Health Education, its Methods and Effects on Parents’ Knowledge, Attitudes, and Behaviours to Prevent Unintentional Child Injuries at Home: A Systematic Review

Thousands of young children die or sustain life changing disabilities every year because of unintentional child injury (UCI) at home. Many injuries could be prevented if parents and caregivers were more aware of risks and accident-avoidance strategies. The aim of this review was two-fold. First, we explored whether health education modified parent or caregiver knowledge, attitudes, or behaviour related to injury awareness and prevention. Our secondary aim was to describe strategies used when delivering health education. Intervention studies using quantitative methods published after 2010 were included. The participants were caregivers or parents of children younger than six years of age. A systematic search of multiple databases yielded twelve studies. The risk of bias (ROB) was assessed using the Cochrane ROBINS-I for non-randomised and ROB-2 for randomised studies. Data synthesis was performed following the steps described in the SWiM guideline. We followed PRISMA guidelines to report the process and results. Interventions were usually one-off, multifaceted, and interactive using printed materials, discussion, didactic teaching, video, and games. Improvement of knowledge ranged from 12.5% to 85%. Attitude improvement was noted in five studies and ranged from 6.6% to 28%. Self-reported behavioural change was noted in six studies. Follow up duration varied from less than one month to six months. The observed changes have not been linked to the numbers or severity of UCI. Health education is beneficial, but the true long-term impact has yet to be fully explored. Studies that provided the greatest improvements used theories of behaviour change and interventions that were designed for the specific needs of the target population. Our review provides health care professionals with evidence of the potential benefits of health education in enhancing parents’ awareness regarding preventing UCI and information about how to deliver health education, that can guide the review of prevention practices of UCI.