Unintentional injury is the leading killer of children in the United States. Children under the age of 5 are at particularly high risk for death from injury. The evidence base for prevention programs in the area of unintentional injury is limited by a lack of rigorous research, inclusion of low-risk participants, and interventions that do not include behavioral skills training. The article presented here will discuss promising injury prevention programs for children below age 5 and will highlight program strengths and weaknesses. Interventions that prevent the leading causes of death among young children will be discussed, including car seat use, safe infant sleep, home hazard reduction, and caregiver supervision.
BorseN. N.GilchristJ.DellingerA. M.RuddR. A.BallesterosM. F., & SleetD. A. (2008). CDC childhood injury report: Patterns of unintentional injuries among 0–19 Year Olds in the United States, 2000–2006. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control.
3.
BrownS. H. M.GrondinD. E., & PotvinJ. R. (2008). Strength limitations to proper child safety seat installation: Implications for child safety. Applied Ergonomics, 40, 617–621.
4.
CarlbergM. M.Shapiro-MendozaC. K., & GoodmanM. (2012). Maternal and infant characteristics associated with accidental suffocation and strangulation in bed in US infants. Maternal and Child Health Journal, 16, 1594–1601. doi:10.1007/s10995-011-0855-0
5.
Centers for Disease Control and Prevention: Injury Prevention & Control: Data & Statistics. (WISQARS). Retrieved on December 1, 2013, fromhttp://www.cdc.gov/injury/wisqars/cost
6.
ChaffinM.BardD.BigfootD. S., & MaherE. J. (2012). Is a structured, manualized, evidence-based treatment protocol culturally competent and equivalently effective among American Indian parents in child welfare?Child Maltreatment, 17, 242–252. doi:10.1177/1077559512457239
7.
ChaffinM.HechtD.BardD.SilovskyJ., & BeasleyW. H. (2012). A statewide trial of the SafeCare home-based services model with parents in child protective services. Pediatrics, 129, 509–515. doi:10.1542/peds.2011-1840
8.
Chung-ParkM. S. (2012). Knowledge, opinions, and practices of infant sleep position among parents. Military Medicine, 177, 235–239. doi:10.7205/MILMED-D-11-00323
9.
DamashekA.BardD., & HechtD. (2012). Provider cultural competency, client satisfaction and engagement in home-based programs to treat child abuse and neglect. Child Maltreatment, 17, 56–66. doi:10.1177/1077559511423570
10.
DamashekA.WilliamsN. A.SherK., & PetersonL. (2009). Relation of caregiver alcohol use to unintentional childhood injury. Journal of Pediatric Psychology, 34, 344–353. doi:10.1093/jpepsy/jsn097
11.
DavidsonL. L.DurkinM. S.KuhnL.O’ConnorP.BarlowB., & HeagartyM. C. (1994). The impact of Safe Kids/Healthy Neighborhoods injury prevention program in Harlem, 1988 through 1991. American Journal of Public Health, 84, 580–586. doi:10.2105/AJPH.84.4.580
12.
DecinaL. E., & LococoK. H. (2005). Child restraint system use and misuse in six states. Accident Analysis and Prevention, 37, 583–590. doi:10.1016/j.aap.2005.01.006
13.
DecinaL. E.TempleM. G., & DorerH. (1994). Increasing child safety-seat use and proper use among toddlers: Evaluation of an enforcement and education program. Accident Analysis and Prevention, 26, 667–673. doi:10.1016/0001-4575(94)90028-0
14.
DiekemaD. S.QuanL., & HoltV. L. (1993). Epilepsy as a risk factor for submersion injury in children. Pediatrics, 91, 612–616.
15.
DiGuiseppiC., & RobertsI. G. (2000). Individual-level injury prevention strategies in the clinical setting. The Future of Children, 10, 53–82. doi:10.2307/1602825
16.
DurkinM. S.LaraqueD.LubmanI., & BarlowB. (1999). Epidemiology and prevention of traffic injuries to urban children and adolescents. Pediatrics, 103, e74. doi:10.1542/peds.103.6.e74
17.
FuL. Y.ColsonE. R.CorwinM. K., & MoonR. Y. (2008). Infant sleep location: Associated maternal and infant characteristics with Sudden Infant Death Syndrome prevention recommendations. The Journal of Pediatrics, 153, 503–508. doi:10.1016/j.jpeds.2008.05.004
18.
Gershater-MolkoR. M.LutzkerJ. R., & WeschD. (2003). Project SafeCare: Improving health, safety, and parenting skills in families reported for, and at-risk for child maltreatment. Journal of Family Violence, 18, 377–386. doi:10.1023/A:1026219920902
19.
GielenA. C., & SleetD. (2003). Application of behavior-change theories and methods to injury prevention. Epidemiological Review, 25, 65–76. doi:10.1093/epirev/mxg004
20.
GrazelR.Gibbons PhalenA., & PolomanoR. C. (2010). Implementation of the American Academy of Pediatrics recommendations to reduce Sudden Infant Death Syndrome risk in neonatal intensive care units: An evaluation of nursing knowledge and practice. Advances in Neonatal Care, 10, 332–342. doi:10.1097/ANC.0b013e3181f36ea0
21.
HaynesR.ReadingR., & GaleS. (2003). Household and neighbourhood risks for injury to 5–14 year old children. Social Science & Medicine, 57, 625–636. doi:10.1016/S0277-9536(02)00446-X
22.
JoynerB. L.OdenR. P.AjaoT. I., & MoonR. Y. (2010). Where should my baby sleep: A qualitative study of African American infant sleep location decisions. Journal of the National Medical Association, 102, 881–889.
23.
KendrickD.CouplandC.MulvaneyC.SimpsonJ.SmithS.SuttonA., . . .WoodsA. (2007). Home safety education and provision of safety equipment for injury prevention (Review). Cochrane Database of Systematic Reviews, 1, CD005014.
24.
KingW. J.KlassenT.LeBlancJ.Bernard-BonninA.RobitailleY.PhamB., . . .PlessI. (2001). The effectiveness of a home visit to prevent childhood injury. Pediatrics, 108, 382–388. doi:10.1542/peds.108.2.382
25.
KrouseA.CraigJ.WatsonU.MatthewsZ.KolskiG., & IsolaK. (2012). Bed-sharing influences, attitudes, and practices: Implications for promoting safe infant sleep. Journal of Child Health Care, 16, 274–283. doi:10.1177/1367493511432300
26.
LandenM. G.BauerU., & KohnM. (2003). Inadequate supervision as a cause of injury deaths among young children in Alaska and Louisiana. Pediatrics, 111, 328–331. doi:10.1542/peds.111.2.328
27.
LutzkerJ. R., & BigelowK. M. (2002). Reducing child maltreatment: A guidebook for parent services. New York, NY: Guilford Press.
28.
MasonB.Ahlers-SchmidtC. R., & SchunnC. (2013). Improving safe sleep environments for well newborns in the hospital setting. Clinical Pediatrics, 52, 969–975. doi:10.1177/0009922813495954
29.
MoonR. Y.CalabreseT., & AirdL. (2008). Reducing the risk of Sudden Infant Death Syndrome in child care and changing provider practices: Lessons learned from a demonstration project. Pediatrics, 122, 788–798.
30.
MoonR. Y.OdenR. P., & GradyK. C. (2004). Back to sleep: An educational intervention with Women, Infants, and Children program clients. Pediatrics, 113, 542–547. doi:10.1542/peds.113.3.542
31.
MorrongielloB. A.CorbettM.McCourtM., & JohnstonN. (2006). Understanding unintentional injury risk in young children II. The Contribution of Caregiver Supervision, Child Attributes, and Parent Attributes. Journal of Pediatric Psychology, 31, 540–551. doi:10.1093/jpepsy/jsj073
32.
MorrongielloB. A.SandomierskiM.ZdzieborskiD., & McCollamH. (2012). A randomized controlled trial evaluating the impact of supervising for Home Safety program on parent appraisals of injury risk and need to actively supervise. Health Psychology, 31, 601–611. doi:10.1037/a0028214
33.
MorrongielloB. A.SchwebelD. C.StewartJ.BellM.DavisA. L., & CorbettM. R. (2013). Examining parents’ behaviors and supervision of their children in the presence of an unfamiliar dog: Does the Blue Dog intervention improve parent practices?Accident Analysis and Prevention, 54, 108–113. doi:10.1016/j.aap.2013.02.005
34.
MorrongielloB. A.ZdzieborskiD.SandomierskiM., & MunroeK. (2013). Results of a randomized controlled trial assessing the efficacy of the Supervising for Home Safety program: Impact on mothers’ supervision practices. Accident Analysis and Prevention, 50, 587–595. doi:10.1016/j.aap.2012.06.007
35.
National Highway Traffic Safety Administration. (NHTSA, 2012). Traffic safety facts 2010 data—children (DOT HS 811 641). Washington, DC: U.S. Department of Transportation. Retrieved fromhttp://www-nrd.nhtsa.dot.gov/Pubs/811641.pdf
36.
OlsenL.BottorffJ. L.RainaP., & FrankishC. J. (2008). An ethnography of low-income mothers’ safeguarding efforts. Journal of Safety Research, 39, 609–616.
37.
PetersonL., & BrownD. (1994). Integrating child injury and abuse-neglect research: Common histories, etiologies, and solutions. Psychological Bulletin, 116, 293–315. doi:10.1037/0033-2909.116.2.293
38.
PetersonL.EwigmanB., & KivlahanC. (1993). Judgments regarding appropriate child supervision to prevent injury: The role of environmental risk and child age. Child Development, 64, 934–950. doi:10.2307/1131228
39.
PetersonL., & MoriL. (1985). Prevention of child injury: An overview of targets, methods, and tactics for psychologists. Journal of Consulting and Clinical Psychology, 53, 586–595. doi:10.1037/0022-006X.53.5.586
40.
PhelanK. J.KhouryJ.KalkwarfH., & LanphearB. (2005). Residential injuries in U.S. children and adolescents. Public Health Reports, 120, 63–70.
41.
PhelanK. J.KhouryJ.XuY.LiddyS.HornunR., & LanphearB. P. (2011). A randomized controlled trial of home injury hazard reduction: The home injury study. Archives of Pediatric Adolescent Medicine, 165, 339–345. doi:10.1001/archpediatrics.2011.29
42.
PowellE. C.MalanchinskiJ., & SheehanK. M. (2010). A randomized trial of a home safety education intervention using a Safe Home model. The Journal of Trauma-Injury Infection & Critical Care, 69, S233–S236. doi:10.1097/TA.0b013e3181f1ec2e
43.
PriceS. K.HillmanL.GardnerP.SchenkK., & WarrenC. (2008). Changing hospital newborn nursery practice: Results from a statewide “Back to Sleep” nurses training program. Maternal and Child Health Journal, 12, 363–371. doi:10.1007/s10995-007-0243-y
44.
RobertsM. C.FanurikD., & LayfieldD. A. (1987). Behavioral approaches to prevention of childhood injuries. Journal of Social Issues, 43, 105–118.
45.
Safe to Sleep public education campaign. (2013). Home Healthcare Nurse, 31, 293.
46.
SchnitzerP. G.CovingtonT. M., & DykstraH. K. (2012). Sudden unexpected infant deaths: Sleep environment and circumstances. American Journal of Public Health, 102, 1204–1212. doi:10.2105/AJPH.2011.300613
47.
SchwebelD.BartonB. K.ShenJ.WellsH.BogarA.HeathG., & McCulloughD. (in press). Systematic review and meta-analysis of behavioral interventions to improve child pedestrian safety. Journal of Pediatric Psychology.
48.
SchwebelD. C., & BrezausekC. M. (2011). Unintentional injury among low-income 5-year-olds with chronic health conditions. Chronic Illness, 7, 201–208. doi:10.1177/1742395310394220
49.
Shapiro-MendozaC. K.KimballM.TomashekK. M.AndersonR. N., & BlandingS. (2009). US infant mortality trends attributable to accidental suffocation and strangulation in bed from 1984–2004: Are rates increasing?Pediatrics, 123, 533–539. doi:10.1542/peds.2007-3746
50.
SinclairS. A., & XiangH. (2008). Injuries among US children with different types of disabilities. American Journal of Public Health, 98, 1510–1516. doi:10.2105/AJPH.2006.097097
51.
SwartL.van NiekerkA.SeedatM., & JordaanE. (2008). Paraprofessional home visitation programme to prevent childhood injuries in low-income communities: A cluster randomised controlled trial. Injury Prevention, 14, 164–169. doi:10.1136/ip.2007.016832
52.
SznajderM.LeducS.JanvrinM. P.BonninM.AegerterP.BaudierF., . . .ChevallierB. (2003). Home delivery of an injury prevention kit for children in four French cities: A controlled randomized trial. Injury Prevention, 9, 261–265. doi:10.1136/ip.9.3.261
53.
Task Force on Sudden Infant Death Syndrome. (2011a). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleep environment. Pediatrics, 128, 1030–1039.
54.
Task Force on Sudden Infant Death Syndrome. (2011b). SIDS and other sleep-related infant deaths: Expansion of recommendations for a safe infant sleep environment. American Academy of Pediatrics, 128, 1341–1367.
55.
TessierK. (2010). Effectiveness of hands-on education for correct child restraint use by parents. Accident Analysis and Prevention, 42, 1041–1047. doi:10.1016/j.aap.2009.12.011
56.
TurnerC.McClureR.NixonJ., & SpinksA. (2005). Community-based programs to promote car seat restraints in children 0–16 years—A systematic review. Accident Analysis and Prevention, 37, 77–83. doi:10.1016/j.aap.2003.12.004
57.
XiangH.StallonesL.ChenG.HostetlerS. G., & KelleherK. (2005). Nonfatal injuries among US children with disabling conditions. American Journal of Public Health, 95, 1970–1975. doi:10.2105/AJPH.2004.057505
