Abstract
BackgroundThe UK has one of the highest fatality rates for deaths from fire-related injuries in children aged 0–14 years; these injuries have the steepest social gradient of all injuries in the UK. Children’s centres provide children under five years old and their families with a range of services and information, including home safety, but their effectiveness in promoting injury prevention has yet to be evaluated. We developed a fire prevention intervention for use in children’s centres comprising an Injury Prevention Briefing (IPB) which provides evidence on what works and best practice from those running injury prevention programmes, and a facilitation package to support implementation of the IPB. This protocol describes the design and methods of a trial evaluating the effectiveness and cost-effectiveness of the IPB and facilitation package in promoting fire prevention.Methods/DesignPragmatic, multicentre cluster randomised controlled trial, with a nested qualitative study, in four study centres in England. Children’s centres in the most disadvantaged areas will be eligible to participate and will be randomised to one of three treatment arms comprising: IPB with facilitation package; IPB with no facilitation package; usual care (control). The primary outcome measure will be the proportion of families who have a fire escape plan at follow-up. Eleven children’s centres per arm are required to detect an absolute difference in the percentage of families with a fire escape plan of 20% in either of the two intervention arms compared with the control arm, with 80% power and a 5% significance level (2-sided), an intraclass correlation coefficient of 0.05 and assuming outcomes are assessed on 20 families per children’s centre. Secondary outcomes include the assessment of the cost-effectiveness of the intervention, other fire safety behaviours and factors associated with degree of implementation of the IPB.DiscussionThis will be the first trial to develop and evaluate a fire prevention intervention for use in children’s centres in the UK. Its findings will be generalisable to children’s centres in the most disadvantaged areas of the UK and may also be generalisable to similar interventions to prevent other types of injury.Trial registrationhttp://NCT01452191 (date of registration: 13/10/2011).
Highlights
The UK has one of the highest fatality rates for deaths from fire-related injuries in children aged 0–14 years; these injuries have the steepest social gradient of all injuries in the UK
With or without safety equipment being provided, is effective in increasing the prevalence of functioning smoke alarms [8,9] and home safety education increases the prevalence of fire escape planning [8]
A recent systematic review identified the main barriers and facilitators to implementing injury prevention interventions; these included the type of approach used, characteristics of the deliverer, the complexity of the intervention, accessibility to safety equipment and the importance of achieving behavioural change [11]
Summary
This trial will enable an evaluation of the effectiveness and cost-effectiveness of implementing an IPB in children’s centres for promoting fire prevention. Families attending children’s centres in these areas may have lower levels of literacy and families with young children are likely to be more mobile than other families [33] This may pose challenges for trial recruitment and retention, so we are using a range of recruitment and follow-up methods including small monetary incentives. This trial will be the first randomised controlled trial to provide data on the effectiveness of implementing an IPB in children’s centres to promote fire prevention in disadvantaged populations.
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