Why 'Accidents' Are Not Accidental: Using Psychological Science to Understand and Prevent Unintentional Child Injuries

摘要

Injuries are the leading cause of death for American children, killing over 11,000 children in 2017. They are also a rapidly increasing public health challenge globally: The World Health Organization ranks injury as the leading cause of death globally for children Ages 5 to 18 years, and the Global Burden of Diseases project estimates over 2 million children Ages 0 to 19 years died from injuries worldwide in 2017. Unintentional injuries, sometimes referred to as "accidents" by the lay public, are generally preventable, and psychological science has much to offer in societal efforts to develop, evaluate, implement, and disseminate effective prevention strategies. I first discuss the multifaceted causes of child injuries, which can be conceptualized using classic psychological theory, such as Bronfenbrenner's ecological theory, or classic injury prevention theory, such as the Haddon Matrix. In either case, behavioral risks stem from the child's developmentally influenced decisions and behaviors; the child's family, social, and physical contexts; and the child's broader cultural environments. Risks can also be conceptualized temporally, through behavioral analysis such as antecedents, behaviors, and consequences of the injury. I then present examples of behaviorally focused interventions that target the child, the adult supervisor, and the environment. In each case, I consider psychological risk factors present and the theory-based strategies that might interrupt or alter risk pathways to prevent injury events. I close with comments on the scope of injury as a global public health challenge and the central role psychologists can and should play to reduce the burden of child injury on the world's population.