Conclusion: Indications for effectiveness
There is some evidence that home-safety interventions are effective in reducing baby-walker use (OR 0.66, 95% CI 0.43 to 1.00). Interventions which provided education only about walkers appeared to be more effective in reducing walker possession and use (OR 0.44, 95% CI 0.31 to 0.63) than those that provided education on a range of safety topics (OR 0.90, 95% CI 0.56 to 1.45). Education delivered in clinical settings also appeared to be more effective in reducing walker possession and use (OR 0.47, 95% CI 0.36 to 0.61) than that delivered at home or in the community (OR 1.12, 95% CI 0.56 to 2.24). Finally the effect may be greater with follow up periods of four months or more (OR 0.54, 95% CI 0.35 to 0.83) compared to shorter follow up periods (OR 1.00, 95% CI 0.42 to 2.35).
Recommendations (for research & practice)
While future evidence is awaited, child health and social care providers should continue to provide fall-safety interventions as part of their strategies to improve child health (since walkers should never be used as a surrogate baby sitter or a substitute for adult supervision). However, providers must ensure that the interventions are based on the latest evidence, are planned using sound public health principles, and are rigorously evaluated.
Review Date: 10/02/2011
Version: 1.0
Status: Publish
Procedure
Articles (reviews) and reports were included that were published between 2000 and 2010, in English and Dutch. The outcomes of the study were reviewed by the Dutch Consumer Safety Institute.
Strategy: An online literature search was performed by a researcher of the Consumer Safety Institute and after this a more thorough search was performed by the documentation centre of CSI (Catalog CenV, Pubmed, Injury lit, Google, Websites, 'Grey' literature). Results of each search were compared on differences and potential missed studies were added. First the titles and then abstracts were scanned in order to include relevant studies. In the case of insufficient information obtained from abstracts the full text articles were obtained. Relevant articles were scrutinized and background documents were created. In addition, relevant references of included articles were checked on new and relevant articles (i.e., snowball search).
The outcomes of the study were reviewed by an expert in the field of child safety in the winter of 2010.
Background documents
Preventing childhood falls at home: meta-analysis and meta-regression (version 1.3)
Denise Kendrick, Michael C. Watson, Caroline A. Mulvaney ... [et al.] (2008)
Home safety education and provision of safety equipment for injury prevention (version 1.0)
D. Kendrick, C. Coupland, C. Mulvaney ... [et al.] (2007)