Literature DB >> 10195971

Preventing injuries in children: cluster randomised controlled trial in primary care.

D Kendrick1, P Marsh, K Fielding, P Miller.   

Abstract

OBJECTIVE: To assess the effectiveness of safety advice at child health surveillance consultations, provision of low cost safety equipment to families receiving means tested state benefits, home safety checks, and first aid training on frequency and severity of unintentional injuries in children at home.
DESIGN: Cluster randomised controlled trial.
SETTING: 36 general practices in Nottingham.
SUBJECTS: All children aged 3-12 months registered with participating practices.
INTERVENTIONS: A package of safety advice at child health surveillance consultations at 6-9, 12-15, and 18-24 months; provision of low cost safety equipment to families on means tested state benefits; and home safety checks and first aid training by health visitors. OUTCOME MEASURES: Primary outcomes measures were frequency and severity of medically attended injuries. Secondary outcome measures were self reported safety practices, possession and use of safety equipment, knowledge and confidence in dealing with first aid, and perceptions of risk of injury and risk of hazards assessed by postal questionnaire at baseline and follow up at 25 months.
RESULTS: At baseline, both groups had similar risk factors for injury, sociodemographic characteristics, safety practices, possession and use of safety equipment, knowledge and confidence in dealing with first aid, and perceptions of risk. No significant difference was found in frequency of at least one medically attended injury (odds ratio 0.97, 95% confidence interval 0.72 to 1.30), at least one attendance at an accident and emergency department for injury (1.02, 0.76 to 1.37), at least one primary care attendance for injury (0.75, 0.48 to 1.17), or at least one hospital admission for injury (0.69, 0.42 to 1.12). No significant difference in the secondary outcome measures was found between the intervention and control groups.
CONCLUSIONS: The intervention package was not effective in reducing the frequency of minor unintentional injuries in children at home, and larger trials are required to assess the effect on more severe injuries.

Entities:  

Mesh:

Year:  1999        PMID: 10195971      PMCID: PMC27827          DOI: 10.1136/bmj.318.7189.980

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  15 in total

1.  A randomised controlled trial of general practitioner safety advice for families with children under 5 years.

Authors:  M Clamp; D Kendrick
Journal:  BMJ       Date:  1998-05-23

2.  Analysis of data arising from a stratified design with the cluster as unit of randomization.

Authors:  A Donner; A Donald
Journal:  Stat Med       Date:  1987 Jan-Feb       Impact factor: 2.373

3.  Educating parents about injury prevention.

Authors:  J L Bass; K A Mehta; M Ostrovsky; S F Halperin
Journal:  Pediatr Clin North Am       Date:  1985-02       Impact factor: 3.278

4.  Prevention of childhood injuries: evaluation of the Statewide Childhood Injury Prevention Program (SCIPP).

Authors:  B Guyer; S S Gallagher; B H Chang; C V Azzara; L A Cupples; T Colton
Journal:  Am J Public Health       Date:  1989-11       Impact factor: 9.308

5.  Home injuries in children: a population-based intervention trial.

Authors:  P Vineis; G Ronco; G Ciccone; F Gogliani
Journal:  Epidemiology       Date:  1994-05       Impact factor: 4.822

Review 6.  Role of the primary health care team in preventing accidents to children.

Authors:  D Kendrick
Journal:  Br J Gen Pract       Date:  1994-08       Impact factor: 5.386

7.  Prevention of accidental falls in infancy by counseling mothers.

Authors:  H Kravitz
Journal:  IMJ Ill Med J       Date:  1973-12

Review 8.  Childhood injury prevention counseling in primary care settings: a critical review of the literature.

Authors:  J L Bass; K K Christoffel; M Widome; W Boyle; P Scheidt; R Stanwick; K Roberts
Journal:  Pediatrics       Date:  1993-10       Impact factor: 7.124

9.  Childhood injury prevention in a suburban Massachusetts population.

Authors:  J L Bass; K A Mehta; M Ostrovsky
Journal:  Public Health Rep       Date:  1991 Jul-Aug       Impact factor: 2.792

10.  The impact of child-resistant containers on the incidence of paraffin (kerosene) ingestion in children.

Authors:  A Krug; J B Ellis; I T Hay; N F Mokgabudi; J Robertson
Journal:  S Afr Med J       Date:  1994-11
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  24 in total

Review 1.  Contamination in trials: is cluster randomisation the answer?

Authors:  D J Torgerson
Journal:  BMJ       Date:  2001-02-10

2.  Preventing injuries in children. Elements of trial's design and analysis might have biased results.

Authors:  E Waters; P Priest; C Foster; A Andermann
Journal:  BMJ       Date:  1999-08-28

Review 3.  Systematic review of controlled trials of interventions to promote smoke alarms.

Authors:  C DiGuiseppi; J P Higgins
Journal:  Arch Dis Child       Date:  2000-05       Impact factor: 3.791

Review 4.  Updating the evidence. A systematic review of what works in preventing childhood unintentional injuries: part 1.

Authors:  E Towner; T Dowswell; S Jarvis
Journal:  Inj Prev       Date:  2001-06       Impact factor: 2.399

Review 5.  Updating the evidence. A systemic review of what works in preventing childhood unintentional injuries: Part 2.

Authors:  E Towner; T Dowswell; S Jarvis
Journal:  Inj Prev       Date:  2001-09       Impact factor: 2.399

Review 6.  Randomised controlled trials in primary care: scope and application.

Authors:  Aziz Sheikh; Liam Smeeth; Richard Ashcroft
Journal:  Br J Gen Pract       Date:  2002-09       Impact factor: 5.386

7.  Injury in childhood: a vexingly simple problem.

Authors:  Andrew W Howard
Journal:  CMAJ       Date:  2006-09-22       Impact factor: 8.262

Review 8.  How has research in the past 5 years changed my practice?

Authors:  Mitch Blair
Journal:  Arch Dis Child       Date:  2007-03       Impact factor: 3.791

9.  Promoting child safety in primary care: a cluster randomised controlled trial to reduce baby walker use.

Authors:  Denise Kendrick; Rachel Illingworth; Amanda Woods; Kim Watts; Jacqueline Collier; Michael Dewey; Rhydian Hapgood; Chih-Mei Chen
Journal:  Br J Gen Pract       Date:  2005-08       Impact factor: 5.386

10.  Spatial effects should be allowed for in primary care and other community-based cluster RCTS.

Authors:  Paul Silcocks; Denise Kendrick
Journal:  Trials       Date:  2010-05-14       Impact factor: 2.279

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