| Ahmad et al. 28 (2018) |
Intervention study (Pakistan) |
207 children aged 8 to 16 years of both genders |
A children’s storybook was used to initiate a discussion with primary school children about preventing traffic accidents. A baseline test was conducted before the discussion, and 2 tests were conducted immediately after the discussion and 2 months later. The results showed a statistically significant improvement in mean scores over time based on gender, grade, and school type (p-value < 0.001) |
A |
| DelCastillo-Andrés et al. 29 (2018) |
Exploratory and quasi-experimental study (Spain) |
122 children aged 10 to 12 years of both genders |
The Safe Fall program is designed to lower the risk of unintentional falls in school-age children. The program was assessed before and after implementation, and the results indicate an improvement in the correct positioning of protective measures across all variables. The difference between the pre- and post-intervention was statistically significant (p < 0.05) for all 5 responses |
A |
| El Selfi et al. 22 (2018) |
Intervention study (Egypt) |
244 women aged 19 to 38 years with at least one child aged 1 to 5 years |
A health education intervention addressed child safety and injury prevention using PowerPoint presentations, explanatory videos, models, pamphlets, and discussions. The pre- and post-intervention questionnaires showed changes in knowledge (34.8%), attitude (18.5%), and self-efficacy (31.1%). There was a significant increase in the average post-intervention score (p < 0.001), except for the attitude towards immediate first aid measures (p = 0.078) |
B |
| Kahriman & Karadeniz 23 (2018) |
Quasi-experimental study (Turkey) |
300 women with an average age of 31 years with children aged 0 to 6 years |
Mothers were taught to be more aware of safety precautions related to various types of pediatric injuries. Two tools were used for this purpose: the Safety Precautions Identification Scale for Prevention of Pediatric Injuries by Mothers of Children Aged 0 to 6 and the Pediatric Injury Risk Assessment Form (RAF). The average scores on both tools showed a significant increase in the pediatric injury identification scale (p = 0.000) and RAF (p < 0.05). Furthermore, there was a significant difference in scores on the pediatric injury identification scale based on the mother’s education level, the child’s age, the number of children, and the mother’s employment status |
A |
| Kuroiwa et al. 16 (2018) |
Single-blind randomized clinical trial (United States) |
213 participants aged 30 to 35 years of both genders |
A study was conducted to compare the effectiveness of traditional lecture-style classes on child passenger safety with rapid and simple social learning using theoretical and practical explanatory videos. The study found that the percentage of correct car seat installations increased from 17% to 52% in the traditional lecture-style classes and from 16% to 50% in the social learning group |
A |
| Machin et al. 19 (2018) |
Qualitative action research (Thailand) |
8 couples (8 men and 8 women), aged 24 to 54 years, with children up to 4 years old |
Analysis of parents’ perceptions of a collaborative program aimed at preventing accidental home injuries in children and its influence on their behavior showed that the intervention improved their children’s injury-prevention behavior at home |
A |
| Schwebel et al. 31 (2018) |
Nonrandomized trial (China) |
56 children aged 8 to 10 years of both genders |
A study was conducted to improve pedestrian safety using a smartphone-based virtual reality program in a simulated environment. The study found that the probability of accidents decreased from 0.40 to 0.09 post-training. Observational data also showed an increase in the chances of pedestrians looking at traffic in the opposite direction when crossing the first traffic lane (OR = 2.4) |
B |
| Silva et al. 24 (2018) |
Descriptive and intervention study (Brazil) |
20 mothers aged 16 to 25 years |
Games with illustrations related to childcare themes were created. The first post-intervention testing showed a significant improvement in knowledge scores. However, in the second test (5 months after the intervention), the scores decreased compared to the first post-test, particularly about the applied thematic criteria |
A |
| Ramos et al. 32 (2018) |
Intervention study (Vietnam) |
40,198 questionnaires from children aged 5 to 11 years of both genders |
An educational session was held in schools to address the dangers of aquatic environments. The session included practical training on how to float in water and essential water safety skills. Interactive games were conducted, and prizes were distributed to the winners. The intervention was found to have a significant positive impact, as observed through a questionnaire application (p < 0.001) |
A |
| Wang et al. 20 (2018) |
Intervention randomized trial (United States) |
277 women with an average age of 27.3 years |
During the study, different strategies were discussed for preventing fire, poisoning, and falls based on the Social Cognitive Theory, which focuses on community support. After a 6-month follow-up, the intervention group was able to reduce the number of safety issues, and this reduction was sustained at the 12-month mark (p = 0.035) |
A |
| White et al. 37 (2018) |
Randomized clinical trial (Australia) |
611 children aged 5 to 7 years and 357 parents or caregivers aged 25 to 66 years of both genders |
The Learn to Be Safe with Emmy and Friends program was compared to a waitlist condition. The program was effective in improving children’s knowledge and skills related to interpersonal safety, as evaluated by their parents. These benefits were sustained even after 6 months of the program, with participating children expressing greater confidence in disclosing sensitive information. However, the program had no significant impact on children’s safety identification skills, disclosure intentions, or their ability to interact safely with others |
A |
| DelCastillo-Andrés et al. 30 (2019) |
Randomized clinical trial (Spain) |
439 children aged 6 to 12 years of both genders |
The Safe Fall program was carried out as part of physical education classes, and the performance of balance exercises was compared. The risk of injury was evaluated before and after the program implementation. It was observed that over 90% of students were at a high risk of injury because of their natural response to falls. However, after the program, the risk percentage reduced significantly, ranging from 8.7% to 18.3% |
A |
| Freitas et al. 34 (2019) |
Experimental study with descriptive and analytical approach (Brazil) |
173 children (average age: 9.8 years old) of both genders |
The educational strategy was designed to encourage children to ask questions and share their ideas about traffic perception. This was done by using multiple suggestions raised by children’s drawings. The results showed a significant improvement in the experimental group’s knowledge (p < 0.05) compared to the control group. However, no significant difference in practices and attitudes between the 2 groups was identified |
A |
| Macy et al. 11 (2019) |
Randomized pilot test (United States) |
339 parents of both genders aged 18 to 29 years |
In this study, 4 different interventions were compared to see which was most effective. These interventions were: (1) a generic information sheet; (2) a personalized brochure sent by mail after the ER visit; (3) a single session of motivational interview-based counseling in the ER; and (4) a complete intervention (counseling and brochure). The results showed that parents who received the complete intervention (counseling and brochure) had an increase (+6.12%) in the proportion of children using an appropriately sized car seat at the 6-month follow-up. On the other hand, the other groups showed a decrease (-1.69 to -9.3%) in the proportion of children using the appropriate car seat |
B |
| McLaughlin et al. 35 (2019) |
Mixed-methods study (California, United States) |
1,424 and 1,522 children for pre- and post-test and 250 and 369 children for pre- and post-intervention crossing behavior analysis, aged 5 to 11 years, both genders |
An educational program was implemented by immersive experiences to encourage safe behavior while crossing the street. Results showed a significant increase in correct responses for 9 out of the 10 questions (p < 0.01). Furthermore, there was a marked improvement in the number of children who looked both ways before crossing the street (41% vs. 10%, p < 0.001) |
A |
| Nascimento et al. 25 (2019) |
Interventional research with primary data (Brazil) |
30 caregivers of both genders with children |
A figure was used as a trigger for dialogue exposure about accident risk situations. Before the action, 187 risk situations were identified. After the action, the number increased to 215. Additionally, the mean of discriminated situations increased to 8.7 (SD = 2.60). The Wilcoxon Test showed a statistically significant change (p < 0.001) |
A |
| Foulds et al. 38 (2021) |
Quantitative study (Bangladesh) |
1,177 children and 776 caregivers |
The mentoring model of Play Safe with Sisimpur program was created to enhance injury prevention knowledge and encourage behavior change. According to research findings, there was a significant increase in the knowledge related to injury prevention and treatment of various types of injuries such as burns, electrocution, falls, home risks, safe play, traffic injuries, and water safety. Additionally, the research results indicate that adults also demonstrated an increase in their injury prevention knowledge, specifically related to animal bites, burns, falls, home risks, and traffic injuries |
B |
| Wang et al. 26 (2020) |
Intervention randomized trial (United States) |
277 biological pairs of babies and mothers, mothers over 18 years old, and babies aged 12 to 32 months |
The intervention was designed to prevent fire and falls, control poisoning, and promote the use of car seats. It was conducted by group sessions that aimed to help families develop skills and new perceptions about child safety. The intervention also provided social support and helped build self-efficacy. The study found that the intervention was more effective in families with multiple home safety problems than in those with few or no problems. The effect size was larger in the former group (Cohen’s d = 0.99) than in the latter group (Cohen’s d = 0.15) |
A |
| Budziszewski et al. 17 (2021) |
Analytical and intervention study (United States) |
200 caregivers of both genders |
The Child Car Seat Program intervention was developed to increase caregivers’ knowledge about the use and importance of car seats. Before the course, caregivers correctly answered an average of 46% of the questions (M = 3.25, SD = 1.46). Notably, the average correct responses increased to 73% (p < 0.001) after the course |
B |
| Choi & Ahn 12 (2021) |
Controlled and randomized clinical trial (South Korea) |
167 participants aged 30 to 39 years of both genders |
The study aimed to compare the effectiveness of 2 types of intervention and control regarding unintentional childhood accident prevention. The first intervention was a virtual program containing interactive quizzes, while the second intervention was the same program content in PDF format. After the intervention, there was no significant difference in safety knowledge between the groups. However, when it came to safety practices, there was a statistically significant difference, with the software group showing the highest improvement, followed by the document group, and the control group showing the least improvement. The mean values were 3.52 ± 0.28, 3.51 ± 0.28, and 3.32 ± 0.25, respectively (p < 0.001) |
A |
| Furman et al. 18 (2021) |
Prospective observational study (United States) |
50 parents and caregivers over 18 years old of both genders |
The impact of the Mobile Safety Center was evaluated by 1 pre- and 3 post- intervention tests (immediate, after 4 weeks, and after 6 months of intervention). During the event, a trained educator presented various safety situations in different areas of the home. After the presentation, participants were tested to evaluate their preparedness for emergencies. The results showed that participants were more likely to have a fire escape plan after the presentation (post-test 1) than before (pre-test), with a significant p-value (0.014). Additionally, participants were more likely to have the poison control number readily accessible after post-test 1 compared to pre-test (p = 0.002) and post-test 2 compared to pre-test (p < 0.001) |
B |
| Gesser-Edelsburg et al. 39 (2021) |
Multimodal qualitative study (Israel) |
101 children aged 3 to 10 years, and 303 adults with an average age of 34 years of both genders |
A hybrid intervention model was implemented to decrease the incidence of unintentional injuries in the Bedouin community. The model involved three approaches: Positive Deviance (PD), Community-Based Participatory Research (CBPR), and Entertainment Education (EE) based on Bedouin theatrical traditions. The model led to the emergence of various PD ideas and practices to prevent and avoid childhood injuries. Additionally, a safe children’s playroom was created in a neighborhood mosque, as well as cross-learning and cascading learning networks were established among Bedouin community members spread across multiple locations |
B |
| Moridi et al. 13 (2021) |
Quasi-experimental study (Iran) |
200 women with an average age of 30 years with children under 5 years old |
An educational program was conducted via WhatsApp group sessions in the form of lectures, Q&A, group discussions, and the use of educational images, video clips, and PowerPoint. The program was based on the health belief model regarding accident prevention behaviors. Following the program, the group’s knowledge and behavior improved in almost all areas, except for perceived barriers |
A |
| Kusol et al. 36 (2022) |
Quasi-experimental study (Thailand) |
120 children aged 7 to 12 years of both genders |
The Potential Support Program on Drowning Prevention is based on the concept of social support. It emphasizes the promotion of students’ potential by working with their teachers to develop positive knowledge, skills, and attitudes toward self-prevention against drowning. An assessment form was used as a pre-and post-test to evaluate the program effectiveness. Comparing the mean differences in drowning prevention potential between the experimental and control groups after participation in the program, the experimental group showed a statistically significant increase (p < 0.001) |
A |
| Temsah et al. 27 (2022) |
Experimental study (Saudi Arabia) |
308 adult participants of both genders |
A pre- and post-test questionnaire was applied, and the intervention was a childhood and adolescence safety knowledge campaign. The knowledge score improved from 36.2 (SD = 17.7) to 79.3 (SD = 15.6) after the campaign participation (p < 0.001). Both the perception of accident avoidability (p < 0.001) and the usefulness of educational campaigns by parents improved (p < 0.001) |
A |
| Bakhurji et al. 14 (2023) |
Intervention study (Saudi Arabia) |
303 adult participants of both genders |
An online module was tested to increase caregivers’ awareness and knowledge about car seats. The module included educational videos, images, and recommendations. The average pre-test knowledge score of 11.64 significantly increased to 13.1 in the post-test (p < 0.001) |
A |
| Estebsari et al. 21 (2023) |
Quasi-experimental study (Iran) |
70 women with children up to 5 years old |
An educational program aimed at reducing the risk of home accidents, based on the Home Accident Prevention Guide from the Iranian Ministry of Health, was evaluated using pre- and post-test questionnaires. Before the intervention, there was no significant difference between the 2 groups (p > 0.05). However, after the intervention, there was a significant difference between the intervention and control groups |
A |
| Kendi et al. 15 (2023) |
Randomized controlled pilot study (United States) |
60 participants aged 30 to 34 years of both genders |
During the study, additional virtual demonstrations of infant car seats were provided at 3 and 6 months of age, in addition to the traditional in-person verification only at 9 months. In each session, the family installed the seat and child position, and some safety technical parameters were assessed together. Errors were noted and corrected. At the end of the study, the confidence and acceptability measures were similar between groups. However, the intervention group achieved a greater reduction in error rate compared to the control group, although the error rate was reduced in both groups (control group: 7% ± 4; intervention group: 2% ± 3; p < 0.001) |
A |
| Taylor et al. 40 (2023) |
Intervention study (United Kingdom) |
762 families with children aged 3 to 7 months of both genders |
The study involved implementing evidence-based home safety promotion strategies, such as safety messages, activity sessions, and home safety checklists. The primary goal was to ensure that families had a working smoke alarm, stored poisons out of reach, and had a stairgate in place. After 24 months, there was no significant difference between groups regarding primary outcome (55.8% vs. 48.8%) or rates of medically attended injuries. However, families who received the intervention were more likely to store poisons safely (OR = 1.81, 95%CI: 1.06-3.07), have a fire escape plan (OR = 1.81, 95%CI: 1.06-3.08), use a fireguard, or have no fire (OR = 3.17, 95%CI: 1.63-6.16), and perform more safety practices |
A |
| Teichman et al. 33 (2023) |
Retrospective cross-sectional study (United States) |
8,832 children aged 6 to 8 years of both genders |
The Safety Ambassador program employs creative and interactive teaching methods to educate children in areas of injury risk, such as traffic and car safety, wheeled sports and helmets, and fall prevention. As a result of these classes, 1st-grade students demonstrated an improvement in their average knowledge score from 9 in the pre-test to 9.8 in the post-test (p < 0.01). Behavior modification scores increased significantly from an average pre-test score of 3.2 to 3.6 in the post-tests (p < 0.01). Additionally, 2nd-grade students improved in both knowledge (p < 0.01) and behavior (p < 0.01) |
B |
Educational strategies for preventing accidents in childhood: a systematic review
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Source: prepared by the authors.