A mixed-methods study characterizing US caregivers' attitudes toward pediatric vehicular heatstroke interventions.

Objective: Several behavioral and technological approaches have been proposed to help prevent pediatric vehicular heatstroke (PVH), or children overheating in cars. While studies have examined technologies' efficacy in controlled settings, it remains unclear how end-users feel about adopting behavioral/technological interventions for use in the real-world. Thus, this study's objective was to characterize caregivers' attitudes toward available PVH interventions.

Methods: We conducted a national survey and focus groups with caregivers of children less than 5 years old. Both studies gathered caregivers' demographics, as well as their opinions about adopting/using broad and specific types of behavioral and technological interventions for PVH. Surveys were analyzed with descriptive statistics; focus groups were analyzed using a grounded theory approach to qualitative data.

Results: There were 1,500 survey respondents and 4 focus groups (16 participants total). Participants across studies shared similar interests in and generally positive opinions toward behavioral and technological PVH interventions, with caveats. A selection of survey findings include: (1) 90% of respondents were Somewhat or Extremely Willing to use technology that would remind them/warn them if they had left a child, (2) 58-64% would use Vehicle-based warning systems (e.g., occupant detection sensor + horn), Car seat-based warning systems (e.g., child detection sensor + siren), or Vehicle-based reminder technology (e.g., trip-based message or chime), and (3) 11% would not use any technology. Focus groups agreed generally with respondents in the survey, expanding results to state more caregivers should be aware of behavioral interventions and to raise concerns about some interventions' ease of use, amount of effort required, risk of malfunction or lack of effectiveness, maintenance, and potential cost. For example, caregivers with rear-seat check reminders believed that chimes and dash messages may be ineffective in the long-term.

Conclusions: The knowledge gained from this study can help to prioritize future PVH intervention efforts and enhance effectiveness among emerging approaches, along with informing how stakeholders may improve consumer awareness, adoption, and rates of correct usages. Based on our findings, this paper will inform ways to bolster caregivers' engagement with behavioral approaches and simultaneous use of effective and accessible technological interventions.