Effects of improved access to safety counseling, products, and home visits on parents' safety practices: results of a randomized trial.
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.
Gielen
Andrea Carlson
AC
Center for Injury Research and Policy, Johns Hopkins University, Bloomberg School of Public Health, 624 N Broadway, Baltimore MD 21205, USA. agielen@jhsph.edu
McDonald
Eileen M
EM
Wilson
Modena E H
ME
Hwang
Wei-Ting
WT
Serwint
Janet R
JR
Andrews
John S
JS
Wang
Mei-Cheng
MC
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