Methodological considerations in participant event monitoring of low-base-rate events in health psychology: children's injuries as a model

Validation of a measure of injury-risk behaviors in the first 2 years of life: Infant/Toddler-Injury Behavior Questionnaire (IT-IBQ)

Unintentional injuries are the leading cause of death for young children and many result from them doing injury-risk behaviors in the home. There are a number of questionnaire measures of injury-risk behaviors for children 2 years and older, but none that apply during infancy. The current study addressed this gap. Parents completed the new Infant/Toddler-Injury Behavior Questionnaire when infants were pre-mobile (sitting independently) and mobile (walking independently), with diary measures of injuries and risk behaviors taken continuously throughout this period. Validated questionnaire measures of chaos and routines in the home were also completed. The IT-IBQ showed positive associations with injuries, risk behaviors, and degree of chaos in the home, and was negatively associated with family routines. The results provide evidence for criterion validity and suggest that the new measure holds promise as one that can aid in identifying infants who are likely to engage in injury-risk behaviors.

The Moderating Role of Maternal Supervision in the Relation of Social-Ecological Risk Factors to Children's Minor Injuries

Although maternal supervision has been found to reduce injury risk in young children, it is not clear whether supervision moderates the impact of social-ecological risk variables on children's injury frequency. This study examined whether maternal supervision moderated the relation of child, maternal, and family risk factors to children's minor injuries. Mothers (N = 170) of toddlers were interviewed biweekly about their children's injuries and their supervision over a 6-month period, and mothers completed measures about child and family variables. Supervision moderated the effect of mothers' marital/partner relationship satisfaction on children's injury frequency; closer supervision was protective for mothers with lower relationship satisfaction. Findings suggest that helping mothers with low levels of relationship satisfaction provide closer supervision for their children may mitigate the effects of low marital satisfaction on children's injury frequency.

Evidence-based assessment of childhood injuries and physical risk-taking behaviors

OBJECTIVE

To offer a critical evidence-based review and summary of assessment methods of childhood injuries and physical risk-taking behaviors.

METHODS

A literature review was conducted to identify methodologies for assessing injury events and physical risk-taking behaviors. Methodologies reviewed included self- or parent-report scales, behavioral observations, and participant event monitoring. We classified methodologies according to published criteria of "well-established," "approaching well-established," or "promising."

RESULTS

7 methodologies were classified as "well-established", 9 were classified as "approaching well-established", and 8 were classified as "promising."

CONCLUSIONS

Several approaches to assessing injuries or physical risk-taking behaviors have strong psychometric properties. Opportunities for further psychometric validation of techniques are noted. It is hoped that this review inspires researchers throughout the fields of pediatric and clinical child psychology to adopt assessments of injury and physical risk-taking in their ongoing research efforts.

Toddlers' unintentional injuries: the role of maternal-reported paternal and maternal supervision

Research indicates that mothers' supervision protects children from injuries. However, little research has examined the role of fathers' supervision in children's injuries.

OBJECTIVES

This study compared the role of maternal and paternal supervision in children's injury risk and severity using maternal reports.

METHODS

Mothers (n = 170) of toddlers were interviewed for 6 months about their children's unintentional injuries.

RESULTS

Children were more likely to engage in high activity levels and were at higher risk for injury when being cared for by their fathers. Although higher supervision predicted lower injury risk for both mothers and fathers, fathers' close supervision (as reported by mothers) was a stronger predictor of injury risk than mothers' supervision.

CONCLUSION

Children's higher levels of activities may have accounted for their higher risk of injury when in their fathers' care. These findings indicate the need to include fathers in injury prevention efforts.

Online training in sports concussion for youth sports coaches

The purpose of this study was to evaluate ACTive: Athletic Concussion Training using Interactive Video Education, an interactive e-learning program designed to train community coaches of youth ages 10-18 in effective sports concussion prevention and management practices. Seventy-five youth sports coaches from across the country completed the study over the Internet. Results of a randomized control trial demonstrated significant differences between treatment and control participants on measures of (a) knowledge about sports concussion, management, and prevention; (b) attitudes about the importance of preventing sports concussion; and (c) intention and self-efficacy in sports concussion management and prevention. The results suggest that ACTive is an effective method of training youth sports coaches who are in an important position to reduce risks associated with sports concussion.

Relation of caregiver alcohol use to unintentional childhood injury

OBJECTIVE

The present study used a case-crossover design to investigate the association of caregiver alcohol consumption and supervision to children's injury occurrence and severity.

METHOD

A community sample of 170 mothers of toddlers was interviewed biweekly about their children's daily injuries for a period of 6 months.

RESULTS

Proximal caregiver-reported alcohol use predicted higher likelihood of injury occurrence and higher injury severity, whereas caregiver-reported supervision predicted lower likelihood of injury occurrence and lower injury severity.

CONCLUSION

Even at low levels, proximal caregiver alcohol use may contribute to higher risk for childhood injuries and more severe injuries. The combined effect of supervision and drinking on injury likelihood warrants further exploration.

There's no place like home: a preliminary study of toddler unintentional injury

This household-based study of 100 parents documents the type and frequency of home toddler unintentional injury and describes parental supervision at the time of injury. Also included is a home assessment for injury-related hazards, parental report of the use of home safety measures, and an 8-week phone survey. The mean number of child injuries was 2.8 (SD = 2.69). Five percent of the injuries required medical attention. Overall, one fifth of the injuries occurred when children were unsupervised. Findings suggest that minor injury may have a developmental component that is different from that of serious injury.

Finding the daredevils: development of a Sensation Seeking Scale for children that is relevant to physical risk taking

OBJECTIVE

There were two objectives in this research. First, to develop and evaluate the criterion validity of a questionnaire measure of sensation seeking in children, by examining how scores on this instrument relate to various indices of physical risk taking in children 7-12 years of age. Second, to develop both a parent-report and child-report version of the instrument.

METHODS

Drawing on the literature, items tapping five potential aspects of sensation seeking were developed, with parents and children responding to comparable items. For each of these five subscales, internal reliability estimates were computed separately for the parent-report and child-report versions. To establish criterion validity, subscale scores were related to three indices of children's risk taking commonly used in research: actual risk taking, intentions-to-risk take, self-reports about risk taking on a standardized questionnaire.

RESULTS

On both the child-report and parent-report versions, the same three of the five subscales yielded acceptable internal reliability scores and significantly related to the various indices of risk taking.

CONCLUSIONS

This new measure adequately assesses aspects of sensation seeking relevant to children's risk taking. Because individuals high in sensation seeking engage in greater risk taking and are at increased risk of injury, this instrument may prove particularly useful to aid in identifying those children most likely to engage in injury-risk behaviors so that targeted interventions can be applied to this group.

Time-dependent recordkeeping fatigue among youth completing health diaries of unintentional injuries

PROBLEM

Increasingly, investigators are asking youth to self-report daily activity patterns and health outcomes in diary studies. This study assesses recordkeeping fatigue with respect to data quality and event reporting among youth participating in a health diary study.

METHOD

Unintentional injury data were collected during a 13-week longitudinal diary study of Ohio youth exposed to agricultural hazards. Two analyses were conducted using data from 2000. Analysis 1 examined trends in discernable recordkeeping errors (DREs) over the course of follow-up. Analysis 2 assessed trends in injury reporting over follow-up.

RESULTS

The percentage of items containing a DRE showed a slight, non-significant decline throughout follow-up. Injury reporting declined significantly (p<0.001) over follow-up.

SUMMARY

There was no compelling evidence of respondent fatigue with respect to DREs. The observed decline in injury reporting is problematic because estimates of youth injury incidence in health diary studies may vary depending upon the length of the follow-up period.

Contributions of multiple risk factors to child injury

OBJECTIVE

Most previous research on etiological factors that predict children's unintentional injuries has focused on single independent risk factors that predict injury, but psychological methods and theory lend themselves to simultaneous consideration of multiple risk factors that might together create an increased or decreased risk for injury.

METHOD

One approach to considering multiple risk factors of child injury, inspired by Lizette Peterson's notion of process analysis, is to consider how risk factors serve in moderated, mediated, and mediated moderation roles to each other. We present two lines of research that exemplify such models. In each, multiple risk factors for child injury are considered within a single theoretical model.

CONCLUSIONS

Implications for understanding the etiology of children's unintentional injuries and developing empirically derived injury prevention techniques are discussed.

Is there a link between children's motor abilities and unintentional injuries?

PROBLEM

The common view is that clumsy children experience unintentional injury more frequently. Empirical evidence supporting this position is mixed.

METHOD

One hundred 6- and 8-year-olds completed a battery of nine tasks designed to assess motor ability. Mothers completed a lifetime injury history measure about their children and families completed a 2-week injury diary assessing frequency and severity of daily injuries.

RESULTS

Internal reliability for the motor ability battery was good. Correlations between motor ability measures and injury risk were nonsignificant and near zero.

DISCUSSION

Motor ability does not appear to be directly related to injury risk. Possible explanations include: (a) coordinated and clumsy children engage in hazardous activities with differing frequency; or (b) other individual difference factors may interact with motor ability to explain children's injury risk.

IMPACT ON INDUSTRY

Children's motor abilities do not appear to be directly linked to rate of unintentional injury, but instead may influence risk for injury in conjunction with other factors. Results could have implications to the engineering of children's toys and playground equipment and to the design of appropriate supervision strategies for children engaging in potentially dangerous activities.

The parental daily diary. A sensitive measure of the process of change in a child maltreatment prevention program

There is a substantial deficit of sensitive measures of parental discipline in the area of prevention, generally, and in child maltreatment prevention specifically, despite reports that over a million children experience maltreatment in the United States every year. Part of the challenge in locating such measures is the impossibility of obtaining accurate observational measures of the degree of harsh discipline, unless extremely large populations are used. The majority of studies on harsh discipline have dealt with this problem by using self-report instruments or proxy observation tasks (such as observing mother-child interactions in a compliance framework). The most well-known self-report instruments, such as the Child Abuse Potential Inventory (Milner, 1986), are constructed to measure parental pathology in maltreating parents rather than to identify parents who might benefit from preventive endeavors. In contrast, there are no well standardized measures of mother-child interaction that document a sensitivity to the presence of harsh discipline, possibly due to the clear pressure of social desirability problems. This paper outlines a daily self-observation measure of parental disciplinary behavior in the form of a diary. This self-monitoring instrument offered data on the overall feelings and disciplinary behaviors used daily following each session on parenting group interventions. The study showed a gradual decrease in physical punishment and a gradual increase in planned ignoring across treatment, as these were introduced as part of an ongoing curriculum. The use of an explicit technique, such as time-out, increased abruptly rather than gradually and effects were seen only after specific instruction. Advantages and future applications of this kind of ongoing self-observation measure of treatment progress are described.

Using an injury diary to describe the ecology of children's daily injuries

PROBLEM

Two problems were addressed in this study. First, are daily injury diaries an effective means to gather information about children's unintentional injuries? Second, what are the circumstances of children's injuries as recorded through the diary method?

METHOD

Two studies were conducted with a total of 172 children to describe the ecology of children's daily unintentional injuries. Families completed a daily diary for 14 days, describing the circumstances surrounding the injuries children experienced each day.

RESULTS

Descriptive data is provided on the locations, causes, and types of injuries children incurred, as well as who was present when they were injured. Daily injury rate was modestly related to the number of major injuries children had incurred in their lifetimes.

DISCUSSION

The diary methodology was an effective means to study the ecology of children's daily injuries. Children's injuries occur in a wide range of circumstances that can be quantified through diary techniques.

IMPACT ON INDUSTRY

Data obtained from daily injury diaries may be useful in a variety of areas, including study of the etiology of childhood injury, design of interventions to prevent injury, and engineering of toys and playground equipment for children.

Accelerating children's risk for injury: mothers' decisions regarding common safety rules

Although safety rules are one of the primary preventative tactics used by parents to avoid childhood injury, very little is known about how rules are applied within families. In this preliminary study in the area of application of family safety rules, we found that mothers tended to impose rules consistently more often than inconsistently, and where they were inconsistent, they tended to regard a risky behavior as unacceptable, even if there was no family rule outlawing the behavior. The number of rules was negatively related to the number of injuries, suggesting that rules may indeed have the preventative properties that parents believe them to have. The importance of understanding how rules may prevent or fail to prevent injuries is underlined and future research challenges are described.