Providing child safety equipment to prevent injuries: randomised controlled trial

Abstract

Objective To assess the effectiveness of safety advice and safety equipment in reducing unintentional injuries for families with children aged under 5 years and living in deprived areas. Design Randomised controlled trial. Setting 47 general practices in Nottingham. Participants 3428 families with children under 5. Intervention A standardised safety consultation and provision of free and fitted stair gates, fire guards, smoke alarms, cupboard locks, and window locks. Main outcome measures Primary outcome measures were whether a child in the family had at least one injury that required medical attendance and rates of attendance in primary and secondary care and of hospital admission for injury over a two year period. Secondary outcome measures included possession of safety equipment and safety practices. Results No significant difference was found in the proportion of families in which a child had a medically attended injury (odds ratio 1.14, 95% confidence interval 0.98 to 1.50) or in the rates of attendance in secondary care (incidence rate ratio 1.02, 0.90 to 1.13) or admission to hospital (1.02, 0.70 to 1.48). However, children in the intervention arm had a significantly higher attendance rate for injuries in primary care (1.37, 1.11 to 1.70, P = 0.003). At both one and two years' follow up, families in the intervention arm were significantly more likely to have a range of safety practices, but absolute differences in the percentages were relatively small. Conclusions The intervention resulted in significant improvements in safety practices for up to two years but did not reduce injuries that necessitated medical attendance. Although equipment was provided and fitted free of charge, the observed changes in safety practices may not have been large enough to affect injury rates.

Fatores de risco que contribuem para o envenenamento pediátrico

“…27,28 However, even if these interventions prove to be effective, many children still get involved in poisoning accidents. [29][30][31] The fact is that, thus far, in countries such as Brazil, laws have not been sanctioned requiring the mandatory packaging with a protective cover for children:…”

Unintentional injuries in the home environment: home safety

“…Estudos da última década identificam potenciais em ações de prevenção 69 , mesmo que haja poucas evidênci-as de redução de injúrias através da utilização de meios como campanhas e doação de equipamentos de proteção [70][71][72][73] . As abordagens que reforçam a necessidade do papel ativo dos pais e responsáveis trouxeram resultados modestos na redução de injúrias 74 .…”

Prevention of childhood poisoning in the home: overview of systematic reviews and a systematic review of primary studies

“…This included six RCTs (Baudier et al, 1988;Clamp & Kendrick, 1998;Colver, Hutchinson, & Judson, 1982;Gielen et al, 2007;Paul, Sanson-Fisher, & Redman, 1994;Watson et al, 2005) and one CBA (Schwarz, Grisso, Miles, Holmes, & Sutton, 1993), evaluating interventions providing safety education (OR 1.61, 95% CI 1.10À2.36 (Gielen et al, 2007)) and safety education plus equipment, with effect sizes ranging from RR 1.15 95% CI 1.03À1.28 (Clamp & Kendrick, 1998) to OR 14.30 95% CI 4.22À18.46 (Colver et al, 1982. The remaining 18 studies (see Table 4) evaluating a range of interventions including safety education, tailored safety education, safety education plus equipment found no significant difference in safe storage of medicines between treatment groups.…”

“…Of the 31 primary studies, six reported significantly more intervention group families stored household and other products safely. Four RCTs (Colver et al, 1982;Hendrickson, 2002;Paul et al, 1994;Watson et al, 2005) provided safety education plus equipment and home safety inspections with effect sizes ranging from OR 1.31 95% CI 1.07À1.60 (Watson et al, 2005) to OR 15.79, 95% CI 4.65À53.62 (Hendrickson, 2005). One RCT provided safety education plus equipment (OR 2.21 95% CI 1.40À3.51 (Woolf et al, 1992)) and one RCT gave home safety counselling and safety equipment with specific injury focussed instructions in the ED prior to discharge (OR 2.58 95% CI 1.12À5.94) (Posner, Hawkins, GarciaEspana, & Durbin, 2004).…”