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Unintentional injuries are a major public health problem. This paper analyses coroners' inquests from Sussex, England, for the period 1485-1688 to consider the circumstances surrounding adult unintentional injury deaths. Parallels with the situation today are examined. Travel was found to be the most hazardous activity, drowning was also highly significant and there were large differences between men and women. [ABSTRACT FROM AUTHOR]

Objective: To gain an in-depth qualitative understanding of parents' views about their children's exposure to road traffic injury risk in low socioeconomic areas. Design: Focus groups facilitated by a moderator with content analysis of data. Setting: Focus groups were conducted in 10 low socioeconomic English districts that also have high rates of child pedestrian injury. Research was conducted in community venues within each area. Subjects: Parents of children aged 9-14 years living in low socioeconomic areas. Results: Parents believe that children play in their local streets for the following reasons: they like playing out with friends near home; there are few safe, secure, and well-maintained public spaces for children; children are excluded from affordable leisure venues because of their costs; insufficient parental responsibility. For children that play in the street, the key sources of risk identified by parents were: illegal riding and driving around estates and on the pavements; the speed and volume of traffic; illegal parking; drivers being poorly informed about where children play; children's risk-taking behavior. Conclusions: Intervention programs need to take into account multiple reasons why children in low socioeconomic areas become exposed to hazardous environments thereby increasing their risk of injury. Multi-agency partnerships involving the community are increasingly needed to implement traditional road safety approaches, such as education, engineering, and enforcement, and provide safe and accessible public space, affordable activities for children, and greater support for parents. [ABSTRACT FROM AUTHOR]

Objectives: To bring together scientific evidence of what works in injury prevention with the knowledge and experience of practitioners, using a case study of smoke alarm installation from England. Design: There is good evidence of strategies to reduce injuries but less is known about the art of translating those strategies to implementation in real-world settings. England's Health Development Agency developed a structured process applicable to many public health fields, which integrates practitioner knowledge into the evidence base and reflects local contexts. The multistep process includes convening structured field meetings with local practitioners and policy makers, which focus on a mapping exercise of strategies, policies, targets, and funding streams related to childhood injury prevention, and barriers and facilitators relating to implementation of specific interventions. Setting: Meetings were held in six venues across England with 98 participants from a range of professional backgrounds and sectors. Results: The collective knowledge of participants provided many local insights unlikely to emerge in conventional research. Discussion topics covered key partners and sectors to include when planning a program; national policies and programs that could be used to drive the agenda; potential sources of funding; the importance of providing and installing appropriate smoke alarms; targeting of programs; and suggestions for gaining access to hard-to-reach populations. Conclusion: This methodology represents an efficient way of gaining insight necessary for successful implementation of evidence based programs. It may be particularly useful in lower and middle income countries, serving to translate evidence into the local contexts and circumstances within which practitioners operate. [ABSTRACT FROM AUTHOR]

This paper presents a summary table and discussion of legislation related to child injury prevention in member countries of the Organisation for Economic Cooperation and Development. The table is an expanded version of the one which appeared in the UNICEF Report Card 'Child Deaths by Injury in Rich Countries' (2001). A commentary is provided on the variations in legislation between countries in terms of range and form of measures and an estimate of degree of enforcement. As legislation is generally considered a powerful tool in injury prevention, the paper examines whether those countries with the widest range of legislation and the strongest enforcement have made the most progress in reducing child injury deaths since the 1970s. It also considers whether a commitment to extensive legislation is reflected in a country's position in the UNICEF league table of injury death. The initial conclusion to these two basic issues is that no clear picture can be seen and we thus need to know far more about the relationship between legislation and societies and cultures as they vary from place to place. This paper hopes to stimulate more widespread debate about the role of legislation in different countries. [ABSTRACT FROM AUTHOR]

AIM: The aim of this paper is to report on a systematic review of the world literature to provide information about the most effective forms of health promotion interventions to reduce childhood (0-14 years) unintentional injuries. The findings are of relevance to policy makers at a local or national level, to practitioners and researchers. METHODS: The relevant literature has been identified through the use of electronic databases, hand searching of journals, scanning reference lists, and consultation with key informants. RESULTS: Examples of interventions that have been effective in reducing injury include: bicycle helmet legislation, area wide traffic calming measures, child safety restraint legislation, child resistant containers to prevent poisoning, and window bars to prevent falls. Interventions effective in changing behaviour include bicycle helmet education and legislation, child restraint legislation, child restraint loan schemes, child restraint educational campaigns, pedestrian education aimed at the child/parent, provision of smoke detectors, and parent education on home hazard reduction. For the community based campaigns, the key to success has been the sustained use of surveillance systems, the commitment of interagency cooperation and the time needed to develop networks and implement a range of interventions. Education, environmental modification and legislation all have a part to play and their effect in combination is important. CONCLUSION: The design of evaluations in injury prevention needs to be improved so that more reliable evidence can be obtained. Better information is needed on process, so that successful strategies can be replicated elsewhere. There is also a need for literature reviews on effectiveness to be updated regularly and for their findings to be widely disseminated to policy makers, researchers, and practitioners. [ABSTRACT FROM PUBLISHER]

OBJECTIVE: To enhance the case definition of unintentional injuries in childhood by applying an objective severity measure to fatal and non-fatal cases. DESIGN: A descriptive prospective epidemiological study of a defined resident childhood population (< 16 years of age) for a one year period, 1990. SETTING: Newcastle upon Tyne, England. Child population estimate for 1990 was 54,400. SUBJECTS: Resident children who died, were admitted to local hospitals, or attended local accident and emergency departments. OUTCOME MEASURES: Using recognised severity scoring systems (for example the injury severity score, trauma score) injuries were classified as severe, moderate, or mild. RESULTS: There were six deaths, 904 admissions, and 11,682 accident and emergency department attendances. All deaths, 25% of admissions, and 1% of accident and emergency attenders were classified as severe. The underlying determinants of severe injuries are different than those for all other injuries (for example age, social class). A comparison with a local survey in 1986 showed a 26% rise in hospital admissions, but no significant rise in the frequency of severe or moderately injured children. Comparisons with other international data showed higher rates of injury admissions and attendances for England, but no significant differences in the frequency of severe injuries. CONCLUSIONS: Objective severity scoring enhances the case definition of unintentional injuries in childhood by allowing for the identification, and, therefore, the more reliable ascertainment of severely injured children. This more completely ascertained set of population cases increases the accuracy of comparisons of injury frequency over time and by place, and, in addition, enhances our basic understanding about the epidemiological characteristics of childhood unintentional injury. [ABSTRACT FROM PUBLISHER]

The article reviews research literature on the role of health education in preventing childhood injuries. The different ideologies in health education and effective teaching and learning models are discussed as well as the educational principles in the preventive, radical, and empowerment models. The characteristics of educational programmes that are successful or unsuccessful are noted.

Objectives To assess the effectiveness of thermostatic mixing valves (TMVs) in reducing bath hot tap water temperature, assess acceptability of TMVs to families and impact on bath time safety practices. Design Pragmatic parallel arm randomised controlled trial. Setting A social housing organisation in Glasgow, Scotland, UK. Participants 124 families with at least one child under 5 years. Intervention A TMV fitted by a qualified plumber and educational leaflets before and at the time of TMV fitting. Main outcome measures Bath hot tap water temperature at 3-month and 12-month post-intervention or randomisation, acceptability, problems with TMVs and bath time safety practices. Results Intervention arm families had a significantly lower bath hot water temperature at 3-month and 12-month follow-up than families in the control arm (3 months: intervention arm median 45.0°C, control arm median 56.0°C, difference between medians, ⇔'11.0, 95% CI ⇔'14.3 to ⇔'7.7); 12 months: intervention arm median 46.0°C, control arm median 55.0°C, difference between medians ⇔'9.0, 95% CI ⇔'11.8 to ⇔'6.2) They were significantly more likely to be happy or very happy with their bath hot water temperature (RR 1.43, 95% CI 1.05 to 1.93), significantly less likely to report the temperature as being too hot (RR 0.33, 95% CI 0.16 to 0.68) and significantly less likely to report checking the temperature of every bath (RR 0.84, 95% CI 0.73 to 0.97). Seven (15%) intervention arm families reported problems with their TMV. Conclusions TMVs and accompanying educational leaflets are effective at reducing bath hot tap water temperatures in the short and longer term and are acceptable to families. Housing providers should consider fitting TMVs in their properties and legislators should consider mandating their use in refurbishments as well as in new builds. [ABSTRACT FROM AUTHOR]

Aim To evaluate the implementation and acceptability of the PRECISE child injury project in Bangladesh. Background Each year in Bangladesh, 30 000 children die from unintentional injuries; drowning is the single leading cause of death in children aged 1–17 years. PRECISE is a community-based project with many interrelated components, including Community crche and SwimSafe programmes, tailored to the Bangladesh environment. Methods The intervention has been implemented in four areas, with two control areas. Quantitative and qualitative methods were used in the evaluation, including a household survey, focus groups and questionnaires, administered to parents, children and service providers. Observation visits were made to randomly selected Creches and SwimSafe centres. Results 44 out of 45 Community creches were operating when the observation visit took place and were functioning well. The creches were accepted by the local community, with evidence of untapped demand for places. Observations on SwimSafe centres showed that 23/30 were operating on the day of the visit and were functioning properly. Physical facilities like landing places and swimming platforms were found to be satisfactory. Most of the swimming graduates reportedly had acquired the standard swimming skills (93%) and knowledge of rescue techniques (95%). Conclusion The interventions were acceptable to the local community, implemented in the manner for which they were designed and contributed to knowledge change, observed and reported behaviour change and modifications to the environment. Tackling unintentional injuries requires coordinated action across health and other sectors, with strong community involvement to enhance sustainability. [ABSTRACT FROM PUBLISHER]

Aim To explore knowledge and reported safety practices of parents of preschool children in relation to thermal injuries. Background In the UK, unintentional injury is an important cause of death and leading cause of Emergency Department attendance and hospital admissions in 1–4 year olds. The burden of injury is highest for children who live in poverty. Children's Centres provide community-based co-ordinated services, information and support for families with preschool children. Methods 200 structured interviews will take place in Children's Centres with parents of preschool children (10 parents at 5 Children's Centres in 4 Study Centres: Bristol, Nottingham, Norwich, Newcastle). Interviews will cover: fire-safety practices for example, smoke alarm ownership and use, risk factors for injury (smokers in the household), knowledge of first-aid. Results Results will describe fire-safety practices and contribute to the design of a randomised controlled trial of an Injury Prevention Briefing for fire-related injuries to be implemented in Children's Centres, and will provide detailed information about fire safety and data to inform sample size calculations. Conclusions The Keeping Children Safe at Home programme aims to develop a better understanding of how to prevent unintentional injuries in preschool children. It aims to apply this knowledge, working with Children's Centres to implement effective approaches with families served by the Centres. The findings of the interview study will inform the development of Injury Prevention Briefings which will be implemented and evaluated in Children's Centres. [ABSTRACT FROM PUBLISHER]

Aim Factors previously associated with the risk of unintentional injury in primary school aged children include a range of child and family variables. Risk factors in the environment have been seldom studied in this age group and their relative contribution to overall injury risk is unclear. Methods Avon longitudinal study of pregnancy and childhood is a large, population-based longitudinal birth cohort study in Avon, England. It recruited mothers during their pregnancy and 14 602 children in the cohort were born in 1991–1992. We investigated the association of parentally reported injury data from 5752 children collected at 5, 6, 8 and 11 years of age with a range of potential risk factors using multivariable analysis with multiple imputation of missing data. Results Using a hierarchical conceptual framework for modelling childhood injury risk, a greater number of factors related to the child's immediate environment (eg, home) were associated with an increased risk of injury than factors in the wider environment (eg, neighbourhood). Environmental factors showed weaker evidence against the null hypothesis of no association with injury than family or child factors. The relative contribution of environmental factors varied with age of the child. Comparisons with previous research will be made. Conclusions This research provides robust evidence of the relative contribution of risk factors for unintentional injuries in primary school aged children in the UK. This is of value to inform the development of targeted interventions to prevent unintentional injuries in these children. [ABSTRACT FROM PUBLISHER]

Aim To perform a systematic review of community-based studies on unintentional injuries in children in WHO's South-East Asian countries to summarise and compare rates of and risk factors for injuries. Background Globally, injuries are among the leading causes of death and disease burden in children. The proportion of deaths due to injuries is significantly higher in the South-East Asia region. However, there is big difference in the mortalities within the region. Methods Medline, Embase and CINAHL were searched for publications on all types of unintentional child injuries in this region published between 01 January 2000 and 31 December 2009. Data were extracted to standard spreadsheets and narratively synthesised. Results A total of 32 studies from six countries were included in the review. There were 13 studies on all injuries, 6 on RTIs, 5 on animal bites, 3 each on drowning and disasters, and 3 on burns. Rates of non-fatal injuries varied from 14 per 1000 (Thailand, 1–17 year), 15 (Bangladesh, 0–17 year), 24 (India, 0–14 year), 220 (Sri Lanka, 0–19 year), with rates among rural children higher in all countries. The rates for fatal injuries ranged from 37/100 000 in Thailand to 44/100 000 in Bangladesh. Conclusion Community-based studies have shown the extent of the problem of unintentional injuries in children and young adolescents. Insights from the review will be used in the development of a community-based study of children aged 0–17 years in Nepal. [ABSTRACT FROM PUBLISHER]

Aim To explore the views of professionals working in Children's Centres on the barriers and facilitators to implementing health promotion and injury prevention interventions. Background In the UK, unintentional injury is an important cause of death in 1–4 year olds. The burden of injury is highest for children who live in poverty. Co-ordinated services, and information and support, are provided by teams of professionals in Children's Centres for the families of these children. This includes injury prevention. Methods 32 semistructured interviews will be conducted with managers and staff from Children's Centres in four centres: Bristol, Nottingham, Norwich and Newcastle. Purposive sampling will be used. Interviews will ask about health education and safety promotion programmes: capacity development within Centres and ways of engaging families. Interviews will be audio-recorded and transcribed. Data will be analysed using the NVivo software package. Results Issues on barriers and facilitators and implications for practice will be documented. It will also allow us to identify how we can best support Children's Centre staff to implement evidence based injury prevention programmes. Conclusions The Keeping Children Safe at Home programme aims to develop a better understanding of how to prevent unintentional injuries in pre-school children. It will apply this knowledge, working with Children's Centre staff, to implement effective approaches with families served by the Centres. The findings from this qualitative study will inform the development of succinct, easy-to-read, evidence-based guidance which will be implemented and evaluated in Children's Centres. [ABSTRACT FROM PUBLISHER]

Objectives The UKBOI study was designed to quantify important components of the population burden of injury in the UK. Methods A mixed methods study incorporating a multi-centred prospective cohort of injured individuals; extrapolation of patient reported outcomes to population metrics using routine data from emergency departments (ED), hospital discharge registers and mortality data; calculation of Disability Adjusted Life Years (DALYs) using Global Burden of Diseases methodology and estimated indirect costs; and the calculation of direct medical costs. Results The study recruited 1517 injured individuals. Estimated numbers (and rates per 100 000) for UK population extrapolations were 750 999 (1240) for hospital admissions, 7 982 947 (13 339) for emergency department attendances, and 22 185 (36.8) for injury related deaths, in the financial year 2005/6. An estimated 1 574 000 DALYs were lost from injuries occurring in that year, with 80% due to Years Lived with Disability (YLDs) and 20% from Years of Life Lost (YLLs). Some 10% of DALYs lost were due to YLDs occurring within 12 months post injury and 70% due to lifelong injuries. Direct medical costs were estimated at 482 million for ED visits and 2.15 billion for inpatient stays, with indirect costs of up to 31.5 billion. The qualitative study with 90 participants revealed many additional negative consequences for individuals, family and society. Implications The high population burden and costs associated with injuries in the UK demonstrates the need for sustained policies and interventions in support of prevention. [ABSTRACT FROM PUBLISHER]

Introduction Road traffic injuries (RTIs) are a leading cause of morbidity, disability and mortality in low income countries. According to the WHO Global Burden of Disease project, in 2004 nearly 1.3 million people of all ages were killed in road traffic crashes around the world and over 50 million were injured or disabled. Objective Investigate the magnitude of and risk factors for childhood road traffic injury in Bangladesh. Methodology A cross sectional study was conducted to determine the current childhood road traffic injury situation in Bangladesh. Face-to-face interviews were used. Multi stage cluster sampling was used to select the sample. Result Nationally representative data were collected from 171 366 rural and urban households. In the sampled households 351 651 children aged 0–17 years were identified; 178 285 were males and 173 366 females. The rate of non-fatal RTI among children under 18 years of age was calculated as 186.55 per 100 000 child-year. The highest incidence (216.06/100 000 child-year) was found among the 59 years age group. Among the total children with non-fatal RTI 75.3% were male and 24.7% were female. The incidence of childhood RTI was found to be three times higher in rural children than urban children. Most of the childhood RTIs were pedestrian injuries. The rate of fatal RTI was 5.97 per 100 000 per year among all children. Conclusion The study findings confirmed that childhood RTI is a major public health problem in Bangladesh. An appropriate prevention programme is urgently required to prevent fatal and non-fatal RTIs in rural areas. [ABSTRACT FROM PUBLISHER]

Objectives The UKBOI study was designed to quantify important components of the population burden of injury in the UK. Methods A mixed methods study, incorporating a multi-centred prospective cohort of injured individuals; extrapolation of patient reported outcomes to population metrics using routine data from emergency departments (ED), hospital discharge registers and mortality data; calculation of Disability Adjusted Life Years (DALYs) using Global Burden of Diseases methodology and estimated indirect costs; and the calculation of direct medical costs. Results The study recruited 1517 injured individuals. Estimated numbers (and rates per 100 000) for UK population extrapolations were 750 999 (1240) for hospital admissions, 7 982 947 (13 339) for emergency department attendances and 22,185 (36.8) for injury related deaths, in the financial year 2005/6. An estimated 1 771 486 DALYs were lost from injuries occurring in that year, with 82% due to Years Lived with Disability (YLDs) and 18% from Years of Life Lost (YLLs). Some 20% of DALYs lost were due to YLDs occurring within 12 months post injury and 62% due to lifelong injuries. Direct medical costs were estimated at 482 million for ED visits and 2.15 billion for inpatient stays, with indirect costs of up to 35.5 billion. The qualitative study with 90 participants revealed many additional negative consequences for individuals, family and society. Implications The high population burden and costs associated with injuries in the UK demonstrates the need for sustained policies and interventions in support of prevention. [ABSTRACT FROM PUBLISHER]

Background Hot bath water scalds are a serious problem in the UK, and thermal injuries disproportionately affect disadvantaged families. TMVs are designed to reduce bath tap water temperature and scald risk. Their use in private homes has not been tested using a randomised design. Method RCT undertaken in collaboration with Glasgow Housing Association. Families with young children were randomised to (a) intervention arm (I)=TMV fitted to the bath water supply pipes and educational leaflets, or (b) control arm (C)=TMV fitted at end of the trial. The primary outcome measure was bath hot tap water temperature at 3 and 12 months post intervention. Secondary outcome measures included acceptability and bath safety practices. Results Intervention arm families had a significantly lower median water temperature at 3 and 12 months follow up than control arm families (3 months: I=45.0C (IQR 45.0C, 46.0C), C=56.0C (IQR 52.0C, 59.0C), p<0.001; 12 months: I=46.0C (IQR 45.3C, 46.0C), C=55.0C (IQR 52.0C, 58.0C), p<0.001). They were significantly more likely to be satisfied with their bath hot water temperature (RR 1.43, 95% CI 1.05 to 1.93), less likely to report their water was too hot (RR 0.33, 95% CI 0.16 to 0.68) and less likely to check the temperature of every bath (RR 0.84, 95% CI 0.73 to 0.97). Seven (15%) families reported problems with their TMV. Conclusion TMVs reduce bath hot tap water temperatures and are acceptable to families. Housing providers should consider fitting TMVs in their properties and legislators should consider mandating their use. [ABSTRACT FROM PUBLISHER]

In most developed nations, unintentional injuries are the leading cause of death for children. In this symposium, an international panel of speakers will present behavioural research designed to promote safe environments and equitable communities for children by modifying environments and/or care giver behaviours to reduce children's exposure to injury risks. Denise Kendrick (UK) will overview evidence relating the effectiveness of home safety education and the provision of safety equipment to care giver safety practices and reductions in children's risk of injury, including mention of factors associated with effectiveness of these interventions. Working at the community level, Andrea Gielen (USA) will present data from intervention research involving partnership of university and community groups, with the goal of preventing home injuries to children in low income communities by promoting the adoption of evidence-based home-safety practices. Barbara Morrongiello (Canada) will present research addressing care giver supervision as an injury risk-reducing strategy. She will present results from an randomised controlled trial designed to increase parental home supervision of young children by targeting pertinent beliefs and attitudes regarding childhood injuries, children's behavioural development and care giver supervision. Finally, David Schwebel (USA) will present research regarding the use of simulated drowning audits to improve lifeguard surveillance at community swimming pools in both low and upper income neighbourhoods. Elizabeth Towner (UK) will serve as Discussant. In that role, she will provide an integrative framework for behavioural approaches in child injury prevention and identify future research needs in the area. [ABSTRACT FROM PUBLISHER]

Objectives The Injury Observatory for Britain and Ireland (IOBI) is an innovative collaboration between the Association of Public Health Observatories and several academic institutions in the four UK home countries and Ireland. Its purpose is to support injury prevention practitioners by making relevant information and tools available through one website. Methods IOBI emerged from a series of informal meetings of interested professionals in 2004–2005. Being a virtual organisation, IOBI has neither a base nor core funding though many of the constituent organisations receive funding from central or devolved government agencies. The IOBI website was established in 2007. It enables access to a range of material including injury data across regions and countries, guidance on interpretating injury data, systematic reviews of injury prevention and government strategies on injury prevention. In 2008 we launched an e-newsletter, Injury Prevention News, and added new resources to the website, including an analysis of injury mortality by country and region. Results Key recent achievements include: organisation of the second Injury Prevention Conference for the UK and Ireland in 2009 a comparative analysis of injury hospitalisations to complement mortality data advising on pilots to collect enhanced emergency department data in the UK performing a survey of readers views on Injury Prevention News. Conclusions Our experience with IOBI demonstrates the need for a forum for injury prevention collaboration in the British Isles. Its success will ultimately be judged by the extent to which it stimulates an increase in injury prevention practice and research. [ABSTRACT FROM PUBLISHER]

Injury Prevention News (IPN) is a free electronic newsletter produced jointly by the Injury Observatory for Britain and Ireland (IOBI; ) and the Collaboration for Accident Prevention and Injury Control (CAPIC; ). The purpose of IPN is to support injury prevention practitioners working in all areas of injury prevention and dealing with all age groups. IPN is a free source of information on new initiatives, statistical publications, research findings, forthcoming conferences and events, and also highlights new additions to the IOBI and CAPIC websites. Although IPN focuses on injury prevention work in the UK and Ireland, it also includes research from around the world. If you would like to receive IPN it can be downloaded freely from either the IOBI or CAPIC websites, or you can subscribe to IPN at the following web address . IPN currently has more than 200 people subscribed from around the world, with many organisations helping to promote IPN by including information in their own e-bulletins and newsletters. IPN is produced three times yearly with editions in January/February, May/June and October/November. For further information or to submit content towards the newsletter please contact Samantha Turner at . [ABSTRACT FROM PUBLISHER]

Objectives To determine whether an advocacy package aimed at elected councillors resulted in improved pedestrian safety in deprived areas. Methods Cluster randomised controlled trial involving 617 councillors from 239 wards in England and Wales, from deprived areas with high pedestrian injury rates. The intervention group were provided with information and maps on casualty sites, numbers and effective interventions. Outcomes were measured at 3, 18 and 27 months. Results The intervention improved short-term outcomes such as increasing councillors interest in child accident prevention (RR 1.09, 95% CI 1.03 to 1.16), increasing belief they could take action to help prevent child accidents (RR 1.36, 95% CI 1.16 to 1.61), and particularly on pedestrian safety (RR 1.55, 95% CI 1.19 to 2.03). By 18 months 63% of intervention councillors reported involvement in supporting new pedestrian road safety schemes. However, pedestrian safety measure changes were statistically non-significant: difference in road length traffic calmed (0.07 km, 95% CI: −0.07 to 0.20); proportion of schools with 20 mph zones (RR 1.47, 95% CI: 0.93 to 2.32), Safe Routes to School (RR 1.34, 95% CI: 0.83 to 2.17; or proportion providing practical pedestrian training (RR 1.23, 95% CI: 0.95 to 1.61). Implications The AIAS intervention succeeded in raising councillors awareness of and interest in pedestrian safety but failed to improve engineering or educational measures of pedestrian safety. Longer term supported advocacy may be needed for change. [ABSTRACT FROM PUBLISHER]

Objectives To explore parents perceptions of barriers and facilitators to injury prevention. Background Even if we develop interventions that are effective and cost-effective in preventing falls, poisoning and scalds among young children at home, we often do not know whether parents will use these interventions. Unless we understand barriers to and facilitators for parents using injury prevention interventions in the home it is unlikely we will be able to develop interventions that parents can and do use and are effective. Methods We will recruit parents participating in a multi-centre case–control study of fall, scald and poisoning injuries in children under 5 years. We will undertake semi-structured interviews with parents of children with and without injuries a range of injuries and varied socioeconomic backgrounds. Framework analysis will be used. Results Reporting results from 64 interviews we will describe commonalities and differences according to a child's age, gender, socioeconomic status, injury type and whether they have experienced an injury. We will describe barriers and facilitators to injury prevention in the home, whether and how these vary according the age and gender of the child and the socioeconomic status of the family. Conclusion The findings will show how parents perceptions of barriers to and facilitators for injury prevention can vary and how these need to be taken into account to develop interventions likely to be implemented by parents. This work can therefore contribute to the development of evidence based interventions. [ABSTRACT FROM PUBLISHER]

Background: Road traffic-related injury is a major global public health problem. In most countries, pedestrian injuries occur predominantly to the poorest in society. A number of evaluated interventions are effective in reducing these injuries. Very little research has been carried out into the distribution and determinants of the uptake of these interventions. Previous research has shown an association between local political influence and the distribution of traffic calming after adjustment for historical crash patterns. This led to the hypothesis that advocacy could be used to increase local politicians' knowledge of pedestrian injury risk and effective interventions, ultimately resulting in improved pedestrian safety. Objective: To design an intervention to improve the uptake of pedestrian safety measures in deprived communities. Setting: Electoral wards in deprived areas of England and Wales with a poor record of pedestrian safety for children and older adults. Methods: Design: mixed-methods study, incorporating a cluster randomized controlled trial. Data: mixture of Geographical Information Systems data (collision loca- tions, road safety interventions(, telephone interviews, and questionnaires. Randomization: 239 electoral wards clustered within 57 local authorities. Participants: 615 politicians representing intervention and control wards. Intervention: a package of tailored information including maps of pedestrian injuries was designed for intervention politicians, and a general information pack for controls. Outcome measures: Primary outcome: number of road safety interventions 25 months after randomization. Secondary outcomes: politicians' interest and involvement in injury prevention; cost of interventions. Process evaluation: use of advocacy pack, facilitators and barriers to involvement, and success. [ABSTRACT FROM AUTHOR]