title: Preventing childhood falls at home: meta-analysis and meta-regression.
abstract: BACKGROUND
  Childhood falls are an important global public health problem, but evidence on their prevention has not been quantitatively synthesized. Despite social inequalities in childhood injury rates, there is a lack of evidence examining the effect of fall-prevention practices by social group.
  
  
  METHODS
  A systematic review of literature was conducted up to June 2004 and meta-analysis using individual patient data to evaluate the effect of home-safety interventions on fall-prevention practices and fall-injury rates. Meta-regression examined the effect of interventions by child age, gender, and social variables. Included were 21 studies, 13 of which contributed to meta-analyses.
  
  
  RESULTS
  Home-safety interventions increased stair-gate use (OR=1.26; 95% CI=1.05, 1.51), and there was some evidence of reduced baby-walker use (OR=0.66; 95% CI=0.43, 1.00), but little evidence of increased possession of window locks, screens, or windows with limited opening (OR=1.16, 95% CI=0.84, 1.59) or of nonslip bath mats or decals (OR=1.15; 95% CI=0.51, 2.62). Two studies reported nonsignificant effects on falls (baby-walker-related falls on flat ground [OR=1.35; 95% CI=0.64, 2.83] or down steps or stairs [OR=0.70; 95% CI=0.14, 3.49]) and medically attended falls (OR=0.78; 95% CI=0.61, 1.00).
  
  
  CONCLUSIONS
  Home-safety education and the provision of safety equipment improved some fall-prevention practices, but the impact on fall-injury rates is unclear. There was some evidence that the effect of home-safety interventions varied by social group.
authors.affiliation: Division of Primary Care, School of Nursing, University of Nottingham, Hucknall Primary Care Trust, Hucknall Health Centre, Nottingham, England, UK. denise.kendrick@nottingham.ac.uk
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
authors.forename: Michael C
authors.initials: MC
authors.lastname: Watson
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Mulvaney
authors.forename: Sherie J
authors.initials: SJ
authors.lastname: Smith
authors.forename: Alex J
authors.initials: AJ
authors.lastname: Sutton
authors.forename: Carol A C
authors.initials: CA
authors.lastname: Coupland
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Mason-Jones
mesh_terms: D000056:Accident Prevention / Q000379:methods*; D000058:Accidental Falls / Q000517:prevention & control*; D000061:Accidents, Home / Q000517:prevention & control*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011482:Protective Devices