Child Injury Prevention Research Articles

Attach importance to prevention and effective interventions on child injury

Injury is a threat to children globally and appears as the leading cause of death among children aged 1 to 17 years in China. Child injury prevention is a public health measure with a high cost-benefit ratio. Many years of research and practices have proved the effectiveness of specific child injury interventions. It is recommended that China should strengthen multi-sectoral cooperation and coordination mechanism on child injury prevention, including the clear clarification of responsibility and ensuring the necessary financial support. It is also essential to widely implement various effective interventions to ensure the healthy development of children.

Objectives and strategies of unintentional injury prevention and control in 31 provincial Children's Development Outlines in China

Objective: To landscape the contents, similarities, and differences of the objectives and strategies for unintentional injury prevention and control in the national and 31 provincial Children's Development Outlines from 2011 to 2020, and propose relevant suggestions. Methods: The content analysis method was used to extract, encode and classify the objective and strategy text of unintentional injury in all Children's Development Outlines and construct the theme of strategy text combined with the '5E' Injury Prevention Framework. Taking the national Children's Development Outline as the benchmark, the relevant contents of 31 provincial Children's Development Outlines in the same period were compared. Results: All Children's Development Outlines took child injury prevention and control as the primary objective set in health, environment, and safety. The national and most provincial Children's Development Outlines set this goal in health, while others put it in environment or safety. Reducing injury-induced death, disability and occurrence were designated as the main content in the objective of child injury prevention and control. However, there were no quantitative requirements for injury occurrence and disability in all the provincial outlines. The themes of unintentional injury prevention and control strategies in all Children's Development Outlines could be divided into the mechanism, law enforcement, education, environment, engineering, first aid, assessment, and economic strategies. Mechanism strategy was the primary domain, followed by law enforcement, education, environment, and engineering strategies, but less attention was put on first aid, assessment, and economic strategies. The unintentional injury prevention and control strategy in the provincial Children's Development Outlines was mainly based on the national outline. Still, it also varied with some emphasis and refinement in different items among all the provinces. Conclusions: Children's Development Outline is a vital policy guarantee for implementing child injury prevention and control work. Developing a system involving good primary data, mechanisms and strategies, law enforcement, and environmental and engineering-related strategies for more common types of child injuries has been attached to great importance. Actively carrying out assessments and encouraging the adoption of more economical strategies could further enrich and improve the unintentional injury prevention and control in Children's Development Outline and promote the progress of related work in China.

Prevalence of injury among children in 28 counties of 6 provinces in China in 2017

Objective: To investigate the incidence of injuries among children aged 0-17 years from 28 counties in six provinces. Methods: According to the earlier study on data in different local areas and the current work plan, we selected the survey objects for a general survey on child injury prevalence in the last 12 months. The subjects included guardians of children who did not attend kindergartens, children from kindergartens, and primary school grades 1-3. Children from grades 4-6 primary school, junior high school, and senior high school were also included. Results: The overall rate of injured children was 4.83%, with the incidence of injuries as 5.75% in the last 12 months before the survey. Both the rate of injured children and incidence of injuries were higher in boys than that in girls. Children whose primary caregivers were relatives, grandparents, minors, or with an education level below the primary school had a relatively higher rate of both injured children and incidence of injuries. The first cause of child injury was fall. The time of child injury was mainly from June to October, mainly at home, with the main activity as playing. The significant injuries in children were contusion and abrasion, and the main parts injured were lower limbs, upper limbs, and head. Most of the injuries were cured, and the primary treatment was outpatient and emergency treatment. Conclusions: Boys and children whose parents can not take care of are the priority population for child injury prevention and control. Targeted prevention and control measures should be implemented according to the characteristics of injuries among children of different ages.

Sex differences in muscle activation patterns associated with anterior cruciate ligament injury during landing and cutting tasks: A systematic review

Neuromuscular control is critical for maintaining dynamic joint stability and mitigating the risk of anterior cruciate ligament (ACL) injury. Given the increased risk of ACL injury in females, sex-based differential muscle activation strategies are often associated with this risk. For example, the quadriceps-dominant muscle activation strategy sometimes observed in females has been discussed as a cause of their increased risk of ACL injury. However, there has been no synthesised knowledge on sex differences in muscle activation patterns associated with ACL injuries. Therefore, the purpose of this review was to synthesise sex differences in muscle activation patterns in movements associated with ACL injuries in both adult and adolescent populations. A systematic electronic database search was conducted. Thirty studies were included in the review. Females demonstrated higher pre- and post-landing activation of the quadriceps and lower activation of the hamstrings in 15 studies. Females also had higher quadriceps-to-hamstring co-contraction ratios during pre- and post-landing phases compared to their male counterparts in 4 of 9 studies that considered co-contraction. While some studies supported the quadriceps-dominant activation strategies in females, no consensus can be drawn due to methodological inconsistencies and limitations. Also, despite the importance of ACL injury prevention in children and adolescents, the evidence on sex difference in muscle activation patterns in this population is insufficient to draw meaningful conclusions.

A Mixed Method Study to Assess the Effect of Training of Adolescents on Perception and Practices regarding Unintentional Childhood Injuries

Background: Adolescents are the future citizens of any society, who can be trained to become responsible members and also function as change agents in the community to improve children’s health. Child-To-Child Approach is an innovative technique which was used in the present study to improve perception and practices regarding unintentional childhood injuries, by training the adolescent population. Methodology: An intervention study was conducted in two villages of Delhi from April 2017 to July 2019, to test the Child-To-Child Approach in preventing childhood injuries, by training the eldest adolescent in each family of intervention area and encouraging them to disseminate the knowledge to other family members. Present study is a part of the main study and analyses improvement in Perception and Practice (PP) regarding injuries after intervention, as assessed from PP scores of adolescents eligible for training, other adolescents and adult women. Focus group discussions (FGD) for assessing perception were also conducted with adolescents and adult women, at the beginning and end of study. Results: During pre-intervention period, PP scores of all three groups of subjects showed no significant difference between the two areas. Statistically significant improvement was observed in PP scores of all three groups of subjects in the intervention area during the post-intervention phase, in comparison to pre-intervention phase as well as in comparison to scores of control area in post-intervention phase. Findings from the FGD showed that perception of both groups regarding types and reasons of injuries was low in the beginning, but increased markedly in the second FGD in both the groups, compared to the first FGD. Conclusion: These findings indicate that training adolescents and encouraging them to disseminate messages to their siblings and to the adult women of their families, which is the essence of Child-To-Child Approach, is effective in improving the perception and practices regarding unintentional childhood injuries.

Prevention of Childhood Injuries

Prevention of Childhood Injuries

Perceptions and Acceptability of a Smartphone App Intervention (ChildSafe) in Malaysia: Qualitative Exploratory Study.

BackgroundHome is a vulnerable place for accidental child injuries. Unintentional injuries are a leading cause of death, hospitalization, and disabilities. These injuries are considered preventable and if not tackled, they will continue to be a persisting problem. Smartphones have become increasingly important in our everyday life and is an important tool not only for communication but also for other purposes—they have apps that can be used for various purposes. Therefore, an app-based intervention (ChildSafe) was developed to assess and reduce child injury at home.ObjectiveThis study aimed to evaluate the acceptance of the ChildSafe smartphone app intervention by parents/guardians.MethodsThis study was conducted using a qualitative exploratory approach on selected participants of the ChildSafe intervention app study. A total of 27 semistructured in-depth interviews were carried out among parents or guardians who have at least one child between the age of 0 and 59 months in the area of Sungai Buloh, Selangor, between November 2017 and March 2018. Interview questions were developed from the consolidated framework for implementation research (CFIR). Interviews were recorded, transcribed verbatim, and data were thematically analyzed guided by CFIR.ResultsThe study revealed users’ perception on usability, feasibility, and acceptability toward the ChildSafe app. Three CFIR domains were identified: intervention characteristics, inner setting, and characteristics of individuals. A total of 5 constructs were revealed under intervention characteristics: evidence strength and quality, relative advantage, adaptability, trialability, and design quality and packaging; 2 under inner setting: implementation climate and readiness for implementation; and 4 under characteristics of individuals: knowledge and beliefs about the intervention, self-efficacy, individual stage of change, and other personal attributes. In general, participants felt the app is extremely useful and effective, easy to use, and purposeful in achieving home safety assessment via reminders. The app replaces the need for participants to search for information on home safety and dangers, as the app itself was designed as a tool to assess for this specific purpose. Even at the nascent stage and despite its limitations, the app has prompted users to consider and make changes around their own home. However, future versions of the app should be expanded to make it more attractive to users as it lacks interactive feedback and additional features.ConclusionsParents/guardians are accepting the use of the ChildSafe app to prevent child injury at home. However, further expansion and improvements are needed to increase the acceptability of this app by parents/guardians.

Descriptive Epidemiology of Unintentional Childhood Injuries in India: An ICMR Taskforce Multisite Study

Children 0-14 years constitute about 31.4% of Indian population, among whom the magnitude and risk factors of childhood injuries have not been adequately studied. To study the prevalence of and assess the factors associated with unintentional injuries among children aged 6 month - 18 years in various regions. This multi-centric, cross-sectional, community-based study was conducted at 11 sites across India. States included were Gujarat, Karnataka, Madhya Pradesh, Punjab, Sikkim, Tamil Nadu, Uttarakhand, and West Bengal between March, 2018 and September, 2020. A total of 2341 urban and rural households from each site were selected based on probability proportionate to size. The World Health Organization (WHO) child injury questionnaire adapted to the Indian settings was used after validation. Information on injuries was collected for previous 12 months. Definitions for types (road traffic accidents, falls, burns, poisoning, drowning, animal-related injuries) and severity of injuries was adapted from the WHO study. Information was elicited from parents/primary caregivers. Data were collected electronically, and handled with a management information system. In the 25751 households studied, there were 31020 children aged 6 months-18 years. A total of 1452 children (66.1% males) had 1535 unintentional injuries (excluding minor injuries) had occurred in the preceding one year. The overall prevalence of unintentional injuries excluding minor injuries was 4.7% (95% CI: 4.4-4.9). The commonest type of injury was fall-related (842, 54.8%) and the least common was drowning (3, 0.2%). Injuries in the home environment accounted for more than 50% of cases. The findings of the study provide inputs for developing a comprehensive child injury prevention policy in the country. Child safe school with age-appropriate measures, a safe home environment, and road safety measures for children should be a three-pronged approach in minimizing the number and the severity of child injuries both in urban and rural areas.

School injuries and their prevention from the present perspective

Background: ‪Injuries are considered worldwide to be the most significant health problem, especially in childhood. In the Czech Republic, injuries are the most common cause of death among children and young adults. The aim of the study was to provide more insight in school accidents in the Czech Republic from 2008 to 2018 and to estimate future trends. Material and methods: ‪Annual reports of the Czech School Inspectorate (CSI) from 2007 to 2017 were the main sources of data. Results: ‪A high number of injuries occur in the school environment, especially at the primary level. In the Czech Republic, there has been a trend of rising numbers in reported school injuries over the last three years, from 33,000 in 2008 to 46,000 in 2018. Over the last 5 years, the number of reported accidents has increased by 1,000 per year. The most injuries occur in primary schools, within the subject Physical Education. Conclusions: ‪There are many activities which focus on the prevention of child injuries, the incidence of which has improved in recent years. Experience shows that when prevention programs include innovations and interesting presentation methods, they are successful.

Validation of the Activity Room: An Ecologically Valid Assessment of Young Children’s Risk-Taking

Physical risk-taking is associated with increased risk of unintentional injury, a global health challenge and the leading cause of death for children in the United States. To assess risk and develop prevention programs, valid tools to assess children’s physical risk-taking are needed. No ecologically valid behavioral measures are widely available. This study describes the development and validation of the “Activity Room” to measure children’s physical risk-taking while presenting low risk of actual injury. Participants were 59 children aged 4 to 6 years old (51% female; 51% non-Hispanic White) and their parents. Children completed two tasks to assess physical risk-taking: (a) vignettes (short stories presenting risk situations) and (b) the “Activity Room” (unsupervised engagement for 5 min in a room with apparatus designed to stimulate potential physical risk-taking). Parents responded to a questionnaire concerning children’s active play behaviors. Correlational analyses evaluated convergent validity of the Activity Room risk-taking outcome. The Activity Room proved feasible; all children engaged eagerly and safely. Convergent validity was demonstrated through two strategies. First, risk-taking in the Activity Room correlated with observed play behaviors, such as climbing and falling. Second, risk-taking in the Activity Room correlated with children’s risk-taking responses in the vignettes and with parent-reported child risk-taking. Results indicate the Activity Room task is a valid technique to assess young children’s risk-taking in an ecologically valid real-world behavioral task. Incorporation of the task as an assessment tool may benefit a range of studies investigating children’s physical risk-taking behavior, risky decision-making, and child injury prevention strategies.

Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial

ObjectiveTo evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries.MethodsThis cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5–7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months.ResultsUnintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405–0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001).ConclusionSchool based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.

Assessing school-based intervention strategies to foster the prevention of choking injuries in children: The results of the CHOP (CHOking Prevention) trial.

There are few public health programs aimed at reducing choking injuries, even though choking is one of the leading causes of death among unintentional injuries in young children. We present the results from the CHOP (CHOking Prevention) project community intervention trial, which aimed to compare three different school-based intervention strategies for food choking prevention. The trial enrolled 41 educational facilities, which were randomized to one of three different intervention strategies to inform about prevention of food choking, or to serve as the control group. In strategy A, education was delivered directly to families, whereas in strategy B, education was delivered first to teachers and by them to families, and in strategy C, education was delivered only to healthcare coordinators in each school and by them to teachers and families. All educational interventions were delivered in the schools by experts and certified trainers. The participants were asked about sociodemographic information and completed questionnaires (pre-, post- and follow-up of intervention). Information from the postintervention and follow-up questionnaires was synthesized into four indicators to evaluate the effectiveness of each intervention strategy. Of the 1,426 participants, 298 were involved in strategy A, 474 in strategy B, 491 in strategy C and 163 in the control group. At postintervention, the scores of the indicators in each strategy significantly outperformed those of the control group, with adjusted p<0.05. At follow-up, the distribution of the indicator scores of each strategy was found to be not significantly different compared to those of the control group (p>0.05). The results of this study suggest that a sustainable school-based public health intervention mediated by teachers is effective as direct training for families in improving knowledge about food choking injury prevention. Nevertheless, further improvements could be made to increase long-term information retention.

Making Microwave Oven Doors Child Resistant to Protect Young Children From Severe Scalds.

Most severe child scalds in the United States involve food and beverages. The wide variety of burn mechanisms, however, makes prevention challenging. Over the past 15 years, we have worked toward protecting young children from 1 specific mechanism: children opening microwave oven doors themselves and spilling the heated contents, resulting in often severe scalds. In our published research, we documented the frequency and severity of these cases and the vulnerability of young toddlers to be burned in this way. We have presented our findings and ideas for prevention at multiple national meetings and enlisted college engineering students to design microwave doors that would thwart a young child from opening them. In 2017, we became active members of a national task group convened by Underwriters Laboratories to address this issue, and two authors became voting members on the Underwriters Laboratories Standards Technical Panel for microwave ovens. We worked with microwave manufacturers and others for >1 year to address concerns of the industry, including those related to potential impacts on older adults. This effort resulted in the task group proposing a change in the standard, requiring "two distinct actions" to open the door of a microwave oven. On September 17, 2018, the panel voted to pass the measure, which will require child-resistant doors for all new microwave ovens in 2023. This report highlights how research can inform and support child injury prevention advocacy. Children will now be protected from this type of scald as microwaves with child-resistant doors replace current models.

Factors Associated With Dropout of Participants in an App-Based Child Injury Prevention Study: Secondary Data Analysis of a Cluster Randomized Controlled Trial.

BackgroundMobile health (mHealth) interventions offer great potential to reach large populations and improve public health. However, high attrition rates threaten evaluation and implementation of mHealth intervention studies.ObjectiveWe explored factors associated with attrition of study participants in an mHealth randomized controlled trial (RCT) evaluating an intervention to reduce unintentional child injury risk in China.MethodsThe cluster RCT compared two groups of an app-based intervention for caregivers of 3-6–year-old children (Bao Hu San). The intervention group received unintentional child injury and parenting education, whereas only parenting education was implemented in the control group. The trial included 2920 study participants in Changsha, China, and lasted 6 months. Data on participant engagement (using the app) were collected electronically throughout the 6-month period. Associations between participant attrition and demographic characteristics, and between attrition and intervention engagement were tested and quantified separately for the intervention and control groups using the adjusted odds ratio (aOR) based on generalized linear mixed models.ResultsIn total, 2920 caregivers from 20 eligible preschools participated, with 1510 in the intervention group and 1410 in the control group. The 6-month attrition rate differed significantly between the two groups (P<.001), at 28.9% (437/1510) in the intervention group and 35.7% (503/1410) in the control group. For the intervention group, the only significant predictor of attrition risk was participants who learned fewer knowledge segments (aOR 2.69, 95% CI 1.19-6.09). For the control group, significant predictors of attrition risk were lower monthly login frequency (aOR 1.48, 95% CI 1.00-2.18), learning fewer knowledge segments (aOR 1.70, 95% CI 1.02-2.81), and shorter learning durations during app engagement (aOR 2.39, 95% CI 1.11-5.15). Demographic characteristics were unrelated to attrition.ConclusionsEngagement in the app intervention was associated with participant attrition. Researchers and practitioners should consider how to best engage participants in app-based interventions to reduce attrition.Trial RegistrationChinese Clinical Trial Registry ChiCTR-IOR-17010438; http://www.chictr.org.cn/showproj.aspx?proj=17376International Registered Report Identifier (IRRID)RR2-10.1186/s12889-018-5790-1

Appalachian Caregiver Perspectives on Childhood Gun Safety in the Home.

BackgroundChildhood gun injuries pose a critical public health challenge. For children, unintentional gun injury deaths primarily occur in the home where parents or other adult guardians, referred to as caregivers hereafter, are responsible for safety. While the American Academic of Pediatrics recommends not having guns in areas where children live and play, firearms are often viewed as normative and fill an important role in many homes. This is particularly true in more rural areas, such as Appalachia, where there is a high density of gun ownership. Additional research is needed to understand rural caregivers’ current gun safety practices in the home.PurposeThe purpose of this study was to gain an understanding of Appalachian caregivers’ gun safety practices, perspectives, and attitudes to assist public health professionals develop more effective interventions and targeted messaging.MethodsTen Appalachian caregivers were interviewed for a qualitative, phenomenologic study designed to elicit an in-depth understanding of firearm safety strategies in the home. An inductive analytic approach to coding and analysis was used to identify main themes and ideas.ResultsCurrent attitudes, practices, and perspectives focused on the primary childhood injury prevention strategies of education, environmental change, and supervision. Findings matched and expanded upon previous literature in the field.ImplicationsCross-cutting themes were identified that have practical implications for the development of public health interventions and messaging for this at-risk population.

Creating a ‘choose your topic’ massive open online course: an innovative and flexible approach to delivering injury prevention education

ABSTRACT Background A pediatric injury prevention course has not been available as a massive open online course (MOOC). Creating a comprehensive topic course is particularly challenging because the traditional, week-by-week linear curriculum design is often a barrier to learners interested in only specific topics. We created a novel, flexible course as both a ‘choose your topic’ MOOC for the public learner and a Small Private Online Course (SPOC) for medical students. Methods We describe creating ‘Injury Prevention for Children and Teens’, a course of 59 video learning segments within eight modules taught by a multidisciplinary panel of 25 nationally-recognized experts. Completion tracking and course evaluations were collected. Results In 2.5 years, 4,822 learners from 148 countries have enrolled. Two-thirds of learners were female. Median age of learners was 31 years. For engagement, 19.3% (n = 932) of learners attempted quizzes, and 5.2% (n = 252) participated in online forum discussions. Medical professionals (n = 162) claimed an average of 13 credit hours per learner. Over 200 senior medical students have taken the SPOC. Conclusion ‘Injury Prevention for Children and Teens’ is a novel approach to injury prevention education that is broad, science-based, accessible, and not cost-prohibitive for a diverse group of global learners.

Economic Benefit in Treatment of Unintentional Childhood Injuries by Implementation of Child-To-Child Approach.

Background:Childhood injury has been recognized as a major threat to child survival and health, as well as economic burden, which includes the cost to government and out-of-pocket expenses (OOPE) to families. Child-To-Child Approach is an innovative technique to reduce childhood injuries and expenses on their treatment.Objectives:To assess economic benefit in the treatment of unintentional childhood injuries, including OOPE by families, by the implementation of the child-To-Child approach.Materials and Methods:The present study is part of a quasi-experimental before-and-after intervention study conducted in the rural area of Delhi for the prevention of childhood injuries through intervention by the child-To-Child approach. Cost of injury treatment, including travel and accommodation expenses, and wage loss were noted. The projected gain in the total cost and out-of-pocket expenditure on injury treatment throughout 20 years of childhood and adolescence were calculated.Results:Both incidences of injuries and total expenditure for treatment of injuries had decreased during the postintervention period in the intervention group, against a rise in the control group. The proportion of OOPE for availing private health care facilities for treatment of injuries, which was more than one-fourth of total expenses, also had decreased in the intervention group during the postintervention period. On economic analysis, it is projected that there will be enormous gain in cost by the implementation of child-To-Child approach in the study area in 20 years, along with saving of OOPE of the families.Conclusion:Child-To-Child approach is effective in preventing childhood injuries and reducing the cost of treatment of injuries.

Renouncement of red blood cells for heart-lung machine filling for perioperative prevention of cerebral injury in children undergoing cardiac surgery

Renouncement of red blood cells for heart-lung machine filling for perioperative prevention of cerebral injury in children undergoing cardiac surgery

Unintentional childhood injuries and their association with activity and location at the time of injury - A case-Crossover study in Delhi.

Childhood injury has been identified as a grave public health problem globally as well as in India. Most studies have reported injuries to have occurred while the child was at home, though injuries while on road, school, or playground also commonly occurred. The objective of the study is to find the association between unintentional childhood injury and the activity and location of the child at the time of injury. The present study is part of a larger study for preventing childhood injuries, conducted from August 2017 to January 2019 in Delhi, and reports the activity and location of the children at the time of injury. A total of 173 injuries that occurred during the total study duration were included in the analysis. Data regarding activity and location of the subjects were collected and analyzed by case-crossover study design, during "case/hazard period" and two "control/reference periods." Majority of the injuries occurred while the subjects were at home and engaged in activities other than normal activity. When various locations and activities were combined, unmatched odds ratios (ORs) were raised for activity other than normal activity (statistically significant) and for location other than at home. Similar results were obtained for matched Mantel-Haenszel OR, with activity other than normal being significantly more risk for injury (P = 0.000). Majority of unintentional injuries occurred in children and adolescents, while the subjects were away from home and engaged in any activity other than normal daily activities. This indicates the importance of teaching safety behavior to children so that they can prevent being injured wherever they go and whatever activity they perform.

Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review.

Injuries are a leading cause of death and disability among children. Numerous injury prevention strategies have been successful in high-income countries, but the majority of unintentional injuries happen to children living in low- and middle-income countries (LMICs). This project aims to delineate the childhood injury prevention initiatives in LMICs. For inclusion, peer-reviewed articles needed to address unintentional injury, include children <18, assess a prevention-related intervention, contain a control group, and be published after 1988. Two pairs of reviewers evaluated articles independently to determine study eligibility. 74 articles were included. 30 studies addressed road traffic injuries, 11 drowning, 8 burns, 3 falls, 8 poisonings, and 21 an unspecified injury type. The findings show positive effects on injury outcome measures following educational interventions, the need for longer follow-up periods after the intervention, the need for effectiveness trials for behavior change, and the need for an increase in injury prevention services in LMICs. This is the first systematic review to summarize the prevention initiatives for all types of childhood unintentional injuries in LMICs. Increased attention and funding are required to go beyond educational initiatives with self-reported measures and little follow-up time to robust interventions that will reduce the global burden of unintentional injuries among children.