Home environmental change for child injury prevention in Nepal: A qualitative study

In Nepal, unintentional home injury is a leading reason for death and disability among pre-school children. However, there is a lack of evidence to inform culturally appropriate interventions to reduce home injuries. This study explored the potential for home environmental change at a community level to prevent unintentional home injury in children and identified the barriers to, and facilitators of, such changes. Focus groups were conducted in the Nepali language with mothers, fathers, teachers, school students and community health volunteers in rural areas of Makwanpur district in Nepal. The discussions were audio-recorded, transcribed, translated into English and analysed thematically. NVivo software was used to support coding and identification of themes. Five focus groups, involving forty-seven participants, were completed leading to the development of four themes. Overall, the findings highlight that community people perceive injuries to be a normal part of childhood and, therefore, few prevention measures were considered. Parents were, however, able to identify ways to change their environment that made it safer. Changes included removing hazards or adding safety equipment, adapting the home or restricting access to potential hazards. Barriers to implementation included limited awareness about injury hazards and risk management, poor quality housing and financial constraint. Facilitators included raising community awareness, acquiring resources and financial support and involving the family and community. Development of interventions to prevent injuries at home in pre-school children should reflect local context and culture; this is best achieved through engagement with parents.

Health conditions and the risk of home injury in French adults: results from a prospective study of the MAVIE cohort

BackgroundHome injury (HI) is a significant cause of mortality and morbidity in adults of all ages. Health conditions significantly impact HI among old adults, but little is known for other adults.Study designProspective cohort study.ObjectiveWe assessed the associations between health-related factors and HI’s risk in a French study, the MAVIE (Mutualistes pour la recherche contre les Accidents de la VIE courante) cohort.MethodsPoisson mixed models were fitted using health-related data information (diseases, treatments and disabilities) at baseline and the number of injuries prospectively recorded during the follow-up, adjusting for significant sociodemographics and exposure to a range of home activities. Attributable fractions were estimated based on risk ratio (RR) estimations measured in the fully adjusted models.ResultsA total of 6146 dwelling adults aged 15 or older were followed up for 5.1 years on average. Vertigo or dizziness (RR=2.36, 95% CI 1.06 to 5.01) and sciatica or back pain (RR=1.49, 95% CI 1.08 to 2.05) were independently associated with an increased risk of HI. These two groups of conditions showed the most significant associations among people aged 15–49, whereas musculoskeletal diseases other than rachialgias and arthropathies were the most significant health-related risk factor in people aged 50 and older. Sciatica or back pain represented the highest burden of HIs in overall adults (8%) and among people aged 15–49 (12%).ConclusionOur results suggest that adults with musculoskeletal disorders and vertigo or dizziness symptoms have a higher risk of HI, regardless of age.

National survey of home injuries during the time of COVID-19: who is at risk?

Background Prior to the COVID-19 pandemic, 44% of all reported injuries in U.S. households occurred in the home. Spending more time at home due to the pandemic may increase the number of home injuries. Methods A nationally representative sample of 2011 U.S. adults were surveyed online between June 17 – June 29, 2020. Propensity score weighting and T-tests were used. Results Twenty-eight percent (28%) of households reported a home injury or ingestion during the pandemic; 13% reported experiencing both. Injuries were most often due to falls (32%). Medication ingestions were reported by 6%; household product ingestions were reported by 4%. Relative to households that experienced no injuries or ingestions, those that reported either or both were more likely to: be in urban areas, have household incomes > $100,000, and have children living in them. Among households reporting more time spent at home, those with children were significantly more likely than those without to report an injury or ingestion. Conclusions Results help target prevention messages while U.S. families are continuing to work and learn remotely. During this pandemic and future stay-at-home orders, there is a need for public health efforts to prevent home injuries and ingestions.

Health conditions and the risk of home injury in French adults: Results from a prospective study of the MAVIE cohort

ABSTRACTBackgroundHome injury (HI) is a significant cause of mortality and morbidity in adults of all ages. Health conditions significantly impact HI among old adults, but little is known for other adults.Study designProspective cohort studyObjectiveWe assessed the associations between health-related factors and HI’s risk in a French study, the MAVIE cohort.MethodsPoisson mixed models were fitted using health-related data information (diseases, treatments, and disabilities) at baseline and the number of injuries prospectively recorded during the follow-up, adjusting for significant socio-demographics and exposure to a range of home activities. Attributable fractions (AFs) were estimated based on RR estimations measured in the fully adjusted models.ResultsA total of 6,146 dwelling adults aged 15 or more were followed up for 5.1 years on average. Vertigo or dizziness (RR=2.36, 95% CI 1.06 to 5.01) and sciatica or back pain (RR=1.49, 95% CI 1.08 to 2.05) were independently associated with an increased risk of HI. These two groups of conditions showed the most significant associations among people aged 15 to 49, whereas musculoskeletal diseases other than rachialgias and arthropathies were the most significant health-related risk factor in people aged 50 and more. Sciatica or back pain represented the highest-burden of HIs in overall adults (8%) and among people aged 15 to 49 (12%).ConclusionOur results suggest that adults with musculoskeletal disorders and vertigo or dizziness symptoms have a higher risk of HI, regardless of age.

Determinants of non-adherence to home injury prevention practice among parents of under-five children in North Seberang Perai district, Penang: A mixed-methods study protocol (Preprint)

BACKGROUND Unintentional injury is a global burden of disease that occurs everywhere, including our home. Young children are most vulnerable to home injuries because they are still developing their physical and psychological skills and spent most of their time at home. Despite being largely preventable, three consecutive national surveys show no reduction in the rate of injury among children under-five. More surprising, children from high-income families were found to have the highest incidence of injury, contradicting the findings from other countries. OBJECTIVE This study aims to identify the determinants of a non-adherence to unintentional home injury prevention practice among parents of under-five children in North Seberang Perai district, Penang. METHODS This sequential explanatory mixed-methods study consists of two phases starting with a quantitative study looking into respondents and their child’s sociodemographic status and their home injury prevention practice, followed by a qualitative study that interview parents with a low level of home injury prevention practice. In phase I, the parent or primary caregiver of a child age less than five years old who age 18 or older and is a Malaysian will be included in the study while being disabled or having a severe psychiatric disorder or having the index child diagnosed with chronic disease will make them not eligible to participate in the study. Derived using two population means formula, a sample size of 495 parents will be sampled among those with under-five children following up at the Maternal Child Health Department in the health clinics of North Seberang Perai using stratified systematic sampling. Independent t-test/Mann Whitney U, simple linear regression and multiple linear regression will be used for data analysis. The sample will be stratified according to household income to look for associated factors and determinants of low prevention practice. In phase II, parents with a low score from the quantitative study will be selected to participate in the qualitative study using purposive sampling. A semi-structured interview using the help of an interview guide will be carried out and recorded with a voice recorder. Thematic analysis approach will be used to analyse the qualitative data. RESULTS The study has been registered under the National Medical Research Registry and awaiting ethical approval. CONCLUSIONS It is hoped that findings from this study can shed light on the barriers faced by under-five parents in carrying out preventive measures at home.

The Epidemiology of Unintentional Home Injuries among Children Aged 0 – 14 Years in Assiut Governorate, Egypt: A Community-Based Cross-Sectional Study: وبائيات الإصابات المنزلية غير المتعمدة بين الأطفال منذ الولادة وحتى سن الرابعة عشر في محافظة أسيوط، مصر: دراسة مجتمعية مستعرضة

Background: The change in the epidemiological pattern of child mortality, the significant progress in combating infectious diseases and the increased risk of injuries to create a new vision for the rate of childhood injuries and deaths around the world because of the serious risk it poses, with injuries killing 5 million people each year, And that most of these injuries occur in and around the home where children spend at this age stage most of their time at home. So I focused in this research on this age stage in one of the largest governorates of Upper Egypt, which is Assiut. Objective: To study the magnitude and pattern of unintentional home injuries in children aged 0 – 14 years and to assess the environmental risk associated with home injuries. Methods: A community-based, cross-sectional study was conducted in 2018, on a rural population in Assiut governorate, Egypt. The total sample of children was selected from 500 households by systematic random sampling. Data were gathered using a predesigned, well-structured questionnaire from both the parents and children. Results: Of 1337 children, the prevalence of home injury was found to be 43.8% in the last 1 year, significantly higher in the age group of 1 – 3 years(60%) followed by 5 – 10 years(45.7%). The total number of injuries and the average number of injuries in boys were significantly higher than girls. The most common type of home injury was falls(54.6%) followed by burn injury(16.1%) and injury with sharps(11.8%). The environmental risk was assessed using standard and working definitions and found unsafe electrical points(97%), unsafe stairs(100%), unsafe short dining table(72%), unsafe kitchen with access to sharps(27.6%), access to active fire(23.6%), and unsafe furniture and objects(22%). Conclusions: Childhood unintentional home injuries are common in Upper Egypt. The total number of injuries and the average number of injuries in boys were significantly higher than girls. The falls were the most common type of injury among all age groups. The study revealed a significant burden of hazards for childhood injuries within their own homes. Recommendations: Implementation of safety and injury prevention measures that may involve legal changes, application of passive safety strategies, educating the parents and the children at schools, and financial support to poor families are important strategies for prevention of home injuries.

Home Injury Prevention Attitude and Performance: A Community-Based Study in a WHO Safe Community

Background Unintentional injuries in the home are one of the threats to childhood quality of life which is considered as a social determinant of health. Regarding mother's leading role in taking care of the children in Iranian families, the present study was conducted to investigate mothers' home-injury prevention attitude and performance and its contributing factors in Sahand, Iran. Methods This was a cross-sectional study conducted in 2017. Sampling was done using random sampling method among all mothers of children less than five years old who attended the health centers to receive child care services. A valid attitude questionnaire and safety performance checklist were used for data collection. Data were analyzed through SPSS-24 software using descriptive (Frequency, mean, etc.) and inferential statistics (chi-square, Kruskal-Wallis) method. Results The Mean age of mothers was 30.58 (±5.01). About 65% of the mothers held high school diplomas or lower degrees. The mean score of mothers' attitude was calculated to be 72.12(±6.79). More than 58% of the mothers had an appropriate level of attitude. The mothers' injury prevention performance mean score was 66.59 (±12.85). Family socioeconomic status, Mother's age, educational level, and job, father's job, age and gender of the child were the contributing factors (p<0.05). Conclusions Most of the mothers had an appropriate level of home-injury prevention attitude and low level of performance. Deprived residency areas should be considered for higher support to prevent injuries. Strengthening Primary Health Care system in safe communities could have a significant role in child safety promotion through mothers KAP promotion.