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Clinical Pediatrics
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Studying Injury Prevention: Practices, Problems, and Pitfalls in Implementation

Shilpa Sangvai, MD, MPH

Department of Pediatrics, The Ohio State University School of Medicine and Public Health and Division of Ambulatory Pediatrics, Children's Hospital Columbus, Columbus, Ohio

Lynne Cipriani, RN

Department of Pediatrics, University of Pittsburgh School of Medicine and Division of Allergy, Immunology and Infectious Disease, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

D. Kathleen Colborn, BS

Department of Pediatrics, University of Pittsburgh School of Medicine and Division of Allergy, Immunology and Infectious Disease, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania

Ellen R. Wald, MD

Department of Pediatrics, University of Pittsburgh School of Medicine and Division of Allergy, Immunology and Infectious Disease, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, erwald{at}wisc.edu

This prospective, randomized, controlled trial was conducted to determine feasibility and effectiveness of a chronic care model approach to injury prevention compared with standard anticipatory guidance. Enrolled caregivers of children aged 0 to 5 years received focused counseling from a physician and health assistant, educational handouts, phone follow-up, and access to free safety devices and automobile restraint evaluations. Only 35.1% of eligible parents participated. Home visits were completed at 6 months to observe safety practices. Injuries were gleaned from parent report and medical record review. Safety practices were evaluated in 27 households. Chart review showed no significant difference in the number of medically attended injuries between groups (P = 0.6). The impact of the chronic care model on injury prevention in primary care could not be determined with certainty. Evaluating effectiveness of injury prevention strategies on actual safety practices with direct observation is challenging.

Key Words: injury prevention • counseling • safety practices

Clinical Pediatrics, Vol. 46, No. 3, 228-235 (2007)
DOI: 10.1177/0009922806293861
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