title: Effects of improved access to safety counseling, products, and home visits on parents' safety practices: results of a randomized trial.
abstract: OBJECTIVE
  To present the results of an intervention trial to enhance parents' home-safety practices through pediatric safety counseling, home visits, and an on-site children's safety center where parents receive personalized education and can purchase reduced-cost products.
  
  
  METHODS
  Pediatricians were randomized to a standard- or an enhanced-intervention group. Parents of their patients were enrolled when the patient was 6 months or younger and observed until 12 to 18 months of age.
  
  
  METHODS
  A hospital-based pediatric resident continuity clinic that serves families living in low-income, inner-city neighborhoods.
  
  
  METHODS
  First- and second-year pediatric residents and their patient-parent dyads.
  
  
  METHODS
  Parents in the standard-intervention group received safety counseling and referral to the children's safety center from their pediatrician. Parents in the enhanced-intervention group received the standard services plus a home-safety visit by a community health worker.
  
  
  RESULTS
  Home observers assessed the following safety practices: reduction of hot-water temperature, poison storage, and presence of smoke alarms, safety gates for stairs, and ipecac syrup.
  
  
  RESULTS
  The prevalence of safety practices ranged from 11% of parents who stored poisons safely to 82% who had a working smoke alarm. No significant differences in safety practices were found between study groups. However, families who visited the children's safety center compared with those who did not had a significantly greater number of safety practices (34% vs 17% had > or 3).
  
  
  CONCLUSIONS
  Home visiting was not effective in improving parents' safety practices. Counseling coupled with convenient access to reduced-cost products appears to be an effective strategy for promoting children's home safety.
authors.affiliation: Center for Injury Research and Policy, Johns Hopkins University, Bloomberg School of Public Health, 624 N Broadway, Baltimore MD 21205, USA. agielen@jhsph.edu
authors.forename: Andrea Carlson
authors.initials: AC
authors.lastname: Gielen
authors.forename: Eileen M
authors.initials: EM
authors.lastname: McDonald
authors.forename: Modena E H
authors.initials: ME
authors.lastname: Wilson
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hwang
authors.forename: Janet R
authors.initials: JR
authors.lastname: Serwint
authors.forename: John S
authors.initials: JS
authors.lastname: Andrews
authors.forename: Mei-Cheng
authors.initials: MC
authors.lastname: Wang
mesh_terms: D000328:Adult; D001294:Attitude to Health; D003376:Counseling / Q000592:standards*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods / Q000592:standards; D006297:Health Services Accessibility / Q000592:standards*; D006302:Health Services Research; D018575:Home Care Services, Hospital-Based / Q000592:standards*; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D007223:Infant; D007224:Infant Care / Q000295:instrumentation / Q000379:methods* / Q000592:standards; D015370:Infant Equipment / Q000191:economics / Q000600:supply & distribution*; D008297:Male; D017063:Outcome Assessment, Health Care; D010290:Parents / Q000193:education* / Q000523:psychology; D010372:Pediatrics / Q000592:standards*; D011203:Poverty; D015397:Program Evaluation; D012017:Referral and Consultation; D017751:Safety Management / Q000592:standards*; D017749:Total Quality Management; D019037:Urban Health Services / Q000592:standards