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Honda C, Yamamoto-Takiguchi N. Association between obtaining injury prevention information and maternal and child health services during COVID-19. BMC Health Serv Res 2024; 24:275. [PMID: 38443936 PMCID: PMC10913221 DOI: 10.1186/s12913-024-10794-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
BACKGROUND Coronavirus disease 2019 disrupted the delivery of public maternal and child health services to caregivers of preschool children, leading to decreased opportunities for injury prevention education. We aim to 1) explore the timing, content, and methods of providing injury prevention information desired by pregnant women and mothers and 2) identify mothers who experienced difficulty in obtaining injury prevention information owing to reduced maternal and child health services. METHODS From March 24 to 29, 2022, we conducted a population-based cross-sectional study and web-based survey. Of the registered monitors of the internet research company Rakuten Insight, 675 mothers raising their first child aged 0-2 during the COVID-19 period (February 2020 to March 2022) were included in the analysis. RESULTS Over half of the mothers wanted injury prevention information throughout their pregnancy. They preferred receiving information through traditional face-to-face services provided by local governments, such as antenatal classes or checkups. However, 34.1% of mothers said they did not obtain the information they needed; this was particularly true of unemployed mothers, had children aged 0-1, and had children with illnesses requiring hospital visits. CONCLUSIONS Mothers who could not obtain injury prevention information were originally disadvantaged mothers concerning access to information. The decrease in maternal and child health services may have widened this information gap. These findings can inform recommendations for caregivers, particularly those susceptible to information gaps during emergencies, and offer insights into future injury prevention education strategies.
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Affiliation(s)
- Chikako Honda
- Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
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Tanskanen AO, Metsä-Simola N, Volotinen L, Danielsbacka M, Martikainen P, Remes H. Maternal psychiatric and somatic illness, and the risk of unintentional injuries in children: variation by type of maternal illness, type of injury and child age. J Epidemiol Community Health 2023:jech-2023-220960. [PMID: 37845023 DOI: 10.1136/jech-2023-220960] [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: 06/06/2023] [Accepted: 09/28/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND Maternal mental illness appears to increase the risk of unintentional childhood injuries, which are a common cause of morbidity and mortality in early childhood. However, little is known about the variations in this association by type of injury and child's age, and studies on the effects of maternal somatic illness on children's injury risk are scarce. METHODS We used Finnish total population register data from 2000 to 2017 to link 1 369 325 children to their biological mothers and followed them for maternal illness and childhood injuries until the children's sixth birthday. Cox regression models were used to examine the associations between maternal illness and children's injuries by type of illness (neurological, psychiatric and cancer), type of injury (transport injuries, falls, burns, drowning or suffocations, poisonings, exposure to inanimate and animate mechanical forces) and child's age (<1 year-olds, 1-2 year-olds, 3-5 year-olds). RESULTS After adjustment for family structure, maternal age at birth, maternal education, income, child's gender, native language and region of residence, children of unwell mothers showed a higher risk of injuries (HR: 1.21, 95% CI: 1.19 to 1.23). This association was clear for maternal neurological (HR: 1.31, 95% CI: 1.26 to 1.36) and psychiatric illnesses (HR: 1.20, 95% CI: 1.18 to 1.23) but inconsistent for cancer. Maternal illness predicted an increased risk of injury across all age groups. CONCLUSIONS Maternal mental and somatic illness may both increase children's injury risk. Adequate social and parenting support for families with maternal illness may reduce childhood injury.
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Affiliation(s)
- Antti O Tanskanen
- Population Research Institute, Väestöliitto, Helsinki, Finland
- INVEST Research Center, University of Turku, Turku, Finland
| | | | - Lotta Volotinen
- Population Research Unit, University of Helsinki, Helsinki, Finland
| | - Mirkka Danielsbacka
- Population Research Institute, Väestöliitto, Helsinki, Finland
- INVEST Research Center, University of Turku, Turku, Finland
| | - Pekka Martikainen
- Population Research Unit, University of Helsinki, Helsinki, Finland
- Max Planck - Institute for Demographic Research, Rostock, Germany
- Max Planck - University of Helsinki Center for Social Inequalities in Population Health, University of Helsinki, Helsinki, Finland
| | - Hanna Remes
- Population Research Unit, University of Helsinki, Helsinki, Finland
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Teichman AL, Walls DO, Choron RL, Starace D, Mosier AS, Lissauer M, Gupta R. Improving elementary students' knowledge and behavior to prevent traumatic injury: the impact of a behavioral skills training model delivered by aspirational role models. Eur J Pediatr 2023:10.1007/s00431-023-05002-3. [PMID: 37154923 DOI: 10.1007/s00431-023-05002-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/26/2023] [Accepted: 04/22/2023] [Indexed: 05/10/2023]
Abstract
Trauma is the leading cause of childhood morbidity and mortality annually in the USA, accounting for 11% of deaths, most commonly due to car crashes, suffocation, drowning, and falls. Prevention is paramount for reducing the incidence of these injuries. As an adult level 1 and pediatric level 2 trauma center, there is a commitment to injury prevention through outreach and education. The Safety Ambassadors Program (SAP) was developed as part of this aim. Safety Ambassadors (SA) are high schoolers who teach elementary school students about safety/injury prevention. The curriculum addresses prevalent areas of injury risk: car/pedestrian safety, wheeled sports/helmets, and fall prevention. The study group hypothesized that participation in SAP leads to improved safety knowledge and behaviors and ultimately reduces childhood preventable injuries. Educational material was delivered by high school students (ages 16-18 years old). First and second-grade participants (ages 6-8 years old) completed pre- and post-course exams to assess knowledge (12 questions) and behavior (4 questions). Results were retrospectively reviewed, and pre/post training mean scores were calculated. Scores were calculated based on number of correct answers on pre/post exam. Comparisons were made using the Student t-test. All tests were 2-tailed with significance set at 0.05. Pre- and post-training results were assessed for 2016-2019. Twenty-eight high schools and 37 elementary schools were enrolled in the program with 8832 student participants in SAP. First graders demonstrated significant improvement in safety knowledge (pre 9 (95% CI 8.9-9.2) vs post 9.8 (95%CI 9.6-9.9), (p < 0.01)) and behavior modification (pre 3.2 (95%CI 3.1-3.2) vs post 3.6 (95% CI 3.5-3.6), (p < 0.01)). Similar findings were seen in 2nd graders: safety knowledge (pre 9.6 (95% CI 9.4-9.9) vs post 10.1 (95% CI 9.9-10.2), (p < 0.01)) and behavior (pre 3.3 (95% CI 3.1-3.4) vs post 3.5 (95%CI 3.4-3.6), (p < 0.01)). Conclusion: SAP is a novel evidence-based educational program delivered to elementary school students by aspirational role models. This model is impactful, relatable, and engaging when provided by participants' older peer mentors. On a local level, it has demonstrated improved safety knowledge and behavior in elementary school students. As trauma is the leading cause of pediatric death and disability, enhanced education may lead to life-saving injury prevention in this vulnerable population. What is Known: • Preventable trauma is the leading cause of pediatric death in the USA and education has contributed to improvements in both safety knowledge and behavior. • The ideal delivery method for injury prevention education in children continues to be under investigation. What is New: • Our data suggest that a peer-based injury prevention model is both an effective education delivery method and easily instituted within existing school systems. • This study supports implementation of peer-based injury prevention programs to improve safety knowledge and practices. • With more widespread institution and research, we hope to ultimately reduce preventable childhood injury.
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Affiliation(s)
- Amanda L Teichman
- Department of Surgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street Suite 6300, New Brunswick, NJ, 08901, USA.
| | - David O Walls
- Department of Surgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street Suite 6300, New Brunswick, NJ, 08901, USA
| | - Rachel L Choron
- Department of Surgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street Suite 6300, New Brunswick, NJ, 08901, USA
| | - Diana Starace
- Department of Surgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street Suite 6300, New Brunswick, NJ, 08901, USA
| | - Allison S Mosier
- Department of Surgery, Division of Acute Care Surgery, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street Suite 6300, New Brunswick, NJ, 08901, USA
| | - Matthew Lissauer
- Acute Care Surgery, Hartford HealthCare Medical Group, 80 Seymour Street, Hartford, CT, 06102, USA
| | - Rajan Gupta
- Acute Care Surgery, Foundation Surgery, Solution Health, 8 Prospect Street, Nashua, NH, 03060, USA
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Feng Y, Li X, Ma X, Zhu Z, Chen K, Gao J, Xia J, Jiang R, Lu J. Using online social networks to provide a parental health-education intervention for preventing unintentional injuries among children aged 0-3 years: A randomized controlled trial and social network analysis in Shanghai, China. Front Public Health 2023; 10:1049851. [PMID: 36711338 PMCID: PMC9875045 DOI: 10.3389/fpubh.2022.1049851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Introduction Unintentional injury among children represents a major public health problem. Online-social-network-based parental-health-education is a potential way to reduce child unintentional injuries. The study aimed to explore the mechanisms by which online-social-network-based health education may reduce the unintentional injuries among children aged 0-3 years. Methods We conducted a participant-blinded, randomized controlled, online-social-network-based health-education intervention study from March 2019 to February 2020 in Shanghai. We established four WeChat groups (two intervention groups and two control groups). For the intervention groups, a doctor's assistant regularly delivered information regarding unintentional injuries among children, and community childcare doctors answered parents' questions concerning their children's health, including unintentional injuries. Meanwhile, the control groups did not receive any information from the assistant. The study selected one intervention group and one control group and compared the ego network and whole network indicators to determine the differences between the intervention and control groups. Results In the intervention and control groups, 64.5% and 31.9% of the members, respectively, engaged in communication, and 1,736 and 273 records, respectively, were obtained. Regarding ego network, the doctor showed the largest network in the intervention group, and the size of the intervention group's network was twice that of the control group; the number of ties in the intervention group was nine times that of the control group. Fourteen and four parents in the intervention and control group played an active role, respectively. Regarding centrality, all WeChat groups were loose and multiple centers existed. Regarding subgroup cohesion, the intervention group had 28 cliques with 27 members, and the control group had 4 cliques with 4 members. For structural hole, 23.7% and 7.5% members in the intervention and control group actively participated in interactions, respectively, having strong control and influence over other parents; 69.2% and 59.1% members in the intervention and control group, respectively, had values of < 1.000, showing that they had strong ability to cross-jump structural holes. Discussion Online-social-networks-based health education interventions could enhance communication among parents, and between parents and community childcare doctors, and also shorten the social distance between them. Thus, online-social-network-based parental-health-education-intervention can be a feasible and generalizable means of preventing unintentional injuries among children.
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Affiliation(s)
- Yuheng Feng
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China,China Research Center on Disability Issues, Fudan University, Shanghai, China,Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Xiaohong Li
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China,China Research Center on Disability Issues, Fudan University, Shanghai, China,Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China,*Correspondence: Xiaohong Li ✉
| | - Xueqi Ma
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China,China Research Center on Disability Issues, Fudan University, Shanghai, China,Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Zhixu Zhu
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China
| | - Kaiyue Chen
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China,China Research Center on Disability Issues, Fudan University, Shanghai, China,Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Jun Gao
- Informatization Office, Fudan University, Shanghai, China
| | - Jingwei Xia
- Shanghai Huangpu District Maternal and Child Health Care Institute, Shanghai, China
| | - Ruo Jiang
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China,China Research Center on Disability Issues, Fudan University, Shanghai, China,Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
| | - Jun Lu
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China,China Research Center on Disability Issues, Fudan University, Shanghai, China,Key Laboratory of Health Technology Assessment, National Health Commission, Fudan University, Shanghai, China
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Hashimoto A, Kawaguchi H, Hashimoto H. Contribution of the Technical Efficiency of Public Health Programs to National Trends and Regional Disparities in Unintentional Childhood Injury in Japan. Front Public Health 2022; 10:913875. [PMID: 35903376 PMCID: PMC9315066 DOI: 10.3389/fpubh.2022.913875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/21/2022] [Indexed: 12/03/2022] Open
Abstract
To achieve the Sustainable Development Goals, strengthening investments in health service inputs has been widely emphasized, but less attention has been paid to tackling variation in the technical efficiency of services. In this study, we estimated the technical efficiency of local public health programs for the prevention of unintentional childhood injury and explored its contribution to national trend changes and regional health disparities in Japan. Efficiency scores were estimated based on the Cobb-Douglas and translog production functions using a true fixed effects model in a stochastic frontier analysis to account for unobserved time-invariant heterogeneity across prefectures. Using public data sources, we compiled panel data from 2001 to 2017 for all 47 prefectures in Japan. We treated disability-adjusted life years (DALYs) as the output, coverage rates of public health programs as inputs, and caregivers' capacity and environmental factors as constraints. To investigate the contribution of efficiency to trend changes and disparities in output, we calculated the predicted DALYs with several measures of inefficiency scores (2001 average, yearly average, and prefecture-year-specific estimates). In the translog model, mean efficiency increased from 0.62 in 2001 to 0.85 in 2017. The efficiency gaps among prefectures narrowed until 2007 and then remained constant until 2017. Holding inefficiency score constant, inputs and constraints contributed to improvements in average DALYs and widened regional gaps. Improved efficiency over the years further contributed to improvements in average DALYs. Efficiency improvement in low-output regions and stagnated improvement in high-output regions offset the trend of widening regional health disparities. Similar results were obtained with the Cobb-Douglas model. Our results demonstrated that assessing the inputs, constraints, output, and technical efficiency of public health programs could provide policy leverage relevant to region-specific conditions and performance to achieve health promotion and equity.
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Affiliation(s)
- Ayumi Hashimoto
- Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | | | - Hideki Hashimoto
- Department of Health and Social Behavior, School of Public Health, University of Tokyo, Tokyo, Japan
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Honda C, Yoshioka-Maeda K, Fujii H, Iwasaki-Motegi R, Yamamoto-Mitani N. Evaluation of Infant Injury Prevention Education Provided during Antenatal Classes after Two Years: A Pilot Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127195. [PMID: 35742444 PMCID: PMC9222745 DOI: 10.3390/ijerph19127195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 02/01/2023]
Abstract
This study examined the long-term effects of an infant injury prevention program implemented during an antenatal class of 131 mothers. Questionnaires were completed 2 years postpartum to assess the incidence of injury (medically attended or home-care), mothers’ perception of injury prevention, implementation of safety practices, and active attitudes toward injury prevention. Responses were obtained from 68 (51.9%) mothers (intervention group, 40; control group, 28), including 24 who reported medically attended injuries and 55 who reported home-care injuries. The incidence of medically attended injuries did not differ between groups. The incidence of home-care injuries was also not significantly different, but was lower in the intervention group (72.5% vs. 92.9%, p = 0.050). Significantly fewer children in the intervention group experienced “injury due to being caught between objects” (12.5% vs. 39.3%, p = 0.014). Mothers in the intervention group were significantly more aware of injury prevention than those in the control group (p = 0.033). The risk of home-care injuries was inversely related to mothers’ injury-prevention perception (odds ratio [OR]: 0.55, p = 0.035). This study suggests that group education during pregnancy regarding injury prevention increases mothers’ perception of injury prevention. These findings support implementing injury prevention education during antenatal classes.
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Affiliation(s)
- Chikako Honda
- Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
- Correspondence: ; Tel.: +81-3-5841-3597
| | - Kyoko Yoshioka-Maeda
- Department of Community Health Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
| | - Hitoshi Fujii
- Department of Medical Statistics, School of Nursing, Mejiro University, 320 Ukiya, Iwatsuki-ku, Saitama-shi 339-8501, Japan;
| | - Riho Iwasaki-Motegi
- Department of Health Promotion, National Institute of Public Health, 2-3-6, Minami, Wako-shi 351-0197, Japan;
| | - Noriko Yamamoto-Mitani
- Department of Gerontological home Care and Long-Term Care Nursing/Palliative Care Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan;
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Shalev L, Rudolf MCJ, Spitzer S. Better safe than sorry: Evaluating the implementation process of a home-visitation intervention aimed at preventing unintentional childhood injuries in the hospital setting. FRONTIERS IN HEALTH SERVICES 2022; 2:944367. [PMID: 36925878 PMCID: PMC10012825 DOI: 10.3389/frhs.2022.944367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/05/2022] [Indexed: 11/13/2022]
Abstract
Background Child home injuries prevention interventions have rarely been implemented in hospitals. The SHABI program ("Keeping our Children Safe"; in Hebrew: "SHomrim Al BetIchut Yeladenu") recruits at-risk families arriving with child injury to the Emergency Department. Medical/nursing students conduct two home visits four months apart, providing safety equipment and guidance. One hundred thirty-five families had a first visit and 98 completed the second. Fifty percentage of families were ultra-Orthodox Jews, 11% Arab, and 28% had ≥3 preschool children. We investigated SHABI's implementation using the Consolidated Framework for Implementation Research (CFIR). Methods Between May 2018 and March 2021 SHABI was implemented in the Emergency Department of a hospital in Israel's northern periphery, an area with high child injury rates. The Implementation process was examined through Emergency Department medical records and tracking registries, hospital management, nurses', and home visitors' meetings notes (n = 9), and a research diary. Hospital's inner setting and SHABI's characteristics were evaluated through interviews with hospital management, nurses, and home visitors 8 months after baseline (n = 18). Home visitors' characteristics were evaluated through interviews, post-visit questionnaire on challenges encountered (n = 233), families' perceptions of SHABI and home visitors' skills through telephone interviews (n = 212); and home visitors awareness of dangers at home (n = 8) baseline and 8 months later. Qualitative data were analyzed through explanatory content analysis according to CFIR constructs. Quantitative data were analyzed using X2 and Wilcoxon test for dependent subgroups. Results Despite alignment between SHABI and the hospital's mission, structural hospital-community disconnect prevented implementation as planned, requiring adaptation and collaboration with the medical school to overcome this barrier. Recruitment was included in the initial patient triage process but was only partially successful. Medical/nursing students were recruited as home visitors, and following training proved competent. Children were a distraction during the visits, but home visitors developed strategies to overcome this. Conclusions Injury prevention programs in hospitals have significant benefits. Identifying implementation barriers and facilitators allowed implementers to make adaptations and cope with the innovative implementation setting. Models of cooperation between hospital, community and other clinical settings should be further examined.
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Affiliation(s)
- Ligat Shalev
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Mary C J Rudolf
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Sivan Spitzer
- Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
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Cooray N, Sun SL, Ho C, Adams S, Keay L, Nassar N, Brown J. Toward a Behavior Theory-Informed and User-Centered Mobile App for Parents to Prevent Infant Falls: Development and Usability Study. JMIR Pediatr Parent 2021; 4:e29731. [PMID: 34932004 PMCID: PMC8726019 DOI: 10.2196/29731] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/28/2021] [Accepted: 07/28/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Falls account for approximately 50% of infant injury hospitalizations, and caretaker behavior is central to preventing infant falls. Behavior theory-informed interventions for injury prevention have been suggested, but to date, few have been reported. The potential of using smartphones for injury prevention intervention delivery is also underexploited. OBJECTIVE This study aims to develop a behavior theory- and evidence-based as well as user-centered digital intervention as a mobile app for parents to prevent infant falls following agile development practices. METHODS Infant falls while feeding was selected as the fall mechanism to demonstrate the approach being taken to develop this intervention. In phase 1, the Behaviour Change Wheel was used as a theoretical framework supported by a literature review to define intervention components that were then implemented as a mobile app. In phase 2, after the person-based approach, user testing through think-aloud interviews and comprehension assessments were used to refine the content and implementation of the intervention. RESULTS The target behaviors identified in phase 1 were adequate rest for the newborn's mother and safe feeding practices defined as prepare, position, and place. From behavioral determinants and the Behaviour Change Wheel, the behavior change functions selected to achieve these target behaviors were psychological capability, social opportunity, and reflective motivation. The selected behavior change techniques aligned with these functions were providing information on health consequences, using a credible source, instruction on performing each behavior, and social support. The defined intervention was implemented in a draft Android app. In phase 2, 4 rounds of user testing were required to achieve the predefined target comprehension level. The results from the think-aloud interviews were used to refine the intervention content and app features. Overall, the results from phase 2 revealed that users found the information provided to be helpful. Features such as self-tracking and inclusion of the social and environmental aspects of falls prevention were liked by the participants. Important feedback for the successful implementation of the digital intervention was also obtained from the user testing. CONCLUSIONS To our knowledge, this is the first study to apply the Behaviour Change Wheel to develop a digital intervention for child injury prevention. This study provides a detailed example of evidence-based development of a behavior theory-informed mobile intervention for injury prevention refined using the person-based approach.
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Affiliation(s)
- Nipuna Cooray
- The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Newtown, Australia
| | - Si Louise Sun
- School of Women's and Children's Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Catherine Ho
- The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Newtown, Australia
| | - Susan Adams
- The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Newtown, Australia
- Department of Paediatric Surgery, Sydney Children's Hospital, Randwick, Australia
| | - Lisa Keay
- The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Newtown, Australia
- School of Optometry and Vision Science, Faculty of Medicine and Health, UNSW Sydney, Sydney, Australia
| | - Natasha Nassar
- Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Julie Brown
- The George Institute for Global Health, Faculty of Medicine and Health, UNSW Sydney, Newtown, Australia
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Tsitsimpikou C, Georgiadis N, Tsarouhas K, Kartsidis P, Foufa E, Bacopoulou F, Choursalas A, Kouretas D, Nikolaidis AK, Koulaouzidou EA. Children and Parents' Awareness Regarding Potential Hazards Derived from the Use of Chemical Products in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412948. [PMID: 34948557 PMCID: PMC8701440 DOI: 10.3390/ijerph182412948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/16/2022]
Abstract
Over the last decades, human activities prompted the high production and widespread use of household chemical products, leading to daily exposure of humans to several chemicals. The objective of this study was to investigate the frequency of chemicals' use by children and parents in Greece and estimate the level of risk awareness and understanding among them. A total of 575 parents and children were asked to answer an anonymous, closed-ended, validated, and self-administered questionnaire. One-third of the children and almost half of the parents participating in the study believed that commonly used chemical products do not pose any risk to human health or to the environment, despite the product labelling. The majority of both children (61.8%) and parents (70.6%) were informed about product safety via the product labelling. Around 20% in both groups could not differentiate between systemic toxicity and acute lethal effects depicted by pictograms on the label and milder hazards, such as skin irritation. Moreover, the information on hazard and precautionary statements appearing on the label was very poorly perceived. Therefore, as both children and parents seem not to clearly identify the hazards and risks arising from the use of everyday chemical products, targeted awareness policies should be implemented to support the safe use of household products.
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Affiliation(s)
| | | | | | - Panagiotis Kartsidis
- School of Medicine, Faculty of Health Sciences, Aristotle University, 54124 Thessaloniki, Greece;
| | - Eleni Foufa
- General Chemical State Laboratory of Greece, 11521 Athens, Greece; (C.T.); (E.F.)
| | - Flora Bacopoulou
- Center for Adolescent Medicine and UNESCO Chair on Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children’s Hospital, 11527 Athens, Greece;
| | - Athanasios Choursalas
- Department of Pediatric Cardiology, Onasseio Cardiac Surgery Center, 17674 Athens, Greece;
| | - Dimitrios Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, 41500 Larissa, Greece;
| | - Alexandros K. Nikolaidis
- Division of Dental Tissues’ Pathology and Therapeutics (Basic Dental Sciences, Endodontology and Operative Dentistry), School of Dentistry, Aristotle University Thessaloniki, 54124 Thessaloniki, Greece;
| | - Elisabeth A. Koulaouzidou
- Division of Dental Tissues’ Pathology and Therapeutics (Basic Dental Sciences, Endodontology and Operative Dentistry), School of Dentistry, Aristotle University Thessaloniki, 54124 Thessaloniki, Greece;
- Correspondence: ; Tel.: +30-231-099-9616
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Evaluation of Communities That Care-Effects on Municipal Youth Crime Rates in Victoria, Australia: 2010-2019. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021; 23:24-35. [PMID: 34626325 DOI: 10.1007/s11121-021-01297-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 10/20/2022]
Abstract
Internationally, youth crime is a significant social problem. Violent youth crime has been rising over the past decade in the state of Victoria, Australia. Communities That Care (CTC) is a coalition training process designed to prevent youth crime. There has been limited evaluation outside the USA. Using a non-experimental design, this study employed official state crime statistics to evaluate the impact on crime as the five-phase CTC process was implemented between 2010 and 2019 across communities in Victoria. The standard five-phase CTC implementation cycle was supplemented with universal programs to reduce sales and supply of alcohol to underage youth (under 18 years). Growth models evaluated community trends in youth crime (all, person, property and deception and other), comparing communities that implemented CTC at phase 4 or greater with communities that had not implemented CTC. In accord with the hypotheses, the study found significant reductions in crimes associated with CTC over the period between 2010 and 2019. A 2% annual reduction in risk was observed for crimes against persons for all age groups (IRR = 0.98, 95% CI [0.96, 0.998]). A 5% annual reduction was observed for crimes of property and deception for adolescents aged between 10 and 17 years (IRR = 0.95, 95% CI [0.90, 0.99]). These findings support CTC as an intervention for preventing youth crime at a population level. Future studies should evaluate intervention mechanisms and economic benefits.
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11
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Jullien S. Prevention of unintentional injuries in children under five years. BMC Pediatr 2021; 21:311. [PMID: 34496772 PMCID: PMC8424785 DOI: 10.1186/s12887-021-02517-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Accepted: 01/21/2021] [Indexed: 11/30/2022] Open
Abstract
We looked at existing recommendations for preventing unintentional injuries in children under five years of age, and we attempted to identify the main sources used as evidence for formulating these recommendations. We conducted a literature search up to the 18th October 2019 by using key terms and manual search in selected sources. We summarized the recommendations and source of the evidence in tables for each of five areas of unintentional injuries: road traffic injuries, drowning, poisoning, thermal injuries, falls. In 2008, the World Health Organization (WHO) published a comprehensive report with strategies for child injury prevention for the European region. More recently, the WHO published several guidance documents focused on one area such as drowning, usually with a global focus. The PrevInfad workgroup (Spanish Association of Primary Care Pediatrics) updated their document on road safety in April 2019, providing recommendations and a summary of the existing evidence. Preventive strategies for injuries in childhood are mainly based on surveillance data and the identification of risk factors. The key strategies for preventing unintentional injuries are a combination of environmental and behaviour modification, that can be achieved through engineering, enforcement and education. Consequently, for this kind of strategies, it is important to evaluate the effectiveness of both the intervention itself, and the way the intervention is advised to parents and caretakers so that there is good compliance of the recommendation.
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Affiliation(s)
- Sophie Jullien
- Barcelona Institute for Global Health, University of Barcelona, Barcelona, Spain.
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12
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Henery PM, Dundas R, Katikireddi SV, Leyland A, Wood R, Pearce A. Social inequalities and hospital admission for unintentional injury in young children in Scotland: A nationwide linked cohort study. LANCET REGIONAL HEALTH-EUROPE 2021; 6:100117. [PMID: 34291228 PMCID: PMC8278494 DOI: 10.1016/j.lanepe.2021.100117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Background Unintentional injury is a leading cause of death/disability, with more disadvantaged children at greater risk. Understanding how inequalities vary by injury type, age, severity, and place of injury, can inform prevention. Methods For all Scotland-born children 2009-2013 (n=195,184), hospital admissions for unintentional injury (HAUI) were linked to socioeconomic circumstances (SECs) at birth: area deprivation via the Scottish Index of Multiple Deprivation (SIMD), mother's occupational social class, parents’ relationship status. HAUI was examined from birth-five, and during infancy. We examined HAUI frequency, severity, injury type, and injury location (home vs. elsewhere). We estimated relative inequalities using the relative indices of inequality (RII, 95% CIs), before and after adjusting for demographics and other non-mediating SECs. Findings More disadvantaged children were at greater risk of any HAUI from birth-five, RII: 1•59(1•49-1•70), 1•74(1•62-1•86), 1•97(1•84-2•12) for area deprivation, maternal occupational social class, and relationship status respectively. These attenuated after adjustment (1•15 [1•06-1•24], 1.22 [1•12-1•33], 1.32 [1•21-1•44]). Inequalities were greater for severe (vs. non-severe), multiple (vs. one-off) and home (vs. other location) injuries. Similar patterns were seen in infancy, excluding SIMD-inequalities in falls, where infants living in more disadvantaged neighbourhoods were at lower risk (0•79 [0•62-1•00]). After adjustment, reverse SIMD-gradients were also observed for all injuries and poisonings. Interpretation Children living in more disadvantaged households are more likely to be injured across multiple dimensions of HAUI in Scotland. Upstream interventions which tackle family-level disadvantage may be most effective at reducing childhood HAUI. Funding Wellcome Trust, Medical Research Council, Scottish Government Chief Scientist Office.
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Affiliation(s)
- Paul M Henery
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Ruth Dundas
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - S Vittal Katikireddi
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Alastair Leyland
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom
| | - Rachael Wood
- NHS National Services Scotland, Public Health Scotland, United Kingdom.,Centre for Clinical Brain Sciences, University of Edinburgh, United Kingdom
| | - Anna Pearce
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow, United Kingdom
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13
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Yong TSM, Perialathan K, Ahmad M, Juatan N, Abdul Majid L, Johari MZ. Perceptions and Acceptability of a Smartphone App Intervention (ChildSafe) in Malaysia: Qualitative Exploratory Study. JMIR Pediatr Parent 2021; 4:e24156. [PMID: 34061039 PMCID: PMC8207251 DOI: 10.2196/24156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Revised: 12/14/2020] [Accepted: 03/11/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Home is a vulnerable place for accidental child injuries. Unintentional injuries are a leading cause of death, hospitalization, and disabilities. These injuries are considered preventable and if not tackled, they will continue to be a persisting problem. Smartphones have become increasingly important in our everyday life and is an important tool not only for communication but also for other purposes-they have apps that can be used for various purposes. Therefore, an app-based intervention (ChildSafe) was developed to assess and reduce child injury at home. OBJECTIVE This study aimed to evaluate the acceptance of the ChildSafe smartphone app intervention by parents/guardians. METHODS This study was conducted using a qualitative exploratory approach on selected participants of the ChildSafe intervention app study. A total of 27 semistructured in-depth interviews were carried out among parents or guardians who have at least one child between the age of 0 and 59 months in the area of Sungai Buloh, Selangor, between November 2017 and March 2018. Interview questions were developed from the consolidated framework for implementation research (CFIR). Interviews were recorded, transcribed verbatim, and data were thematically analyzed guided by CFIR. RESULTS The study revealed users' perception on usability, feasibility, and acceptability toward the ChildSafe app. Three CFIR domains were identified: intervention characteristics, inner setting, and characteristics of individuals. A total of 5 constructs were revealed under intervention characteristics: evidence strength and quality, relative advantage, adaptability, trialability, and design quality and packaging; 2 under inner setting: implementation climate and readiness for implementation; and 4 under characteristics of individuals: knowledge and beliefs about the intervention, self-efficacy, individual stage of change, and other personal attributes. In general, participants felt the app is extremely useful and effective, easy to use, and purposeful in achieving home safety assessment via reminders. The app replaces the need for participants to search for information on home safety and dangers, as the app itself was designed as a tool to assess for this specific purpose. Even at the nascent stage and despite its limitations, the app has prompted users to consider and make changes around their own home. However, future versions of the app should be expanded to make it more attractive to users as it lacks interactive feedback and additional features. CONCLUSIONS Parents/guardians are accepting the use of the ChildSafe app to prevent child injury at home. However, further expansion and improvements are needed to increase the acceptability of this app by parents/guardians.
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Affiliation(s)
- Teresa Sui Mien Yong
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Komathi Perialathan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Masitah Ahmad
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Nurashma Juatan
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Liana Abdul Majid
- Institute of Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
| | - Mohammad Zabri Johari
- Institute for Health Behavioural Research, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Malaysia
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Seegert S, Meehan TD, Veres RA. Safety Education for Children Cannot Stop for a Pandemic: Transitioning an Injury Prevention Program to a Virtual Format. EARLY CHILDHOOD EDUCATION JOURNAL 2021; 49:881-886. [PMID: 34054287 PMCID: PMC8142608 DOI: 10.1007/s10643-021-01212-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/17/2021] [Indexed: 06/12/2023]
Abstract
In-person safety programs for pre-kindergarten children were not able to go on in their usual way during the summer of 2020 due to the Covid-19 pandemic. While some communities opted to cancel the programs, one organization in Northwest Ohio chose to reformat it, knowing that this education is a critical introduction to lifelong safety habits. Through social media, video-taped education from community safety professionals, and activity packets given to registrants, "Safety City" was able to go on. The new format incorporated all of the childhood safety topics normally presented in the live version of the program. The efforts described here indicate that it is feasible to alter presentation formats from in-person to virtual to connect even young children with important education. As such, similar programs needing to make this transition while the world continues to adjust to pandemic precautions may benefit from understanding the strengths, limitations, and insights from the process.
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Affiliation(s)
- Sara Seegert
- ProMedica Research, ProMedica Toledo Hospital, 2121 Hughes Dr. HMT 830, Toledo, OH 43606 USA
| | - Taylor D. Meehan
- ProMedica Injury Prevention and Community Outreach, ProMedica Russell J. Ebeid Children’s Hospital, Toledo, OH USA
| | - Regina A. Veres
- ProMedica Injury Prevention and Community Outreach, ProMedica Russell J. Ebeid Children’s Hospital, Toledo, OH USA
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Fareleira F, Xavier MR, Velte J, Teixeira A, Martins C. Parenting, child development and primary care-'Crescer em Grande!' intervention (CeG!) based on the Touchpoints approach: a cluster-randomised controlled trial protocol. BMJ Open 2021; 11:e042043. [PMID: 33980514 PMCID: PMC8117987 DOI: 10.1136/bmjopen-2020-042043] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 11/03/2022] Open
Abstract
INTRODUCTION Despite support for parenting being already recognised as a priority, there remains a paucity of evidence on how to facilitate its adoption in regular visits of maternal and child health primary care (PC). We describe the protocol for a study to assess the effect of an innovative universal Touchpoints-based intervention-'Crescer em Grande!' (CeG!) - when supporting the process of transition to parenthood and early infancy, at multiple PC units. METHODS AND ANALYSIS A cluster-randomised trial will be conducted in 12 PC units (clusters) from the Lisbon metropolitan area, Portugal. Participants will be a minimum of three family physicians and one nurse/unit, as well as 216 expecting parents and future babies until 18 months who are using the PC services. Sites will be randomised to either the CeG! or usual care. The CeG! will consist of: (1) the integration of the Touchpoints approach in PC maternal and well-child visits, with the support of 28 leaflets for parents to file in a folder; plus (2) training for PC providers on how to perform the CeG! into existing practice. Parents will be required to fill in questionnaires at point throughout their child's 18-month, mostly online. The primary outcome will be the self-perception of parental competence (Parenting Sense of Competence Scale). Other outcomes include: family functioning, couple dynamics, mental health, well-being/quality of life, psychological experience of pregnancy, attachment, child development. Acceptability, satisfaction and feasibility of CeG! will also be obtained from providers' and parents' perspectives. Costs associated with delivering the CeG! will be calculated. Study analyses will be under the principle of intention-to-treat. ETHICS AND DISSEMINATION Approval was obtained from the Ethics Committee of the Regional Health Administration. The results will be shared with participants and disseminated via peer-reviewed published papers, presentations at scientific and professional conferences. TRIAL REGISTRATION NUMBER ISRCTN90692907.
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Affiliation(s)
- Filipa Fareleira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
| | - Maria Raul Xavier
- Universidade Católica Portuguesa, Faculty of Education and Psychology, Research Centre for Human Development, Porto, Portugal
| | - Julia Velte
- Unidade de Saúde Familiar AlphaMouro, Sintra, Portugal
| | - Andreia Teixeira
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
| | - Carlos Martins
- Center for Health Technology and Services Research (CINTESIS), Faculty of Medicine of the University of Porto, Porto, Portugal
- Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine of the University of Porto, Porto, Portugal
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Feasibility and Acceptability of a Tailored Infant Safe Sleep Coaching Intervention for African American Families. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18084133. [PMID: 33919783 PMCID: PMC8070675 DOI: 10.3390/ijerph18084133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 11/23/2022]
Abstract
Background: Approximately 3600 infants die suddenly and unexpectedly annually in the United States. Research suggests limitations of current behavioral interventions to reduce the risk for sleep-related deaths among African American families living in under-resourced neighborhoods. Guided by the theory of planned behavior and the socio-ecological model, the My Baby’s Sleep (MBS) intervention intends to reduce the risk for sleep-related infant deaths while addressing complex needs of African American families living in under-resourced neighborhoods. Objective: To assess feasibility and acceptability of MBS, a 7-month intervention that includes four home visits and multiple check-ins via phone and text message. Methods: This was a single-arm feasibility and acceptability study with quantitative and qualitive measures. African American families were recruited from community agencies that served an under-resourced metropolitan area. Results: Eight families (eight mothers, nine co-caregivers) completed the intervention. Families reported high acceptability of MBS content, process, and format, as evidenced by qualitative data and mean evaluation scores. Conclusion: MBS is feasible and acceptable among African American families living in under-resourced neighborhoods. These results suggest further investigation of MBS intervention efficacy in a large-scale randomized controlled trial.
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17
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Lyngsøe BK, Munk-Olsen T, Vestergaard CH, Rytter D, Christensen KS, Bech BH. Maternal depression and childhood injury risk: A population-based cohort study in Denmark. Brain Behav 2021; 11:e02029. [PMID: 33452760 PMCID: PMC7994683 DOI: 10.1002/brb3.2029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 11/24/2020] [Accepted: 12/23/2020] [Indexed: 01/02/2023] Open
Abstract
AIMS To assess the association between different stages of maternal depression and injury risk in offspring aged 0-10 years. METHODS Population-based cohort study of all live-born children in Denmark from 1 January 1997 until 31 December 2013 (n = 1,064,387). Main outcome measure was emergency department contacts with a main diagnosis of injury coded as DS00-DT98 (chapter XIX) according to the ICD-10. All information was obtained from Danish national registries. RESULTS Maternal depression was associated with higher injury hazard in the offspring throughout childhood compared to offspring of mothers with no history of depression. The strongest association was seen for the first year of life. First-time maternal depression was most strongly associated with injury in the child, especially in the first year of life (aHR = 1.70, 95% CI: 1.48-1.96). Children of mothers with relapse depression had 1.57 higher hazard of injury in the first year of life (aHR: 1.57, 95% CI: 1.44-1.70). Children of mothers with previously treated depression (postdepression) had 1.13 higher hazard of injury in the first year of life (aHR: 1.13, 95% CI: 1.09-1.17). Continuous treatment for depression was associated with a nonsignificant higher hazard of injuries in the first year of life (aHR: 1.06, 95% CI: 0.91-1.23). CONCLUSIONS Maternal depression was associated with higher injury risk in the offspring, particularly in early childhood. The association persisted in children of mothers with relapse depression. Our results suggest that children of mothers with depression are vulnerable several years after depression onset and treatment cessation.
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Affiliation(s)
- Bente Kjaer Lyngsøe
- Research Unit for General Practice, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark.,Aarhus University Hospital, Aarhus, Denmark
| | - Trine Munk-Olsen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Denmark
| | | | - Dorte Rytter
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Kaj Sparle Christensen
- Research Unit for General Practice, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Bodil Hammer Bech
- Research Unit for General Practice, Aarhus, Denmark.,Department of Public Health, Aarhus University, Aarhus, Denmark
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18
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Alshammari KO. Assessment of knowledge, attitude, and practice about first aid among male school teachers in Hail city. J Family Med Prim Care 2021; 10:138-142. [PMID: 34017716 PMCID: PMC8132825 DOI: 10.4103/jfmpc.jfmpc_1322_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/05/2020] [Accepted: 10/03/2020] [Indexed: 11/06/2022] Open
Abstract
Introduction: Children in schools are more prone to get injured during their activities. Awareness toward first aid is vital for teachers to provide solutions in case of the occurrence of accidents. Our work aimed to assess the knowledge, attitude, and practice of first aid and the associated factors among male school teachers in Hail city. Methodology: This is a cross-sectional study. A questionnaire-based survey was performed among teachers in primary, middle, and secondary male schools in the Hail region, Saudi Arabia. Statistical analysis was performed using STATA 12 software, Continuous variables were presented as mean, and SD and inter-group differences were compared using t-test. Categorical variables showed as numbers and percentages. P values <0.05 were considered statistically significant. Results: A total of 604 teachers were included in our sample; all completed an online structured questionnaire formed of 20 questions. The majority of participants were male teachers (80.96%). The teachers had a mean age of 39 ± 7.8 years old. Most of the teachers (90.9%) knew about first aids. More than one-half of teachers (58.28%) had not taken first aid training, and the majority of participants (87.9%) need to learn first aid principles. Age, sex, and marital status were significantly (P < 0.05) associated with the knowledge of first aids. Most of our samples depend on media and social media to gain information regarding first aid principles. Conclusion: Our study concluded that the school teachers in Hail city had good knowledge and attitude about the first aid. However, more training workshops were recommended for improving the first aid practice of teachers.
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Sampei M, Kato T, Piedvache A, Morisaki N, Saito J, Akiyama Y, Shinohara R, Yamagata Z, Urayama KY, Kondo N. Municipality-Level Checklist to Promote Parental Behaviors Related to Prevention of Unintentional Injury in Young Children: A Multilevel Analysis of National Data. J Epidemiol 2020; 30:450-456. [PMID: 31527342 PMCID: PMC7492702 DOI: 10.2188/jea.je20190079] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Unintentional injury is a major cause of morbidity and mortality among young children in developed countries. In this national study, we examined the role of municipality-level safety checklist implementation for reducing risky child-safety-related parental behaviors. Methods Nationwide data were collected to evaluate the impact of the Healthy Parents and Children 21 initiative of the Japanese government. Questionnaires related to safety checklist implementation were administered to a random sample of municipal offices and to parents at the child’s routine 1.5-year health exam on parental behaviors related to child safety. Adjusting for municipality and individual-level variables, multilevel analysis was used to examine the relationship between municipality checklist implementation (4-month health exam) and six child-safety-related parental behaviors at the 1.5-year health exam. Results Families (n = 23,394) across 371 municipalities in Japan were included in this study; 5.6% of municipalities implemented a child safety intervention. Living in a municipality with a checklist intervention was associated with reduction in certain risk behaviors (not keeping tobacco/ashtray and candy out of the reach of infants, not using a car seat, not having a lock on bathing room door). However, after additionally taking into account municipality-level residual effects, only the “tobacco” behavior showed association with municipality of residence (Interval odds ratio, 0.25–0.94) and others were weak in the context of other potential municipality-level influences. Conclusions A municipality-level intervention taking a checklist-based approach at the 4-month health exam in Japan appears to promote certain child safety behaviors in parents with children around 1.5 years of age.
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Affiliation(s)
- Makiko Sampei
- Department of Social Medicine, National Center for Child Health and Development
| | - Tsuguhiko Kato
- Department of Social Medicine, National Center for Child Health and Development
| | - Aurelie Piedvache
- Department of Social Medicine, National Center for Child Health and Development
| | - Naho Morisaki
- Department of Social Medicine, National Center for Child Health and Development
| | - Junko Saito
- Division of Prevention, Center for Public Health Sciences, National Cancer Center.,Department of Health Education and Health Sociology, Department of Health and Social Behavior, School of Public Health, The University of Tokyo
| | - Yuka Akiyama
- Department of Health Sciences, School of Medicine. University of Yamanashi
| | - Ryoji Shinohara
- Center for Birth Cohort Studies Graduate School of Interdisciplinary Research, University of Yamanashi
| | - Zentaro Yamagata
- Department of Health Sciences, School of Medicine. University of Yamanashi
| | - Kevin Y Urayama
- Department of Social Medicine, National Center for Child Health and Development.,Graduate School of Public Health, St. Luke's International University
| | - Naoki Kondo
- Department of Health Education and Health Sociology, Department of Health and Social Behavior, School of Public Health, The University of Tokyo
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20
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Nevriana A, Pierce M, Dalman C, Wicks S, Hasselberg M, Hope H, Abel KM, Kosidou K. Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden. BMJ 2020; 369:m853. [PMID: 32269017 PMCID: PMC7190076 DOI: 10.1136/bmj.m853] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To determine the association between parental mental illness and the risk of injuries among offspring. DESIGN Retrospective cohort study. SETTING Swedish population based registers. PARTICIPANTS 1 542 000 children born in 1996-2011 linked to 893 334 mothers and 873 935 fathers. EXPOSURES Maternal or paternal mental illness (non-affective psychosis, affective psychosis, alcohol or drug misuse, mood disorders, anxiety and stress related disorders, eating disorders, personality disorders) identified through linkage to inpatient or outpatient healthcare registers. MAIN OUTCOME MEASURES Risk of injuries (transport injury, fall, burn, drowning and suffocation, poisoning, violence) at ages 0-1, 2-5, 6-9, 10-12, and 13-17 years, comparing children of parents with mental illness and children of parents without mental illness, calculated as the rate difference and rate ratio adjusted for confounders. RESULTS Children with parental mental illness contributed to 201 670.5 person years of follow-up, while children without parental mental illness contributed to 2 434 161.5 person years. Children of parents with mental illness had higher rates of injuries than children of parents without mental illness (for any injury at age 0-1, these children had an additional 2088 injuries per 100 000 person years; number of injuries for children with and without parental mental illness was 10 235 and 72 723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100 000 person years among children with parental mental illness compared with children without parental mental illness. A higher adjusted rate ratio for injuries was observed from birth through adolescence and the risk was highest during the first year of life (adjusted rate ratio at age 0-1 for the overall association between any parental mental illness that has been recorded in the registers and injuries 1.30, 95% confidence interval 1.26 to 1.33). Adjusted rate ratios at age 0-1 ranged from 1.28 (1.24 to 1.32) for fall injuries to 3.54 (2.28 to 5.48) for violence related injuries. Common and serious maternal and paternal mental illness was associated with increased risk of injuries in children, and estimates were slightly higher for common mental disorders. CONCLUSIONS Parental mental illness is associated with increased risk of injuries among offspring, particularly during the first years of the child's life. Efforts to increase access to parental support for parents with mental illness, and to recognise and treat perinatal mental morbidity in parents in secondary care might prevent child injury.
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Affiliation(s)
- Alicia Nevriana
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Matthias Pierce
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
| | - Christina Dalman
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Susanne Wicks
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
| | - Marie Hasselberg
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Holly Hope
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
| | - Kathryn M Abel
- Centre for Women's Mental Health, Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kyriaki Kosidou
- Department of Global Public Health, Karolinska Institutet, 17177 Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm Region, Stockholm, Sweden
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21
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Bhatta S, Mytton JA, Deave T. Assessment of home hazards for non-fatal childhood injuries in rural Nepal: a community survey. Inj Prev 2020; 27:104-110. [PMID: 32060131 DOI: 10.1136/injuryprev-2019-043482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 01/03/2020] [Accepted: 01/07/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Unintentional injuries in and around the home are important causes of preventable death and disability among young children globally. In Nepal, there is a lack of data regarding home injuries and home hazards to guide the development of effective interventions for preventing childhood home injuries. This study aimed to determine the burden of unintentional home injuries in children <5 years in rural Nepal and quantify the injury hazards in their homes. METHODS A survey was conducted in 740 households in rural areas of the Makwanpur district during February and March 2015. The primary carer reported home injuries which occurred in the previous 3 months and data collector observation identified the injury hazards. Injury incidence, mechanism and the proportion of households with different hazards were described. Multivariable logistic regression explored associations between the number and type of home hazards and injuries. RESULTS Injuries severe enough to need treatment, or resulting in non-participation in usual activities for at least a day, were reported in 242/1042 (23.2%) children <5 years. The mean number of injury hazards per household was 14.98 (SD=4.48), range of 3-31. Regression analysis found an estimated increase of 31% in the odds of injury occurrence associated with each additional injury hazard found in the home (adjusted OR 1.31; 95% CI 1.20 to 1.42). CONCLUSIONS A high proportion of young children in rural Nepal sustained injuries severe enough to miss a day of usual activities. Increased frequency of hazards was associated with an increased injury risk.
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Affiliation(s)
- Santosh Bhatta
- Centre for Academic Child Health, University of the West of England, Bristol, UK
| | - Julie A Mytton
- Centre for Academic Child Health, University of the West of England, Bristol, UK
| | - Toity Deave
- Centre for Academic Child Health, University of the West of England, Bristol, UK
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Berecki-Gisolf J, Rowland B, Reavley N, Minuzzo B, Toumbourou J. Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001-2017. Inj Prev 2019; 26:463-470. [PMID: 31753904 PMCID: PMC7513265 DOI: 10.1136/injuryprev-2019-043386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 09/20/2019] [Accepted: 09/23/2019] [Indexed: 11/04/2022]
Abstract
BACKGROUND Injuries are one of the three leading causes of morbidity and mortality for young people internationally. Although community risk factors are modifiable causes of youth injury, there has been limited evaluation of community interventions. Communities That Care (CTC) offers a coalition training process to increase evidence-based practices that reduce youth injury risk factors. METHOD Using a non-experimental design, this study made use of population-based hospital admissions data to evaluate the impact on injuries for 15 communities that implemented CTC between 2001 and 2017 in Victoria, Australia. Negative binomial regression models evaluated trends in injury admissions (all, unintentional and transport), comparing CTC and non-CTC communities across different age groups. RESULTS Statistically significant relative reductions in all hospital injury admissions in 0-4 year olds were associated with communities completing the CTC process and in 0-19 year olds when communities began their second cycle of CTC. When analysed by subgroup, a similar pattern was observed with unintentional injuries but not with transport injuries. CONCLUSION The findings support CTC coalition training as an intervention strategy for preventing youth hospital injury admissions. However, future studies should consider stronger research designs, confirm findings in different community contexts, use other data sources and evaluate intervention mechanisms.
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Affiliation(s)
- Janneke Berecki-Gisolf
- Monash University Accident Research Centre, Monash University, Clayton, Victoria, Australia
| | - Bosco Rowland
- Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Nicola Reavley
- Centre for Mental Health, The University of Melbourne School of Population and Global Health, Melbourne, Victoria, Australia
| | | | - John Toumbourou
- Faculty of Health, Deakin University, Geelong, Victoria, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Victoria, Australia
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Ning P, Cheng P, Schwebel DC, Yang Y, Yu R, Deng J, Li S, Hu G. An App-Based Intervention for Caregivers to Prevent Unintentional Injury Among Preschoolers: Cluster Randomized Controlled Trial. JMIR Mhealth Uhealth 2019; 7:e13519. [PMID: 31400105 PMCID: PMC6713040 DOI: 10.2196/13519] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 05/08/2019] [Accepted: 06/16/2019] [Indexed: 12/29/2022] Open
Abstract
Background App-based interventions have the potential to reduce child injury in countries with limited prevention resources, but their effectiveness has not been rigorously examined. Objective This study aimed to assess the effectiveness of an app-based intervention for caregivers of preschoolers to prevent unintentional injury among Chinese preschoolers. Methods A 6-month cluster randomized controlled trial was conducted from December 2017 to June 2018. Recruitment was conducted through preschools, which were randomly allocated to either the control group (ie, app-based parenting education excluding unintentional injury prevention) or the intervention group (ie, app-based parenting education including unintentional injury prevention). A total of 2920 caregivers of preschoolers aged 3-6 years from 20 preschools in Changsha, China, were recruited offline through the schools. The primary outcome was unintentional injury incidences among preschoolers in the past 3 months; this measure was assessed through an online caregiver-report at the baseline visit and at 3-month and 6-month follow-up visits. Secondary outcome measures included caregivers’ self-reported attitudes and behaviors concerning child supervision during the last week. Generalized estimating equations (GEEs) were used to assess the effectiveness of the app-based intervention on responses at 3 and 6 months after adjusting for sociodemographic variables, baseline level of the outcome variable, and engagement with interventions in the assigned group. All analyses were intention-to-treat. A per-protocol sensitivity analysis was also conducted. Results In total, 1980 of the 2920 caregivers completed the study. The mean age of participants was 32.0 years (SD 5.5) and 68.99% (1366/1980) of them were female. During the 6-month follow-up visit, unintentional injury incidence did not change significantly in either group: incidence in the intervention group went from 8.76% (94/1073) to 8.11% (87/1073), P=.59; incidence in the control group went from 9.4% (85/907) to 7.5% (69/907), P=.15. The changes did not differ between the groups (odds ratio [OR] 1.14, 95% CI 0.80-1.62). Changes in the average score in attitude concerning unintentional injury prevention were also similar between the groups (B .05, 95% CI -0.03 to 0.13). Changes in unintentional injury prevention behaviors were greater in the intervention group than in the control group after the intervention (B .87, 95% CI 0.33-1.42). Analyses of individual injury prevention behaviors showed that the intervention reduced three risky behaviors: unsafe feeding of children (OR 0.73, 95% CI 0.60-0.89); incorrectly placing children in cars (OR 0.73, 95% CI 0.57-0.93); and allowing children to ride bicycles, electric bicycles, or motorcycles unsupervised (OR 0.80, 95% CI 0.64-0.99). The intervention also improved scores on three safety-focused behaviors: testing water temperature before giving children a bath (OR 1.26, 95% CI 1.05-1.52); properly storing sharp objects (OR 1.24, 95% CI 1.01-1.52); and safely storing medicines, detergents, and pesticides (OR 1.24, 95% CI 1.02-1.51). Conclusions The app-based intervention did not reduce unintentional injury incidence among preschoolers but significantly improved caregivers’ safety behaviors. This app-based intervention approach to improve caregiver behaviors surrounding child injury risk offers promise to be modified and ultimately disseminated broadly. Trial Registration Chinese Clinical Trial Registry ChiCTR-IOR-17010438; http://www.chictr.org.cn/showproj.aspx?proj=17376 (Archived by WebCite at http://www.webcitation.org/75jt17X84) International Registered Report Identifier (IRRID) RR2-10.1186/s12889-018-5790-1
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Affiliation(s)
- Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, Emerging Pathogen Institute, University of Florida, Gainesville, FL, United States
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shukun Li
- Information and Network Center, Central South University, Changsha, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Ning P, Gao D, Cheng P, Schwebel DC, Wei X, Tan L, Xiao W, He J, Fu Y, Chen B, Yang Y, Deng J, Wu Y, Yu R, Li S, Hu G. Needs Analysis for a Parenting App to Prevent Unintentional Injury in Newborn Babies and Toddlers: Focus Group and Survey Study Among Chinese Caregivers. JMIR Mhealth Uhealth 2019; 7:e11957. [PMID: 31038465 PMCID: PMC6658302 DOI: 10.2196/11957] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 01/30/2019] [Accepted: 03/24/2019] [Indexed: 01/20/2023] Open
Abstract
Background With the growing popularity of mobile health technology, app-based interventions delivered by smartphone have become an increasingly important strategy toward injury prevention. Objective This study aimed to develop a framework supporting the design of an app-based intervention to prevent unintentional injury, targeted for caregivers of Chinese children aged 0 to 6 years. Methods A theory-based mixed-method study, including focus groups and Web-based quantitative survey, was performed. Adult caregivers who care for children aged 0 to 6 years and own a smartphone were recruited into 2 sequential stages of research. First, focus groups were conducted among the caregivers at community health care centers and preschools from December 2015 to March 2016. Focus groups (8-10 participants per group) explored awareness, experiences, and opinions of caregivers toward using an app to prevent unintentional injury among children. Second, based on the focus groups findings, a Web-based quantitative survey was designed and distributed to caregivers in November 2016; it collected information on specific needs for the app-based intervention. Thematic analysis and quantitative descriptive analyses were performed. Results In total, 12 focus groups were completed, involving 108 caregivers. Most participants expressed a strong desire to learn knowledge and skills about unintentional child injury prevention and held positive attitudes toward app-based interventions. Participants expressed multiple preferences concerning the app-based intervention, including their contents, functions, interactive styles, installation and registration logistics, and privacy protection and information security. Following the focus groups, 1505 caregivers completed a WeChat-based quantitative survey, which generated roughly similar results to those of focus groups and added numerical metrics concerning participants’ preferences on what to learn, when to learn it, and how to learn it. A detailed framework was established involving 5 components: (1) content design, (2) functional design, (3) interactive style, (4) installation and registration logistics, and (5) privacy protection and information security, and 15 specific requirements. Conclusions We developed a framework that can be used as a guide to design app-based interventions for parents and caregivers, specifically for unintentional injury prevention of children aged 0 to 6 years.
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Affiliation(s)
- Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Deyue Gao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Xiang Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Liheng Tan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Wangxin Xiao
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jieyi He
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yanhong Fu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Bo Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yue Wu
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, China
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shukun Li
- Information and Network Center, Central South University, Changsha, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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25
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Ning P, Chen B, Cheng P, Yang Y, Schwebel DC, Yu R, Deng J, Li S, Hu G. Effectiveness of an app-based intervention for unintentional injury among caregivers of preschoolers: protocol for a cluster randomized controlled trial. BMC Public Health 2018; 18:865. [PMID: 29996813 PMCID: PMC6042388 DOI: 10.1186/s12889-018-5790-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/03/2018] [Indexed: 11/28/2022] Open
Abstract
Background Each year, over 15,000 preschoolers die from unintentional injuries in China. Many interventions proven to work in other nations have not been implemented nationwide in China. The rapid popularity of smartphones offers an opportunity to overcome this limitation and disseminate evidence-based interventions to the large population of China. This study aims to assess the effectiveness of an app-based intervention for caregivers of preschoolers to prevent unintentional injury among young Chinese children. Method A single-blinded, 6-month, parallel-group cluster randomized controlled trial with 1:1 allocation ratio will be conducted in Changsha, China. In total, 2626 caregivers of preschoolers ages 3–6 years old who own a smartphone will be recruited from 20 preschools. Clusters will be randomized at the preschool level and allocated to either the control group (routine education plus app-based parenting education excluding unintentional injury prevention) or the intervention group (routine education plus app-based parenting education including unintentional injury prevention). The app-based injury prevention program was developed based on the Theory of Planned Behavior, the Haddon Matrix, the Mobile Learning framework, and a needs assessment. Data collection will be conducted at baseline, 3-month, and 6-month follow-up via app-based survey plus printed questionnaire survey. The primary outcome measure is unintentional injury incidence among preschoolers in the past 3 months. Secondary outcome measures include economic losses due to unintentional injury in the past 3 months, the Incremental Cost-Effectiveness Ratios (ICERs), and parent’s attitudes and behaviors concerning supervision to prevent preschooler unintentional injury in the past week. An intention-to-treat approach will be used to evaluate outcome measures. Chi-square tests will examine differences for outcome measures between groups at each time point and generalized estimation equations (GEE) will test the overall effectiveness of the app-based intervention. Missing outcome data will be imputed using the Expectation Maximization algorithm (EM). Discussion This trial will examine evidence concerning the effectiveness of an innovative app-based intervention for caregivers of Chinese preschoolers. If effective, the app-based intervention could offer an effective population-based intervention option to cost-effectively promote unintentional injury prevention in countries and regions where injury control is under-supported. Trial registration ChiCTR-IOR-17010438. Registered 15 January 2017. Electronic supplementary material The online version of this article (10.1186/s12889-018-5790-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Peishan Ning
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Bo Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Peixia Cheng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - David C Schwebel
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Renhe Yu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Jing Deng
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China
| | - Shukun Li
- Information and Network Center, Central South University, Changsha, Hunan, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, 410078, Hunan, China.
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Titi N, van Niekerk A, Ahmed R. Child understandings of the causation of childhood burn injuries: Child activity, parental domestic demands, and impoverished settings. Child Care Health Dev 2018; 44:494-500. [PMID: 28718941 DOI: 10.1111/cch.12484] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 05/09/2017] [Accepted: 06/12/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Burns are a global public health problem. In South Africa, the rate of paediatric burn deaths is 5 times higher than other upper middle-income countries, with concentrations in impoverished settings. Globally, the majority of research focuses on expert and caregiver descriptions of burn occurrence, causation, and prevention, with limited consideration of children's perspectives. This study investigated children's understanding of the causation and prevention of childhood burns. METHODS Data were collected from eighteen 10- to 11-year-old children living in selected impoverished, fire-affected neighbourhoods in Cape Town, through 3 isiXhosa focus groups. All focus groups were transcribed, coded, and analysed for emerging themes through thematic analysis. RESULTS Themes regarding burn causation and risks centred around 4 themes: (a) developmental limits in context; (b) domestic chores, child capacity, and inability to say "no"; (c) inadequate supervision and compromised caregiving; and (d) unsafe structures. Child accounts of prevention pertained to (e) burn injury prevention activities in comprised environments and emphasized child agency, and upgrading the physical environment. CONCLUSION The children in this study ascribed burn injuries as the consequence of their developmental limits in the context of poverty, constraints on parental supervision, and unsafe environments. The children recommended safety education and upgrading their physical environments as part of burns injury prevention. The child accounts offer useful insights to inform safety interventions in impoverished settings.
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Affiliation(s)
- N Titi
- Violence, Injury and Peace Research Unit, South African Medical Research Council-Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
| | - A van Niekerk
- Violence, Injury and Peace Research Unit, South African Medical Research Council-Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
| | - R Ahmed
- Department of Psychology, University of the Western Cape, Cape Town, South Africa
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Smith J, Zheng X, Lafreniere K, Pike I. Social marketing to address attitudes and behaviours related to preventable injuries in British Columbia, Canada. Inj Prev 2018; 24:i52-i59. [PMID: 29549106 PMCID: PMC5992365 DOI: 10.1136/injuryprev-2017-042651] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/31/2018] [Accepted: 02/08/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Social marketing is a tool used in the domain of public health for prevention and public education. Because injury prevention is a priority public health issue in British Columbia, Canada, a 3-year consultation was undertaken to understand public attitudes towards preventable injuries and mount a province-wide social marketing campaign aimed at adults aged 25-55 years. METHODS Public response to the campaign was assessed through an online survey administered to a regionally representative sample of adults within the target age group between 1 and 4 times per year on an ongoing basis since campaign launch. A linear regression model was applied to a subset of this data (n=5186 respondents) to test the association between exposure to the Preventable campaign and scores on perceived preventability of injuries as well as conscious forethought applied to injury-related behaviours. RESULTS Campaign exposure was significant in both models (preventability: β=0.27, 95% CI 0.20 to 0.35; conscious thought: β=0.24, 95% CI 0.13 to 0.35), as was parental status (preventability: β=0.12, 95% CI 0.03 to 0.21; conscious thought: β=0.18, 95% CI 0.06 to 0.30). Exposure to the more recent campaign slogan was predictive of 0.47 higher score on conscious thought (95% CI 0.27 to 0.66). DISCUSSION This study provides some evidence that the Preventable approach is having positive effect on attitudes and behaviours related to preventable injuries in the target population. Future work will seek to compare these data to other jurisdictions as the Preventable social marketing campaign expands to other parts of Canada.
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Affiliation(s)
- Jennifer Smith
- BC Injury Research and Prevention Unit, Vancouver, British Columbia, Canada.,The Community Against Preventable Injuries, Vancouver, British Columbia, Canada
| | - Xin Zheng
- BC Injury Research and Prevention Unit, Vancouver, British Columbia, Canada
| | - Kevin Lafreniere
- The Community Against Preventable Injuries, Vancouver, British Columbia, Canada
| | - Ian Pike
- BC Injury Research and Prevention Unit, Vancouver, British Columbia, Canada.,The Community Against Preventable Injuries, Vancouver, British Columbia, Canada.,Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
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Alonge O, Agrawal P, Meddings D, Hyder AA. A systematic approach to injury policy assessment: introducing the assessment of child injury prevention policies (A-CHIPP). Inj Prev 2017; 25:199-205. [DOI: 10.1136/injuryprev-2017-042576] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 10/19/2017] [Accepted: 10/22/2017] [Indexed: 11/03/2022]
Abstract
IntroductionThis study presents a systematic approach—assessment of child injury prevention policies (A-CHIPP)—to assess and track policies on effective child injury interventions at the national level. Results from an initial pilot test of the approach in selected countries are presented.MethodA literature review was conducted to identify conceptual models for injury policy assessment, and domains and indicators were proposed for assessing national injury policies for children aged 1–9 years. The indicators focused on current evidence-supported interventions targeting the leading external causes of child injury mortality globally, and were organised into a self-administered A-CHIPP questionnaire comprising 22 questions. The questionnaire was modified based on reviews by experts in child injury prevention. For an initial test of the approach, 13 countries from all six WHO regions were selected to examine the accuracy, usefulness and ease of understanding of the A-CHIPP questionnaire.ResultsData on the A-CHIPP questionnaire were received from nine countries. Drowning and road traffic injuries were reported as the leading causes of child injury deaths in seven of these countries. Most of the countries lacked national policies on interventions that address child injuries; supportive factors such as finance and leadership for injury prevention were also lacking. All countries rated the questionnaire highly on its relevance for assessment of injury prevention policies.ConclusionThe A-CHIPP questionnaire is useful for national assessment of child injury policies, and such an assessment could draw attention of stakeholders to policy gaps and progress in child injury prevention in all countries.
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Lewis MG, Guddattu V, Kamath A, Biju S, Noronha J, Nayak B, Nair NS. Pooling of effect estimates obtained from various study designs in systematic reviews of public health interventions: A Bayesian approach to meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2017. [DOI: 10.1016/j.cegh.2016.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Massey SH, Newmark RL, Wakschlag LS. Explicating the role of empathic processes in substance use disorders: A conceptual framework and research agenda. Drug Alcohol Rev 2017; 37:316-332. [PMID: 28493364 DOI: 10.1111/dar.12548] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/05/2016] [Accepted: 03/02/2017] [Indexed: 11/29/2022]
Abstract
ISSUES Elucidating the role of empathic processes in developmental pathways to substance use disorders could have important implications for prevention. APPROACH We searched the biomedical and social sciences literature to determine what is known about empathy and psychopathological manifestations of severe lack of empathy in the initiation, development and maintenance of psychoactive substance use. Thirty-seven empirical studies were identified and formally reviewed. KEY FINDINGS Adults with alcohol and stimulant use disorders exhibited detectable impairments in both cognitive and affective empathy, measured behaviourally, neuroanatomically and by self-report, relative to controls. There were no developmental studies specifically designed to test the role of empathy in substance use pathways, but several studies that included measures of empathy suggest that empathy may be protective. Studies on severe empathic deficits were mixed regarding a unique role of empathy in substance use trajectories, independent of interpersonal style, impulsivity and social deviance. Implications and Conclusions. In the context of findings and methodological limitations of this review, we recommend more rigorous examination of empathy across the spectrum of substance use behaviour. Future work should utilise the following: (i) prospective assessment of empathic capacity in substance abusers during and following treatment; (ii) large, developmentally based prospective designs beginning prior to substance initiation incorporating multiple measures of empathy; (iii) assessment of the moderating role of gender, race and ethnicity; and (iv) prospective study of empathy in children at elevated risk for substance use disorders. [Massey SH, Newmark RL, Wakschlag LS. Explicating the role of empathic processes in substance use disorders: A conceptual framework and research agenda.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA.,Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Rebecca L Newmark
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA.,Institute for Innovations in Developmental Sciences, Northwestern University, Chicago, USA
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Froula LM, Lenane AM, Pasternack JR, Garfunkel LC, Baldwin CD. Case-Based Workshop for Teaching Child Abuse Prevention to Resident Physicians. MEDEDPORTAL : THE JOURNAL OF TEACHING AND LEARNING RESOURCES 2017; 13:10547. [PMID: 30800749 PMCID: PMC6354723 DOI: 10.15766/mep_2374-8265.10547] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 02/05/2017] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Child abuse is a ubiquitous problem with personal, interpersonal, and social consequences. Risk factors are well established, and preventive strategies have been effective in decreasing abusive parenting behaviors and child maltreatment incident reports. Curriculum tools are needed to incorporate these strategies into training programs so physicians are adequately trained to identify and prevent child maltreatment at the earliest opportunity. METHODS A literature review established the core content for the curriculum. Resident learning needs were assessed with an online survey sent to graduating residents and teaching faculty. Curriculum objectives were composed to target core content and to address learning needs. Adult learning theories were applied to design interactive, case-based workshops to meet the curriculum objectives. A qualitative assessment tool was distributed to participating residents pre- and postcurriculum. Evaluators were blinded to pre/post status. Follow-up surveys distributed 3 months after the curriculum evaluated for retention of content and application to clinical practice. RESULTS After workshop participation, residents showed a greater tendency to associate somatic and behavioral complaints with potential toxic stress or abuse and demonstrated understanding of ongoing needs and risks in affected families. On follow-up surveys, most residents self-reported progress toward incorporating discussion of risk factors, stress, and abuse into routine well-child visits. DISCUSSION Resident physicians who attended the child abuse prevention workshop acquired knowledge and skills relevant to secondary and tertiary child abuse prevention and indicated progress toward primary prevention goals during the subsequent 3 months.
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Affiliation(s)
- Lynette M. Froula
- Instructor of Clinical Emergency Medicine, Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry
| | - Ann M. Lenane
- Associate Professor, Departments of Pediatrics of Emergency Medicine, University of Rochester School of Medicine and Dentistry
| | - Julie R. Pasternack
- Senior Instructor, Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry
| | - Lynn C. Garfunkel
- Associate Professor, Department of Pediatrics, University of Rochester School of Medicine and Dentistry
| | - Constance D. Baldwin
- Professor, Department of Pediatrics, University of Rochester School of Medicine and Dentistry
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Coore Desai C, Reece JA, Shakespeare-Pellington S. The prevention of violence in childhood through parenting programmes: a global review. PSYCHOL HEALTH MED 2017; 22:166-186. [PMID: 28133982 DOI: 10.1080/13548506.2016.1271952] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Charlene Coore Desai
- Department of Child & Adolescent Health, University of the West Indies, Mona, Kingston, Jamaica
| | - Jody-Ann Reece
- Department of Child & Adolescent Health, University of the West Indies, Mona, Kingston, Jamaica
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Chow CB, Wong WHS, Leung WC, Tang MHY, Chan KL, Or CK, Li TM, Ho FKW, Lo D, Ip P. Effectiveness of a Technology-Based Injury Prevention Program for Enhancing Mothers' Knowledge of Child Safety: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2016; 5:e205. [PMID: 27799138 PMCID: PMC5108924 DOI: 10.2196/resprot.6216] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 08/08/2016] [Accepted: 08/25/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Provision of anticipatory guidance for parents is recommended as an effective strategy to prevent injuries among young children. Technology-based anticipatory guidance has been suggested to reinforce the effectiveness of injury prevention and improve parents' knowledge of child safety. OBJECTIVE This study aims to examine the effectiveness of a technology-based injury prevention program with parental anticipatory guidance for enhancing mothers' knowledge of child safety. METHODS In this randomized controlled trial, 308 mothers will be recruited from the antenatal clinics and postnatal wards of two major public hospitals in Hong Kong. Participating mothers will be randomly assigned into intervention and control groups. Mothers in the intervention group will be given free access to a technology-based injury prevention program with anticipatory guidance, whereas mothers in the control group will be given a relevant booklet on parenting. The injury prevention program, available as a website or on a mobile app, includes behavioral components based on the Theory of Planned Behavior. The primary outcome measure will be the change in the mother's knowledge of child safety. The secondary outcome measures will be age-appropriate domestic safety knowledge, attitudes, intentions, perceived behavioral control, and self-reported behavior related to home safety practice. We will also determine dose-response relationships between the outcome measures and the website and mobile app usage. RESULTS Enrolment of participants will begin in October 2016. Results are expected by June 2018. CONCLUSIONS Parents will be able to easily access the domestic injury prevention website to find information regarding child injury prevention. It is anticipated that the technology-based intervention will help parents improve their knowledge of child safety and raise their awareness about the consequences of domestic injuries and the importance of prevention. TRIAL REGISTRATION Clinicaltrials.gov Clinicaltrials.gov NCT02835768; http://clinicaltrials.gov/ct2/show/NCT02835768 (Archived by WebCite at http://www.webcitation/6lbXYM6b9).
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Affiliation(s)
- Chun Bong Chow
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Wing Cheong Leung
- Department of Obstetrics and Gynaecology, Kwong Wah Hospital, Hong Kong, China
| | - Mary Hoi-Yin Tang
- Department of Obstetrics and Gynaecology, The University of Hong Kong, Hong Kong, China
| | - Ko Ling Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Calvin Kl Or
- Department of Industrial and Manufacturing Systems Engineering, The University of Hong Kong, Hong Kong, China
| | - Tim Mh Li
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Frederick Ka Wing Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Daniel Lo
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China
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Möller H, Falster K, Ivers R, Falster MO, Clapham K, Jorm L. Closing the Aboriginal child injury gap: targets for injury prevention. Aust N Z J Public Health 2016; 41:8-14. [DOI: 10.1111/1753-6405.12591] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/01/2016] [Accepted: 06/01/2016] [Indexed: 11/28/2022] Open
Affiliation(s)
- Holger Möller
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
| | - Kathleen Falster
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
- National Centre for Epidemiology and Population Health; The Australian National University; Australian Capital Territory
- The Sax Institute; New South Wales
| | - Rebecca Ivers
- The George Institute for Global Health; New South Wales
| | - Michael O. Falster
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
| | - Kathleen Clapham
- The Australian Health Services Research Institute; University of Wollongong; New South Wales
| | - Louisa Jorm
- Centre for Big Data Research in Health; UNSW Kensington Campus; New South Wales
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Salam RA, Arshad A, Das JK, Khan MN, Mahmood W, Freedman SB, Bhutta ZA. Interventions to Prevent Unintentional Injuries Among Adolescents: A Systematic Review and Meta-Analysis. J Adolesc Health 2016; 59:S76-S87. [PMID: 27664598 PMCID: PMC5026686 DOI: 10.1016/j.jadohealth.2016.07.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 07/13/2016] [Accepted: 08/01/2016] [Indexed: 12/26/2022]
Abstract
Globally, every day, ∼2,300 children and adolescents succumb to unintentional injuries sustained from motor vehicle collisions, drowning, poisoning, falls, burns, and violence. The rate of deaths due to motor vehicle injuries in adolescents is 10.2 per 100,000 adolescents. We systematically reviewed published evidence to identify interventions to prevent unintentional injuries among adolescents aged 11-19 years. We defined unintentional injuries as a subset of injuries for which there was no evidence of predetermined intent, and the definition included motor vehicle injuries, suffocation, drowning, poisoning, burns, falls, and sports and recreation. Thirty-five studies met study eligibility criteria. The included studies focused on interventions to prevent motor vehicle injuries and sports-related injuries. Results suggest that possession of a graduated driver license (GDL) significantly reduced road accidents by 19% (relative risk [RR]: .81; 95% confidence interval [CI]: .75-.88; n = 5). There was no impact of GDL programs on incidence of injuries (RR: .78; 95% CI: .57-1.06; n = 2), helmet use (RR: 1.0; 95% CI: .98-1.02; n = 3), and seat belt use (RR: .99; 95% CI: .97-1.0; n = 3). Sports-related injury prevention interventions led to reductions in the incidence of injuries (RR: .66; 95% CI: .53-.82; n = 15), incidence of injury per hour of exposure (RR: .63; 95% CI: .47-.86; n = 5), and injuries per number of exposures (RR: .79; 95% CI: .70-.88; n = 4). Subgroup analysis according to the type of interventions suggests that training ± education and the use of safety equipment had significant impacts on reducing the incidence of injuries. We did not find any study focusing on interventions to prevent suffocation, drowning, poisoning, burns, and falls in the adolescent age group. The existing evidence is mostly from high-income countries, limiting the generalizability of these findings for low- and middle-income countries. Studies evaluating these interventions need to be replicated in a low- and middle-income country-context to evaluate effectiveness with standardized outcome measures.
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Affiliation(s)
- Rehana A. Salam
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Ahmed Arshad
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Jai K. Das
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | - Marium Naveed Khan
- Division of Women and Child Health, Aga Khan University, Karachi, Pakistan
| | | | - Stephen B. Freedman
- Section of Pediatric Emergency Medicine, Alberta Children's Hospital and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada,Section of Gastroenterology, Alberta Children's Hospital and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Zulfiqar A. Bhutta
- Centre for Global Child Heath, The Hospital for Sick Children, Toronto, Canada,Center of Excellence in Women and Child Health, The Aga Khan University, Karachi, Pakistan,Address correspondence to: Zulfiqar A. Bhutta, Ph.D., Centre for Global Child Health, The Hospital for Sick Children, 686 Bay Street, Toronto, Ontario M6S 1S6, Canada.Centre for Global Child HealthThe Hospital for Sick Children686 Bay StreetTorontoOntarioM6S 1S6Canada
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A tool to measure complexity in public health interventions: Its statistical properties and meta-regression approach to adjust it in meta-analysis. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2016. [DOI: 10.1016/j.cegh.2015.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Johnston CA, Vaughan E, Moreno JP. The Difficulty of Prevention: A Behavioral Perspective. Am J Lifestyle Med 2016; 10:14-16. [PMID: 30202254 PMCID: PMC6124857 DOI: 10.1177/1559827615609532] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Accepted: 09/11/2015] [Indexed: 11/16/2022] Open
Abstract
Behavioral medicine provides insight in to the problem of injury prevention. Society often views unintentional injuries as only an accident when in reality many accident-related injuries are preventable. However, barriers to behavioral change in injury prevention exist for both patients (eg, inconvenience, perceived risk-benefit ratio) and health care providers (eg, feeling of badgering nonadherent patients, patient misinformation). To overcome barriers, the article discusses strategies for health care providers to address injury prevention such as choosing active over passive strategies, informing patients of predictable injury-prone circumstances, and individualizing patient risks.
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Affiliation(s)
- Craig A. Johnston
- Craig A. Johnston, PhD, Department of Health and Human Performance, University of Houston, Houston, TX 77030; e-mail:
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Shidhaye R, Lund C, Chisholm D. Closing the treatment gap for mental, neurological and substance use disorders by strengthening existing health care platforms: strategies for delivery and integration of evidence-based interventions. Int J Ment Health Syst 2015; 9:40. [PMID: 26719762 PMCID: PMC4696279 DOI: 10.1186/s13033-015-0031-9] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 12/18/2015] [Indexed: 10/30/2022] Open
Abstract
This paper outlines the main elements and features of a mental health care delivery platform and its delivery channels. These include evidence-based interventions that can be delivered via this platform as well as broader health system strengthening strategies for more effective and efficient delivery of services. The focus is broadly on health systems perspective rather than strictly disorder-oriented intervention analysis. A set of evidence-based interventions within the WHO pyramid framework of self-care, primary care, and specialist care have been identified; the main challenge lies in the translation of that evidence into practice. The delivery of these interventions requires an approach that puts into practice key principles of public health, adopts systems thinking, promotes whole-of-government involvement and is focused on quality improvement. Key strategies for effective translation of evidence into action include collaborative stepped care, strengthening human resources, and integrating mental health into general health care. In order to pursue these principles and strategies using a platform-wide approach, policy makers need to engage with a wide range of stakeholders and make use of the best available evidence in a transparent manner.
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Affiliation(s)
- Rahul Shidhaye
- />Centre for Chronic Conditions and Injuries, Public Health Foundation of India, 19, Rishi Nagar, Char Imli, Bhopal, Madhya Pradesh India
- />CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Crick Lund
- />Department of Psychiatry and Mental Health, Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa
- />Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Dan Chisholm
- />Department of Mental Health and Substance Abuse, World Health Organization, Geneva, Switzerland
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Shi X, Shi J, Wheeler KK, Stallones L, Ameratunga S, Shakespeare T, Smith GA, Xiang H. Unintentional injuries in children with disabilities: a systematic review and meta-analysis. Inj Epidemiol 2015; 2:21. [PMID: 27747753 PMCID: PMC5005703 DOI: 10.1186/s40621-015-0053-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Accepted: 08/18/2015] [Indexed: 11/24/2022] Open
Abstract
Children with disabilities are thought to have an increased risk of unintentional injuries, but quantitative syntheses of findings from previous studies have not been done. We conducted a systematic review and meta-analysis to assess whether pre-existing disability can increase the risk of unintentional injuries among children when they are compared to children without disability. We searched 13 electronic databases to identify original research published between 1 January 1990 and 28 February 2013. We included those studies that reported on unintentional injuries among children with pre-existing disabilities compared with children without disabilities. We conducted quality assessments and then calculated pooled odds ratios of injury using random-effects models. Fifteen eligible studies were included from 24,898 references initially identified, and there was a total sample of 83,286 children with disabilities drawn from the eligible studies. When compared with children without disabilities, the pooled OR of injury was 1.86 (95 % CI 1.65–2.10) in children with disabilities. The pooled ORs of injury were 1.28, 1.75, and 1.86 in the 0–4 years, 5–9 years, and ≥10 years of age subgroups, respectively. Compared with children without disabilities, the pooled OR was 1.75 (95 % CI 1.26–2.43) among those with International Classification of Functioning (ICF) limitations. When disability was defined as physical disabilities, the pooled OR was 2.39 (95 % CI 1.43–4.00), and among those with cognitive disabilities, the pooled OR was 1.77 (95 % CI 1.49–2.11). There was significant heterogeneity in the included studies. Compared with peers without disabilities, children with disabilities are at a significantly higher risk of injury. Teens with disabilities may be an important subgroup for future injury prevention efforts. More data are needed from low- and middle-income countries.
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Affiliation(s)
- Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical College, Zunyi, Guizhou, China.,Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Junxin Shi
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.,Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Krista K Wheeler
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.,Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
| | - Lorann Stallones
- Colorado Injury Control Research Center, Colorado State University, Fort Collins, Colorado, USA
| | - Shanthi Ameratunga
- Section of Epidemiology and Biostatistics, School of Population Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Tom Shakespeare
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Gary A Smith
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA.,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - Huiyun Xiang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, 700 Children's Drive, Columbus, OH, 43205, USA. .,Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA. .,Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA.
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Mack DE, Aymar M, Cosby J, Wilson PM, Bradley C, Walters Gray C. Understanding Barriers for Communicating Injury Prevention Messages and Strategies Moving Forward: Perspectives from Community Stakeholders. Public Health Nurs 2015; 33:159-66. [PMID: 26309126 DOI: 10.1111/phn.12224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The primary objective of this study was to elicit the perspectives of direct care providers on barriers and facilitators to communicating injury prevention messages to parents/caregivers of children under 4 years of age. The secondary objective was to examine characteristics of an injury prevention messaging strategy preferred by direct care providers. DESIGN AND SAMPLE This qualitative study was conducted across four regions in Ontario Canada. Fifty-nine direct care providers were purposefully sampled and data interpreted using focus group analysis. MEASURES Transcripts were analyzed verbatim using content and discourse analysis. RESULTS Several barriers to communicating injury prevention messages were identified encompassing (a) role, (b) parental, (c) social determinants, and (d) evidence impediments. In an effort to offset some of these barriers, participants endorsed the development of a tailored multicomponent injury prevention strategy adopting action-based messages. CONCLUSION The results of this study provide an in-depth exploration of direct care providers perceptions that can inform the design of materials and dissemination strategies to help increase and optimize access to injury prevention information. Injury prevention messages should be action-oriented, specifically tailored to the stage of child development, and disseminated through both face-to-face interactions and mobile technology.
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Affiliation(s)
- Diane E Mack
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada
| | - Matt Aymar
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada
| | - Jarold Cosby
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada
| | - Philip M Wilson
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St Catharines, Ontario, Canada
| | - Christina Bradley
- Niagara Region Public Health, Chronic Disease and Injury Prevention Division, Thorold, Ontario, Canada
| | - Casey Walters Gray
- Kingston, Frontenac, Lennox and Addington Public Health, Reproductive and Child Health Team, Kingston, Ontario, Canada
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Walz H, Bohn B, Sander J, Eberle C, Alisch M, Oswald B, Kroke A. Access to Difficult-to-reach Population Subgroups: A Family Midwife Based Home Visiting Service for Implementing Nutrition-related Preventive Activities - A Mixed Methods Explorative Study. AIMS Public Health 2015; 2:516-536. [PMID: 29546123 PMCID: PMC5690248 DOI: 10.3934/publichealth.2015.3.516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 08/10/2015] [Indexed: 11/18/2022] Open
Abstract
Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming), an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs) to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1) to determine whether a discernible impact of home visits by FMs can be described; (2) to identify subgroups among these families in need of more specific interventions; (3) to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM) were analyzed (secondary analysis), and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology) statement. Based on the FMs reports, a significant improvement (p < 0.001) regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015). Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition-related preventive activities.
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Affiliation(s)
- Helena Walz
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
| | - Barbara Bohn
- formerly: Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany; currently: University of Ulm, Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm, Germany
| | - Jessica Sander
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
| | - Claudia Eberle
- Fulda University of Applied Sciences, Department of Nursing and Health Sciences, Fulda, Germany
| | - Monika Alisch
- Fulda University of Applied Sciences, Department of Social Work, Fulda, Germany
| | - Bernhard Oswald
- Youth Welfare Office, Quality Management / Early Prevention, Fulda, Germany
| | - Anja Kroke
- Fulda University of Applied Sciences, Department of Nutritional, Food and Consumer Sciences, Fulda, Germany
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Zou K, Wynn PM, Miller P, Hindmarch P, Majsak-Newman G, Young B, Hayes M, Kendrick D. Preventing childhood scalds within the home: Overview of systematic reviews and a systematic review of primary studies. Burns 2015; 41:907-24. [PMID: 25841997 PMCID: PMC4504085 DOI: 10.1016/j.burns.2014.11.002] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 10/14/2014] [Accepted: 11/04/2014] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To synthesise and evaluate the evidence of the effectiveness of interventions to prevent scalds in children. METHODS An overview of systematic reviews (SR) and a SR of primary studies were performed evaluating interventions to prevent scalds in children. A comprehensive literature search was conducted covering various resources up to October 2012. Experimental and controlled observational studies reporting scald injuries, safety practices and safety equipment use were included. RESULTS Fourteen systematic reviews and 39 primary studies were included. There is little evidence that interventions are effective in reducing the incidence of scalds in children. More evidence was found that inventions are effective in promoting safe hot tap water temperature, especially when home safety education, home safety checks and discounted or free safety equipment including thermometers and thermostatic mixing valves were provided. No consistent evidence was found for the effectiveness of interventions on the safe handling of hot food or drinks nor improving kitchen safety practices. CONCLUSION Education, home safety checks along with thermometers or thermostatic mixing valves should be promoted to reduce tap water scalds. Further research is needed to evaluate the effectiveness of interventions on scald injuries and to disentangle the effects of multifaceted interventions on scald injuries and safety practices.
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Affiliation(s)
- Kun Zou
- Division of Primary Care, University of Nottingham, 13th Floor Tower Building, University Park, Nottingham NG7 2RD, UK.
| | - Persephone M Wynn
- Division of Primary Care, University of Nottingham, 13th Floor Tower Building, University Park, Nottingham NG7 2RD, UK.
| | - Philip Miller
- Acute Medicine, Nottingham University Hospitals NHS Trust, City Hospital Campus, Hucknall Road, Nottingham NG5 1PB, UK.
| | - Paul Hindmarch
- Great North Children's Hospital, Research Unit Level 2, New Victoria Wing, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK.
| | - Gosia Majsak-Newman
- NHS Clinical Research & Trials Unit, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK.
| | - Ben Young
- Division of Primary Care, University of Nottingham, 13th Floor Tower Building, University Park, Nottingham NG7 2RD, UK.
| | - Mike Hayes
- Child Accident Prevention Trust, Canterbury Court (1.09), 1-3 Brixton Road, London SW9 6DE, UK.
| | - Denise Kendrick
- Division of Primary Care, University of Nottingham, 13th Floor Tower Building, University Park, Nottingham NG7 2RD, UK.
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Massey SH, Bublitz MH, Magee SR, Salisbury A, Niaura RS, Wakschlag LS, Stroud LR. Maternal-fetal attachment differentiates patterns of prenatal smoking and exposure. Addict Behav 2015; 45:51-6. [PMID: 25644587 DOI: 10.1016/j.addbeh.2015.01.028] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 12/14/2014] [Accepted: 01/14/2015] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers. METHODS Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 week gestation, and postpartum day one. Maternal Fetal Attachment Scale total and subscale scores (role-taking, differentiation of self from fetus, interaction with fetus, attributing characteristics to fetus, giving of self) were examined among non-smokers, pregnancy quitters, and persistent smokers. RESULTS At 30 weeks, pregnancy quitters scored higher on the 'giving of self' subscale compared to persistent smokers (21.6±2.4 versus 19.9±2.9; p=.004). Maternal 'giving of self' also differentiated pregnancies exposed to cigarette smoking from those without exposure from 30 weeks through delivery (19.9±2.9 versus 21.2±2.2; p=.002). Controlling for age, income, unemployment, gravida, and father's smoking status, 'giving of self' differentiated pregnancy quitters from persistent smokers [OR=5.144; 95% C.I. 1.509 - 17.538; B (SE)=1.638 (.626); p=.009]. CONCLUSIONS Women who reported a greater desire to maintain their personal health for the health of their fetus were more likely to quit smoking during pregnancy. Implications of findings for interventions and understanding mechanisms of risk are discussed.
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Affiliation(s)
- Suena H Massey
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, 676 North Saint Clair Street, Suite 1000, Chicago, IL 60611, USA,; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA.
| | - Margaret H Bublitz
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
| | - Susanna R Magee
- Department of Family Medicine, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Amy Salisbury
- Department of Pediatrics, Alpert Medical School of Brown University, Box G-A1, Providence, RI 02912, USA.
| | - Raymond S Niaura
- Schroeder Institute for Tobacco Research and Policy Studies, USA.
| | - Lauren S Wakschlag
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 633 North Saint Clair Street, 19th Floor, Chicago, IL 60611, USA; Institute for Policy Research, Northwestern University, 2040 Sheridan Road, Evanston, IL 60208, USA.
| | - Laura R Stroud
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Box G-BH, Providence, RI 02906, USA; Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Coro West, 164 Summit Ave, Suite 309, Providence, RI 02906, USA.
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Singh A, Yeh CJ, Verma N, Das AK. Overview of Attention Deficit Hyperactivity Disorder in Young Children. Health Psychol Res 2015; 3:2115. [PMID: 26973960 PMCID: PMC4768532 DOI: 10.4081/hpr.2015.2115] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 01/01/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a complex disorder, which can be seen as a disorder of life time, developing in preschool years and manifesting symptoms (full and/or partial) throughout the adulthood; therefore, it is not surprising that there are no simple solutions. The aim of this paper is to provide a short and concise review which can be used to inform affected children and adults; family members of affected children and adults, and other medical, paramedical, non-medical, and educational professionals about the disorder. This paper has also tried to look into the process of how ADHD develops; what are the associated problems; and how many other children and adults are affected by such problems all over the world basically to understand ADHD more precisely in order to develop a better medical and or non-medical multimodal intervention plan. If preschool teachers and clinicians are aware of what the research tells us about ADHD, the varying theories of its cause, and which areas need further research, the knowledge will assist them in supporting the families of children with ADHD. By including information in this review about the connection between biological behavior, it is hoped that preschool teachers and clinicians at all levels will feel more confident about explaining to parents of ADHD children, and older ADHD children themselves about the probable causes of ADHD.
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Affiliation(s)
- Ajay Singh
- Department of Early Childhood and Elementary Education, College of Education and Human Services, Murray State University , Murray, KY, USA
| | - Chia Jung Yeh
- Human Development and Family Science, College of Health and Human Performance, East Carolina University , Greenville, NC, USA
| | - Nidhi Verma
- Department of Psychology, Kurukshetra University , Kurukshetra, India
| | - Ajay Kumar Das
- Department of Adolescent, Career and Special Education, Murray State University , Murray, KY, USA
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Ablewhite J, Peel I, McDaid L, Hawkins A, Goodenough T, Deave T, Stewart J, Kendrick D. Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study. BMC Public Health 2015; 15:280. [PMID: 25885179 PMCID: PMC4392794 DOI: 10.1186/s12889-015-1547-2] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 02/16/2015] [Indexed: 11/25/2022] Open
Abstract
Background Childhood unintentional injury represents an important global health problem. Most of these injuries occur at home, and many are preventable. The main aim of this study was to identify key facilitators and barriers for parents in keeping their children safe from unintentional injury within their homes. A further aim was to develop an understanding of parents’ perceptions of what might help them to implement injury prevention activities. Methods Semi-structured interviews were conducted with sixty-four parents with a child aged less than five years at parent’s homes. Interview data was transcribed verbatim, and thematic analysis was undertaken. This was a Multi-centre qualitative study conducted in four study centres in England (Nottingham, Bristol, Norwich and Newcastle). Results Barriers to injury prevention included parents’ not anticipating injury risks nor the consequences of some risk-taking behaviours, a perception that some injuries were an inevitable part of child development, interrupted supervision due to distractions, maternal fatigue and the presence of older siblings, difficulties in adapting homes, unreliability and cost of safety equipment and provision of safety information later than needed in relation to child age and development. Facilitators for injury prevention included parental supervision and teaching children about injury risks. This included parents’ allowing children to learn about injury risks through controlled risk taking, using “safety rules” and supervising children to ensure that safety rules were adhered to. Adapting the home by installing safety equipment or removing hazards were also key facilitators. Some parents felt that learning about injury events through other parents’ experiences may help parents anticipate injury risks. Conclusions There are a range of barriers to, and facilitators for parents undertaking injury prevention that would be addressable during the design of home safety interventions. Addressing these in future studies may increase the effectiveness of interventions.
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Affiliation(s)
- Joanne Ablewhite
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Isabel Peel
- Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK.
| | - Lisa McDaid
- Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS, Foundation Trust, Norwich, NR4 7UY, UK.
| | - Adrian Hawkins
- The Great North Children's Hospital, Royal Victoria Infirmary, Newcastle Upon Tyne, NE1 4LP, UK.
| | - Trudy Goodenough
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK.
| | - Toity Deave
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK.
| | - Jane Stewart
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
| | - Denise Kendrick
- Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK.
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Yıldırım Sarı H, Girli A, Ozturk Ozgonenel S, Rowley H. Determination of Injury Risks and Safety Measures Taken by Mothers of Children With an Intellectual Disability and Autism Spectrum Disorder. Int J Nurs Knowl 2015; 27:95-103. [PMID: 25759189 DOI: 10.1111/2047-3095.12079] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of the study is to determine the injury risk behaviors and home safety measures in children with an intellectual disability or autism spectrum disorder. METHOD The study sample included mothers of 100 children between the ages of 2 and 12 years. FINDINGS There was a significant difference between the home safety measures and the children's ages, the birth order of the children, and the mother's and father's ages. There was not a significant relationship between the children's ages, diagnosis, and Injury Behavior Checklist (IBC). There is a positive correlation between the total score of the Home Safety Measures Control List and IBC.
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Affiliation(s)
- Hatice Yıldırım Sarı
- Health Science Faculty, Nursing Department, Izmir Katip Celebi University, İzmir, Turkey
| | - Alev Girli
- Education Faculty, Special Training Department, Dokuz Eylul University, İzmir, Turkey
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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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Nguyen-Thanh V, Clément J, Thélot B, Richard JB, Lamboy B, Arwidson P. Les interventions efficaces en prévention des accidents de la vie courante chez les enfants : une synthèse de littérature. SANTE PUBLIQUE 2015. [DOI: 10.3917/spub.154.0481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Olds DL, Kitzman H, Knudtson MD, Anson E, Smith JA, Cole R. Effect of home visiting by nurses on maternal and child mortality: results of a 2-decade follow-up of a randomized clinical trial. JAMA Pediatr 2014; 168:800-6. [PMID: 25003802 PMCID: PMC4235164 DOI: 10.1001/jamapediatrics.2014.472] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Mothers and children living in adverse contexts are at risk of premature death. OBJECTIVE To determine the effect of prenatal and infant/toddler nurse home visiting on maternal and child mortality during a 2-decade period (1990-2011). DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial was designed originally to assess the home visiting program's effect on pregnancy outcomes and maternal and child health through child age 2 years. The study was conducted in a public system of obstetric and pediatric care in Memphis, Tennessee. Participants included primarily African American women and their first live-born children living in highly disadvantaged urban neighborhoods, who were assigned to 1 of 4 treatment groups: treatment 1 (transportation for prenatal care [n = 166]), treatment 2 (transportation plus developmental screening for infants and toddlers [n = 514]), treatment 3 (transportation plus prenatal/postpartum home visiting [n = 230]), and treatment 4 (transportation, screening, and prenatal, postpartum, and infant/toddler home visiting [n = 228]). Treatments 1 and 3 were included originally to increase statistical power for testing pregnancy outcomes. For determining mortality, background information was available for all 1138 mothers assigned to all 4 treatments and all but 2 live-born children in treatments 2 and 4 (n = 704). Inclusion of children in treatments 1 and 3 was not possible because background information was missing on too many children. INTERVENTIONS Nurses sought to improve the outcomes of pregnancy, children's health and development, and mothers' health and life-course with home visits beginning during pregnancy and continuing through child age 2 years. MAIN OUTCOMES AND MEASURES All-cause mortality in mothers and preventable-cause mortality in children (sudden infant death syndrome, unintentional injury, and homicide) derived from the National Death Index. RESULTS The mean (SE) 21-year maternal all-cause mortality rate was 3.7% (0.74%) in the combined control group (treatments 1 and 2), 0.4% (0.43%) in treatment 3, and 2.2% (0.97%) in treatment 4. The survival contrast of treatments 1 and 2 combined with treatment 3 was significant (P = .007); the contrast of treatments 1 and 2 combined with treatment 4 was not significant (P = .19), and the contrast of treatments 1 and 2 combined with treatments 3 and 4 combined was significant (post hoc P = .008). At child age 20 years, the preventable-cause child mortality rate was 1.6% (0.57%) in treatment 2 and 0.0% (SE not calculable) in treatment 4; the survival contrast was significant (P = .04). CONCLUSIONS AND RELEVANCE Prenatal and infant/toddler home visitation by nurses is a promising means of reducing all-cause mortality among mothers and preventable-cause mortality in their first-born children living in highly disadvantaged settings. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT00708695.
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Affiliation(s)
- David L Olds
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora
| | - Harriet Kitzman
- School of Nursing, University of Rochester, Rochester, New York
| | - Michael D Knudtson
- Department of Pediatrics, School of Medicine, University of Colorado, Aurora
| | - Elizabeth Anson
- School of Nursing, University of Rochester, Rochester, New York
| | - Joyce A Smith
- School of Nursing, University of Rochester, Rochester, New York
| | - Robert Cole
- School of Nursing, University of Rochester, Rochester, New York
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Ravishankar N, Mujja A, Lewis MG, Sreekumaran Nair N. A tool to measure complexity in public health interventions. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2014. [DOI: 10.1016/j.cegh.2014.04.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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