title: Approaches used by parents to keep their children safe at home: a qualitative study to explore the perspectives of parents with children aged under five years.
abstract: BACKGROUND
  Childhood unintentional injury represents an important global health problem. Many unintentional injuries experienced by children aged under 5 years occur within the home and are preventable. The aim of this study was to explore the approaches used by parents of children under five in order to help prevent unintentional injuries in the home and the factors which influence their use. Understanding how parents approach risk-management in the home has important implications for injury practitioners.
  
  
  METHODS
  A multi-centre qualitative study using semi-structured interviews. A thematic approach was used to analyse the data. Sixty five parents of children aged under 5 years, from four study areas were interviewed: Bristol, Newcastle, Norwich and Nottingham.
  
  
  RESULTS
  Three main injury prevention strategies used by parents were: a) Environmental such as removal of hazards, and use of safety equipment; b) parental supervision; and c) teaching, for example, teaching children about safety and use of rules and routine. Strategies were often used in combination due to their individual limitations. Parental assessment of injury risk, use of strategy and perceived effectiveness were fluid processes dependent on a child's character, developmental age and the prior experiences of both parent and child. Some parents were more proactive in their approach to home safety while others only reacted if their child demonstrated an interest in a particular object or activity perceived as being an injury risk.
  
  
  CONCLUSIONS
  Parents' injury prevention practices encompass a range of strategies that are fluid in line with the child's age and stage of development; however, parents report that they still find it challenging to decide which strategy to use and when.
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK. joanne.ablewhite@nottingham.ac.uk.
authors.forename: Joanne
authors.initials: J
authors.lastname: Ablewhite
authors.affiliation: Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK. L.Mcdaid@uea.ac.uk.
authors.forename: Lisa
authors.initials: L
authors.lastname: McDaid
authors.affiliation: Emergency Department, Nottingham University Hospitals NHS Trust, Nottingham, NG7 2UH, UK. adrian.hawkins@nuth.nhs.uk.
authors.forename: Adrian
authors.initials: A
authors.lastname: Hawkins
authors.affiliation: Clinical Research & Trials Unit, Norfolk and Norwich University Hospital NHS Foundation Trust, Norwich, NR4 7UY, UK. isabel.peel@nuh.nhs.uk.
authors.forename: Isabel
authors.initials: I
authors.lastname: Peel
authors.affiliation: Faculty of Health and Applied Sciences, University of the West of England, Bristol, BS16 1QY, UK. Trudy.Goodenough@uwe.ac.uk.
authors.forename: Trudy
authors.initials: T
authors.lastname: Goodenough
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, UK. toity.deave@uwe.ac.uk.
authors.forename: Toity
authors.initials: T
authors.lastname: Deave
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK. J.Stewart@nottingham.ac.uk.
authors.forename: Jane
authors.initials: J
authors.lastname: Stewart
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham, NG7 2HA, UK. Michael.Watson@nottingham.ac.uk.
authors.forename: Michael
authors.initials: M
authors.lastname: Watson
authors.affiliation: Division of Primary Care, University of Nottingham, Nottingham, NG7 2RD, UK. denise.kendrick@nottingham.ac.uk.
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
mesh_terms: D001294:Attitude to Health; D002657:Child Development; D000067576:Child Health; D002675:Child, Preschool; D004739:England; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010290:Parents; D010465:Perception; D011482:Protective Devices; D036301:Qualitative Research; D012449:Safety; D014947:Wounds and Injuries / Q000517:prevention & control*