The impact of child safety promotion on different social strata in a WHO Safe Community

Educational technologies for accident prevention due to falls in childhood: a scoping review

OBJECTIVES

to map evidence on educational technology use for accident prevention due to falls in childhood.

METHODS

a scoping review, carried out in October and November 2022, in the MEDLINE, Web of Science, BDENF and CINAHL databases and LILACS bibliographic index. There was no delimitation of language or time. Data were extracted and analyzed descriptively by two independent researchers. The research protocol was registered in the Open Science Framework.

RESULTS

twenty-six studies were selected. Booklets, pamphlets and leaflets were the most used technologies, presenting health services as the most frequent environment to develop research on fall prevention. The technologies developed were important outcomes: increased knowledge of children, family members, caregivers, health and education professionals.

CONCLUSIONS

educational technology use makes it possible to increase knowledge, adopt safe practices and reduce falls.

School-based education programmes for the prevention of unintentional injuries in children and young people

BACKGROUND

Unintentional injuries are the leading cause of death in children aged four to 18 years and are a major cause of ill health. The school setting offers the opportunity to deliver preventive interventions to a large number of children and has been used to address a range of public health problems. However, the effectiveness of the school setting for the prevention of different injury mechanisms in school-aged children is not well understood.

OBJECTIVES

To assess the effects of school-based educational programmes for the prevention of injuries in children and evaluate their impact on improving children's safety skills, behaviour and practices, and knowledge, and assess their cost-effectiveness.

SEARCH METHODS

We ran the most recent searches up to 16 September 2016 for the following electronic databases: Cochrane Injuries Group Specialised Register; Cochrane Central Register of Controlled Trials; Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations; Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R); Embase and Embase Classic (Ovid); ISI Web of Science: Science Citation Index Expanded; ISI Web of Science Conference Proceedings Citation Index-Science; ISI Web of Science: Social Sciences Citation Index; ISI Web of Science: Conference Proceedings Citation Index - Social Sciences & Humanities; and the 14 October 2016 for the following electronic databases: Health Economics Evaluations Database (HEED); Health Technology Assessment Database (HTA); CINAHL Plus (EBSCO); ZETOC; LILACS; PsycINFO; ERIC; Dissertation Abstracts Online; IBSS; BEI; ASSIA; CSA Sociological Abstracts; Injury Prevention Web; SafetyLit; EconLit (US); PAIS; UK Clinical Research Network Study Portfolio; Open Grey; Index to Theses in the UK and Ireland; Bibliomap and TRoPHI.

SELECTION CRITERIA

We included randomised controlled trials (RCTs), non-randomised controlled trials (non-RCTs), and controlled before-and-after (CBA) studies that evaluated school-based educational programmes aimed at preventing a range of injury mechanisms. The primary outcome was self-reported or medically attended unintentional (or unspecified intent) injuries and secondary outcomes were observed safety skills, observed behaviour, self-reported behaviour and safety practices, safety knowledge, and health economic outcomes. The control groups received no intervention, a delayed injury-prevention intervention or alternative school-based curricular activities. We included studies that aimed interventions at primary or secondary prevention of injuries from more than one injury mechanism and were delivered, in part or in full, in schools catering for children aged four to 18 years.

DATA COLLECTION AND ANALYSIS

We used standard methodological procedures expected by Cochrane. Two review authors identified relevant trials from title and abstracts of studies identified in searches and two review authors extracted data from the included studies and assessed risk of bias. We grouped different types of interventions according to the outcome assessed and the injury mechanism targeted. Where data permitted, we performed random-effects meta-analyses to provide a summary of results across studies.

MAIN RESULTS

The review included 27 studies reported in 30 articles. The studies had 73,557 participants with 12 studies from the US; four from China; two from each of Australia, Canada, the Netherlands and the UK; and one from each of Israel, Greece and Brazil. Thirteen studies were RCTs, six were non-RCTs and eight were CBAs. Of the included studies, 18 provided some element of the intervention in children aged four to 11 years, 17 studies included children aged 11 to 14 years and nine studies included children aged 14 to 18 years.The overall quality of the results was poor, with the all studies assessed as being at high or unclear risks of bias across multiple domains, and varied interventions and data collection methods employed. Interventions comprised information-giving, peer education or were multi-component.Seven studies reported the primary outcome of injury occurrence and only three of these were similar enough to combine in a meta-analysis, with a pooled incidence rate ratio of 0.73 (95% confidence interval (CI) 0.49 to 1.08; 2073 children) and substantial statistical heterogeneity (I² = 63%). However, this body of evidence was low certainty, due to concerns over this heterogeneity (inconsistency) and imprecision. This heterogeneity may be explained by the non-RCT study design of one of the studies, as a sensitivity analysis with this study removed found stronger evidence of an effect and no heterogeneity (I² = 0%).Two studies report an improvement in safety skills in the intervention group. Likewise, the four studies measuring observed safety behaviour reported an improvement in the intervention group relative to the control. Thirteen out of 19 studies describing self-reported behaviour and safety practices showed improvements, and of the 21 studies assessing changes in safety knowledge, 19 reported an improvement in at least one question domain in the intervention compared to the control group. However, we were unable to pool data for our secondary outcomes, so our conclusions were limited, as they were drawn from highly diverse single studies and the body of evidence was low (safety skills) or very low (behaviour, safety knowledge) certainty. Only one study reported intervention costs but did not undertake a full economic evaluation (very low certainty evidence).

AUTHORS' CONCLUSIONS

There is insufficient evidence to determine whether school-based educational programmes can prevent unintentional injuries. More high-quality studies are needed to evaluate the impact of educational programmes on injury occurrence. There is some weak evidence that such programmes improve safety skills, behaviour/practices and knowledge, although the evidence was of low or very low quality certainty. We found insufficient economic studies to assess cost-effectiveness.

Safe communities in China as a strategy for injury prevention and safety promotion programmes in the era of rapid economic growth

Due to its rapid economic development, China is facing a huge health, social, and economic burden resulting from injuries. The study's objective was to examine Safe Communities in China as a strategy for injury prevention and safety promotion programmes in the era of rapid economic growth. Literature searches in English and Chinese, which included grey literature, were performed on the Chinese Journal Full-text Search System and Medline, using the words "Safe Community", "injury", "economics", and "prevention". The results showed that the existing 35 recognized members of the International Safe Community Network have not placed due emphasis on suicide prevention, which is one of the leading problems in both rural and urban China. A few groups, such as children, the elderly, cyclists, and pedestrians, have received due emphasis, while other vulnerable groups, such as migrant workers, motorcyclists, students, players, and farmers have not received the necessary attention from the Safe Community perspective. As the evidence describes, Safe Communities in China can be a very effective strategy for injury prevention, but four aspects need to be strengthened in the future: (1) establish and strengthen the policy and regulations in terms of injury prevention at the national level; (2) create a system to involve professional organizations and personnel in projects; (3) consider the economic development status of different parts of China; and (4) intentional injury prevention should receive greater attention.

Prevention of the Choking Game: parent perspectives

Background:

Many preadolescents and adolescents have been reported to take part in forced asphyxiation as a means of creating a feeling of being high without taking drugs. This activity goes by different names, including the Choking Game, Blackout, and Space Monkey. The limited epidemiological data suggest that about 6-11% of adolescents report having engaged in this behavior.

Methods:

This study surveyed a predominantly Caucasian cohort of parents regarding their knowledge of the choking game and its associated risks, as well as their attitudes toward possible prevention efforts.

Results:

Three quarters of parents responding reported being familiar with the choking game but considerably fewer (20%) reported having talked to their children about this activity. Ninety-six percent of parents reported knowing that unintentional death was a potential risk and ninety percent believe information about this activity should be included in school health curricula.

Conclusion:

Parents of adolescents in the United States appear to be quite knowledgeable about the Choking Game and its potential risks and are overwhelmingly supportive of prevention measures. The parents surveyed understood the importance of preventing children from engaging in the Choking Game, but may need specific help in how to talk to their children about it. Further work is needed to confirm that the proportion of parents identified as aware of this risk taking behavior is consistent across other populations and to urgently identify effective prevention efforts that can be integrated into existing health curricula.