Home Injury Prevention Research Articles

Public-Private Partnerships: A model for injury prevention and safety promotion – Benefitting communities and NGOs

Abstract Injuries are a leading cause of death up to 45years, and 12% of all hospital beds in Norway are dedicated to accident-related treatments. Addressing injuries poses a significant public health challenge, and preventing accidents is crucial for saving money and resources. The Norwegian Act of Public Health mandates that municipalities promote the population’s health and well-being, contribute to favourable environmental conditions, and prevent mental and somatic illnesses and injuries. This is echoed in various laws and regulations, providing a supportive framework for injury prevention and safety promotion. However, translating these laws and regulations into effective policies and preventive activities necessitates collaboration across sectors and levels. To meet these demands, a public-private partnership for safety has been established through five-year cooperation agreements between the Ministry of Health, Finance Norway (Association for financial and insurance industry in Norway), and the Norwegian Safety Forum (NSF). As a non-profit organization, NSF is a national advocate for safety, specializing in home and leisure injury prevention, road safety and Safe Community initiatives in Norway. Program Description The collaboration aims to reduce accidents and injuries. The agreement secures basic financing for NSF and serves as a platform for knowledge sharing and competence building across sectors. It facilitates seminars and meetings to promote learning among different professions, benefiting municipalities and the public. The collaboration leverages the Ministry’s resources, insurance companies’ data and knowledge, and NSF’s expertise to develop injury prevention programs through dialogue with communities and organizations. This model brings together private-public and NGO perspectives. It also provides enhanced possibilities for coordination on both national and community level, enhancing data and knowledge availability and strengthening capacity for safety promotion.

Determinants of Unintentional Home Injury Prevention Practice Among B40 Parents of Under-Five Children in Selangor: A Study Protocol

Introduction: Unintentional injuries among children are considered a major public health concern since they are one of the leading causes of child death and disability. Inadequate study has been done on whether and how parental influences are linked to childhood injury at home especially among the community with low-socioeconomic status. The study aims to determine the factors affecting unintentional home injury prevention practice among low socioeconomic status (B40) parents of under-five children in Selangor, Malaysia. Methods: This is a cross-sectional and quantitative study. A sample size of 453 parents will be sampled among B40 parents with under-five children in Selangor using a stratified random sampling method. For analysis, only complete questionnaires will be used. Data entry and statistical analysis will be carried out using IBM SPSS version 28.0. Chi-square/Fisher Exact test and simple logistic regression will be used for data analysis. Multiple logistic regression will be used to examine the predictors of poor home injury prevention practice. Discussion: Findings from the study will provide insight on challenges experienced by B40 parents of children under five in implementing preventive injury measures at home.

CHASE (Children’s Housing Assessment for a Safe Environment): a protocol for the inspection and modification of injury risks in children’s homes

BackgroundDecades of research and practice experience have led to an extensive body of evidence about effective home safety modifications. However, the benefits of safety modifications have not reached all segments of society. Poor quality housing in low-income neighborhoods, along with limited access to safety products and injury prevention information, can be significant barriers to child safety.MethodsThis is a longitudinal study of 300 low-income families in Baltimore City and Baltimore County with children under 7 years of age who are referred from existing Green & Healthy Homes Initiative (GHHI) home visiting programs. Three home visits will be completed to assess home injury hazards using a previously developed tool, the Children’s Housing Assessment for a Safe Environment (CHASE), and provide a Scope of Work that includes home modifications specific to the identified home injury hazards. An Assessor will also provide do-it-yourself education materials and injury prevention supplies to assist residents in completing the modifications. If the parent or caregiver is unable to complete the home modifications, a professional Housing Intervention Services team will complete the home modifications necessary to prevent injury in the home. This study will involve both quantitative and qualitative data analysis methods. Paired and regression analyses will be conducted to examine the maintenance of modifications and the variables associated with positive outcomes. A thematic analysis of staff and participant interviews will be used to identify perceived barriers and facilitators of successful program implementation.DiscussionBetter data on residential injuries of children and an improvement in the overall surveillance of home injuries are necessitated. This study will set a strong foundation for a larger future study of health and cost effectiveness outcomes and will advance our understanding of the feasibility, costs, and potential benefits of addressing and preventing home injuries to children.

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.

Unintentional injury is a global burden that occurs everywhere, including in our homes. Young children are most vulnerable to home injuries because they still develop their physical and psychological skills and spend 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 surprisingly, children from high-income families were found to have the highest incidence of injury, contradicting the findings from other countries. This study aims to identify the determinants of non-adherence to unintentional home injury prevention practice among parents of under-five children in the North Seberang Perai district, Penang. This sequential explanatory mixed-methods study consists of two phases consisting of a quantitative study which looks into respondents and their child's sociodemographic status, their home injury prevention practice and the independent variables, followed by a qualitative study that interviews parents with non-adherence to home injury prevention practice and explore their barriers. 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 the two-group proportion formula, a sample size of 453 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. Chi-square/Fisher Exact test, simple logistic regression and multiple logistic 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. The thematic analysis approach will be used to analyse the qualitative data. The study has been registered under the National Medical Research Registry. 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.

Implementation fidelity of the ‘Stay One Step Ahead’ home safety intervention: a mixed-methods analysis

ObjectiveTo assess implementation fidelity of the Stay One Step Ahead (SOSA), a complex intervention which was delivered by health visiting teams, children’s centres, and family mentors and was aimed at...

Understanding Parental Perceptions of Content-Specific Barriers to Preventing Unintentional Injuries in the Home.

Preventable injuries are the leading cause of death in children around the world, including in Japan. As children under the age of 5 years spend most of their time at home, home injury prevention is critical for child safety. The purpose of this study was to identify specific, focused, and precise barriers against injury prevention practice. We conducted an online survey to examine the barriers faced by parents when taking actions to prevent home injuries. The results revealed common reasons why parents do not or cannot take a recommended action across injury types, and that the magnitude of importance for a specific barrier depends on the type of injury. Identifying content-specific barriers could help researchers and educators understand parents' needs, discuss what barriers are more important than others by injury type, and develop effective strategies based on the 3Es of injury prevention (enforcement, engineering, and education).

Stay-at-home, Safe at Home? A survey of parental home safety practices before and during the COVID-19 pandemic

BackgroundTo slow the spread of COVID-19, many nonessential businesses, daycares, and schools closed, and areas imposed “stay-at-home” orders. Closures led to young children spending more time at home, traditionally, the place where more than one-half of unintentional pediatric injuries occur. The objective of the current study was to describe parental safety perceptions and confidence, safety device purchase and installation, and injury prevention practices and behaviors, in homes with children 6 years of age and younger, before and during the COVID-19 pandemic.MethodsA cross-sectional survey with a convenience sample of US participants, 18 years or older, was conducted from November 2020 to February 2021. Parents of children (≤ 6 years) were recruited via social media ads and posts on Facebook and Twitter and invited to complete an anonymous, online survey about their home safety practices before and during the COVID-19 stay-at-home order. Upon completion, parents could participate in a prize drawing to receive one of five $100 gift cards.ResultsA total of 499 participants completed the survey. Most (47.9%) were 45–54 years of age and reported the amount of time at home increased for them (93.9%) and their children (90.6%) during the stay-at-home period. Thirty-seven percent (36.9%) of parents considered their homes safe but recognized room for improvement and felt confident in their ability to make their homes safe for their children (72.8%). From the time before until the COVID-19 stay-at-home orders were in place, parents increased their home injury prevention practices (42.3%). Parents that had identified unsafe areas in the home before the stay-at-home order were significantly more likely to increase their safety behaviors, take childproofing actions, and purchase or install safety devices during the stay-at-home order (p < 0.0001). Parents with younger children (5 years) were significantly more likely than parents with older children to take childproofing actions (p < .0001) including purchasing and installing safety devices (p < 0.0001).ConclusionsSpending more time at home during the COVID-19 pandemic may have helped the sampled parents, especially those with younger children, identify unsafe areas in their homes and encourage them to modify their behaviors, and purchase and install safety devices to help make their homes safer for their children.

An Exploration of Emergency Department Visits for Home Unintentional Injuries Among Children With Autism Spectrum Disorder for Evidence to Modify Injury Prevention Guidelines.

Current childhood injury prevention guidance is anchored by a child's age. For example, children are considered at high risk for falls at ages 4 years and less, and guidance for prevention focuses on these ages. However, these guidelines may not be adequate for children with autism spectrum disorders (ASD). This retrospective chart review examined injury characteristics for children with ASD receiving treatment in a pediatric emergency department between 2014 and 2016. Bivariate statistics determined injury demographic correlates. Chart narratives were also coded using traditional content analysis to determine the mechanism that caused the home injury. The sample (27 cases) was mostly male (89%), Black (48%), with a mean age of 7.8 (SD, 4.9) years. The most common mechanism was a fall (44%), followed by self-injurious behavior (33%), and then burns (22%). All cases identified at least 1 mechanism contributing to the injury, in 2 cases, 2 items were mentioned. Of the 29 items identified, most involved a house feature that was not stairs (24%); some included stairs, furniture, or a combination of foreign object and grill (21%); and few identified food/beverage/liquid (11%). Analyses suggest that unintentional home injury prevention for children with ASD may require prevention guidance extended through older ages.

Home modifications to prevent home fall injuries in houses with Māori occupants (MHIPI): a randomised controlled trial

As with many Indigenous populations internationally, Māori in New Zealand suffer health inequity. We aimed to assess the rate of fall injuries at home with and without home modifications in houses with Māori occupants. We did a single-blind randomised controlled trial in the Wellington and Taranaki regions of New Zealand and enrolled owner-occupied households with at least one Māori occupant. Only households who stated they intended to live at that address for the subsequent 3 years were eligible for participation. We randomly assigned (1:1) households to either the intervention group, who received home modifications (handrails for outside steps and internal stairs, grab rails for bathrooms, outside lighting, repairs to window catches, high-visibility and slip-resistant edging for outside steps, fixing of lifted edges of carpets and mats, non-slip bath mats, and slip-resistant surfacing for outside areas such as decks) immediately, or the control group, who received the modifications 3 years later. Data on home injuries were obtained from the Accident Compensation Corporation and coded by study team members, who were masked to study group allocation. The primary outcome was the rate of medically treated fall injuries at home per household per year, analysed according to intention to treat. This Māori Home Injury Prevention Intervention (MHIPI) trial is now completed, and is registered with the Australian New Zealand Clinical Trials Registry, ACTRN12613000148774. Between Sept 3, 2013, and Oct 1, 2014, 824 households were assessed for eligibility and 254 were enrolled, of which 126 (50%) were assigned to the intervention group and 128 (50%) were assigned to the control group. After adjustment for previous falls and geographical region, there was an estimated 31% reduction in the rate of fall injuries at home per year exposed to the intervention compared with households in the control group (adjusted relative rate 0·69 [95% CI 0·47-1·00]). Low-cost home modifications and repairs can be an effective means to reduce injury disparities. The high prevalence of modifiable safety issues in Māori homes merits considerable policy and community effort. Health Research Council of New Zealand.

Social innovation in health: a critical but overlooked component of the COVID-19 pandemic response

<b>Objective:</b> For children aged 1–5 years, the authors used the Delphi method to determine (1) the most important injury hazards in each area of the home; (2) the most important...

Epidemiology of Upper-Extremity Amputations Using the National Electronic Injury Surveillance System.

Upper-extremity amputations can be devastating injuries that lead to lifelong disabilities. The purpose of our study was to review national data and identify populations at risk and injury patterns that could be targeted with prevention strategies. Data from the National Electronic Injury Surveillance System between years 2012 and 2018 were reviewed. Injuries affecting the upper extremity resulting in amputation were included. Patient demographics, anatomical location, mechanism of injury, level of care provided, and setting of injury were recorded. Descriptive was recorded and tabulated for each category. There were 4,766 patients identified with amputations to the upper extremity from 2012 to 2018. The following categories are listed below: age in years, sex, race, anatomical location of injury, most common mechanisms of injury, disposition of patient, environmental location. Our data show that male children younger than 10 years are at the high risk for finger amputations. In addition, the majority of these injuries occur in the home. This suggests that safety prevention in the home is a significant area in need of improvement. We recommend further research in areas of home safety and injury prevention to decrease the risk of the devastating injuries.

The Perceptions of Palestinian Health Professionals toward Factors Facilitating or Impeding the Prevention of Home Injuries among Young Children: A Qualitative Study

ABSTRACT Background Unintentional injuries are a major global health problem that affects children considerably. Such injuries are most common among under-fives and this places a significant burden on healthcare systems, particularly in low- and middle-income countries. In Palestine, there is a paucity of research in this area. Aim To explore health professionals’ perceptions regarding factors affecting the prevention of home injuries to children aged below five in Ramallah. Methods A qualitative approach was adopted, employing semi-structured interviews with 24 health professionals who worked with children in a primary health care setting. Data were analysed using thematic analysis. Results Three types of factors that facilitated or impeded the prevention of home injuries emerged: health professional-related factors, i.e. lack of training, workload, and team collaboration; parent-related factors, i.e. low economic status, lack of awareness, and the mothers’ employment status; and environmental factors, i.e. home size and structure, lack of data, low prioritisation among policymakers, lack of funds, and the political situation. Conclusions The findings of this study suggest that continuous education and specialised training of healthcare professionals is imperative to their pivotal role in increasing the awareness of parents and children about the prevention of home injuries, mainly in healthcare settings with limited resources such as Palestine.

Investigation of the Effect of Education Based on the Theory of Planned Behavior on the Mothers’ Preventive Practices Regarding Toddler Home Injuries

Home injuries are among the causes of death and disability in toddlers. Preventing home injuries is an essential part of the child health care program. Using education-based models interventions can promote mothers’ practices regarding home injuries. This study aimed to investigate the effect of education based on the theory of planned behavior (TPB) on the mothers’ preventive practices regarding toddler home injuries. A quasi-experimental study was conducted on 116 mothers referred to comprehensive health centers (58 mothers in each experimental and control group), who were selected using the cluster sampling method. Data were collected using a researcher-developed TPB questionnaire, which was validated by I-CVI (≥0.78), and CVR (≥0.79). Its reliability also confirmed by Cronbach’s alpha coefficients (.52-.93). Afterward, educational intervention was implemented in the experimental group based on TPB in four 45 to 60 minute sessions. After 2 months, the data were recollected from the two groups and analyzed using SPSS software version 16. Comparing the scores of TPB constructs (i.e., perceived behavioral control, behavioral intention, and subjective norms), and mothers’ preventive practices regarding toddler home injuries revealed no statistically significant difference between the 2 groups pre-intervention. However, after the intervention, significant differences were observed between the 2 groups in terms of awareness, the TPB constructs (except for subjective norms), and preventive practices of the mothers ( p &lt; .001). Mothers’ preventive practices regarding toddler home injuries were improved after applying TPB; hence, it is suggested a larger study be completed to confirm the results of this theory-based education.

Factors Associated With Residential Relocation and Effects on Early Childhood Development in a Low-Income Home Visitation Population.

Residential relocation (RR) is associated with behavior problems and cognitive delays in school-age children. Little is known regarding effects of RR on early childhood development. The data from this study were collected from 2011 to 2016 through the Cincinnati Home Injury Prevention and Literacy Promotion Trial. The purpose of the current study was to identify factors associated with RR and determine effects of RR on early childhood development in a cohort of mother/child dyads (n = 424). High RR was relocating ≥ 3 times over the 24-month study period. Differences in baseline characteristics and early childhood development, measured by the Ages and Stages Questionnaire (ASQ) and MacArthur Bates Communicative Development Inventory, according to relocations, were estimated by negative binomial regression and logistic regression, respectively. Participants moved on average 1.46 times over 24months. Relocations decreased by 0.05 for each year of increasing maternal age. Mothers with college degrees moved 0.72 fewer times than those with a high school diploma or less. Mothers living alone moved 0.47 fewer times than their counterparts. Mothers who could not count on someone to loan them $1000 and those with food insecurity more (0.41) than their counterparts(0.50). Odds of scoring in the bottom-tertile for the communication domain of the ASQ was significantly higher in those relocating ≥ 3 times. High RR was associated with concern for delayed language development at 24-month follow-up in some, but not all models. Early intervention may be more successful if primary care physicians and community health professionals collaborate to link families at risk of high RR to relevant community based resources.

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

BackgroundPrior 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.MethodsA 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.ResultsTwenty-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.ConclusionsResults 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.

Study Protocol of a Randomized Controlled Trial of Home Modification to Prevent Home Fall Injuries in Houses with Māori Occupants

Worldwide, injuries due to falls in the home impose a substantial burden and merit considerable effort to find effective prevention measures. The current study is one of very few randomized controlled trials that assess the effectiveness of home modification for preventing falls. It is the first carried out with a minority or indigenous community and focused on reducing inequities. Just over 250 households in Aotearoa, New Zealand, with Māori occupants were recruited in two strata, 150 from the Wellington region and 100 from the Taranaki region. These were randomly allocated to equally sized treatment and control groups within the respective regions, the treatment group receiving a package of home modifications designed to prevent falls at the start of the study, and the control group receiving the package at the end of the study. Injury data came from the Accident Compensation Corporation, a state-owned no-fault injury insurer. This provided coverage of virtually all unintentional injuries requiring medical treatment. Matched injury claims were made available for analysis once all identifying fields had been removed. These data will be pooled with data for Māori households from the already-conducted Home Injury Prevention Intervention (HIPI) study, which tested an identical intervention on the general population. In the analysis, the primary outcome measure will be fall injury rates over time, comparing treatment and control households, adjusting for the stratum and prior falls in the household. A secondary measure will be the rates of specific injuries, which are most likely to be prevented by the package of modifications tested. We anticipate that the findings will provide robust evidence for effective injury prevention measures that can reduce an important contributor to health inequities for indigenous populations such as the Māori.

Home injury prevention attitude and performance: a community-based study in a designated 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 safe community, East-Azerbaijan, Iran.Methods:This was a cross-sectional study conducted in 2017. Sampling was done using "Random Sampling method" among all mothers having at least one U-5 child and attended the health centers to receive childcare services. A valid attitude questionnaire and safety performance checklist were used for data collection. Data were analyzed by SPSS-24, using descriptive (frequency, mean, etc.) and inferential statistics (chi-square, Kruskal-Wallis).Results:The mean age of mothers was 30.58 (±5.01). About 65% of the mothers had primary or secondary school education. The mean score of mothers' attitude was 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’s socioeconomic status, mother's age, educational level, and job, father's job, age, and gender of the child were the contributing factors (p less than 0.05). Conclusions:Most of the mothers have an appropriate level of home-injury prevention attitude but a low level of performance. Strengthening Primary Health Care system in safe communities would have a leading role in child safety promotion through increasing the mother's knowledge, attitude and performance level.

وبائيات الإصابات المنزلية غير المتعمدة بين الأطفال منذ الولادة وحتى سن الرابعة عشر في محافظة أسيوط، مصر: دراسة مجتمعية مستعرضة

إن التغير في النمط الوبائي لوفيات الأطفال والتقدم الكبير فى مكافحة الأمراض المعدية وزيادة خطر الإصابات ليخلق رؤية جديدة لمعدل إصابات ووفيات الأطفال حول العالم لما تمثله من خطر جسيم حيث تتسبب الإصابات في قتل 5مليون شخص كل عام وأن معظم هذه الإصابات يقع داخل وحول نطاق المنزل حيث يقضى الأطفال في هذه المرحلة العمرية أكثر وقتهم بالمنزل. لذا ركزت في هذا البحث على هذه المرحلة العمرية في واحده من أكبر محافظات صعيد مصر وهي أسيوط. الهدف: دراسة حجم ونمط الإصابات المنزلية غير المقصودة في الأطفال الذين تتراوح أعمارهم بين 0 و 14 عامًا وتقييم المخاطر البيئية المرتبطة بالإصابات المنزلية. الأساليب: أجريت دراسة مجتمعية مستعرضة في عام 2018، على سكان الريف في محافظة أسيوط، مصر. تم اختيار العينة الإجمالية للأطفال من 500 أسرة عن طريق أخذ عينات عشوائية منهجية. تم جمع البيانات باستخدام استبيان محدد سلفا ومنظم من كل من الآباء والأمهات والأطفال. النتائج: من بين 1337 طفلاً، وجد أن معدل الإصابة في المنزل بلغ 43.8% في العام الماضي، وهو أعلى بكثير في الفئة العمرية من 1 إلى 3 سنوات (60%) تليها 5-10 سنوات (45.7%). كان إجمالي عدد الإصابات ومتوسط عدد الإصابات لدى الأولاد أعلى بكثير من البنات. كان أكثر أنواع الإصابات المنزلية شيوعًا هو السقوط (54.6%) يليه الإصابة بالحروق (16.1%) والإصابة بالأدوات الحادة (11.8%)، وتم تقييم الخطر البيئي باستخدام تعريفات قياسية وعملية ووجد نقاط كهربائية غير آمنة (97%)، السلالم غير الآمنة (100%)، طاولة طعام غير آمنة قصيرة (72%)، مطبخ غير آمن مع إمكانية الوصول إلى الأدوات الحادة (27.6%)، الوصول إلى النيران النشطة (23.6%)، والأثاث والأشياء غير الآمنة (22%). الاستنتاجات: إن إصابات الأطفال المنزلية غير المقصودة شائعة في صعيد مصر. كان إجمالي عدد الإصابات ومتوسط عدد الإصابات لدى الأولاد أعلى بكثير من البنات. كان السقوط أكثر أنواع الإصابات شيوعًا بين جميع الفئات العمرية. كشفت الدراسة عن وجود عبء كبير من أخطار إصابات الطفولة داخل منازلهم. التوصيات: يعد تنفيذ تدابير السلامة والوقاية من الإصابات التي قد تنطوي على تغييرات قانونية، وتطبيق استراتيجيات السلامة السلبية، وتثقيف الآباء والأمهات والأطفال في المدارس، والدعم المالي للأسر الفقيرة، استراتيجيات مهمة للوقاية من الإصابات المنزلية.

Characteristics of indoor injuries in hotels compared to home among young children.

Although attention has recently been afforded to home injury prevention for young children, we often encounter young children who have experienced indoor injuries at places other than the home. We aimed to identify characteristics of unintentional indoor injuries that occurred when young children were not at home. We retrospectively reviewed the medical records of young children (aged <6years) with indoor injuries from January to June 2017. We classified patients injured in hotel rooms as the "Hotel group" and compared them to patients injured at home ("Home group"). Among 102 patients who met the study criteria, 33 patients (32.4%) were classified as the Hotel group. Falls were the most frequent cause of injury in both groups (Home, 56.5% versus Hotel, 87.9%). Falls from beds were more likely to happen in hotel rooms (1.4% versus 48.5%). In regard to fall-associated injuries, head and / or facial injury was most frequent in both groups (Home, 92.3% versus Hotel, 89.7%). A suture and follow-up were less likely in the Home group than in the Hotel group (18.8% versus 42.4%, 39.1% versus 69.7%, respectively). In hotel rooms, head and / or facial injuries due to falling from a bed were the most common types of injury, and they often needed more invasive procedures than home injuries. Injuries that tended to occur in hotel rooms are more predictable than home injuries. Modification of the surrounding environment has the potential to prevent unintentional injuries not only in the home environment but also in hotel rooms.

Home injury prevention attitude and performance: a community-based study in a designated safe community.

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 safe community, East-Azerbaijan, Iran. This was a cross-sectional study conducted in 2017. Sampling was done using "Random Sampling method" among all mothers having at least one U-5 child and attended the health centers to receive childcare services. A valid attitude questionnaire and safety performance checklist were used for data collection. Data were analyzed by SPSS-24, using descriptive (frequency, mean, etc.) and inferential statistics (chi-square, Kruskal-Wallis). The mean age of mothers was 30.58 (±5.01). About 65% of the mothers had primary or secondary school education. The mean score of mothers' attitude was 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's socioeconomic status, mother's age, educational level, and job, father's job, age, and gender of the child were the contributing factors (p less than 0.05). Most of the mothers have an appropriate level of home-injury prevention attitude but a low level of performance. Strengthening Primary Health Care system in safe communities would have a leading role in child safety promotion through increasing the mother's knowledge, attitude and performance level.