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An J, Ko Y, Yang H. Comparison of pediatric poisoning patterns before and during the COVID-19 pandemic in South Korea. PLoS One 2024; 19:e0309016. [PMID: 39150910 PMCID: PMC11329157 DOI: 10.1371/journal.pone.0309016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 08/03/2024] [Indexed: 08/18/2024] Open
Abstract
OBJECTIVE To investigate the epidemiological changes in emergency department (ED), including changes in toxic substances and ED outcomes in pediatric and adolescent patients who visited the EDs before and during the COVID-19 pandemic. METHODS This cross-sectional observational study used data from the ED-based Injury In-depth Surveillance from 2017 to 2021 in South Korea (SK). The study population comprised patients aged <19 years who visited 23 EDs because of poisoning before and during the COVID-19 outbreak. We divided the study period into pre-COVID-19 (January 2017 to February 2020) and COVID-19 periods (March 2020 to December 2021). RESULTS In total, 5862 patients were included in the final analysis, with 3863 and 1999 in the pre-COVID-19 and COVID-19 periods, respectively. The patients' mean age increased from 8.3 ± 7.1 to 11.2 ± 6.9 years between the pre-COVID-19 and COVID-19 periods (P < 0.001), and the number of adolescents (aged 13-18 years) significantly increased during the COVID-19 period (1653 [42.8%] vs. 1252 [62.6%]; P < 0.001). The number of intentional poisoning cases increased from 1332 (34.5%) before COVID-19 to 1174 (58.7%) during COVID-19 (P < 0.001). Specifically, pharmaceutical poisoning significantly increased during the COVID-19 period (2242 [58.0%] vs. 1443 [72.2%]; P < 0.001), with central nervous system (CNS) drug poisoning being the most common type (780 [34.8%] vs. 747 [51.8%]; P < 0.001). Among the intentional poisoning cases, pharmaceutical substance use significantly increased during the COVID-19 period (1207 [90.6%] vs. 1102 [93.9%]; P = 0.007). We used Bayesian structural time series (BSTS) forecasting models to forecast the number of ED visits during COVID-19. The total number of pediatric patients with poisoning decreased during the COVID-19 pandemic. However, when using the BSTS forecasting model, the decrease in the number of patients was not significant. Furthermore, the forecasting models showed no statistically significant increase in the number of intentional pediatric poisoning cases. CONCLUSIONS The previous studies suggested a decrease in the total number of patients with poisoning but an increase in intentional poisoning cases during the COVID-19 pandemic. By using similar methods to those of previous studies, our results also reached the same conclusion. However, the BSTS model, which predicts real-world time series patterns, seasonal effects, and cumulative effects, shows no significant change in pediatric poisoning patterns during the COVID-19 pandemic.
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Affiliation(s)
- Juho An
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Yura Ko
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, South Korea
| | - Heewon Yang
- Department of Emergency Medicine, Ajou University School of Medicine, Suwon, South Korea
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Curci SG, Gallegos JV. Commentary: Prevention of Unintentional Injury During Preschool: Consideration of Risky Play and Superhero Identification. J Pediatr Psychol 2024; 49:244-246. [PMID: 38031475 DOI: 10.1093/jpepsy/jsad091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/19/2023] [Accepted: 11/20/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Sarah G Curci
- Department of Psychology, Arizona State University, USA
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McCart M, Glang A, Kelley K, Perez A, Minor D, Hitchcock JW, Miles L, Schwebel DC. Pilot evaluation of a virtual training program for child injury prevention. HEALTH EDUCATION RESEARCH 2023; 38:268-275. [PMID: 36919955 DOI: 10.1093/her/cyad013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 05/24/2023]
Abstract
Unintentional injuries are a leading cause of child death. The present study evaluated the effectiveness of a behavioral injury prevention program for children aged 3-18 years and their caregivers. To accommodate families during the Coronavirus-19 pandemic, training was modified to be delivered virtually. Forty-one children aged 3-18 years and 14 parents/caregivers of children aged 3-5 years attended one of several 4-hour online injury prevention training sessions directed toward residents of Washington state. Training was targeted to three different developmental stages (ages 3-5, 6-12 and 13-18 years). Study outcomes included knowledge about injury prevention strategies, perceived vulnerability for injury, self-efficacy to engage in safety behaviors and behavioral intentions to be safe. Following training, participants showed improved self-efficacy to stay safe, excellent knowledge about the learned material and increased behavioral intention to engage safely. There was minimal change in perceived vulnerability to injury among children; caregivers of young children felt their children were somewhat less vulnerable to injury following the training. Almost all participants said they would recommend the program to others. Results suggest that a virtual behavioral training program delivered remotely is feasible and may be effective to create behavior change and reduce child injury risk. Given its scalability and reach, such programs are recommended for further study, refinement and, if demonstrated effective in larger-scale controlled trials, dissemination to address the leading cause of child mortality in the United States, unintentional injury.
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Affiliation(s)
- M McCart
- Department of Psychology, University of Oregon, 1585 E 13th Ave, Eugene, OR 97403, USA
| | - A Glang
- Department of Psychology, University of Oregon, 1585 E 13th Ave, Eugene, OR 97403, USA
| | - K Kelley
- Department of Psychology, University of Oregon, 1585 E 13th Ave, Eugene, OR 97403, USA
| | - A Perez
- Department of Psychology, University of Oregon, 1585 E 13th Ave, Eugene, OR 97403, USA
| | - D Minor
- Washington State Department of Social and Health Services, 800 NE 136th Ave #110, Bremerton, WA 98312, USA
| | - J W Hitchcock
- Washington State Department of Health, 11 Israel Rd SE, Tumwater, WA 98501, USA
| | - L Miles
- Washington State Department of Social and Health Services, 800 NE 136th Ave #110, Bremerton, WA 98312, USA
| | - D C Schwebel
- Department of Psychology, University of Alabama at Birmingham, 745 Hackberry Ln, Birmingham, AL 35233, USA
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Kawahara T, Doi S, Isumi A, Ochi M, Fujiwara T. Interventions to change parental parenting behaviour to reduce unintentional childhood injury: a randomised controlled trial. Inj Prev 2023; 29:126-133. [PMID: 36368911 DOI: 10.1136/ip-2022-044721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 10/22/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The previous study has shown the impact of paternal involvement in childcare on unintentional childhood injury; yet the causality is unknown. The purpose of this study is to investigate whether the intervention of an educational video on paternal involvement in childcare can prevent unintentional injury among young children. METHODS A randomised controlled trial of parents of children born at two obstetrics wards in Japan (n=451, intervention group: 223, control group: 228) was conducted. Parents in the intervention group watched an educational video that promote paternal involvement in childcare, while parents in the control group watched an educational video on the prevention of shaken baby syndrome. The participants were followed for up to 18 months after the birth of their child. The primary outcome of this study was unintentional injury at 3, 6, 12 and 18 months. The secondary outcome was paternal involvement in childcare based on maternal observation. Unintentional injury-free rates over time were assessed using the Cox proportional hazard model. RESULTS Children in the intervention group were less likely to have unintentional injury, such as burn (HR: 0.29 (95% CI: 0.09 to 0.87)) and caught by a door (HR: 0.66 (95% CI: 0.48 to 0.91)) compared with the control group. Fathers in the intervention group showed higher frequency of taking their children for a walk (coefficient: 0.19 (95% CI: 0.05 to 0.32)). CONCLUSIONS Educational videos promoting paternal involvement in childcare is effective to prevent unintentional childhood injury.
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Affiliation(s)
- Tomoki Kawahara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
| | - Satomi Doi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
| | - Manami Ochi
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Department of Health and Welfare Services, National Institute of Public Health, Wako, Japan
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
- Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Japan
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Helfrich ET, Saraiva CM, Chimiak JM, Nochetto M. A review of 149 Divers Alert Network emergency call records involving diving minors. Diving Hyperb Med 2023; 53:7-15. [PMID: 36966517 PMCID: PMC10318175 DOI: 10.28920/dhm53.1.7-15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 12/08/2022] [Indexed: 03/29/2023]
Abstract
INTRODUCTION Minors have been scuba diving for decades, and while the initial concerns about potential long-term complications related to bone development appear to be unfounded, the incidence of scuba diving injuries among them has been poorly studied. METHODS We reviewed 10,159 cases recorded in the DAN Medical Services call centre database from 2014 through 2016 and identified 149 cases of injured divers younger than 18 years. Records were analysed for case categorisation on the most common dive injuries. Information about demographics, level of training, risk factors, and relevant behavioural aspects were collected when available. RESULTS While the most common reason for the call was to rule out decompression sickness, the majority of cases pertained to ear and sinus issues. However, 15% of the dive-related injuries involving minors had a final diagnosis of pulmonary barotrauma (PBt). While no reliable data is available on the incidence of PBt in adult divers, the authors' impression based on personal experience suggests that the number of cases of PBt in minors trends higher than in the general diving population. The narratives on some relevant records describe unmanageable levels of anxiety leading to panic. CONCLUSIONS Based on the results and narratives on these cases, it is reasonable to infer that psychological immaturity, suboptimal management of adverse situations, and inadequate supervision might have led to severe injuries among these minor divers.
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Affiliation(s)
| | | | | | - Matias Nochetto
- Divers Alert Network, Durham (NC), USA
- Corresponding author: Dr Matias Nochetto, Vice President, Medical Services, Divers Alert Network, Durham NC, USA
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Unintentional injuries and potential determinants of falls in young children: Results from the Piccolipiù Italian birth cohort. PLoS One 2022; 17:e0275521. [PMID: 36191030 PMCID: PMC9529104 DOI: 10.1371/journal.pone.0275521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 09/19/2022] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES Unintentional injuries such as falls, are particularly frequent in early childhood. To date, epidemiological studies in this field have been carried out using routine data sources or registries and many studies were observational studies with a cross-sectional design. The aims of the study are to describe unintentional injuries in the first two years of life in the Piccolipiù birth cohort, and to investigate the association between mother and children characteristics and the First Event of Raised surface Fall (FERF). METHODS This longitudinal observational study included 3038 children from an Italian birth cohort. Data on socio-demographic factors, socio-economic indicators, maternal health and lifestyle characteristics and child's sleeping behavior, obtained from questionnaires completed at birth, 12 and 24 months of age, were considered in the analyses as potential risk factors of FERF. Time of occurrence of FERF was analyzed using the Kaplan-Meier method. The multivariable analysis for time to event was carried out using a Cox proportional hazards model. RESULTS Falls from raised surfaces are the leading cause of unintentional injuries in the cohort with 610 (21.1%) and 577 (20.0%) cases among children during the first and second year of life, respectively. An increased risk of FERF was associated with several risk factors: maternal psychological distress (HR 1.41, 95%CI 1.10-1.81), maternal alcohol intake (HR 1.26, 95%CI 1.10-1.45), and child's sleeping problems (HR 1.28, 95%CI 1.09-1.51). Children with older aged mothers (HR 0.98, 95%CI 0.96-0.99) and living in northern Italy (HR 0.64, 95%CI 0.55-0.75) had a lower risk of FERF. CONCLUSION The results of the study suggest that a higher risk of FERF is associated with socio-demographic factors, maternal characteristics and child sleeping behavior that could hinder parent empowerment.
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Lee WS, Lee KS, Ha EK, Kim JH, Shim SM, Lee SW, Han MY. Effect of parental supervision of infants at age 4 to 6 months on injuries at age 4 to 12 months. Sci Rep 2022; 12:10252. [PMID: 35715479 PMCID: PMC9205875 DOI: 10.1038/s41598-022-14321-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 06/06/2022] [Indexed: 11/09/2022] Open
Abstract
This study analyzed the effect of parental supervision of infants at age 4 to 6 months on injuries at age 4 to 12 months. Among all Korean children born during 2008-2009, 464,326 (50.6%) infant had parents who responded to a questionnaire that surveyed their safety and supervision when infant were 4 to 6 months-old. Based on questionnaire score, infant were divided into "safe" or "unsafe" group. 1:1 propensity score matching was used to balance the groups, and injury diagnosis and treatments were analyzed. After matching, we examined the records of 405,862 infant. The unsafe group had significantly increased risk ratios (RRs) for injury of head/neck (RR: 1.06), trunk/abdominopelvic region (RR: 1.12), upper extremities (RR: 1.04), and from burn and frostbite (RR: 1.10). The risks of a wound and fracture and foreign body injury were significantly greater in infant whose parents sometimes left them alone (RR: 1.15 and 1.06, respectively), and whose parents did not always keep their eyes on them (RR: 1.04 and 1.13, respectively). Infant whose parents had a hot drink when carrying them had an increased risk of burn injuries (RR: 1.21). Injuries were less common in infant whose parents provided more supervision.
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Affiliation(s)
- Won Seok Lee
- Department of Pediatrics, CHA Ilsan Medical Center, CHA University, Goyang, Republic of Korea.,Department of Data Science, Sejong University College of Software Convergence, 209, Neungdong-ro, Gwangjin-gu, Seoul, 05006, Republic of Korea
| | - Kyung Suk Lee
- Department of Pediatrics, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Republic of Korea
| | - Eun Kyo Ha
- Department of Pediatrics, Hallym University Kangnam Sacred Heart Hospital, Seoul, Republic of Korea
| | - Ju Hee Kim
- Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - So Min Shim
- Department of Data Science, Sejong University College of Software Convergence, 209, Neungdong-ro, Gwangjin-gu, Seoul, 05006, Republic of Korea
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, 209, Neungdong-ro, Gwangjin-gu, Seoul, 05006, Republic of Korea. .,Department of Precision Medicine, Sungkyunkwan University School of Medicine, Suwon, Republic of Korea.
| | - Man Yong Han
- Department of Pediatrics, School of Medicine, CHA Bundang Medical Center, CHA University, 59, Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggi-do, 13496, Republic of Korea.
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Chen M, Chan KL. Effectiveness of Digital Health Interventions on Unintentional Injury, Violence, and Suicide: Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2022; 23:605-619. [PMID: 33094703 DOI: 10.1177/1524838020967346] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Digital technologies are increasingly used in health-care delivery and are being introduced into work to prevent unintentional injury, violence, and suicide to reduce mortality. To understand the potential of digital health interventions (DHIs) to prevent and reduce these problems, we conduct a meta-analysis and provide an overview of their effectiveness and characteristics related to the effects. We searched electronic databases and reference lists of relevant reviews to identify randomized controlled trials (RCTs) published in or before March 2020 evaluating DHIs on injury, violence, or suicide reduction. Based on the 34 RCT studies included in the meta-analysis, the overall random effect size was 0.21, and the effect sizes for reducing suicidal ideation, interpersonal violence, and unintentional injury were 0.17, 0.24, and 0.31, respectively, which can be regarded as comparable to the effect sizes of traditional face-to-face interventions. However, there was considerable heterogeneity between the studies. In conclusion, DHIs have great potential to reduce unintentional injury, violence, and suicide. Future research should explore DHIs' successful components to facilitate future implementation and wider access.
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Affiliation(s)
- Mengtong Chen
- Department of Social Work, 26679Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ko Ling Chan
- Department of Applied Social Sciences, 26680The Hong Kong Polytechnic University, Hunghom, Hong Kong
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Ma X, Zhang Q, Jiang R, Lu J, Wang H, Xia Q, Zheng J, Deng W, Chang F, Li X. Parents' attitudes as mediators between knowledge and behaviours in unintentional injuries at home of children aged 0-3 in Shanghai, Eastern China: a cross-sectional study. BMJ Open 2021; 11:e054228. [PMID: 34949628 PMCID: PMC8712987 DOI: 10.1136/bmjopen-2021-054228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Parental behaviours are important in preventing unintentional injury at home among young children. Previous research showed an inconsistent relationship between knowledge and behaviours, indicating that the mechanisms may vary for different behaviours. This study aimed to examine the mediating roles of different attitudes in the mechanism of knowledge acting on different behaviours. DESIGN Cross-sectional study. SETTING Eastern China. PARTICIPANTS Participants were recruited using stratified community-based sampling. A total of 488 parents of children aged 0-3 years participated in the study and 476 (97.5%) valid questionnaires were recovered. PRIMARY OUTCOME MEASURES Parents' knowledge, attitudes (including injury attribution, preventability and responsibility) and behaviours (including supervision behaviours, risky behaviours and providing a safe home environment). RESULTS The results of mediation analysis showed that the mediator variables were different for different behaviours and that all associations were positive. Parents' knowledge (β 0.19, 95% CI 0.13 to 0.24) and attitude of injury attribution (β 0.37, 95% CI 0.21 to 0.46) were directly associated with risky behaviours. Attitude of preventability was directly associated with parents' supervision behaviour (β 0.27, 95% CI 0.14 to 0.40). Parents' attitude of preventability mediated the positive association between knowledge, attitudes of injury attribution and responsibility, and supervision behaviours, as well as providing a safe home environment. In addition, the occurrence of child injuries at home was directly associated with home environment (β -0.41, 95% CI -0.82 to -0.01). CONCLUSIONS The current findings confirm that attitudes play varying mediating roles between knowledge and different behaviours. An important recommendation is that parents' attitudes, especially towards preventability and responsibility, need to be considered when health providers develop health education programmes targeted at improving parental supervision behaviours and providing a safe home environment.
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Affiliation(s)
- Xueqi Ma
- School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability, Fudan University, Shanghai, China
| | - Qi Zhang
- School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA
| | - Ruo Jiang
- School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability, Fudan University, Shanghai, China
| | - Jun Lu
- School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability, Fudan University, Shanghai, China
| | - Huiping Wang
- Preventive Health Department, Community Health Centre of Jiading Town, Shanghai, China
| | - Qinghua Xia
- Chronic Disease Prevention and Control Department, Changning District Center for Disease Control and Prevention, Shanghai, China
| | - Jicui Zheng
- Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai, China
| | - Wei Deng
- School of Public Health, Fudan University, Shanghai, China
| | - Fengshui Chang
- School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability, Fudan University, Shanghai, China
| | - Xiaohong Li
- School of Public Health, Fudan University, Shanghai, China
- China Research Center on Disability, Fudan University, Shanghai, China
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George A, G R, Shetty S. Effect of a Home Safety Supervisory Program on Occurrence of Childhood Injuries: A Cluster Randomized Controlled Trial. Indian Pediatr 2021. [DOI: 10.1007/s13312-021-2238-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Adderley H, Wittkowski A, Calam R, Gregg L. Adult mental health practitioner beliefs about psychosis, parenting, and the role of the practitioner: A Q methodological investigation. Psychol Psychother 2020; 93:657-673. [PMID: 31448869 PMCID: PMC7687147 DOI: 10.1111/papt.12249] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/27/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVES There is a lack of research into parenting interventions for families which include a parent experiencing psychosis or other serious mental illness (SMI). Preliminary findings highlight the potential benefits of adult mental health practitioners supporting parents experiencing SMI by using self-directed parenting interventions. This study explored beliefs relating to parenting and psychosis held by practitioners working in adult mental health settings, specifically examining their beliefs about the parenting needs of adults experiencing psychosis who have dependent children, as well as their role as adult mental health practitioners. DESIGN This study used Q methodology to explore the beliefs of mental health practitioners on psychosis and parenting. METHODS Twenty-one adult mental health practitioners ranked 58 items according to how much they agreed with the belief statement presented. Participants also provided additional written information and interviews to contextualize the Q methodology data. RESULTS Three factors emerged representing three groups of practitioners with similar beliefs around psychosis and parenting. Factors were labelled: 'Parenting interventions are worthwhile, and I'd deliver them', 'Parenting interventions are worthwhile, but I'm not confident to deliver them', and 'Parenting interventions might be worthwhile, but it's not my responsibility'. CONCLUSION Using parenting interventions as part of their clinical work was acceptable to most practitioners; however, some lacked confidence in their ability to work in a family-focused way. Efforts now need to focus on enhancing practitioners' skill, knowledge, and confidence in family-focused approaches to provide increased and improved support to families which include a parent experiencing psychosis or other SMI. PRACTITIONER POINTS Parenting interventions need to be made more available and accessible to parents experiencing serious mental illness (SMI), such as psychosis. Adult mental health practitioners are willing to incorporate parenting interventions into their work with parents accessing their services, but some lack confidence to do this. These results highlight the importance of equipping practitioners with the skill, knowledge, and confidence to engage in family-focused approaches. Further research needs to involve parents experiencing SMI as well practitioners working in adult mental health services.
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Affiliation(s)
| | | | - Rachel Calam
- School of Health SciencesUniversity of ManchesterUK
| | - Lynsey Gregg
- School of Health SciencesUniversity of ManchesterUK
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Hakoum MB, Bou-Karroum L, Al-Gibbawi M, Khamis AM, Raslan AS, Badour S, Agarwal A, Alturki F, Guyatt G, El-Jardali F, Akl EA. Reporting of conflicts of interest by authors of primary studies on health policy and systems research: a cross-sectional survey. BMJ Open 2020; 10:e032425. [PMID: 32690493 PMCID: PMC7371338 DOI: 10.1136/bmjopen-2019-032425] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES The objective of this study was to assess the frequency and types of conflict of interest (COI) disclosed by authors of primary studies of health policy and systems research (HPSR). DESIGN We conducted a cross-sectional survey using standard systematic review methodology for study selection and data extraction. We conducted descriptive analyses. SETTING We collected data from papers published in 2016 in 'health policy and service journals' category in Web of Science database. PARTICIPANTS We included primary studies (eg, randomised controlled trials, cohort studies, qualitative studies) of HPSR published in English in 2016 peer-reviewed health policy and services journals. OUTCOME MEASURES Reported COI disclosures including whether authors reported COI or not, form in which COI disclosures were provided, number of authors per paper who report any type of COI, number of authors per paper who report specific types and subtypes of COI. RESULTS We included 200 eligible primary studies of which 132 (66%) included COI disclosure statements of authors. Of the 132 studies, 19 (14%) had at least one author reporting at least one type of COI and the most frequently reported type was individual financial COI (n=15, 11%). None of the authors reported individual intellectual COIs or personal COIs. Financial and individual COIs were reported more frequently compared with non-financial and institutional COIs. CONCLUSION A low percentage of HPSR primary studies included authors reporting COI. Non-financial or institutional COIs were the least reported types of COI.
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Affiliation(s)
- Maram B Hakoum
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | - Lama Bou-Karroum
- Center for Systematic Reviews for Health Policy and Systems Research, American University of Beirut, Beirut, Lebanon
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | | | - Assem M Khamis
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
| | | | - Sanaa Badour
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Arnav Agarwal
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Fadel Alturki
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Fadi El-Jardali
- Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Knowledge to Policy (K2P) Center, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Elie A Akl
- Clinical Research Institute, American University of Beirut, Beirut, Lebanon
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
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Rajan S, Navaneetham J, Philip M, Muralidhar D. Young adults' perception of parenting style: A retrospective exploration. SOCIAL HEALTH AND BEHAVIOR 2020. [DOI: 10.4103/shb.shb_48_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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14
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Helton JJ, Weaver NL. Unintentional child injury in child welfare placements. CHILD ABUSE & NEGLECT 2020; 99:104231. [PMID: 31726245 DOI: 10.1016/j.chiabu.2019.104231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 09/30/2019] [Accepted: 10/11/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Child welfare professionals are charged with protecting children from non-accidental caregiving behaviors resulting in intentional injuries as well as environmental risks and parenting behaviors resulting in unintentional injuries. Yet little is known about unintentional injury prevalence and risk factors by child welfare placement type. OBJECTIVE To examine factors related to unintentional child injury requiring medical attention, including child welfare placement type, child behavioral problems, caregiver characteristics, and neighborhood factors. METHODS Data from the second and third wave of the 2010 National Survey of Child and Adolescent Well-Being (NSCAW II) were used. Stable child welfare placements between waves 2 and 3 included investigated biological, reunified, adopted, licensed and unlicensed kin, and nonkin foster homes. Logistic regression analysis modeled injury as a function of placement type while controlling for other covariates. Interaction effects between placement and child behavioral scores were also modeled. RESULTS Children with more behavioral problems were at greater odds of an injury (OR = 1.05, p < .01) compared to children with fewer behavioral problems. However, interaction models showed that children with more behavioral problems were at decreased odds of injury if living with unlicensed kin (OR = .91, p < .05), licensed kin (OR = .92, p < .001), or foster care (OR = .92, p < .001) compared to biological homes. CONCLUSION The absence of a behavioral problem was associated with higher risk of injury for children placed in foster care. More research is needed to better understand injury type, prevalence and specific risk factors.
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Affiliation(s)
- Jesse J Helton
- College of Public Health and Social Justice, St. Louis University, St. Louis, MO, United States.
| | - Nancy L Weaver
- College of Public Health and Social Justice, St. Louis University, St. Louis, MO, United States
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Garg P, Eastwood J, Liaw ST. A Realist Synthesis of Literature Informing Programme Theories for Well Child Care in Primary Health Systems of Developed Economies. Int J Integr Care 2019; 19:5. [PMID: 31367204 PMCID: PMC6659757 DOI: 10.5334/ijic.4177] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 07/10/2019] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Well-child Care is the provision of preventative health care services for children and their families. The approach, however, to the universal provision of those services is contentious. METHODS We undertook a realist synthesis to enhance understanding of the theoretical mechanisms driving Well-child Care by searching for published and grey literature from multiple databases. FINDINGS Well-child Care is re-conceptualised as an integrated program delivered in the continuum of pregnancy, infancy and childhood. Depending on the context, Well-child Care can be a policy, a strategy, or an actual clinical practice that promotes child and family health. The main mechanisms include: role, training and continuity of health providers; administrators' views of the return of investment on achieved outcomes; access to services by families; and the adaptation of programs to meet the dynamic needs of stakeholders. Evidence indicates that for most outcomes, Well-child Care is best delivered in partnerships between community health, social care, and early childhood education sectors. CONCLUSIONS We conclude that Well-child Care policy and program leaders should shift their focus to the integration of: human and physical resources; policy instruments; and shared agreement on outcomes measures across health, social and education sectors. In addition, countries should work towards strengthening universal early education programs and parents' health literacy regarding child development, health and safety.
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Affiliation(s)
- Pankaj Garg
- Department of Community Paediatrics, Liverpool Hospital, Liverpool, NSW, AU
- Specialist Disability Health Team, South Western Sydney Local Health District, NSW, AU
- South Western Sydney Local Health District, NSW, AU
- Ingham Institute of Applied Medical Research, Liverpool, NSW, AU
- School of Women’s and Children’s Health, University of New South Wales (UNSW), AU
| | - John Eastwood
- Ingham Institute of Applied Medical Research, Liverpool, NSW, AU
- School of Women’s and Children’s Health, University of New South Wales (UNSW), AU
- School of Public Health, University of Sydney, Sydney, NSW, AU
- School of Public Health, Griffith University, Gold Coast, QLD, AU
- Department of Community Paediatrics, Sydney Local Health District, Croydon, NSW, AU
- School of Public Health and Community Medicine, UNSW, AU
| | - Siaw-Teng Liaw
- Ingham Institute of Applied Medical Research, Liverpool, NSW, AU
- School of Public Health and Community Medicine, UNSW, AU
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BAYRAM T, ILGIN C, KULBAY H, TOZAKOGLU B, KARADUMAN İ, COLAK BC, SAVE D. The Factors associated with mothers’ preventive measures against home accidents: a descriptive study from Istanbul, Turkey. CLINICAL AND EXPERIMENTAL HEALTH SCIENCES 2019. [DOI: 10.33808/clinexphealthsci.564220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Sever A, Essa-Hadad J, Luder A, Weiss O, Agay-Shay K, Rudolf M. Keeping children safe: a model for predicting families at risk for recurrent childhood injuries. Public Health 2019; 170:10-16. [PMID: 30897384 DOI: 10.1016/j.puhe.2019.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 10/24/2018] [Accepted: 02/04/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Existing research on recurrent unintentional injury (UI) focuses on the individual child rather than family risks. This study developed a statistical model for identifying families at highest risk, for potential use in targeting public health interventions. STUDY DESIGN A retrospective birth cohort study of hospital and emergency room (ER) medical records of children born in Ziv hospital between 2005 and 2012, attending ER for UI between 2005 and 2015, was conducted. METHODS Using national IDs, we assigned children to mothers and created the family entity. Data were divided into two time periods. Negative binomial regression was used to examine predictive factors in the first period for recurrent child UI in the second period. Sensitivity analyses were conducted to examine the model's robustness. RESULTS Eight predictive factors for child injury (P < 0.05) were found: male gender, the number of UI visits, the number of illness visits, age 36-59 months, birth weight <1500 g, maternal ER visits, siblings' UI visits, and the number of younger siblings. Some predictive factors are documented in the literature; others are novel. Five were significant in all sensitivity analyses. CONCLUSIONS These factors can assist in predicting risk for a child's repeat UI and family's cumulative UI risk. The model may offer a valuable and novel approach to targeting interventions for families at highest risk.
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Affiliation(s)
- A Sever
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, POB 1589, Henrietta Szold 8 Safed 1311502, Israel.
| | - J Essa-Hadad
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, POB 1589, Henrietta Szold 8 Safed 1311502, Israel.
| | - A Luder
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, POB 1589, Henrietta Szold 8 Safed 1311502, Israel; Department of Pediatrics, Ziv Medical Center, Safed, Israel.
| | - O Weiss
- Beterem - Safe Kids, Pitah Tikva, Israel.
| | - K Agay-Shay
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, POB 1589, Henrietta Szold 8 Safed 1311502, Israel.
| | - M Rudolf
- Department of Population Health, Azrieli Faculty of Medicine, Bar Ilan University, POB 1589, Henrietta Szold 8 Safed 1311502, Israel.
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Barcelos RS, Del-Ponte B, Santos IS. Interventions to reduce accidents in childhood: a systematic review. J Pediatr (Rio J) 2018; 94:351-367. [PMID: 29291398 DOI: 10.1016/j.jped.2017.10.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Revised: 09/19/2017] [Accepted: 09/27/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE To review the literature on interventions planned to prevent the incidence of injuries in childhood. SOURCE OF DATA The PubMed, Web of Science, and Bireme databases were searched by two independent reviewers, employing the single terms accidents, accident, injuries, injury, clinical trial, intervention, educational intervention, and multiple interventions, and their combinations, present in the article title or abstract, with no limits except period of publication (2006-2016) and studies in human subjects. SYNTHESIS OF DATA Initially, 11,097 titles were located. Fifteen articles were selected for the review. Eleven were randomized trials (four carried out at the children's households, five in pediatric healthcare services, and two at schools), and four were non-randomized trials carried out at the children's households. Four of the randomized trials were analyzed by intention-to-treat and a protective effect of the intervention was observed: decrease in the number of risk factors, decrease in the number of medical consultations due to injuries, decrease in the prevalence of risk behaviors, and increase of the parents' knowledge regarding injury prevention in childhood. CONCLUSION Traumatic injuries in childhood are amenable to primary prevention through strategies that consider the child's age and level of development, as well as structural aspects of the environment.
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Affiliation(s)
- Raquel S Barcelos
- Universidade Federal de Pelotas (UFPel), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil.
| | - Bianca Del-Ponte
- Universidade Federal de Pelotas (UFPel), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil
| | - Iná S Santos
- Universidade Federal de Pelotas (UFPel), Departamento de Medicina Social, Programa de Pós-graduação em Epidemiologia, Pelotas, RS, Brazil
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Interventions to reduce accidents in childhood: a systematic review. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2018.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Machin AI, Ngamsuoy A, Pearson P. Collaborative child home injury prevention in Thailand: An action research study. Nurs Health Sci 2018; 20:206-213. [PMID: 29349899 DOI: 10.1111/nhs.12403] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 09/20/2017] [Accepted: 10/25/2017] [Indexed: 11/29/2022]
Abstract
Child home accidental injury is a global health issue, and promoting child safety is a pediatric nursing challenge worldwide. Planning child home accidental injury prevention requires understanding of factors influencing parents' behavior. Evidence suggests that participatory health promotion positively influences behavior; however, research on Thai parents is limited. This qualitative, action research study aimed to understand Thai parents' experiences of participating in a collaborative child home accidental injury prevention program and its influence on their behavior. Eight parental mother/father couples from one Thai province consented to participate, providing a wide range of data via in-depth individual interviews and self-assessment questionnaires. Thematic analysis of interview transcripts yielded three themes: collaborative learning, parental behavior change, and reflective learning extends beyond families. Participants reported that workshop participation improved their child home accidental injury-prevention behavior. The present study can inform pediatric nursing, child health-care practice, and child health policy in Thailand and beyond.
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Affiliation(s)
- Alison I Machin
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Amornrat Ngamsuoy
- Department of Paediatric Nursing, Chiang Mai University, Chiang Mai, Thailand
| | - Pauline Pearson
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
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Worsening Inequalities in Child Injury Deaths in the WHO European Region. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101128. [PMID: 28954422 PMCID: PMC5664629 DOI: 10.3390/ijerph14101128] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/02/2017] [Accepted: 09/19/2017] [Indexed: 01/21/2023]
Abstract
This article compares the mortality data for injuries in children aged 0–14 years in the World Health Organization WHO European region as estimated by the WHO Global Health Estimates for 2000 and 2015. While the region has seen a decline in child mortality due to injuries over the years, inequality persists between the low- and middle-income countries and high-income countries in the region. The gap in child mortality due to unintentional injuries has widened over the years between these two socioeconomic regions, particularly in terms of road injuries. In contrast, mortality rate ratios due to intentional injuries have narrowed between 2000 and 2015. The low- and middle-income countries need to scale up their efforts in injury prevention by adopting stricter regulations and higher safety practices to narrow the East-West gap in unintentional injuries.
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Navaneetham NJ, Ravindran D. Group Work Intervention for the Parents of Children with Mental Health Issues Admitted in the Tertiary Care Center. Indian J Psychol Med 2017; 39:430-435. [PMID: 28852235 PMCID: PMC5559989 DOI: 10.4103/0253-7176.211762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The objective of this study was to develop a structured curriculum for a group-based parenting program for parents/caregivers of children or adolescents treated in the inpatient child and adolescent mental health unit of a national health institute. METHODS Data from group session reports of 3 years of conducting group-based parenting programs in the same setting were analyzed and prominent themes of discussions were shortlisted before finally arriving at a six-session group parenting program module. RESULTS A six-session intervention module was designed by psychiatric social workers experienced in group work. The content followed combination of various theoretical approaches and methodologies ultimately aiming in improving the overall knowledge and understanding of parents or caregivers on various child and adolescent mental health issues, and enhancing their skills and competence in dealing with various emotional and behavioral problems in children. CONCLUSION Group-based parenting programs are found to be effective in improving the over psychosocial health of parents and the emotional and behavioral problems of children and adolescents as a result of better parenting. Development and standardization of culture appropriate group intervention curriculums would help in the development of this cost effective method as a medium of change.
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Abstract
BACKGROUND The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. METHODS A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. RESULTS A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. CONCLUSION Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. LEVEL OF EVIDENCE Therapeutic/care management study, level V.
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Affiliation(s)
- Oskar G Jenni
- Child Development Center and the Children's Research Center, University Children's Hospital Zurich, Zurich, Switzerland.
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Carlsson A, Dykes AK, Jansson A, Bramhagen AC. Mothers' awareness towards child injuries and injury prevention at home: an intervention study. BMC Res Notes 2016; 9:223. [PMID: 27091157 PMCID: PMC4836089 DOI: 10.1186/s13104-016-2031-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 04/07/2016] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Most injuries to young children happen in the home. Therefore, this study aimed to investigate if extended individual information to mothers' related to injury to children in the home and possible preventative actions has any effect on their awareness of the problem and if Sense of Coherence has an influence. METHODS This was a quasi-experimental designed intervention study with a comparison group. Extended individual information with empowerment as the approach was used. RESULTS Ninety-nine mothers of children under the age of 7 months participate. A questionnaire with sociodemographic data and questions regarding awareness towards prevention was used. Mothers who took part in the intervention significantly increased their awareness of the fact that child injuries take place at home when compared with the mothers in the comparison group, [OR 2.3, CI 1.3-4.3]. However, no significant improvement of awareness towards prevention was noted, neither any association to the mothers' SOC-scores. CONCLUSION This study showed that the intervention had a positive effect on mothers' awareness towards the fact that child injuries are taking place at home, but it did not increase the mothers' awareness towards prevention of child injury.
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Affiliation(s)
- Anna Carlsson
- />Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströmsgata 25, 205 06 Malmö, Sweden
| | - Anna-Karin Dykes
- />Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströmsgata 25, 205 06 Malmö, Sweden
- />Faculty of Medicine, Department of Health Sciences Centre, Lund University, Lund, Sweden
| | - Annkristin Jansson
- />Faculty of Medicine, Department of Health Sciences Centre, Lund University, Lund, Sweden
| | - Ann-Cathrine Bramhagen
- />Faculty of Health and Society, Department of Care Science, Malmö University, Jan Waldenströmsgata 25, 205 06 Malmö, Sweden
- />Skane University Hospitals, Malmö, Sweden
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Abstract
OBJECTIVE The aim of this study was to explore the safety-related concerns of parents of children with a variety of disabilities and chronic conditions. We sought to examine concerns common to parents as they related to their children's delayed development, behavioral difficulties, and chronic conditions. METHOD A qualitative approach guided by grounded theory was used. Participants included parents of children between 1 and 5 years with a disability or chronic condition who resided in British Columbia, Canada. Data were collected using in-depth in-person interviews and analysis conducted using constant comparative methods. RESULTS Three themes were identified that reflected parental safety concerns. These included concerns about: (1) Child's level of understanding about danger; (2) Child interactions with physical environment (concerns about child movement, concerns about ingestions); (3) Child interactions with social environment. Difficult-to-manage behaviors and cognitive limitations exacerbated parents' safety concerns. Parents were found to share safety concerns about movement and ingestions across a range of types of child health conditions. CONCLUSION For themes of child movement and child ingestions, findings supported the utility of a noncategorical approach for the design of injury prevention strategies for these types of concerns. Parent concerns about child lack of understanding about risk and social safety concerns were linked to a smaller number of conditions and supported a more tailored approach. Flexible approaches may be needed that can offer both generic and specific information and to meet the needs of parents and clinicians.
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Schell SL, Morrongiello BA, Pogrebtsova E. Training Older Siblings to Be Better Supervisors: An RCT Evaluating the “Safe Sibs” Program. J Pediatr Psychol 2015; 40:756-67. [DOI: 10.1093/jpepsy/jsv030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 03/11/2015] [Indexed: 11/13/2022] Open
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Agarwal M, Williams J, Tavoulareas D, Studnek JR. A Brief Educational Intervention Improves Medication Safety Knowledge in Grandparents of Young Children. AIMS Public Health 2015; 2:44-55. [PMID: 29546094 PMCID: PMC5690368 DOI: 10.3934/publichealth.2015.1.44] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 03/03/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Increasing grandparent-grandchild interactions have not been targeted as a potential contributing factor to the recent surge in pediatric poisonings. We hypothesized that in grandparents with a young grandchild, a single educational intervention based on the PROTECT "Up & Away" campaign will improve safe medication knowledge and storage at follow-up from baseline. METHODS This prospective cohort study validated the educational intervention and survey via cognitive debriefing followed by evaluation of the educational intervention in increasing safe medication storage. Participants had to read and speak English and have annual contact with one grandchild ≤ 5-years-old. Participants were recruited from a convenience sample of employees in a regional healthcare system. They completed a pre-intervention survey querying baseline demographics, poisoning prevention knowledge, and medication storage, followed by the educational intervention and post-intervention survey. Participants completed a delayed post-intervention survey 50-90 days later assessing medication storage and poisoning prevention knowledge. Storage sites were classified as safe or unsafe a priori; a panel classified handwritten responses. RESULTS 120 participants were enrolled; 95 (79%) completed the delayed post-intervention survey. Participants were predominantly female (93%) and white (76%); 50% had a clinical degree. Participants averaged 1.9 grandchildren. Initially, 23% of participants reported safe medication storage; this improved to 48% after the intervention (OR 6.4; 95% CI = 2.5-21.0). 78% of participants made at least one improvement in their medication storage after the intervention even if they did not meet all criteria for safe storage. Participants also demonstrated retention of poisoning prevention knowledge. CONCLUSIONS This brief educational intervention improved safe medication storage and poisoning prevention knowledge in grandparents of young children; further evaluation of this intervention is warranted.
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Affiliation(s)
- Maneesha Agarwal
- Pediatric Emergency Medicine, Emory University & Children's Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Janice Williams
- Department of Emergency Medicine, Carolinas Medical Center, Charlotte, NC 28203, USA
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Khanom A, Hill RA, Brophy S, Morgan K, Rapport F, Lyons R. Mothers' perspectives on the delivery of childhood injury messages: a qualitative study from the growing up in Wales, environments for healthy living study (EHL). BMC Public Health 2013; 13:806. [PMID: 24007442 PMCID: PMC3844439 DOI: 10.1186/1471-2458-13-806] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 08/29/2013] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Childhood injury is the second leading cause of death for infants aged 1-5 years in the United Kingdom (UK) and most unintentional injuries occur in the home. We explored mothers' knowledge and awareness of child injury prevention and sought to discover mothers' views about the best method of designing interventions to deliver appropriate child safety messages to prevent injury in the home. METHODS Qualitative study based on 21 semi-structured interviews with prospective mothers and mothers of young children. Mothers were selected according to neighbourhood deprivation status. RESULTS There was no difference in awareness of safety devices according to mothers' deprivation status. Social networks were important in raising awareness and adherence to child safety advice. Mothers who were recent migrants had not always encountered safety messages or safety equipment commonly used in the UK. Mothers' recommended that safety information should be basic and concise, and include both written and pictorial information and case studies focus on proactive preventive messages. Messages should be delivered both by mass media and suitably trained individuals and be timed to coincide with pregnancy and repeated at age appropriate stages of child development. CONCLUSIONS The findings suggest that timely childhood injury-related risk messages should be delivered during pregnancy and in line with developmental milestones of the child, through a range of sources including social networks, mass media, face-to-face advice from health professionals and other suitably trained mothers. In addition information on the safe use of home appliances around children and use of child safety equipment should be targeted specifically at those who have recently migrated to the United Kingdom.
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Affiliation(s)
| | - Rebecca A Hill
- College of Medicine, Swansea University, Swansea SA2 8PP, Wales
| | - Sinead Brophy
- College of Medicine, Swansea University, Swansea SA2 8PP, Wales
| | - Kelly Morgan
- College of Medicine, Swansea University, Swansea SA2 8PP, Wales
| | - Frances Rapport
- College of Medicine, Swansea University, Swansea SA2 8PP, Wales
| | - Ronan Lyons
- College of Medicine, Swansea University, Swansea SA2 8PP, Wales
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Affiliation(s)
- Robyn Norton
- George Institute for Global Health, University of Oxford, Oxford, United Kingdom.
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Childhood mortality due to unintentional injuries in Japan, 2000–2009. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:528-40. [PMID: 23364538 PMCID: PMC3635160 DOI: 10.3390/ijerph10020528] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/21/2013] [Accepted: 01/23/2013] [Indexed: 12/03/2022]
Abstract
This study examined deaths due to unintentional injuries among children in Japan to identify the age groups and sexes at most risk, and the types of injuries, so that effective forms of targeted intervention can be devised. Among children aged 0–14 years, deaths whose underlying causes had been classified under code V01-X59 of the ICD-10 were defined as deaths of children caused by unintentional injuries. Using data from the Vital Statistics 2000–2009 for analysis, we examined the changes in mortality and trends in terms of sex, age, and cause of death. Mortality decreased by 46.2%, from 933 in 2000 to 502 in 2009. The mortality rate among children aged 1–4 years decreased by almost half. The total number of deaths during this decade was 7,362 (boys: 4,690, girls: 2,672). Among the causes of death, the majority were due to “transport accidents”, followed by “other accidental threats to breathing”, and “accidental drowning and submersion”. The characteristics observed in terms of sex, age, and cause of death—that is, deaths from suffocation among infants aged less than 1 year, drowning deaths among boys, and transport accidents involving pedestrians and cyclists—must be addressed as targets for future intervention.
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Mytton JA, Towner EM, Kendrick D, Stewart-Brown S, Emond A, Ingram J, Blair PS, Powell J, Mulvaney C, Thomas J, Deave T, Potter B. The First-aid Advice and Safety Training (FAST) parents programme for the prevention of unintentional injuries in preschool children: a protocol. Inj Prev 2013; 20:e2. [PMID: 23302145 DOI: 10.1136/injuryprev-2012-040689] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Unintentional injury is the leading cause of preventable death in children in the UK, and 0-4-year-olds frequently attend emergency departments following injuries in the home. Parenting programmes designed to support parents, promote behaviour change and enhance parent-child relationships have been shown to improve health outcomes in children. It is not known whether group-based parenting programmes have the potential to prevent unintentional injuries in preschool children. METHODS A study to develop a group-based parenting programme to prevent unintentional home injuries in preschool children, and assess the feasibility of evaluation through a cluster-randomised controlled trial. The intervention, designed for parents of children who have sustained a medically attended injury, will be developed with two voluntary sector organisations. The feasibility study will assess ability to recruit parents, deliver the programme and follow-up participants. Participants will complete questionnaires at baseline, 3 months and 6 months, and report injuries in their preschool children using a tool designed and validated for this study. Qualitative methods will assess user and deliverer perceptions of the programme. DISCUSSION This study will develop the first group-based parenting programme to prevent injuries in preschool children, and design tools for parent-reported injury outcomes. A key challenge will be to recruit parents to participate in a manner that is non-stigmatising, and does not result in feelings of guilt or belief that they are perceived to be a bad parent. The findings will be used to prepare a trial to assess the effectiveness and cost-effectiveness of the intervention.
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Affiliation(s)
- Julie A Mytton
- University of the West of England, Bristol, Centre for Child and Adolescent Health, , University of the West of England, Bristol, UK
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Morrongiello BA, Zdzieborski D, Sandomierski M, Munroe K. Results of a randomized controlled trial assessing the efficacy of the Supervising for Home Safety program: Impact on mothers' supervision practices. ACCIDENT; ANALYSIS AND PREVENTION 2013; 50:587-595. [PMID: 22771287 DOI: 10.1016/j.aap.2012.06.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 06/03/2012] [Accepted: 06/05/2012] [Indexed: 06/01/2023]
Abstract
Unintentional injury constitutes a major health risk for young children, with many injuries occurring in the home. Although active supervision by parents has been shown to be effective to prevent injuries, evidence indicates that parents do not consistently apply this strategy. To address this issue, a randomized controlled trial was conducted to evaluate the impact of the Supervising for Home Safety program on parent supervision practices in the home and when unobtrusively observed in a naturalistic laboratory setting. Using a participant-event monitoring procedure, parents of children aged 2 through 5 years completed supervision recording sheets weekly both before and after exposure to the intervention program; Control parents completed the same measures but received a program focusing on child nutrition and active lifestyles. Unobtrusive video recordings of parent supervision of their child in a room containing contrived hazards also were taken pre- and post-intervention. Results indicated that groups did not differ in demographic characteristics. Comparisons of post- with pre-intervention diary reported home supervision practices revealed a significant decrease in time that children were unsupervised, an increase in in-view supervision, and an increase in level of supervision when children were out of view, with all changes found only for the Intervention group. Similarly, only parents in the Intervention group showed a significant increase in attention to the child in the contrived hazards context, with these differences evident immediately after and 3 months after exposure to the intervention. These results provide the first evidence that an intervention program can positively impact caregiver supervision.
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Lee LK, Walia T, Forbes PW, Osganian SK, Samuels R, Cox JE, Mooney DP. Home safety practices in an urban low-income population: level of agreement between parental self-report and observed behaviors. Clin Pediatr (Phila) 2012; 51:1119-24. [PMID: 22967813 DOI: 10.1177/0009922812460083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Home-related injuries are overrepresented in children from low-income households. The objectives of this study were to determine frequencies of home safety behaviors and the level of agreement between parental self-report and observed safety practices in low-income homes. In a prospective, interventional home injury prevention study of 49 low-income families with children <5 years old, a trained home visitor administered baseline parental home safety behavior questionnaires and assessments. There was high agreement between caregiver self-report and home visitor observation for lack of cabinet latch (99%, 95% confidence interval [CI] = 88%-99%) and stair gate use (100%, 95% CI = 88-100%). There was lower agreement for the safe storage of cleaning supplies (62%, 95% CI = 46%-75%), sharps (74%, 95% CI = 59%-85%), and medicines/vitamins (83%, 95% CI = 69%-92%) because of the overreporting of safe practices. Self-reports of some home safety behaviors are relatively accurate, but certain practices may need to be verified by direct assessment.
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Affiliation(s)
- Lois K Lee
- Children's Hospital Boston, Boston, MA 02115, USA.
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Mills A, Schmied V, Taylor C, Dahlen H, Schuiringa W, Hudson ME. Connecting, learning, leaving: supporting young parents in the community. HEALTH & SOCIAL CARE IN THE COMMUNITY 2012; 20:663-672. [PMID: 22978634 DOI: 10.1111/j.1365-2524.2012.01084.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Providing support and parenting education through home visiting is a key early intervention strategy with young parents. Less is known about what home visitors do that makes a difference. The purpose of this paper is to describe the role and experiences of professional staff working with young parents participating in a multicomponent parent support programme (home visiting and supported parenting groups) provided by a non-government organisation in a socially disadvantaged area of Sydney, Australia. This was a qualitative descriptive study. Data were collected through three focus groups conducted with the same six staff over an 18-month period. Participant descriptions of their role and experiences working with young mothers were analysed thematically. Additional data from 20 anonymised client records were analysed through content analysis. Analysis of the focus group data revealed two themes, 'Connecting' and 'Facilitating Learning'. The theme 'Connecting' reflected the development of a relationship with the young mother commencing with 'how do we engage them?', 'building trust' through to formation of a relationship described as 'they know we're not friends, they know we're workers'. The second theme, 'Facilitating Learning' was informed by the analysis of both group and client record data and comprised a number of themes around what and how mothers learnt, through to 'ending the relationship' as the mothers left the programme. The quality of a mothers' learning was dependent on the quality of the connection between herself and the staff, similarly their capacity and, or confidence to leave the programme was dependent on the relationship, 'connecting' and the learning undertaken. Role modelling through interactions with children as well as with each other was seen as the most effective way to facilitate social and parenting skill development, while formal education sessions were evaluated by the workers to be less successful than informal ones.
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Affiliation(s)
- Annie Mills
- School of Nursing and Midwifery, University of Western Sydney, Penrith, Australia
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Weber P, Jenni O. Screening in child health: studies of the efficacy and relevance of preventive care practices. DEUTSCHES ARZTEBLATT INTERNATIONAL 2012; 109:431-5. [PMID: 22787505 DOI: 10.3238/arztebl.2012.0431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Accepted: 04/17/2012] [Indexed: 11/27/2022]
Abstract
BACKGROUND Pediatric screening enables the prevention or early detection of diseases and developmental disturbances in infancy and childhood. Screening is a standard component of pediatric practice in many countries, but its scientific basis is not well known. METHODS The scientific justification for pediatric screening beyond the neonatal period is presented on the basis of a selective review of the literature on some aspects of pediatric screening. RESULTS The level of evidence varies highly among pediatric screening interventions and can be difficult to determine because of confounding variables. Parent counseling is associated with improvements in child-raising competence, accident prevention, and reading behavior. The early detection of abnormalities in a child's motor, linguistic, mental, or social development is possible and often leads to effective early interventions. Cyanotic congenital heart defects can be detected with 63% sensitivity and 99.8% specificity; cerebral palsy can be diagnosed with 33% to 100% sensitivity and 52.3% to 100% specificity (different figures from multiple studies). Physical therapy seems to improve some manifestations of cerebral palsy. Motor development at 90 days is correlated with motor development at 57 months (72% sensitivity, 91% specificity). A developmental quotient above 85 in a two-year-old child is correlated with an intelligence quotient above 85 when the child is 7 years old. CONCLUSION There is an increasing amount of scientific evidence in favor of pediatric screening. Nonetheless, further epidemiological studies are needed.
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Affiliation(s)
- Peter Weber
- Department of Neuropediatrics, University Children’s Hospital Basel.
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Karazsia BT, Guilfoyle SM, Wildman BG. The mediating role of hyperactivity and inattention on sex differences in paediatric injury risk. Child Care Health Dev 2012; 38:358-65. [PMID: 21623871 DOI: 10.1111/j.1365-2214.2011.01243.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Extensive research suggests that risk of injury is higher among young boys versus young girls. The present study examined a mediational model to identify mechanisms that may explain differences in injury risk. METHODS Reports of child behaviour and two indices of injury risk among 114 children in early childhood were obtained from parents in community-based paediatric medical centres. RESULTS Regression analyses and post-hoc examination of indirect effects supported a mediation model in which the relationship between child sex and child injury risk was explained by hyperactivity and inattention. CONCLUSIONS Interventions that promote child well-being by targeting constellations of externalizing behaviour problems may simultaneously decrease paediatric injury risk.
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Affiliation(s)
- B T Karazsia
- Department of Psychology, The College of Wooster, OH 44691, USA.
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Childhood unintentional injuries: need for a community-based home injury risk assessments in pakistan. Int J Pediatr 2012; 2012:203204. [PMID: 22577399 PMCID: PMC3332195 DOI: 10.1155/2012/203204] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2011] [Revised: 01/27/2012] [Accepted: 01/30/2012] [Indexed: 11/21/2022] Open
Abstract
Background. A substantial proportion of the annual 875,000 childhood unintentional injury deaths occur in the home. Very few printed tools are available in South Asia for disseminating home injury prevention information. Methods. Three tools were planned: an injury hazard assessment tool appropriate for a developing country setting, an educational pamphlet highlighting strategies for reducing home injury hazards, and an in-home safety tutorial program to be delivered by a trained community health worker. Results. The three tools were successfully developed. Two intervention neighborhoods in Karachi, Pakistan, were mapped. The tools were pretested in this local setting and are now ready for pilot testing in an intervention study. Conclusion. Planning for an innovative, community-based pilot study takes considerable time and effort in a low-income setting like Pakistan. The primary outcome of the pre-testing phase of the study was the development of three important tools geared for low-income housing communities in Pakistan.
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Simpson JC, Nicholls J. Preventing unintentional childhood injury at home: injury circumstances and interventions. Int J Inj Contr Saf Promot 2011; 19:141-51. [PMID: 22136531 DOI: 10.1080/17457300.2011.635208] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
New Zealand's (NZ) preschoolers carry the greatest injury burden among children aged 0-14 years. These injuries commonly occur at home. To identify how NZ addresses child injury the 1990s national injury datasets and associated free text were examined retrospectively, NZ injury circumstances and interventions were compared to internationally recognised hazards and best practice, and whether NZ interventions addressed common circumstances of injury was assessed. Certain injuries, often associated with activities of daily living, were not addressed by interventions, although most interventions advocated internationally are implemented in NZ. Possible reasons for main injuries not being addressed were the specificity and variable effectiveness of interventions, normality of many injury circumstances, difficulties in evaluating complex environments, and the need for active intervention. There is considerable scope for NZ to improve its child safety. It is unlikely that simple solutions will be found for complex circumstances in which injury events occur. Strategies to address multifaceted problems requiring changes to personal, social and societal factors are required, with evaluation methods able to match their complexity.
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Affiliation(s)
- Jean C Simpson
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, P O Box 56, Dunedin, 9054, New Zealand.
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Abstract
BACKGROUND Injury is the leading cause of death for children older than 1 year. The incidence of childhood injury varies greatly depending on social factors, including income, family violence, and other social stressors. This study reports the incidence of injury among children aged 5 years in a cohort of vulnerable families. METHODS The Fragile Families and Child Wellbeing Study is a longitudinal cohort of approximately 5,000 at-risk families across the United States. Data from interviews with mothers conducted shortly after giving birth and follow-up surveys at 1 year, 3 years, and 5 years were used. Multivariate regression analysis was used to identify independent risk factors for injury in year 5. RESULTS Five-year follow-up data on injury was complete for 2,397 families. Two hundred ninety-six children were injured at the age of 5 years (12.3%). Multivariate regression found that the strongest predictors of injury in year 5 were male gender (OR, 2.62; 95% CI, 1.02-6.75; p = 0.04) and being in the lowest income stratum (OR, 1.23; 95% CI, 1.01-1.49; p = 0.03). CONCLUSIONS Children in vulnerable families are at higher risk for injury. The incidence of 12.3% found in this cohort is substantially higher than CDC risk for 5-year-old children, that is, overall 9.3%. This longitudinal cohort has demonstrated a persistently elevated risk of childhood injury, but risk factors for injury have changed with age. As these children reached school age, low household income and male gender were risk factors for injury. This suggests that recognition of gender differences and targeted interventions for caregivers and play environments may be useful.
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Phelan KJ, Khoury J, Xu Y, Liddy S, Hornung R, Lanphear BP. A randomized controlled trial of home injury hazard reduction: the HOME injury study. ACTA ACUST UNITED AC 2011; 165:339-45. [PMID: 21464382 DOI: 10.1001/archpediatrics.2011.29] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVE To test the efficacy of installing safety devices in the homes of young children on total injury rates and on injuries deemed a priori modifiable by the installation of these devices. DESIGN A nested, prospective, randomized controlled trial. SETTING Indoor environment of housing units. PARTICIPANTS Mothers and their children from birth to 3 years old participating in the Home Observation and Measures of the Environment study. Among 8878 prenatal patients, 1263 (14.2%) were eligible, 413 (32.7%) agreed to participate, and 355 were randomly assigned to the intervention (n = 181) or control (n = 174) groups. INTERVENTION Installation of multiple passive measures (eg, stair gates, cabinet locks, and smoke detectors) to reduce exposure to injury hazards. Injury hazards were assessed at home visits by teams of trained research assistants using a validated survey. MAIN OUTCOME MEASURE Modifiable and medically attended injury (ie, telephone calls, office visits, and emergency visits for injury). RESULTS The mean age of children at intervention was 6.3 months. Injury hazards were reduced in the intervention homes but not in the control homes at 1 and 2 years (P < .004). There was no difference in the rate for all medically attended injuries in intervention children compared with controls: 14.3 injuries (95% confidence interval [CI], 9.7-21.1 injuries) vs 20.8 injuries (95% CI, 14.4-29.9 injuries) per 100 child-years (P = .17); but there was a significant reduction in the rate of modifiable medically attended injuries in intervention children compared with controls: 2.3 injuries (95% CI, 1.0-5.5 injuries) vs 7.7 injuries (95% CI, 4.2-14.2 injuries) per 100 child-years (P = .03). CONCLUSION An intervention to reduce exposure to hazards in homes led to a 70% reduction in the rate of modifiable medically attended injury. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00129324.
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Affiliation(s)
- Kieran J Phelan
- Center for Children's Environmental Health, University of Cincinnati, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA.
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Fujiwara T, Okuyama M, Takahashi K. Paternal involvement in childcare and unintentional injury of young children: a population-based cohort study in Japan. Int J Epidemiol 2009; 39:588-97. [DOI: 10.1093/ije/dyp340] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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