Dog safety in rural China: children's sources of safety information and effect on knowledge, attitudes, and practices

Featured Article: Evaluating Smartphone-Based Virtual Reality to Improve Chinese Schoolchildren's Pedestrian Safety: A Nonrandomized Trial

Objective

This nonrandomized trial evaluated whether classroom-based training in a smartphone-based virtual reality (VR) pedestrian environment (a) teaches schoolchildren to cross streets safely, and (b) increases their self-efficacy for street-crossing.

Methods

Fifty-six children, aged 8-10 years, attending primary school in Changsha, China participated. Baseline pedestrian safety assessment occurred in the VR environment and through unobtrusive observation of a subsample crossing a street for 11 days outside school. Self-efficacy was assessed through both self-report and observation. Following baseline, children engaged in the VR for 12 days in their classrooms, honing complex cognitive-perceptual skills required to engage safely in traffic. Follow-up assessment replicated baseline.

Results

Probability of crash in the VR decreased posttraining (0.40 vs. 0.09), and observational data found the odds of looking at oncoming traffic while crossing the first lane of traffic increased (odds ratio [OR] = 2.4). Self-efficacy increases occurred in self-report (proportional OR = 4.7 crossing busy streets) and observation of following crossing-guard signals (OR = 0.2, first lane).

Conclusions

Pedestrian safety training via smartphone-based VR provides children the repeated practice needed to learn the complex skills required to cross streets safely, and also helps them improve self-efficacy to cross streets. Given rapid motorization and global smartphone penetration, plus epidemiological findings that about 75,000 children die annually worldwide in pedestrian crashes, smartphone-based VR could supplement existing policy and prevention efforts to improve global child pedestrian safety.

Cognitive and Behavioral Risk Factors for Unintentional Drowning Among Rural Chinese Children

BACKGROUND

Unintentional drowning is among the top causes of pediatric death worldwide and the leading cause of death for children under age 14 in China. Environmental factors such as abundant bodies of water and psychosocial factors such as lack of parental supervision contribute to heightened risk of pediatric drowning in rural China, but little is known about the role of individual characteristics such as knowledge and perceived vulnerability in the drowning risk of rural Chinese children.

PURPOSE

The present study aimed to explore the cognitive and behavioral risk factors for unintentional drowning among school-aged rural Chinese children.

METHOD

Two hundred and eighty children (mean age = 10.03 years, range 8-13) enrolled at an elementary school in rural Zhejiang Province, China completed self-report assessments of knowledge about drowning prevention, perceived vulnerability toward drowning, and history of non-fatal drowning experiences, as well as demographic information. A simulation task using a dollhouse assessed children's anticipated behaviors with water.

RESULTS

Fifty-two percent of the sample reported exposure to water sources at least once daily, and 21 % of the sample reported at least one non-fatal drowning experience in their lifetime. Regression analysis showed that male gender, better swimming ability, less safety knowledge, and lower levels of perceived vulnerability were associated with more self-reported risky practice in/near water. More safety knowledge also predicted safer behaviors in the dollhouse simulation task. None of the risk factors predicted self-reported history of non-fatal drowning incidents.

CONCLUSION

High exposure to water sources and non-fatal drowning experiences were found among school-aged children in rural China. Drowning risk factors included demographic, cognitive, and behavioral characteristics of children. Results offer evidence for developing interventions in both Zhejiang Province and other regions with similar geographic and population characteristics.

A randomized trial evaluating child dog-bite prevention in rural China through video-based testimonials

OBJECTIVE

Dog-bite injuries pose significant threat to children globally. School-age children are especially at risk because of their insufficient safety knowledge and cognitively immature tendency toward low perceived vulnerability to bites, and this risk is elevated further for school-age children living in rural China due to the large number of stray dogs, all potential rabies carriers, present in their communities.

METHOD

This randomized controlled trial evaluated whether viewing an educational video of testimonials would change safety knowledge, perceived vulnerability, and simulated behaviors with dogs among a sample of 280 third and fourth graders living in rural China. Participants were randomly assigned to view either an educational video of testimonials on dog-bite prevention (treatment) or an educational video of testimonials on drowning prevention (comparison). Safety knowledge, perceived vulnerability to dog bites, and simulated behavior with dogs using a dollhouse model were assessed both before and after exposure to the video of testimonials.

RESULTS

Children who watched the educational video of testimonials on dog-bite prevention had increased safety knowledge, higher perceived vulnerability, and less risky simulated behaviors with dogs compared with the comparison group. Mediation analysis revealed that the intervention successfully changed children's simulated behaviors with dogs through greater safety knowledge and increased perceived vulnerability.

CONCLUSIONS

Results suggest the incorporation of testimonials into injury prevention programs has potential for broad global dissemination. The fact that both increased knowledge and heightened perceived vulnerability mediated changes in simulated behavior suggests the dual roles of knowledge and appraisal on children's injury-risk behavior.

Evaluation of a Drowning Prevention Program Based on Testimonial Videos: A Randomized Controlled Trial

OBJECTIVE

Unintentional drowning is the most common cause of childhood death in rural China. Global intervention efforts offer mixed results regarding the efficacy of educational programs.

METHODS

Using a randomized controlled design, we evaluated a testimonial-based intervention to reduce drowning risk among 280 3rd- and 4th-grade rural Chinese children. Children were randomly assigned to view either testimonials on drowning risk (intervention) or dog-bite risk (control). Safety knowledge and perceived vulnerability were measured by self-report questionnaires, and simulated behaviors in and near water were assessed with a culturally appropriate dollhouse task.

RESULTS

Children in the intervention group had improved children's safety knowledge and simulated behaviors but not perceived vulnerability compared with controls.

CONCLUSIONS

The testimonial-based intervention's efficacy appears promising, as it improved safety knowledge and simulated risk behaviors with water among rural Chinese children.

Evaluating a website to teach children safety with dogs

BACKGROUND

Paediatric dog bites are a significant public health problem worldwide. Existing prevention programmes focused on altering children's risky behaviour with pet dogs tend to be atheoretical and only moderately effective.

OBJECTIVE

Test efficacy of a website to train young children in relevant cognitive skills to be safe with pet dogs in their home.

SETTING

Birmingham, Alabama, USA.

METHODS

A randomised trial will be conducted with an expected sample of two groups of 34 children (total N=68) ages 4-6 years. One group will engage in the newly designed website at home for 2 weeks and the other group will engage in a control website on transportation safety for an equivalent amount of time. All participants will complete a battery of laboratory-based tests to assess safety with dogs and cognitive functioning at baseline and postintervention.

OUTCOME MEASURES

Primary analyses will be conducted through linear mixed models testing change over time. Children's cognitive functioning, knowledge about safety with dogs, and behaviour with dogs in simulation and in vivo will serve as the primary outcomes.

CLINICAL TRIAL REGISTRATION

This study is exempt from registry at the US government website, http://www.clinicaltrials.gov, based on being a behavioural trial in the early phases of testing.