title: Evaluation of Early Childhood Home Visiting to Prevent Medically Attended Unintentional Injury.
abstract: OBJECTIVE
  We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years).
  
  
  METHODS
  A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, OH. The birth cohort (2006 to 2012) was linked to administrative home visiting records and data from a population-based injury surveillance system containing records of emergency department (ED) visits and hospitalizations. Cox proportional-hazard regression was used to compare medically attended unintentional injury risk (0 to 2, 0 to 3, and 3 to 5 years) in a home-visited group versus a propensity score-matched comparison group. The study population was composed of 2,729 mother-child pairs who received home visiting and 2,729 matched mother-child pairs in a comparison group.
  
  
  RESULTS
  From birth to 2 years, 17.2% of the study population had at least one medically attended unintentional injury. The risk for medically attended unintentional injury from aged 0 to 2 and 0 to 3 years was significantly higher in the home-visited group relative to the comparison group (hazard ratio 1.17, 95% confidence interval 1.01 to 1.35; hazard ratio 1.15, 95% confidence interval 1.00 to 1.31, respectively). Additional injuries in the home-visited group were superficial, and the increased risk for medically attended unintentional injury was observed for ED visits and not hospitalizations.
  
  
  CONCLUSIONS
  Home-visited children were more likely to have a medically attended unintentional injury from birth to aged 3 years. This finding may be partially attributed to home visitor surveillance of injuries or greater health care-seeking behavior. Implications and alternative explanations are discussed.
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH. Electronic address: alonzo.folger@cchmc.org.
authors.forename: Alonzo T
authors.initials: AT
authors.lastname: Folger
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Bowers
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Judith W
authors.initials: JW
authors.lastname: Dexheimer
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Ting
authors.initials: T
authors.lastname: Sa
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Hall
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Judith B
authors.initials: JB
authors.lastname: Van Ginkel
authors.affiliation: Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Ammerman
mesh_terms: D000056:Accident Prevention / Q000379:methods*; D000061:Accidents, Home / Q000517:prevention & control* / Q000706:statistics & numerical data; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006792:House Calls / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009820:Ohio / Q000453:epidemiology; D016487:Parenting; D010290:Parents / Q000193:education*; D011159:Population Surveillance; D015397:Program Evaluation; D011482:Protective Devices / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D014947:Wounds and Injuries / Q000453:epidemiology / Q000517:prevention & control*