Cochrane review: Parenting interventions for the prevention of unintentional injuries in childhood
Authors: Kendrick Denise , Barlow Jane , Hampshire Amanda , Polnay Leon , Stewart‐Brown Sarah 
Published: June 2009

Background

Parent education and training programmes can improve maternal psychosocial health, child behavioural problems and parenting practices. This review assesses the effects of parenting interventions for reducing child injury.

Objectives

To assess the effects of parenting interventions for preventing unintentional injury as well as increasing possession and use of safety equipment and parental safety practices.

Search strategy

We searched CENTRAL, MEDLINE, EMBASE, Biological Abstracts, Psych INFO, Sociofile, Social Science Citation Index, CINAHL, Dissertation Abstracts, ERIC, DARE, ASSIA, Web of Science, SIGLE and ZETOC. We also handsearched abstracts from the World Conferences on Injury Prevention & Control and the journal Injury Prevention. The searches were conducted in May 2005.

Selection criteria

We included randomised controlled trials (RCTs), non‐randomised controlled trials (non‐RCTs) and controlled before and after studies (CBAs), which evaluated parenting interventions administered to parents of children aged 18 years and under, and reported outcome data on injuries (unintentional or unspecified intent), and possession and use of safety equipment or safety practices. Parenting interventions were defined as those with a specified protocol, manual or curriculum aimed at changing knowledge, attitudes or skills covering a range of parenting topics.

Data collection and analysis

Studies were selected, data were extracted and quality appraised independently by two authors. Pooled relative risks (RR) were estimated using random effect models.

Main results

Fifteen studies were included in the review: 11 RCTs (one included a CBA within the same study), one non‐RCT, one study contained both randomised and non‐randomised arms and two CBAs. Two provided solely educational interventions. Thirteen provided interventions comprising parenting education and other support services; 11 of which were home visiting programmes and two of which were paediatric practice‐based interventions. Thirteen studies recruited families at risk of adverse child health outcomes. Nine RCTs were included in the primary meta‐analysis, which indicated that intervention families had a significantly lower risk of injury (RR 0.82, 95% CI 0.71 to 0.95). Several studies found fewer home hazards, a home environment more conducive to child safety, or a greater number of safety practices in intervention families.

Authors' conclusions

Parenting interventions, most commonly provided within the home using multi‐faceted interventions may be effective in reducing child injury. The evidence relates mainly to interventions provided to families at risk of adverse child health outcomes. Further research is required to explore mechanisms by which these interventions reduce injury, the features of parenting interventions that are necessary or sufficient to reduce injury and the generalisability to different population groups.

Plain Language Summary

Parenting interventions for the prevention of unintentional injuries in childhood

Parent education and training programmes can improve parenting, mothers' mental health and behaviour problems in children. This review looked at whether such programmes also help parents provide a safer home environment and reduce injuries in children. The reviewers found 15 parent education and training programmes that had been studied which measured home safety or childhood injuries. Eleven of these were home visiting programmes which provided a range of support services as well as parent education or training. These were usually provided to families whose children were considered to be at risk of poor health. The results showed that children from families who had received the education and training programmes had fewer injuries than those from families who had not had the programmes. The results for home safety were more varied, but some studies found a positive effect on home safety. It is not clear exactly how these programmes reduce injuries or whether they would work as well in less disadvantaged groups or in different settings.