Parenting interventions for the prevention of unintentional injuries in childhood

 

Abstract

Background

Parent education and training programmes can improve maternal psychosocial health, child behavioural problems and parenting practices. This review assesses the effects of parenting interventions for reducing child injury.

Objectives

To assess the effects of parenting interventions for preventing unintentional injury as well as increasing possession and use of safety equipment and parental safety practices.

Search methods

We searched CENTRAL, MEDLINE, EMBASE, Biological Abstracts, Psych INFO, Sociofile, Social Science Citation Index, CINAHL, Dissertation Abstracts, ERIC, DARE, ASSIA, Web of Science, SIGLE and ZETOC. We also handsearched abstracts from the World Conferences on Injury Prevention & Control and the journal Injury Prevention. The searches were conducted in May 2005.

Selection criteria

We included randomised controlled trials (RCTs), non-randomised controlled trials (non-RCTs) and controlled before and after studies (CBAs), which evaluated parenting interventions administered to parents of children aged 18 years and under, and reported outcome data on injuries (unintentional or unspecified intent), and possession and use of safety equipment or safety practices. Parenting interventions were defined as those with a specified protocol, manual or curriculum aimed at changing knowledge, attitudes or skills covering a range of parenting topics.

Data collection and analysis

Studies were selected, data were extracted and quality appraised independently by two authors. Pooled relative risks (RR) were estimated using random effect models.

Main results

Fifteen studies were included in the review: 11 RCTs (one included a CBA within the same study), one non-RCT, one study contained both randomised and non-randomised arms and two CBAs. Two provided solely educational interventions. Thirteen provided interventions comprising parenting education and other support services; 11 of which were home visiting programmes and two of which were paediatric practice-based interventions. Thirteen studies recruited families at risk of adverse child health outcomes. Nine RCTs were included in the primary meta-analysis, which indicated that intervention families had a significantly lower risk of injury (RR 0.82, 95% CI 0.71 to 0.95). Several studies found fewer home hazards, a home environment more conducive to child safety, or a greater number of safety practices in intervention families.

Authors' conclusions

Parenting interventions, most commonly provided within the home using multi-faceted interventions may be effective in reducing child injury. The evidence relates mainly to interventions provided to families at risk of adverse child health outcomes. Further research is required to explore mechanisms by which these interventions reduce injury, the features of parenting interventions that are necessary or sufficient to reduce injury and the generalisability to different population groups.

 

Plain language summary

Parenting interventions for the prevention of unintentional injuries in childhood

Parent education and training programmes can improve parenting, mothers' mental health and behaviour problems in children. This review looked at whether such programmes also help parents provide a safer home environment and reduce injuries in children. The reviewers found 15 parent education and training programmes that had been studied which measured home safety or childhood injuries. Eleven of these were home visiting programmes which provided a range of support services as well as parent education or training. These were usually provided to families whose children were considered to be at risk of poor health. The results showed that children from families who had received the education and training programmes had fewer injuries than those from families who had not had the programmes. The results for home safety were more varied, but some studies found a positive effect on home safety. It is not clear exactly how these programmes reduce injuries or whether they would work as well in less disadvantaged groups or in different settings.

 

摘要

背景

親職介入措施對於預防非故意的幼兒傷害

父母的教育及訓練計畫可以改善母親的心理健康，兒童的行為問題及親職做法。這篇回顧評估親職介入措施用以減少兒童傷害的效果。

目標

評估親職介入措施用以預防非故意傷害，同時增加擁有並使用安全的設備及父母安全做法的效果。

搜尋策略

我們檢索CENTRAL, MEDLINE, EMBASE, Biological Abstracts, Psych INFO, Sociofile, Social Science Citation Index, CINAHL, Dissertation Abstracts, ERIC, DARE, ASSIA, Web of Science, SIGLE及ZETOC。我們也人工檢索自the World Conferences on Injury Prevention & Control及the journal Injury Prevention的摘要。檢索建立於2005年五月。

選擇標準

我們納入隨機對照試驗(randomised controlled trials (RCTs))，非隨機對照試驗((nonRCTs))及前後對照研究(before and after studies (CBAs))，其評估親職介入措施實行於18歲以下兒童之父母，並報告關傷害(非故意或意圖不明的)，及擁有與使用安全設備或安全做法。親職的介入措施定義為那些具有明確的計畫書，手冊或課程其著重於改變涵蓋育兒主題之知識，態度或技巧。

資料收集與分析

兩位作者分別獨立篩選研究，摘錄資料並評價研究的品質。採用隨機效果模式(random effect models)來評估加總的相對危險性(relative risks (RR))。

主要結論

十五篇研究納入這篇回顧:11篇RCTs(一篇研究同時包含CBA)，一篇nonRCT，一篇研究包含隨機的及非隨機的研究設計及兩篇CBAs。兩篇研究僅提供教育性的介入措施。十三篇研究提供介入措施其包含親職教育及其他的支持性服務其中11篇為家庭探訪計畫，兩篇為小兒科以實務為基礎的介入措施。十三篇研究招募具有負面兒童健康結果風險的家庭。九篇RCTs納入於初階的統合分析中，其指出介入措施的家庭具有顯著較低的傷害危險性((RR 0.82, 95% CI 0.71 to 0.95))。數篇研究發現在介入措施的家庭中其有較少的家庭危險，家庭環境更有利於兒童安全，或有較多的安全做法。

作者結論

親職介入措施，最常提供家庭內使用多面向的介入措施也許對於減少兒童傷害是有效的。證據主要有關提供介入措施予有負面兒童健康結果危險性之家庭。需要進一步的研究以探究這些介入措施減少傷害的機制，親職介入措施的特點其必須或足以減少傷害，並推論於不同的母群體。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

要添加。