The Harstad Injury Prevention Study: prevention of burns in small children by a community-based intervention. Harstad injury prevention study: prevention of burns in young children by community based intervention. Prevention of childhood injuries: evaluation of the Statewide Childhood Injury Prevention Program (SCIPP). Burn prevention programs for children: do they reduce burn-related hospitalizations?
Burns are known to cause considerable morbidity and mortality, and scalding is the most common type of burn injury in small children. A community-based injury prevention programme was initiated in the Norwegian city of Harstad (22,000 inhabitants) in 1987 and evaluated by means of data from a hospital-based injury recording system. One part of the programme aimed at reducing burns in children below 5 years of age. Accident analyses based on the local database revealed coffee to be the most frequent liquid causing scalds, which mostly occurred in the kitchen. Sixty-six per cent of the injured were boys and two-thirds were below 2 years of age. The prevention study was divided in a baseline period (19.5 months) with no local intervention-and a succeeding 7-year period containing a wide range of active and passive prevention strategies. From the first to the second period the mean burn injury rate decreased 52.9 per cent, from 52.4 to 24.7 per 10,000 person years (P < 0.05). In a reference city located 1,000 km away, the rates increased from 61.9 to 68.0 per 10,000 person years (NS). The burn injury rate reduction was considered mainly attributable to the strengthening of public participation and the enhancement of community empowerment achieved by recording and actively using the local burn injury data. To describe the long term effectiveness of a community based program targeting prevention of burns in young children.
                Quasiexperimental.
                The Norwegian city of Harstad (main intervention), six surrounding municipalities (intervention diffusion), and Trondheim (reference).
                Children under age 5 years in the three study populations.
                Outpatient and inpatient hospital data were coded according to the Nordic system, and collected as part of a national injury surveillance system. Burn data collection started in May 1985. The first 19.5 months of the study provided baseline data, while the last 10 years involved community based intervention, using a mix of passive and active interventions.
                The mean burn injury rate decreased by 51.5% after the implementation of the intervention in Harstad (p < 0.05) and by 40.1% in the six municipalities (not significant). Rates in the reference city, Trondheim, increased 18.1% (not significant). In Harstad and the six surrounding municipalities there was a considerable reduction in hospital admissions, operations, and bed days. Interventions with passive strategies were more effective, stove and tap water burns being eliminated in the last four years, while active strategies were less effective.
                A program targeting burns in children can be effective and sustainable. Local injury data provided the stimulus for community action. We evaluated the effectiveness of a community-based injury prevention program designed to reduce the incidence of burns, falls in the home, motor vehicle occupant injuries, and poisonings and suffocations among children ages 0-5 years. Between September 1980 and June 1982, we implemented five injury prevention projects concurrently in nine Massachusetts cities and town; five sites, matched on selected demographic characteristics, were control communities. An estimated 42 percent of households with children ages 0-5 years were exposed to one or more of the interventions over the two-year period in the nine communities. Participation in safety programs increased three-fold in the intervention communities and two-fold in the control communities. Safety knowledge and practices increased in both intervention and control communities. Households that reported participatory exposure to the interventions had higher safety knowledge and behavior scores than those that received other community exposure or no exposure to intervention activities. We found a distinct reduction in motor vehicle occupant injuries among children ages 0-5 years in the intervention compared with control communities, associated with participatory exposure of about 55 percent of households with children ages 0-5 years. We have no evidence that the coordinated intervention programs reduced the other target injuries--although exposure to prevention messages was associated with safety behaviors for burns and poisonings. Severe burns in children can result in prolonged suffering, disability, disfigurement, and in impaired physical and mental development. Hospitalization rates of children with burns are much higher than for children with other trauma. Therefore, various child burn prevention programs have been implemented, but their efficacy has been evaluated only by assessment of knowledge or satisfaction rather than evaluating actual changes in burn-related hospitalizations. Our objective was to map Israeli child burn prevention programs and to measure their success from the rate of burn-related hospitalizations.
                A questionnaire-based survey was conducted of organizations participating in injury prevention programs. Official data was obtained on burn-related hospitalizations of children aged 0-4 and 5-14 for 1998 and 2000, and was correlated with the existence or absence of injury prevention programs, and with the population's socio-economic status (SES).
                In localities with burn prevention programs, there was a reduction in the rate of burn-related hospitalizations of infants, from 1.39 to 1.05 per 1000 infants (p<0.05), in contrast to localities where programs did not exist. The greatest change was in middle and high socio-economic communities. The prevention programs had no similar effects on school-aged children.
                Injury prevention programs are effective in reducing burn-related hospitalizations among infants and toddlers, especially from more affluent communities, but not among school-aged children.
There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children.
It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.