Evaluating implementation of a fire-prevention injury prevention briefing in children's centres: Cluster randomised controlled trial.
BACKGROUND
Many developed countries have high mortality rates for fire-related deaths in children aged 0-14 years with steep social gradients. Evidence-based interventions to promote fire safety practices exist, but the impact of implementing a range of these interventions in children's services has not been assessed. We developed an Injury Prevention Briefing (IPB), which brought together evidence about effective fire safety interventions and good practice in delivering interventions; plus training and facilitation to support its use and evaluated its implementation.


METHODS
We conducted a cluster randomised controlled trial, with integrated qualitative and cost-effectiveness nested studies, across four study sites in England involving children's centres in disadvantaged areas; participants were staff and families attending those centres. Centres were stratified by study site and randomised within strata to one of three arms: IPB plus facilitation (IPB+), IPB only, usual care. IPB+ centres received initial training and facilitation at months 1, 3, and 8. Baseline data from children's centres were collected between August 2011 and January 2012 and follow-up data were collected between June 2012 and June 2013. Parent baseline data were collected between January 2012 and May 2012 and follow-up data between May 2013 and September 2013. Data comprised baseline and 12 month parent- and staff-completed questionnaires, facilitation contact data, activity logs and staff interviews. The primary outcome was whether families had a plan for escaping from a house fire. Treatment arms were compared using multilevel models to account for clustering by children's centre.


RESULTS
1112 parents at 36 children's centres participated. There was no significant effect of the intervention on families' possession of plans for escaping from a house fire (adjusted odds ratio (AOR) IPB only vs. usual care: 0.93, 95%CI 0.58, 1.49; AOR IPB+ vs. usual care 1.41, 95%CI 0.91, 2.20). However, significantly more families in the intervention arms reported more behaviours for escaping from house fires (AOR IPB only vs. usual care: 2.56, 95%CI 01.38, 4.76; AOR IPB+ vs. usual care 1.78, 95%CI 1.01, 3.15).


CONCLUSIONS
Our study demonstrated that children's centres can deliver an injury prevention intervention to families in disadvantaged communities and achieve changes in home safety behaviours.
Centre for Child & Adolescent Health, Health & Applied Sciences, University of the West of England Bristol, Bristol, United Kingdom.
Toity
T
Deave
Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, United Kingdom.
Adrian
A
Hawkins
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Arun
A
Kumar
Child Accident Prevention Trust, Barnet, London, United Kingdom.
Mike
M
Hayes
Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
Nicola
N
Cooper
Faculty of Medicine and Health Sciences, School of Health Sciences, University of Nottingham, Nottingham, United Kingdom.
Michael
M
Watson
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Joanne
J
Ablewhite
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Carol
C
Coupland
Department of Health Sciences, University of Leicester, Leicester, United Kingdom.
Alex
A
Sutton
Norfolk and Suffolk Primary and Community Care Research Office, Hosted by South Norfolk CCG, Norwich, United Kingdom.
Gosia
G
Majsak-Newman
Norfolk and Norwich University Hospital, NHS Clinical Research and Trials Unit, Norwich Medical School, University of East Anglia, Norwich, United Kingdom.
Lisa
L
McDaid
Centre for Child & Adolescent Health, Health & Applied Sciences, University of the West of England Bristol, Bristol, United Kingdom.
Trudy
T
Goodenough
University of the West of England, Research and Innovation, University Hospitals Bristol NHS Foundation Trust, Education Centre, Bristol, United Kingdom.
Kate
K
Beckett
Institute of Health & Society, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne, United Kingdom.|Newcastle Clinical Trials Unit, Newcastle University, Newcastle upon Tyne, United Kingdom.
Elaine
E
McColl
Jenny Lind Paediatric Department, Norfolk and Norwich University Hospital, Norwich, United Kingdom.
Richard
R
Reading
Division of Primary Care, School of Medicine, University of Nottingham, Nottingham, United Kingdom.
Denise
D
Kendrick
D000056:Accident Prevention; D002656:Child Day Care Centers; D002675:Child, Preschool; D005260:Female; D005390:Fires / Q000517:prevention & control*; D006801:Humans; D008297:Male; D006113:United Kingdom