RESUMEN
Unintentional injury constitutes a major health risk for young children, with many injuries occurring in the home. Although active supervision by parents has been shown to be effective to prevent injuries, evidence indicates that parents do not consistently apply this strategy. To address this issue, a randomized controlled trial was conducted to evaluate the impact of the Supervising for Home Safety program on parent supervision practices in the home and when unobtrusively observed in a naturalistic laboratory setting. Using a participant-event monitoring procedure, parents of children aged 2 through 5 years completed supervision recording sheets weekly both before and after exposure to the intervention program; Control parents completed the same measures but received a program focusing on child nutrition and active lifestyles. Unobtrusive video recordings of parent supervision of their child in a room containing contrived hazards also were taken pre- and post-intervention. Results indicated that groups did not differ in demographic characteristics. Comparisons of post- with pre-intervention diary reported home supervision practices revealed a significant decrease in time that children were unsupervised, an increase in in-view supervision, and an increase in level of supervision when children were out of view, with all changes found only for the Intervention group. Similarly, only parents in the Intervention group showed a significant increase in attention to the child in the contrived hazards context, with these differences evident immediately after and 3 months after exposure to the intervention. These results provide the first evidence that an intervention program can positively impact caregiver supervision.
Asunto(s)
Accidentes Domésticos/prevención & control , Atención , Educación en Salud/métodos , Madres , Adulto , Preescolar , Femenino , Humanos , Lactante , Masculino , Evaluación de Resultado en la Atención de SaludRESUMEN
INTRODUCTION: A video to promote parents' appreciation of young children's risk of injury and need for active supervision was recently developed (Morrongiello, Zdzieborski, Sandomierski, & Lasenby-Lessard, 2009). Integrating this video with tailored activities resulted in the Supervising for Home Safety program. The current randomized, controlled trial evaluated the efficacy of this program for increasing parental appraisals of child-injury risk and the need to actively supervise 2- through 5-year-old children. METHOD: Parents were recruited throughout the community and randomly assigned to either intervention (content focused on child-injury risks and supervision needs) or control (content focused on child nutrition and exercise) groups, with these balanced for child sex and age. Pre- and postintervention measures of parental appraisals of child-injury risk (vulnerability for injury, potential injury severity, preventability of injury) and supervision (value of active supervision, self-efficacy for actively supervising) were taken. RESULTS: Following exposure to the intervention, appraisals of children's injury risk and parents' need to actively supervise significantly increased in the intervention group but not the control group, and all effects, except change in vulnerability appraisal, persisted for 12 months after exposure to the intervention program. Additional analyses were conducted to explore barriers that parents identified to closely supervising and solutions they suggested to address barriers. CONCLUSIONS: The Supervising for Home Safety program produced the desired effects on parental appraisals. It holds promise as a program that may improve parents' supervision practices.
Asunto(s)
Relaciones Padres-Hijo , Responsabilidad Parental , Riesgo , Heridas y Lesiones/prevención & control , Niño , Consejo , Familia , Relaciones Familiares , Femenino , Humanos , Masculino , Seguridad , Autoeficacia , Grabación en VideoRESUMEN
Farm environments pose unique safety hazards for children. With this in mind, this paper raises several points about how caregiver supervision influences risk of childhood injuries. First, research suggests that it is not the absence of a supervisor per se but the poorer quality of supervision that leads to pediatric injuries on farms, particularly for young children who behave in unpredictable ways at a time when caregivers are likely to be distracted with farm work. Second, research suggests that "adequate" supervision varies with context. In nonfarm contexts, continuous attention and close proximity (i.e., being within arm's reach) constitute an adequate level of supervision to ensure young children's safety. In agricultural contexts, attention and continuity are also relevant. However, close proximity is less beneficial because this often results in exposing children to hazards (animals, dangerous equipment) if the supervisor is working. Third, research suggests that in both agricultural and nonagricultural contexts, the extent to which supervision is associated with injury varies with a child's developmental level. Specifically, supervision seems to play a more primary role in moderating injury risk for young children (preschool), and this influence decreases as children age and increasingly independent are allowed to engage in more activities without a supervisor present. Building on these findings, practical recommendations are provided to enhance the safety of children on farms and future research directions are discussed.
Asunto(s)
Agricultura/organización & administración , Traumatismos Ocupacionales/prevención & control , Adolescente , Factores de Edad , Agricultura/normas , Niño , Preescolar , Guías como Asunto , Humanos , Salud Laboral/normas , Traumatismos Ocupacionales/epidemiología , Factores de Riesgo , Estados Unidos/epidemiologíaRESUMEN
OBJECTIVES: Using a prospective design, this research examined supervision of young elementary-school children at home and how this relates to child injury, parent permissiveness, and children's risk-taking propensity. METHODS: Mothers reported children's history of injuries and recorded home supervision over a 2-month interval on a weekly basis. Children independently completed diaries about daily events, including injuries. RESULTS: Children spent 24% of time alone, mostly supervised intermittently or not at all. Parent permissiveness was associated with increased time unsupervised, while children's risk-taking propensity was associated with decreased time unsupervised. Greater direct supervision was associated with fewer injuries, while more indirect and non-supervision time emerged as risk factors and were associated with more frequent injury. CONCLUSIONS: These results extend those from preschool-aged children and suggest that caregiver supervision influences risk of injury across a broad age range throughout childhood. Implications for children's safety are discussed.
Asunto(s)
Prevención de Accidentes , Accidentes , Juego e Implementos de Juego , Riesgo , Seguridad , Heridas y Lesiones , Adulto , Niño , Femenino , Humanos , Masculino , Relaciones Padres-Hijo , Padres , Estudios Prospectivos , Asunción de Riesgos , Medio Social , Encuestas y CuestionariosRESUMEN
Recent research reveals that supervision can be a protective factor for childhood injury. Parents who closely supervise young children at home have children who experience fewer injuries. What is not known, however, is what messaging approaches (e.g., injury statistics, graphic images of injured children, personal testimonials by parents) are best to persuade parents to supervise more closely. Using video as the medium, the present focus group study of urban Canadian mothers explored their reactions to different formats and messages in order to: identify best practices to convince mothers that childhood injury prevention is important; determine how best to communicate messages about supervision to mothers; and identify what the nature and scope of these messages should be for motivating and empowering mothers to supervise closely. Results suggest that those who become aware of the scope of childhood injuries are motivated to pay attention to messaging about supervision, that such messages must be delivered with care so that parents do not feel guilty or blamed for acknowledging they could more closely supervise than they already are, that certain messages are not useful for encouraging closer supervision, and that both the content and presentation characteristics (images, accompanying sound) of messages are important determinants of effectiveness for motivating mothers to supervise more closely. Implications for developing interventions that effectively communicate information about child-injury risk and supervision to mothers are discussed.