Preventing childhood injuries in Uganda - development of a child safety kit; preparation for a cluster randomised controlled trial

乌干达预防儿童受伤——开发儿童安全包；

基本信息

批准号：
MR/T003480/2
负责人：
Margaret Peden
金额：
$ 7.03万
依托单位：
Imperial College London
依托单位国家：
英国
项目类别：
Research Grant
财政年份：
2020
资助国家：
英国
起止时间：
2020 至无数据
项目状态：
已结题

来源：
https://gtr.ukri.org/projects?ref=MR%2FT003480%2F2
关键词：
Preventing childhood injuries Uganda development

项目摘要

Injuries are a leading cause of death among children around the world. Globally, nearly 650,000 children under the age of 15 lose their lives every year to injuries and violence. This burden is unequally distributed between low- and middle-income countries (LMIC) and high-income countries (HIC) with the mortality rate from unintentional injuries in LMICs being nearly double that of HICs. In particular, Sub-Saharan Africa has the highest proportion of under 5 deaths in the world.More than 70% of these injuries are non-transport unintentional or "accidental" injuries. Evidence shows that a large proportion of childhood unintentional injuries take place in and around the home, where children are generally believed to be well supervised. Children, especially those under 5 years, spend a significant amount of their time in and around the home which exposes them to various injury hazards e.g. stairs and windows without safety grills, access to poisonous substances and chemicals, areas of open water, access to ground level stoves.Despite an overall global reduction in child injury mortality rates over the past two decades, available data indicates that the rate of decline has been much slower in LMICs and the gap between LMICs and HICs is widening. This is due in part to higher risks, inadequate preventive measures and a lack of access to timely medical care in LMICs. The nature of household injuries among children has been well documented in HICs but much less is known in LMICs. Much of what is known about preventing child injuries in the home stems from research conducted in HICs where preventive measures have been shown to be effective e.g. safety caps, smoke alarms, stair gates coupled with education of parents/carers. What is not known is how effective these measures would be in LMICs.This study aims to test the effectiveness of a child safety kit (developed through co-design to reflect differing risk profiles, cultural appropriateness and availability/affordability) against traditional education. The study will be carried out in Jinja, Uganda and will involve two phases: Phase 1 (the focus of this development grant, conducted over 1 year) will focus on contextualizing the child injury problem and developing the child safety kit through mixed methods (a review of hospital data, focus groups with parents/carers, in-depth interviews with key informants, an affordability/availability survey and a market survey to ascertain willingness to pay for safety equipment); and Phase 2 which will measure behaviour change and reductions in injuries through a cluster Randomised Control Trial (cRCT). We will assess the reduction in child injuries in two villages (clusters) - one which will have the full child safety kit of equipment plus educational material, workshops and awareness campaign for parents versus the other cluster with only education - over 3 years.A key component of Phase 1 will be to support collaborative research between scientific researchers, policy makers and parents such that all stakeholders involved in the health of under 5's have the opportunity to be full participants from conceptualisation to communication of results. The co-design approach will result in the development of a holistic intervention to include the child safety kit, educational material, training workshops for parents and a community-based awareness campaign. Engaging the community from the beginning will result in improved knowledge and awareness through the sharing of opinions and experience and will optimise equipment usage during Phase 2. The results of Phase 1 will identify any challenges to implementing the intervention, provide accurate data on which to calculate sample sizes for the cRCT and determine the key outcomes. To our knowledge, this will be the first cRCT on child safety equipment and education conducted in Africa.

伤害是世界各地儿童死亡的主要原因。在全球范围内，近65万名15岁以下的儿童每年因受伤和暴力而丧生。这种负担在低收入和中等收入国家（LMIC）和高收入国家（HIC）之间分配不平等，而LMIC的无意伤害的死亡率几乎是HIC的两倍。特别是，撒哈拉以南非洲在世界5人死亡中的比例最高。这些伤害中有70％超过70％是非通行的无意或“意外”伤害。有证据表明，大部分童年的无意伤害发生在房屋和周围周围，通常认为儿童受到了良好的监督。儿童，尤其是5岁以下的儿童，在房屋和周围和周围花费了大量时间，使他们遇到各种伤害危害，例如楼梯和窗户没有安全烤架，使用有毒物质和化学物质，开放水域，进入地面炉灶的区域。尽管在过去二十年中，童损死亡率的总体降低了，但可用的数据表明，LMIC的下降速度和LMIC和HICS之间的差距较慢。这部分是由于风险更高，预防措施不足以及LMIC中缺乏及时的医疗服务。儿童家庭伤害的性质在HIC中已经有充分的文献记载，但在LMIC中却少得多。关于预防家庭伤害的许多知识是源于在HIC中进行的研究，这些研究已证明预防措施有效，例如安全帽，烟雾报警器，楼梯大门，加上父母/护理人员的教育。尚不清楚的是这些措施在LMIC中的有效性。这项研究旨在测试儿童安全套件的有效性（通过共同设计开发，以反映风险不同，文化适用性和可用性/负担能力），以应对传统教育。该研究将在乌干达的金贾（Jinja）进行，将涉及两个阶段：第1阶段（该发展赠款的重点，1年以上进行）将重点放在使童损问题上的上下文化，并通过混合方法审查医院数据的审查，与父母/仓库的焦点小组审查，与父母/货物的焦点，对可用性的调查和确定性的安全性，以审查和确定性，以审查和确定性，以审查和确定性，以审查和确定性。和第2阶段将通过簇随机对照试验（CRCT）来衡量行为改变并减少伤害。我们将评估两个村庄的儿童受伤的减少（群集） - 一个将拥有完整的设备安全套件，教育材料，教育材料，研讨会和仅接受教育的其他集群的教育材料，研讨会和宣传运动 - 第1阶段的关键组成部分将是一个关键的组成部分，以支持与构成型号的全部构成的构成与健康相关的合作界的共同研究，以支持所有构成型号的合作，并在5年内进行了与健康的融合。结果。共同设计的方法将导致整体干预措施，包括儿童安全套件，教育材料，父母的培训研讨会和社区意识运动。从一开始就通过共享观点和经验来互动会导致知识和意识的提高，并将在第2阶段期间优化设备使用情况。第1阶段的结果将确定实施干预措施的任何挑战，提供准确的数据来计算CRCT的样本量并确定关键成果。据我们所知，这将是第一个在非洲进行的儿童安全设备和教育的CRCT。