Organizational factors related to the adoption of an injury prevention program by U.S. children’s hospitals

Abstract

Most childhood injuries can be prevented with the correct use of safety devices and appropriate supervision. Children's hospitals are well positioned to promote these behaviors with evidence-based programming; however, barriers exist to adopting such programs. The purpose of this study was to describe organizational and administrative factors related to the adoption of an efficacious injury prevention (IP) program by children's hospitals in the USA. IP specialists at 232 U.S. children's hospitals were invited to complete a baseline survey, and then offered Safe N' Sound (SNS), an efficacious computer IP program targeting parents of young children. Following this promotion period, specialists were surveyed again to assess their level of SNS adoption. Organizational and administrative factors associated with SNS adoption were identified using conditional random forest models (n = 93). Random forests identified a set of six predictors with potential utility for classifying hospitals as having SNS adoption activity or not; the final pruned classification tree indicated that four of these were best able to differentiate hospitals with and without adoption activity-having a medical director, having other hospital units that provided IP programming, the number of requests the IP unit received within the past year, and the belief of administrative leaders in their responsibility to develop programming all influence decisions. Hospitals without a medical director were most likely to demonstrate adoption activity. Medical directors, or other organizational leaders, can facilitate the adoption process for evidence-based intervention, but may need to be engaged intentionally when disseminating new products, tools, or approaches.