Parents’ attitudes as mediators between knowledge and behaviours in unintentional injuries at home of children aged 0–3 in Shanghai, Eastern China: a cross-sectional study

Abstract

ObjectiveParental behaviours are important in preventing unintentional injury at home among young children. Previous research showed an inconsistent relationship between knowledge and behaviours, indicating that the mechanisms may vary for different behaviours. This study aimed to examine the mediating roles of different attitudes in the mechanism of knowledge acting on different behaviours.DesignCross-sectional study.SettingEastern China.ParticipantsParticipants were recruited using stratified community-based sampling. A total of 488 parents of children aged 0–3 years participated in the study and 476 (97.5%) valid questionnaires were recovered.Primary outcome measuresParents’ knowledge, attitudes (including injury attribution, preventability and responsibility) and behaviours (including supervision behaviours, risky behaviours and providing a safe home environment).ResultsThe results of mediation analysis showed that the mediator variables were different for different behaviours and that all associations were positive. Parents’ knowledge (β 0.19, 95% CI 0.13 to 0.24) and attitude of injury attribution (β 0.37, 95% CI 0.21 to 0.46) were directly associated with risky behaviours. Attitude of preventability was directly associated with parents’ supervision behaviour (β 0.27, 95% CI 0.14 to 0.40). Parents’ attitude of preventability mediated the positive association between knowledge, attitudes of injury attribution and responsibility, and supervision behaviours, as well as providing a safe home environment. In addition, the occurrence of child injuries at home was directly associated with home environment (β −0.41, 95% CI −0.82 to −0.01).ConclusionsThe current findings confirm that attitudes play varying mediating roles between knowledge and different behaviours. An important recommendation is that parents’ attitudes, especially towards preventability and responsibility, need to be considered when health providers develop health education programmes targeted at improving parental supervision behaviours and providing a safe home environment.

Risk factors of in-home unintentional injuries among 0-6-year-old children in Changsha city of China: a cross-sectional survey based on Bronfenbrenner’s ecological system theory

“…In our study, the incidence of IUIs was 33.42%, higher than the results in other studies [ 15 , 33 ], which may be the result that our subjects were children aged 0 ~ 6, who occupied a higher injury risk than other age groups. In addition, children aged 0 ~ 3 in this study were investigated by face-to-face interview, which made the data of younger children more reliable and had a certain influence on the incidence rate.…”

“…Despite risky behaviors occupied the strongest effect on children’s IUIs, reducing risks caused by risky behaviors required more reasonable parental supervision and better home environment. The direct effects of environmental risks and supervision were validated across the entire sample, similar to previous studies [ 33 , 38 ]. More importantly, we proved the indirect role of the both on IUIs.…”

Effectiveness of WeChat-group-based parental health education in preventing unintentional injuries among children aged 0–3: randomized controlled trial in Shanghai

“…Parents of young children need to possess and portray certain skills and behaviors to ensure the safety of their children, which means that they may have to be taught these behaviors and skills [ 10 ]. This study is based on the Haddon matrix tool [ 31 ], which suggests that any accident is affected by a host, an agent, and the environment.…”

“…The beliefs component covered injury attribution, which was measured by a single item: “It is owing to bad luck that children get unintentionally injured.” The responsibility and preventability component was evaluated using two questions. The behaviors component covered daily supervision behaviors, which were assessed via five questions, and behaviors to prevent specific injuries, which were measured via items on several different injuries drawn from Ma et al’s research [ 10 ]. Supplementary Table 2 outlines the questionnaire items.…”

“…Evidence shows that the main reasons for unintentional injuries among young children at home were the parents’ lack of safety knowledge, their attitudes and behaviors, and the children’s attributes [ 8 , 9 ]. Ma et al found that improving parents’ knowledge, attitudes, and behaviors had a positive effect on unintentional injury occurrence in children and that attitudes also serve as mediators between knowledge and behaviors [ 10 ]. Although children aged 0–6 are a priority population under The National Basic Public Health Service Program, a systematic review has stated that a majority of studies focus on children aged 0–3 years [ 11 ].…”