title: The feasibility of using a parenting programme for the prevention of unintentional home injuries in the under-fives: a cluster randomised controlled trial.
abstract: BACKGROUND
  Unintentional injury is the leading cause of preventable death of children over the age of 1 year in the UK and a major cause of attendance at emergency departments. Children having one injury are at increased risk of further injuries. Parenting programmes can reduce injuries in preschool children if delivered in the home and on a one-to-one basis. It is not known if group-based programmes delivered outside the home are effective.
  
  
  OBJECTIVE
  To develop (1) a parenting programme to prevent recurrent unintentional home injuries in preschool children and (2) a tool for parents to report unintentional home injuries occurring to their preschool children. To assess the feasibility of delivering and evaluating the parenting programme through a cluster randomised controlled trial, specifically to (1) assess methods for the recruitment and retention of parents; (2) determine the training, equipment and facilities needed for the delivery of the programme; (3) establish appropriate primary and secondary outcome measures and methods for their collection; (4) determine how 'normal care' in a comparison arm should be defined; and (5) determine the resource utilisation and costing data that would need to be collected for the cost-effectiveness component of a future trial; and (6) produce estimates of effect sizes to inform sample size estimation for a main trial.
  
  
  METHODS
  Feasibility multicentre, cluster, randomised, unblinded trial.
  
  
  METHODS
  Eight children's centres in Bristol and Nottingham, UK.
  
  
  METHODS
  Ninety-six parents of preschool children who had sustained an unintentional injury requiring medical attention in the previous 12 months.
  
  
  METHODS
  The First-aid Advice and Safety Training (FAST) parent programme, comprising parenting support and skills combined with first aid and home safety advice.
  
  
  METHODS
  Parent-reported medically attended injuries in the index child and any preschool siblings sustained during a 6-month period of observation.
  
  
  RESULTS
  An 8-week parenting programme was produced, designed with participant-friendly, incrementally progressive content. A slimline, month-to-a-view injury calendar, spiral bound and suitable for hanging on a wall, was designed for parents to record injuries occurring to their preschool children during the 6-month period of observed time. Fifty-one parents were recruited (40 meeting eligibility criteria plus 11 following 'open invite' to participate); 15 parents completed the FAST parent programme and 49 provided data at baseline and during follow-up. Completion of the programme was significantly greater for participants using the 'open invite' approach (85%) than for those recruited using the original eligibility criteria (31%). Prototype resource use checklists, unit costs and total costs were developed for phases 0, 1 and 2 of the study for use in a future trial.
  
  
  CONCLUSIONS
  This feasibility study has developed an innovative injury prevention intervention and a tool to record parent-reported injuries in preschool children. It was not feasible to recruit parents of children who had sustained a recent injury, or to ask health visitor teams to identify potential participants and to deliver the programme. A trial should target all families attending children's centres in disadvantaged areas. The intervention could be delivered by a health professional supported by a member of the children's centre team in a community setting.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN03605270.
  
  
  BACKGROUND
  This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 18, No. 3. See the NIHR Journals Library website for further project information.
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Julie
authors.initials: J
authors.lastname: Mytton
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Jenny
authors.initials: J
authors.lastname: Ingram
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Manns
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, UK.
authors.forename: Tony
authors.initials: T
authors.lastname: Stevens
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, UK.
authors.forename: Caroline
authors.initials: C
authors.lastname: Mulvaney
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Blair
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Jane
authors.initials: J
authors.lastname: Powell
authors.affiliation: Wellspring Healthy Living Centre, Bristol, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Potter
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Towner
authors.affiliation: School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Emond
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK.
authors.forename: Toity
authors.initials: T
authors.lastname: Deave
authors.affiliation: Institute of Education, University of London, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Thomas
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, UK.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
authors.affiliation: Division of Health Sciences, University of Warwick, Coventry, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Stewart-Brown
mesh_terms: D000061:Accidents, Home / Q000517:prevention & control*; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005392:First Aid / Q000379:methods; D006266:Health Education / Q000191:economics / Q000458:organization & administration*; D006296:Health Services / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016487:Parenting; D015397:Program Evaluation; D012307:Risk Factors; D012449:Safety; D006113:United Kingdom; D014947:Wounds and Injuries / Q000517:prevention & control* / Q000628:therapy