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Providing child safety equipment to prevent injuries: randomised controlled trial
Michael Watson1, Denise Kendrick, Carol Coupland
1Faculty of Medicine and Health Sciences, School of Nursing, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2HA. michael.watson@nottingham.ac.uk
Insights
Providing safety equipment and advice to families with young children in deprived areas improved safety practices but did not reduce medically attended injuries. The intervention
Area of Science:
- Public Health
- Injury Prevention
- Child Safety
Background:
- Unintentional injuries are a significant concern for children under 5, particularly in deprived areas.
- Safety advice and equipment are potential interventions to mitigate these risks.
Purpose of the Study:
- To evaluate the effectiveness of safety advice and equipment in reducing unintentional injuries among young children in deprived families.
- To assess the impact on medically attended injuries and healthcare utilization.
Main Methods:
- A randomized controlled trial involving 3428 families with children under 5 in Nottingham.
- Intervention included standardized safety consultations and free provision/fitting of safety equipment (stair gates, fire guards, smoke alarms, etc.).
- Primary outcomes measured medically attended injuries, primary/secondary care attendance, and hospital admissions over two years.
Main Results:
- No significant reduction in medically attended injuries, secondary care attendance, or hospital admissions was observed.
- A significant increase in primary care attendance for injuries was noted in the intervention group.
- Families receiving the intervention showed improved safety practices at one and two-year follow-ups, though differences were modest.
Conclusions:
- The intervention successfully enhanced safety practices in families for up to two years.
- Despite improved practices, the intervention did not lead to a reduction in injuries requiring medical attention.
- The magnitude of safety practice changes may have been insufficient to impact overall injury rates.
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.
