact sheet 2004. Retrieved from www.safekidscanada.ca

  • Schwebel, D., Summerlin, A., Bounds, M., & Morrongiello, B. A. (2006). The Stamp-in-Safety program: A behavioral intervention to reduce behaviors that can lead to unintentional playground injury in a preschool setting. Journal of Pediatric Psychology, 31, 152–162.

    Article  PubMed  Google Scholar 

  • Shanon, A., Bashaw, B., Lewis, J., & Feldman, W. (1992). Nonfatal childhood injuries: A survey at the Children’s Hospital of Eastern Ontario. Canadian Medical Association Journal, 14, 361–365.

    Google Scholar 

  • Stanton, B., Cole, M., Galbraith, J., Li, X., Pendleton, S., & Cottrel, L. (2004). Randomized trial of a parent intervention: Parents can make a difference in long-term adolescent risk behaviors, perceptions, and knowledge. Archives of Pediatrics and Adolescent Medicine, 158, 947–955.

    Article  PubMed  Google Scholar 

  • Tucker, R. N., & Healy, S. (2006). Safe kids Canada: Playgrounds safety and standards. Retrieved from www.sickkids.ca/SKCForPartners?custom?PlaygrdSafetyandStandardsFeb06.pdf.

  • World Health Organization (WHO). (2005). Child and adolescent injury prevention: A global call to action. Geneva: WHO.

    Google Scholar 

Download references

Acknowledgments

The authors extend their thanks to Pamela Fuselli (Vice President of Government & Stakeholder Relations at Parachute-formerly Safe Kids Canada) and Denise Silverstone (Director, National Programs and Services, Boys and Girls Clubs of Canada) for helping to make this research happen, the staff at the Boys and Girls Clubs of Canada for their care in the program delivery, and the children for their enthusiastic participation. The first author was supported by a Canada Research Chair award. The second author received a doctoral scholarship, and this research was funded by a grant to the first author, from the Canadian Institutes for Health Research. Reprint requests can be sent to bmorrong@uoguelph.ca or to her attention at the Psychology Department, University of Guelph, Guelph, ON N1G 2 W1, Canada.

Author information

Authors and Affiliations

  1. Psychology Department, University of Guelph, MacKinnon Building–Trent Lane, Guelph, ON, N1G 2W1, Canada

    Barbara A. Morrongiello & Alexa Kane

Authors
  1. Barbara A. Morrongiello
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexa Kane
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Barbara A. Morrongiello.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Morrongiello, B.A., Kane, A. An Evaluation of the Cool 2 Be Safe Program: An Evidence-Based Community-Disseminated Program to Positively Impact Children’s Beliefs About Injury Risk on Playgrounds. Prev Sci 16, 61–69 (2015). https://doi.org/10.1007/s11121-014-0484-0

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11121-014-0484-0

Keywords

Search

Navigation