Keeping children safe at home: protocol for a matched case-control study of modifiable risk factors for poisoning

IntroductionChildhood poisonings are common, placing a substantial burden on health services. Case–control studies have found inconsistent evidence about modifiable risk factors for poisonings among children aged 0–4 years. This study quantifies associations between poison prevention practices and medically attended poisonings in children aged 0–4 years.MethodsMulticentre case–control study conducted at hospitals, minor injury units and family practices from four study centres in England between 2010 and 2013. Participants comprised 567 children presenting with unintentional poisoning occurring at home and 2320 community control participants matched on age, sex, date of event and study centre. Parents/caregivers provided data on safety practices, safety equipment use, home hazards and potential confounders by means of self-completion questionnaires. Data were analysed using conditional logistic regression.ResultsCompared with community controls, parents of poisoned children were significantly more likely not to store medicines out of reach (adjusted OR (AOR) 1.59; 95% CI 1.21 to 2.09; population attributable fraction (PAF) 15%), not to store medicines safely (locked or out of reach (AOR 1.83; 95% CI 1.38 to 2.42; PAF 16%) and not to have put all medicines (AOR 2.11; 95% CI 1.54 to 2.90; PAF 20%) or household products (AOR 1.79, 95% CI 1.29 to 2.48; PAF 11%) away immediately after use.ConclusionsNot storing medicines out of reach or locked away and not putting medicines and household products away immediately after use increased the odds of secondary care attended poisonings in children aged 0–4 years. If associations are causal, implementing these poison prevention practices could each prevent between 11% and 20% of poisonings.

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“…The methods are described in the published protocol 12. Parental consent to participate was assumed by return of completed study questionnaires.…”

Section: Methodsmentioning

confidence: 99%

Poison prevention practices and medically attended poisoning in young children: multicentre case–control study

et al. 2016

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“…The aim was to recruit sixty-four parents of children aged less than 5 years, across four study centres (Nottingham, Bristol, Norwich and Newcastle). The sample was recruited from parents who had already taken part in multi-centre case–control studies [ 15 - 17 ] investigating risk and protective factors for childhood injuries. This included 48 (16 per centre) parents of cases from the case–control studies who had sought medical attention for their child following an unintentional fall, poisoning or scald within their home.…”

Section: Methodsmentioning

confidence: 99%

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

et al. 2015

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BackgroundChildhood unintentional injury represents an important global health problem. Most of these injuries occur at home, and many are preventable. The main aim of this study was to identify key facilitators and barriers for parents in keeping their children safe from unintentional injury within their homes. A further aim was to develop an understanding of parents’ perceptions of what might help them to implement injury prevention activities.MethodsSemi-structured interviews were conducted with sixty-four parents with a child aged less than five years at parent’s homes. Interview data was transcribed verbatim, and thematic analysis was undertaken. This was a Multi-centre qualitative study conducted in four study centres in England (Nottingham, Bristol, Norwich and Newcastle).ResultsBarriers to injury prevention included parents’ not anticipating injury risks nor the consequences of some risk-taking behaviours, a perception that some injuries were an inevitable part of child development, interrupted supervision due to distractions, maternal fatigue and the presence of older siblings, difficulties in adapting homes, unreliability and cost of safety equipment and provision of safety information later than needed in relation to child age and development. Facilitators for injury prevention included parental supervision and teaching children about injury risks. This included parents’ allowing children to learn about injury risks through controlled risk taking, using “safety rules” and supervising children to ensure that safety rules were adhered to. Adapting the home by installing safety equipment or removing hazards were also key facilitators. Some parents felt that learning about injury events through other parents’ experiences may help parents anticipate injury risks.ConclusionsThere are a range of barriers to, and facilitators for parents undertaking injury prevention that would be addressable during the design of home safety interventions. Addressing these in future studies may increase the effectiveness of interventions.

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“…This interview study was a nested study undertaken alongside multi-centre case–control studies exploring risk factors for falls, poisoning and scalds which are described elsewhere [ 24 – 26 ]. A total of 65 participants were recruited from four study centres: Nottingham, Bristol, Newcastle-upon-Tyne and Norwich.…”

Section: Methodsmentioning

confidence: 99%

Approaches used by parents to keep their children safe at home: a qualitative study to explore the perspectives of parents with children aged under five years

et al. 2015

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BackgroundChildhood unintentional injury represents an important global health problem. Many unintentional injuries experienced by children aged under 5 years occur within the home and are preventable. The aim of this study was to explore the approaches used by parents of children under five in order to help prevent unintentional injuries in the home and the factors which influence their use. Understanding how parents approach risk-management in the home has important implications for injury practitioners.MethodsA multi-centre qualitative study using semi-structured interviews. A thematic approach was used to analyse the data. Sixty five parents of children aged under 5 years, from four study areas were interviewed: Bristol, Newcastle, Norwich and Nottingham.ResultsThree main injury prevention strategies used by parents were: a) Environmental such as removal of hazards, and use of safety equipment; b) parental supervision; and c) teaching, for example, teaching children about safety and use of rules and routine. Strategies were often used in combination due to their individual limitations. Parental assessment of injury risk, use of strategy and perceived effectiveness were fluid processes dependent on a child’s character, developmental age and the prior experiences of both parent and child. Some parents were more proactive in their approach to home safety while others only reacted if their child demonstrated an interest in a particular object or activity perceived as being an injury risk.ConclusionParents’ injury prevention practices encompass a range of strategies that are fluid in line with the child’s age and stage of development; however, parents report that they still find it challenging to decide which strategy to use and when.

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Keeping children safe at home: protocol for a matched case-control study of modifiable risk factors for poisoning

Cited by 10 publications

References 43 publications

Poison prevention practices and medically attended poisoning in young children: multicentre case–control study

Poison prevention practices and medically attended poisoning in young children: multicentre case–control study

Parental perceptions of barriers and facilitators to preventing child unintentional injuries within the home: a qualitative study

Approaches used by parents to keep their children safe at home: a qualitative study to explore the perspectives of parents with children aged under five years

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