The Effectiveness of a Home Visit to Prevent Childhood Injury (original) (raw)
Related papers
Injury Prevention, 2005
Objective: To assess the long term effect of a home safety visit on the rate of home injury. Design: Telephone survey conducted 36 months after participation in a randomized controlled trial of a home safety intervention. A structured interview assessed participant knowledge, beliefs, or practices around injury prevention and the number of injuries requiring medical attention. Setting: Five pediatric teaching hospitals in four Canadian urban centres. Participants: Children less than 8 years of age presenting to an emergency department with a targeted home injury (fall, scald, burn, poisoning or ingestion, choking, or head injury while riding a bicycle), a non-targeted injury, or a medical illness. Results: We contacted 774 (66%) of the 1172 original participants. A higher proportion of participants in the intervention group (63%) reported that home visits changed their knowledge, beliefs, or practices around the prevention of home injuries compared with those in the non-intervention group (43%; p,0.001). Over the 36 month follow up period the rate of injury visits to the doctor was significantly less for the intervention group (rate ratio = 0.74; 95% CI 0.63 to 0.87), consistent with the original (12 month) study results (rate ratio = 0.69; 95% CI 0.54 to 0.88). However, the effectiveness of the intervention appears to be diminishing with time (rate ratio for the 12-36 month study interval = 0.80; 95% CI 0.64 to 1.00). Conclusions: A home safety visit was able to demonstrate sustained, but modest, effectiveness of an intervention aimed at improving home safety and reducing injury. This study reinforces the need of home safety programs to focus on passive intervention and a simple well defined message.
International Journal of Emergency Medicine, 2010
Background Although unintentional injuries are major causes of morbidity and mortality in less developed countries, they have received scant attention, and injury prevention policies and programs have just begun to be addressed systemically. Aims To reduce hazards associated with home injuries due to falls and ingestions through an injury prevention program administered by home visitors. Methods Non-blinded randomized controlled trial design of two interventions where one branch of the study group served as the control for the other in an urban neighborhood in Karachi, Pakistan. The study participants included 340 families with at least one child aged 3 years or less, discharged home from the Emergency Department following a visit for any reason other than an injury. The interventions included: (1) counseling to reduce falls; (2) counseling to reduce poisoning and choking. The primary outcome measure for each intervention was the relative risk of change in the home status from “unsafe” to “safe” after the intervention. Results There were 170 families in the fall prevention and 170 families in the ingestion prevention branch of the study. The percentage of homes deemed “safe” in which the families had received fall intervention counseling was 13.5% compared to 3.5% in the control group (relative risk 3.8; 95% CI: 1.5 to 10.0; p = 0.002), whereas the percentage of homes deemed “safe” in which the families had received the ingestions intervention counseling was 18.8% compared to 2.4% in the control group (relative risk 7.8; 95% CI: 2.4 to 25.3; p < 0.001). Effectiveness did not depend on education or the socioeconomic status of the study participants. The mean number of fall hazards was reduced from 3.1 at baseline to 2.4 in the fall intervention counseling group, and the mean number of ingestion hazards decreased from 2.3 to 1.9. (p < 0.001). Conclusions Our study demonstrates the effectiveness of an educational intervention aimed at improving the home safety practices of families with young children.
A Randomized Trial of a Home Safety Education Intervention Using a Safe Home Model
The Journal of Trauma: Injury, Infection, and Critical Care, 2010
Young children are at risk for injuries in the home. This study was to compare a safe house model to The Injury Prevention Program (TIPP) sheet for providing injury prevention information. Parents of children who were younger than 6 years were randomized to injury prevention education using a safe home model or an age appropriate TIPP sheet. There was a pretest before the intervention. The recall of injury prevention information was assessed by a telephone posttest 4 weeks to 6 weeks after the intervention. To obtain a sample broadly representative of community demographics, we recruited families in the dermatology clinic of a teaching hospital. We collected complete information for 371 families of which 181 were in the safe home model group and 190 were in the TIPP group. There were no differences between groups in percent minority race, education, or insurance; the parents in the safe home group were slightly older (34.4 ± 6.5 vs. 32.9 ± 5.8). More than 80% in each group had education beyond high school. There was no difference between groups in pretest scores, 8.0 ± 1.3 for the safe home model group and 8.1 ± 1.1 for the TIPP group. There was no difference between groups in posttest scores, 9.0 ± 0.8 for the safe home model group and 9.1 ± 0.9 for the TIPP group. The safe home model and the TIPP sheets were both effective in improving safety knowledge. The use of a safe home model complements current strategies to improve injury prevention knowledge.
Home injury patterns in children: A comparison by hospital sites
Paediatrics & child health
Many intervention studies typically require data from several centres to ensure adequate power. The usual intention is to pool data after testing for heterogeneity. Sites that differ in sample characteristics may, on the one hand, complicate the assessment of the intervention, but on the other hand, they may add important insights through analysis of site-specific findings. The aims of the present paper were to compare the distribution of injuries and risk factors among children participating in a five-centre study of a home-based injury prevention program, and to contrast parental injury awareness and knowledge with home safety measures. Five children's hospitals in Canada agreed to participate in a case-control study combined with a randomized controlled trial. Patients were children zero to seven years of age presenting to a hospital emergency department with a fall, burn, ingestion or choking. Two controls were matched to each case, one with another injury and another with a...
Unintentional Home Injury Prevention in Preschool Children; a Study of Contributing Factors
SBMU pulishing, 2016
Introduction: Different factors such as parents’ knowledge and attitudes regarding preventive measures (PM) have a great role in reducing children unintentional home injuries. The present study aims to evaluate the contributing factors of unintentional home injury prevention in preschool victims presented to the emergency department. Methods: The subjects consisted of all the mothers of preschool children who were presented to the emergency department of Imam Hossein and Shohadaie-Hafte-Tir Hospitals, with unintentional home injuries, from March 2011 to February 2012. The participants were divided into two groups according to implementation of preventive measures status. The significant confounding factors of PM application was determined by chi-squared test and entered into the backward multivariate logistic regression model. Results: 230 mothers with the mean age of 29.4 ± 5.2 years were evaluated. 225 (97.83%) of them were still married, 74 (32.17%) had high school education or higher, 122 (53.04%) were homemakers, and 31 (13.49%) worked outside the home for at least 8 hours daily. High level of knowledge (OR = 0.05; 95% CI: 0.002‒0.32; P = 0.002), appropriate attitude (OR = 0.12; 95% CI: 0.03‒0.51; P = 0.01), having at least three children (OR = 7.2; 95% CI: 1.1‒32.9; P = 0.04), daily absence of mother for at least 8 hours (OR = 9.2; 95% CI: 2.2‒35.46; P = 0.002), and a history of home injury during the previous 3 weeks (OR = 8.3; 95% CI: 2.1‒41.3; P = 0.001) were independent factors which influenced application of preventive measures. Conclusion: Increasing mothers’ knowledge level and improving their attitudes were facilitating factors and mothers’ absence from the house for more than 8 hours a day and having at least 3 children were obstacles to application of preventive measures. In addition, a history of same injury during the previous 3 weeks increased the risk of repeated event.
Indian Pediatrics, 2021
Objectives: To evaluate the effect of home safety supervisory program on improvement in childhood safety, self-reported home hazard of caregivers, and caregivers' supervisory attitude. Design: Randomized controlled trial. Setting and Subject: Caregivers of children between 2 to 5 years of age residing in selected villages in Karnataka. Intervention: Intervention group was administered Home safety supervisory program (HSSP), whereas the control group received teaching on child care. Results: The intervention group had a significant reduction in the frequency of childhood injuries when compared with the control group [MD (95% CI) 8.96 vs 3.37], after the administration of Home safety supervisory program. There was a significant difference in the mean baseline scores of caregivers self-reported home hazard practices between the two groups (P<0.001), and improvement in the supervisory attitudes of caregivers in the intervention group (P<0.001). Conclusion: Appropriate and effective home hazard reduction teaching reduces home injuries in children. The improved awareness of caregivers in child safety, and child supervision emphasizes the importance of this program.
Child injury: Does home matter?
Social Science & Medicine, 2016
This study examined the relationship between home risk and hospital treated injury in Australian children up to five years old. Women with children between two and four years of age enrolled in the [REMOVED] were invited to complete a Home Injury Prevention Survey from March 2013 to June 2014. A total home risk score (HRS) was calculated and linked to the child's injury related statewide hospital emergency and admissions data and [REMOVED] baseline demographic surveys. Data from 562 households relating to 566 child participants were included. We found an inverse relationship between home risk and child injury, with children living in homes with the least injury risk (based on the absence of hazardous structural features of the home and safe practices reported) having 1.90 times the injury rate of children living in high risk homes (95% CI 1.15-3.14). Whilst this appears counter-intuitive, families in the lowest risk homes were more likely to be socioeconomically disadvantaged than families in the highest risk homes (more sole parents, lower maternal education levels, younger maternal age and lower income). After adjusting for demographic and socioeconomic factors, the relationship between home risk and injury was no longer significant (p>0.05). Our findings suggest that children in socioeconomically deprived families have higher rates of injury, despite living in a physical environment that contains substantially fewer injury risks than their less deprived counterparts. Although measures to reduce child injury risk through the modification of the physical environment remain an important part of the injury prevention approach, our study findings support continued efforts to implement societal-wide, long term policy and practice changes to address the socioeconomic differentials in child health outcomes.