Evaluating implementation of a fire-prevention Injury Prevention Briefing in children’s centres: cluster randomised controlled trial

摘要

Background Many developed countries have high mortality rates for fire-related deaths in\udchildren aged 0-14 years with steep social gradients. Evidence-based interventions to\udpromote fire safety practices exist, but the impact of implementing a range of these\udinterventions in children’s services has not been assessed. We developed an Injury Prevention\udBriefing (IPB), which brought together evidence about effective fire safety interventions and\udgood practice in delivering interventions; plus training and facilitation to support its use and\udevaluated its implementation.\udMethods We conducted a cluster randomised controlled trial, with integrated qualitative and\udcost-effectiveness nested studies, across four study sites in England involving children’s\udcentres in disadvantaged areas; participants were staff and families attending those centres.\udCentres were stratified by study site and randomised within strata to one of three arms: IPB\udplus facilitation (IPB+), IPB only, usual care. IPB+ centres received initial training and\udfacilitation at months 1, 3, and 8. Baseline data from children’s centres were collected\udbetween August 2011 and January 2012 and follow-up data were collected between June\ud2012 and June 2013. Parent baseline data were collected between January 2012 and May\ud2012 and follow-up data between May 2013 and September 2013. Data comprised baseline\udand 12 month parent- and staff-completed questionnaires, facilitation contact data, activity\udlogs and staff interviews. The primary outcome was whether families had a plan for escaping\udfrom a house fire. Treatment arms were compared using multilevel models to account for\udclustering by children’s centre.\udResults 1112 parents at 36 children’s centres participated. There was no significant effect of\udthe intervention on families’ possession of plans for escaping from a house fire (adjusted\udodds ratio (AOR) IPB only vs. usual care: 0.93, 95%CI 0.58, 1.49; AOR IPB+ vs. usual care \ud1.41, 95%CI 0.91, 2.20). However, significantly more families in the intervention arms\udreported more behaviours for escaping from house fires (AOR IPB only vs. usual care: 2.56,\ud95%CI 01.38, 4.76; AOR IPB+ vs. usual care 1.78, 95%CI 1.01, 3.15).\udConclusion Our study demonstrated that children’s centres can deliver an injury prevention\udintervention to families in disadvantaged communities and achieve changes in home safety\udbehaviours.