Evaluation of community coalition training effects on youth hospital-admitted injury incidence in Victoria, Australia: 2001-2017

We Are All in This Together-Whole of Community Pain Science Education Campaigns to Promote Better Management of Persistent Pain

Persistent pain is a major public health issue-estimated to affect a quarter of the world's population. Public understanding of persistent pain is based on outdated biomedical models, laden with misconceptions that are contrary to best evidence. This understanding is a barrier to effective pain management. Thus, there have been calls for public health-based interventions to address these misconceptions. Previous pain-focussed public education campaigns have targeted pain beliefs and behaviours that are thought to promote recovery, such as staying active. However, prevailing pain-related misconceptions render many of these approaches counter-intuitive, at best. Pain Science Education improves understanding of 'how pain works' and has been demonstrated to improve pain and disability outcomes. Extending Pain Science Education beyond the clinic to the wider community seems warranted. Learning from previous back pain-focussed and other public health educational campaigns could optimise the potential benefit of such a Pain Science Education campaign. Pain Science Education-grounded campaigns have been delivered in Australia and the UK and show promise, but robust evaluations are needed before any firm conclusions on their population impact can be made. Several challenges exist going forward. Not least is the need to ensure all stakeholders are involved in the development and implementation of Pain Science Education public messaging campaigns. Furthermore, it is crucial that campaigns are undertaken through a health equity lens, incorporating underrepresented communities to ensure that any intervention does not widen existing health inequalities associated with persistent pain. PERSPECTIVE: Public misconceptions about pain are a significant public health challenge and a viable intervention target to reduce the personal, social, and economic burden of persistent pain. Adaptation of Pain Science Education, which improves misconceptions in a clinical setting, into the public health setting seems a promising approach to explore.

Determinants of unintentional injuries in preschool age children in high-income countries: A systematic review

BACKGROUND

Injuries are the leading cause of death and disability in preschool children who are subject to specific risk factors. We sought to clarify the determinants of unintentional injuries in children aged 5 years and under in high-income countries and report on the methodological quality of the selected studies.

METHODS

A systematic review was conducted of observational studies investigating determinants of unintentional injury in children aged 0-5. Searches were conducted in Web of Science, Medline, Embase, PsycInfo and CINAHL. All methods of data analysis and reporting followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2021) guidelines. Determinants are reported at the child, parental, household and area level.

RESULTS

An initial search revealed 6179 records. Nineteen studies met the inclusion criteria: 17 cohort studies and 2 case control studies. While studies included longitudinal surveys and administrative healthcare data analysis, the highest quality studies examined were case-control designs. Child factors associated with unintentional injury include male gender, age of the child at the time of injury, advanced gross motor score, sleeping problems, birth order, attention deficit hyperactivity disorder (ADHD) diagnosis and below average score on the standard strengths and difficulties scale. Parental factors associated with unintentional injuries included younger parenthood, poor maternal mental health, hazardous or harmful drinking by an adult within the home, substance misuse, low maternal education, low paternal involvement in childcare and routine and manual socioeconomic classification. Household factors associated with injury were social rented accommodation, single-parent household, White ethnicity in the United Kingdom, number of children in the home and parental perception of a disorganised home environment. Area-level factors associated with injury were area-level deprivation and geographic remoteness.

CONCLUSION

Child factors were the strongest risk factors for injury, whereas parental factors were the most consistent. Further research is needed to examine the role of supervision in the relationships between these risk factors and injury. Injury intent should be considered in studies using administrative healthcare data. Prospective research may consider utilising linked survey and administrative data to counter the inherent weaknesses of these research approaches.

Policies are Needed to Increase the Reach and Impact of Evidence-Based Parenting Supports: A Call for a Population-Based Approach to Supporting Parents, Children, and Families

Parents can be essential change-agents in their children's lives. To support parents in their parenting role, a range of programs have been developed and evaluated. In this paper, we provide an overview of the evidence for the effectiveness of parenting interventions for parents and children across a range of outcomes, including child and adolescent mental and physical health, child and adolescent competencies and academic outcomes, parental skills and competencies, parental wellbeing and mental health, and prevention of child maltreatment and family violence. Although there is extensive research showing the effectiveness of evidence-based parenting programs, these are not yet widely available at a population level and many parents are unable to access support. We outline how to achieve increased reach of evidence-based parenting supports, highlighting the policy imperative to adequately support the use of these supports as a way to address high priority mental health, physical health, and social problems.

Child Maltreatment and Long-Term Physical and Mental Health Outcomes: An Exploration of Biopsychosocial Determinants and Implications for Prevention

Child maltreatment rates remain unacceptably high and rates are likely to escalate as COVID-related economic problems continue. A comprehensive and evidence-building approach is needed to prevent, detect and intervene where child maltreatment occurs. This review identifies key challenges in definitions, overviews the latest data on prevalence rates, reviews risk and protective factors, and examines common long-term mental health outcomes for children who experience maltreatment. The review takes a systems approach to child maltreatment outcomes through its focus on the overall burden of disease, gene-environment interactions, neurobiological mechanisms and social ecologies linking maltreatment to mental ill-health. Five recommendations relating to the accurate measurement of trends, research on brain structures and processes, improving the reach and impact of teleservices for detecting, preventing and treating child maladjustment, community-based approaches, and building population-focused multidisciplinary alliances and think tanks are presented.