Parenting interventions for the prevention of unintentional injuries in childhood

Teaching parenting skills could be an effective way to reduce childhood injuries, a new review of studies suggests, especially for disadvantaged families.

Families that received parent training had a lower risk of injury to their children compared to families that did not. Moreover, several studies found fewer hazards, a safer home environment for children and more safety practices in families that had undergone such training.

“We felt this review was particularly important because in industrialized countries injuries are the leading cause of death in childhood,” said lead author Dr. Denise Kendrick, at the division of primary care at the University of Nottingham in England. “There is also evidence to show that poorer children are much more likely to sustain a childhood injury than children from more privileged backgrounds, and that the gap between the two is widening.”

The review included 15 studies, mostly involving families at high-risk for injury to the children. Family teaching mainly took place in the homes and covered a wide variety of topics in addition to safety, such as child development and parenting skills.

Teaching specific to home safety included storing poisons out of reach of the child, having a working smoke alarm and using electric socket covers and safety gates. Some studies also looked at the use of child safety seats in cars.

The review appears in the latest issue of The Cochrane Library , a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

“Our key finding was that providing additional parenting support to families that are experiencing adversity can reduce the number of hazards, improve the home environment and reduce the likelihood of their children sustaining injuries,” Kendrick said. “Given the extent of the problem of childhood injuries, it was surprising that there were not more interventions that target this as part of a broader package of care provided to parents.”

“The important piece of information is that injury prevention is tied to the parent also receiving child development and parenting tips,” said Bridget Clementi, injury prevention manager for the Children's Health Alliance of Wisconsin in Milwaukee. “It is important to not only focus on the injury prevention parts, but also to get to the heart of the importance of close parental supervision.”

This review was not able to answer questions such as whether group-based programs work as well as home-based programs or whether parent-teaching programs provided to all families works as well as those provided to families experiencing adversity.

“Looking at the interventions, they were all over the place,” Clementi said. “In some studies the teachings were done once a week over the first year of life, while others had a single meeting. Some instruction was delivered by trained professionals and others by mothers in the community. It is hard to compare these studies to get to the ... best way to deliver these services.”

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit http://www.cochrane.org for more information.

Kendrick D, et al. Parenting interventions for the prevention of unintentional injuries in childhood (Review). Cochrane Database of Systematic Reviews 2007. Issue 4. Art. No.: CD006020.