Effect of Multi-level Intervention on Frequency of Child Occupants’ Safe Behaviors in Iran Using Socio-ecological Model

Abstract Background This study aims to examines child occupants’ unsafe behaviors and design, implement and evaluate the multi-level intervention program using Socio-ecological model (SEM) to promote child occupants’ safe behaviors. Methods This interventional study was conducted in two educational districts of Tabriz, northwest of Iran. SEM was used in two intervention and control groups (n = 160 children per group). The intervention group received educational programs through virtual education application. Messages, images and short videos of unsafe behaviors were sent to students, teachers and parents by this application. Social support was provided through peers, parents and teachers to promote safe behaviors. Interventions were implemented at intrapersonal, interpersonal and social levels. The frequency of unsafe behaviors was examined in both groups before and after intervention. Results Behaviors of sitting in the front seat, sitting on the lap of the front passenger, standing in the back seat and sticking hands or other parts of the body out of the window decreased among children by 64.8%, 32.4%, 38% and 84% in the intervention group, respectively (vs. 27%, 23%, 7% and 30.6% in the control group, respectively). However, no statistically significant difference was observed between the two groups in the frequency of using safety seats. Conclusion Using multi-level interventions by SEM could reduce child occupants’ unsafe behaviors.