Increasing awareness of food-choking and nutrition in children through education of caregivers: the CHOP community intervention trial study protocol

Abstract

Background Choking is one of the leading causes of death among unintentional injuries in young children. Food choking represents a considerable public health burden, which might be reduced through increased effective preventative education programs. We present a protocol for a community intervention trial termed CHOP (CHOking Prevention project) that aimed to teach Italian families how to prevent food choking injuries and increase knowledge relating to nutrition. Methods Italian educational facilities were enrolled. Stratified randomization blocked by geographical area was performed. Each stratum was randomized to one of three different intervention strategies or to a control group. Educational intervention was delivered in the schools by experts and certified trainers as per the following three intervention strategies: directly to families (Strategy A); to teaching staff only, who subsequently delivered the same educational intervention to families (Strategy B); to health service staff only, who then delivered the educational intervention to teaching staff, who subsequently delivered the intervention to families (Strategy C). Participants completed a questionnaire about their knowledge on the topics presented during the educational interventions (pre-, post-, and follow-up of intervention). Information from the questionnaires was synthetized into 6 indicators in order to measure how effective each intervention strategy was. Discussion The issue of food choking injuries in children is relevant to public health. The protocol we present provides an opportunity to progress towards overcoming such challenges through a working model that can be implemented also in other countries. Trial registration ClinicalTrials.gov NCT03218618. The study was registered on 14 July 2017.

Monitoring Public Perception of Health Risks in Brazil and Italy: Cross-Cultural Research on the Risk Perception of Choking in Children

“…The prevention policies recently implemented in Italy have raised public awareness about the serious complications arising from the ingestion of batteries and magnets [ 19 ].…”

“…In this direction, recent efforts were made on regulations, disseminating activities (safe food), and targeted initiatives to schools. For example, the Italian Choking Prevention project (CHOP) [ 19 ] was established to identify the most effective educational strategy for preventing FB injuries. The prevention policy’s actions should also consider the parent’s risk perception, which is an essential and culture-related element [ 7 ].…”

Assessing school‐based intervention strategies to foster the prevention of choking injuries in children: The results of the CHOP (CHOking Prevention) trial

“…The CHOP project was designed as a community intervention trial to compare three different school-based intervention strategies and is described elsewhere (Lorenzoni et al, 2019); trial profile is reported in Figure 1. The project delivered education on primary and secondary food choking prevention under the umbrella topic of nutrition education.…”

“…However, three of forty-four schools withdrew the consent after the randomization was done (Figure 1). The eligibility criteria for school participation are detailed elsewhere (Lorenzoni et al, 2019).…”

“…From a public health perspective, in the presence of a lack of compulsory prenatal classes or postnatal training opportunities for new parents, the identification of sustainable and effective educational strategies is a priority. Under the hypothesis that a schoolbased intervention may represent the most realistic way to reach as many families as possible for a community-based training program, the CHOP (CHOking Prevention) project (Lorenzoni et al, 2019) was conducted.…”