Determinants of non-adherence to home injury prevention practice among parents of under-five children in North Seberang Perai district, Penang: A mixed-methods study protocol (Preprint)

Abstract

BACKGROUND Unintentional injury is a global burden of disease that occurs everywhere, including our home. Young children are most vulnerable to home injuries because they are still developing their physical and psychological skills and spent most of their time at home. Despite being largely preventable, three consecutive national surveys show no reduction in the rate of injury among children under-five. More surprising, children from high-income families were found to have the highest incidence of injury, contradicting the findings from other countries. OBJECTIVE This study aims to identify the determinants of a non-adherence to unintentional home injury prevention practice among parents of under-five children in North Seberang Perai district, Penang. METHODS This sequential explanatory mixed-methods study consists of two phases starting with a quantitative study looking into respondents and their child’s sociodemographic status and their home injury prevention practice, followed by a qualitative study that interview parents with a low level of home injury prevention practice. In phase I, the parent or primary caregiver of a child age less than five years old who age 18 or older and is a Malaysian will be included in the study while being disabled or having a severe psychiatric disorder or having the index child diagnosed with chronic disease will make them not eligible to participate in the study. Derived using two population means formula, a sample size of 495 parents will be sampled among those with under-five children following up at the Maternal Child Health Department in the health clinics of North Seberang Perai using stratified systematic sampling. Independent t-test/Mann Whitney U, simple linear regression and multiple linear regression will be used for data analysis. The sample will be stratified according to household income to look for associated factors and determinants of low prevention practice. In phase II, parents with a low score from the quantitative study will be selected to participate in the qualitative study using purposive sampling. A semi-structured interview using the help of an interview guide will be carried out and recorded with a voice recorder. Thematic analysis approach will be used to analyse the qualitative data. RESULTS The study has been registered under the National Medical Research Registry and awaiting ethical approval. CONCLUSIONS It is hoped that findings from this study can shed light on the barriers faced by under-five parents in carrying out preventive measures at home.