Reducing Injury Among High-Risk Preschool Children
Project Number: R40 MC 00294-03 Project Date: 01/01/2002 Grantee: Children's Hospital Medical Center Department/Center: Pediatric Surgery
Final Report
Pending
Principal Investigator
Victor Garcia M.D., Director, Trauma Service, Children's Hospital Medical Center Pediatric Surgery, 3333 Burnet Avenue Cincinnati, OH 45229-3039 victor.garcia@chmcc.org
Abstract
Background: Although unintentional injury is the leading cause of death for all children, it exacts a disproportionately high toll among the economically disadvantaged. Low income and minority children are twice as likely to die in a car crash, four times more likely to die from drowning, and five times more likely to die in a fire. Usage rates of effective prevention devices such as safety seats and bicycle helmets are much lower among economically disadvantaged families. The purpose of this randomized controlled trial is to reduce risk of injury among economically disadvantaged preschool age children and families through a Head Start-based injury prevention program based on Social Learning Theory, The primary goals are to increase use of injury prevention devices and behaviors among Head Start children and their adult caregivers, identify barriers to use of these devices and behaviors, to increase awareness and knowledge of the risks of pediatric injury among preschool children, parents, and teachers. Methods: Head Start schools will be randomly assigned to intervention or control status. Focus groups will be conducted with parents at non-participating Head Start centers to identify barriers to use of injury prevention technologies within this population. A classroom curriculum will be refined and taught by the Head Start faculty. Parents will participate in monthly meetings, parent leadership training, and will receive monthly printed materials. Teachers will receive pediatric injury prevention training throughout the school year. The second program year will be supervised by teachers and parents. Data collection will include focus groups, pre- and post-program observation of pedestrian behaviors & occupant restraint usage, pre- and post-program parent and teacher questionnaires, and testing of children's injury awareness and knowledge. Analysis of observation data will employ the General Estimating Equation. Questionnaire and testing data will be analyzed using chi-square tests and McNemar's test of agreement. Summary : The results of this study may identify a unique, theory-based public health approach to pediatric injury in high risk groups that can be integrated into the existing Head Start infrastructure. If the model is effective, it can be expanded to other preschool and daycare settings as well as to other health-related issues.
