Effectiveness of systematically delivered evidence-based home safety promotion to improve child home safety
Michael James Taylor1,2, Elizabeth Orton2, Tina Patel2
1Healthcare Public Health Team, NHS England and NHS Improvement Midlands, Nottingham, UK michael.taylor2@nottingham.ac.uk.
Insights
Systematic home safety promotion improved some child safety practices in high-need areas. While not impacting all primary outcomes, it encouraged safer poison storage and fire safety measures.
Area of Science:
- Public Health
- Child Safety
- Preventive Medicine
Background:
- Child home injuries are a significant public health concern.
- Evidence-based interventions are crucial for improving child home safety practices.
Purpose of the Study:
- To evaluate the effectiveness of a systematically delivered, evidence-based home safety promotion program.
- To improve child home safety practices in areas with high social need.
Main Methods:
- A controlled before-and-after study was conducted in nine UK electoral wards.
- 361 families in intervention wards and 401 in control wards participated.
- Interventions included monthly safety messages, activity sessions, safety weeks, and checklists.
Main Results:
- No significant difference in the primary composite outcome (smoke alarm, poison storage, stairgate) or medically attended injuries.
- Intervention group showed increased safe poison storage, fire escape plans, and fireguard use.
- Families in the intervention group adopted more overall safety practices.
Conclusions:
- Systematic, evidence-based home safety promotion can increase the adoption of specific safety practices in high-need communities.
- Multicomponent child home safety interventions should be considered for commissioning.
Objective:
Evaluate the effectiveness of systematically delivered evidence-based home safety promotion for improving child home safety practices.
Design:
Controlled before-and-after study.
Setting:
Nine electoral wards in Nottingham, UK.
Participants:
361 families with children aged 2-7 months at recruitment living in four intervention wards with high health, education and social need; and 401 in five matched control wards.
Intervention:
Evidence-based home safety promotion delivered by health visiting teams, family mentors and children's centres including 24 monthly safety messages; home safety activity sessions; quarterly 'safety weeks'; home safety checklists.
Outcomes:
Primary: composite measure comprising having a working smoke alarm, storing poisons out of reach and having a stairgate. Secondary: other home safety practices; medically attended injuries. Parents completed questionnaires at 12 and 24 months after recruitment plus optional three monthly injury questionnaires.
Results:
At 24 months there was no significant difference between groups in the primary outcome (55.8% vs 48.8%; OR 1.58, 95% CI 0.98 to 2.55) or medically attended injury rates (incidence rate ratio 0.89, 95% CI 0.51 to 1.56), but intervention families were more likely to store poisons safely (OR 1.81, 95% CI 1.06 to 3.07), have a fire escape plan (OR 1.81, 95% CI 1.06 to 3.08), use a fireguard or have no fire (OR 3.17, 95% CI 1.63 to 6.16) and perform more safety practices (β 0.46, 95% CI 0.13 to 0.79).
Conclusions:
Systematic evidence-based home safety promotion in areas with substantial need increases adoption of some safety practices. Funders should consider commissioning evidence-based multicomponent child home safety interventions.
Trial Registration Number:
ISRCTN31210493.
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