Conclusion: No indications for effectiveness
There is a paucity of research studies from wich evidence regarding the effectiveness of community-based intervention programmes for the prevention of fall-related injury in children could be based. One systematic review for this statement was found (McClure et al., 2005). In this article only six studies fitting the inclusion criteria (community-based intervention study, target population children aged 0-16 years, outcome measures injury rates due to falls and community or historical control included in study design) were identified. Only two of these used a trial design with a contemporary community control. Neither one of the high quality evaluation studies showed an effect from the intervention and while authors of the remaining studies reported trends effective falls prevention programmes, the pre- and post-intervention design, uncontrolled for background secular trends, makes causal inferences from these studies difficult.
Klassen et al. (2000) suggest some general principles for successful community based studies: (1) the use of multiple strategies grounded in a theory of behavior change. (2) interventions should be integrated into the community and approaches should be tailored to meet unique community needs. (3) community stakeholders should be included in the development of community-based strategies.
Recommendations (for research & practice)
Suggestions for future research:
There is a urgent need for the development and implementation of high quality community based programmes to put into practice a range of countermeasures shown to be efficacious in reducing fall-related injury in research settings. High quality evaluations of community based falls-related injury prevention programmes achieve population level improvements in injury outcomes.
Suggestions for practice and policy:
A framework for considering the problem of falls in children from a prevention perspective should be developed and a evidence-based suite of interventions should be combined to create programme guidelines suitable for implementation (with local adaptions) in communities throughout the world.
Review Date: 16/12/2010
Version: 1.1
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 summer of 2011.
Background documents
Community-based injury prevention interventions (version 1.0)
T.P. Klassen, J.M. MacKay, D. Moher ...[et al] (2000)
Community-based programmes to prevent falls in children : a systematic review (version 1.0)
Rod McClure, Jim Nixon, Annelise Spinks ... [et al] (2005)