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Cumulative effect of risk and protective factors on unintentional injury for Chinese rural children: a nested
Hui Zhang1, Fengxin Bai2, Hongling Song3
1School of Nursing, Harbin Medical University, No. 39 Xinyang Road, Gaoxin District, Daqing City, 163319, Hei Longjiang Province, China.
Insights
Childhood unintentional injuries are a major concern. This study found that the cumulative effect of risk and protective factors significantly influences injury occurrence and severity in rural children.
Area of Science:
- Pediatric health
- Injury prevention science
- Public health research
Background:
- Childhood unintentional injuries represent a leading cause of death and disability globally.
- While risk factors are known, their cumulative impact on injury development remains unclear.
- Understanding these cumulative effects is crucial for effective prevention strategies.
Purpose of the Study:
- To investigate the cumulative effect of risk factors and protective factors on unintentional injuries in rural children.
- To explore the interaction between these factors and their combined influence on injury occurrence and severity.
- To provide data-driven insights for targeted injury prevention programs.
Main Methods:
- A nested case-control study design was employed, utilizing data from a cohort database.
- The study included 1696 children aged 6 to 14 years, with 424 injury cases and 1272 matched controls.
- Statistical analyses, including linear and logistic regression, were performed after controlling for sociodemographic variables.
Main Results:
- The risk of unintentional injury significantly increased with a higher number of cumulative risk factors.
- Increasing numbers of protective factors were associated with a decreased risk and severity of injury.
- The interaction between risk and protective factors explained a substantial portion (32.2%) of unintentional injury severity.
Conclusions:
- Cumulative risk and protective factors, along with their interaction, are significantly associated with the occurrence and severity of unintentional injuries in children.
- These findings highlight the importance of considering the combined influence of multiple factors in injury prevention.
- The study underscores the need for comprehensive strategies addressing both risk and protective elements in childhood injury prevention efforts.
Background:
Childhood unintentional injuries are the leading cause of death and disability for children. Despite the risk factors that lead to the occurrence of injuries have been identified, the relationship between cumulative effect of risk/protective factors and unintentional injuries is unclear. The aim of this study was to explore the cumulative effect of risk factors as well as protective factors and their interaction on unintentional injury to rural children.
Methods:
We used a nested case-control study design from a cohort database. The study comprised 1696 children aged 6 to 14 years. Among them, 424 were cases with unintentional injury and 1272 were their matched control. After controlling for the significant sociodemographic variables, linear and logistic regression analyses were performed.
Results:
The risk of unintentional injury increased with the increasing number of risk factors - RFI from 1 to 3 (ORRFI(1) = 0.978, 95% CI 0.739-1.296), (ORRFI(2) = 1.720, 95% CI 1.233-2.397), (ORRFI(3) = 5.162, 95% CI 3.129-8.517). PFI (1) was associated with lower risk of injury, but this association was at the edge of significance (p = 0.052). The increased risk in those with PFI (2) was not significant (p = 0.254). The severity of the unintentional injury significantly increased with the increasing number of the risk factors (p < 0.01), and significantly decreased with both the increasing number of protective factors (p = 0.001) and interaction of the risk and protective factors (p < 0.01).The interaction of RFI and PFI could explain 32.2% of the unintentional injury severity.
Conclusions:
According to the findings of the present study, cumulative risk factors and protective factors, as well as their interaction were associated with the occurrence and/ or severity of unintentional injury in children.
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