title: Do maternal depressive symptoms, stress and a lack of social support influence whether mothers living in deprived circumstances adopt safety practices for the prevention of childhood injury?
abstract: BACKGROUND
  Maternal depressive symptoms are common, as are childhood injuries, particularly among the socio-economically disadvantaged. Maternal depression may be associated with lesser engagement in injury prevention practices. Providing support to mothers can reduce the risk of child injury, but the mechanism by which this occurs is unclear. The aim of this study was to examine the relationship between maternal depressive symptoms, social support and stress, and engagement in home safety practices to prevent injuries to pre-school children living in socio-economically deprived families in the UK.
  
  
  METHODS
  Three questionnaires were posted to mothers of young children living in deprived areas in the city of Nottingham, UK, who were enrolled in the control group of a randomized controlled trial (RCT). The questionnaires assessed socio-demographic characteristics at baseline; depressive symptoms, perceived social support and self-reported stress 21 months later and engagement in home safety practices 24 months post baseline. The mothers in the control group received no intervention. Main outcome measures were the use of fireguards, stair gates, smoke alarms, window locks and safe storage of medicines, sharp objects and cleaning products.
  
  
  RESULTS
  One-third (36.4%) of mothers reported depressive symptoms. The most widely adopted safety practices were safe storage of medicines (93.5%) and use of smoke alarms (86.2%). The majority of mothers did not use fireguards (60.7%) or store sharp objects safely (63.8%). Depressive symptoms were not independently associated with any of the seven safety practices. Mothers reporting some lack of social support were more likely not to store medicines safely [odds ratio, OR, 4.08 (95% confidence interval, CI, 1.79-9.30) compared with those reporting no lack of social support] and mothers reporting moderate or large amounts of stress were more likely not to store sharp objects safely [OR 1.77 (95% CI 1.11-2.83) compared with mothers reporting no or little stress] after controlling for confounders.
  
  
  CONCLUSIONS
  Our results suggest that depressive symptoms, stress and a lack of social support are not important influences on the adoption of safety practices by mothers living in deprived areas in the UK, at least in the short term. Further work is required to explore the effects of chronic maternal depressive symptoms on the adoption of safety practices.
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK. Caroline.Mulvaney@nottingham.ac.uk
authors.forename: C
authors.initials: C
authors.lastname: Mulvaney
authors.forename: D
authors.initials: D
authors.lastname: Kendrick
mesh_terms: D002654:Child Care / Q000379:methods*; D002675:Child, Preschool; D003863:Depression / Q000523:psychology*; D004739:England; D005260:Female; D006794:Household Articles; D006801:Humans; D007223:Infant; D009034:Mother-Child Relations; D009035:Mothers / Q000523:psychology; D011610:Psychosocial Deprivation; D012449:Safety; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000517:prevention & control*