Individual-level injury prevention strategies in the clinical setting

Health care providers have numerous opportunities to intervene with parents and children to promote child safety practices that reduce rates of unintentional injuries. These individual-level interventions may be delivered in a variety of settings such as physician offices, clinics, emergency departments, or hospitals. This article systematically reviews 22 randomized controlled trials (RCTs) that examined the impact of interventions delivered in the clinical setting on child safety practices and unintentional injuries. The results indicate that counseling and other interventions in the clinical setting are effective at increasing the adoption of some safety practices, but not others. Specifically, motor vehicle restraint use, smoke alarm ownership, and maintenance of a safe hot tap water temperature were more likely to be adopted following interventions in the clinical setting. Clinical interventions were not proven effective at increasing a variety of safety practices designed to protect young children from injuries in the home, increasing bicycle helmet use, or reducing the occurrence of childhood injuries, though few studies examined the latter two outcomes. Clinical interventions were most effective when they combined an array of health education and behavior change strategies such as counseling, demonstrations, the provision of subsidized safety devices, and reinforcement. The article concludes with implications for research and practice.