Impact of the national home safety equipment scheme ‘Safe At Home’ on hospital admissions for unintentional injury in children under 5: controlled interrupted time series analysis

Hill, Trevor; Coupland, Carol; Kendrick, Denise; Jones, Matthew; Akbari, Ashley; Rodgers, Sarah; Watson, Michael Craig; Tyrrell, Edward; Merrill, Sheila; Orton, Elizabeth

Abstract

Background: Unintentional home injuries are a leading cause of preventable death in young children. Safety education and equipment provision improve home safety practices, but their impact on injuries is less clear. Between 2009 and 2011 a national home safety equipment scheme was implemented in England (Safe At Home), targeting high injury rate areas and socio-economically disadvantaged families with children under 5. This provided a ‘natural experiment’ for evaluating the scheme’s impact on hospital admissions for unintentional injuries.

Methods: Controlled interrupted time series analysis of unintentional injury hospital admission rates in small areas (Lower layer Super-Output Areas (LSOAs)) in England where the scheme was implemented (intervention areas, n=9,466)) matched with LSOAs in England and Wales where it was not implemented (control areas, n=9,466), with subgroup analyses by density of equipment provision.

Results: 57,656 homes receiving safety equipment were included in the analysis. In the two years after the scheme ended, monthly admission rates declined in intervention areas (-0.33% (-0.47% to -0.18%)) but did not decline in control areas (0.04% (-0.11% to 0.19%), p value for difference in trend=0.001)). Greater reductions in admission rates were seen as equipment provision density increased. Effects were not maintained beyond two years after the scheme ended.

Conclusions: A national home safety equipment scheme was associated with a reduction in injury-related hospital admissions in children under 5 in the 2-years after the scheme ended. Providing a higher number of items of safety equipment appears to be more effective in reducing injury rates than providing fewer items.

Citation

Hill, T., Coupland, C., Kendrick, D., Jones, M., Akbari, A., Rodgers, S., …Orton, E. (2022). Impact of the national home safety equipment scheme ‘Safe At Home’ on hospital admissions for unintentional injury in children under 5: controlled interrupted time series analysis. Journal of Epidemiology and Community Health, 76(1), 53-59. https://doi.org/10.1136/jech-2021-216613

• Journal Article Type: Article
• Acceptance Date: May 31, 2021
• Online Publication Date: Jun 22, 2021
• Publication Date: 2022-01
• Deposit Date: Jun 1, 2021
• Publicly Available Date: Jun 22, 2021
• Journal: Journal of Epidemiology and Community Health
• Print ISSN: 0143-005X
• Electronic ISSN: 1470-2738
• Publisher: BMJ Publishing Group
• Peer Reviewed: Peer Reviewed
• Volume: 76
• Issue: 1
• Pages: 53-59
• DOI: https://doi.org/10.1136/jech-2021-216613
• Keywords: Unintentional injury, safety equipment, children
• Public URL: https://nottingham-repository.worktribe.com/output/5621561
• Publisher URL: https://jech.bmj.com/content/early/2021/06/21/jech-2021-216613