Do self reported safety behaviours predict childhood unintentional injuries?

OBJECTIVE The aim of this study was to investigate the validity of self reported safety behaviours as a proxy for injuries in unintentional injuries research. SETTING The study population comprised parents and guardians of children aged 3-12 months in 18 general practices throughout Nottingham (n = 764) who responded to a questionnaire on safety practices. METHOD Injury data were collected by searching the primary and secondary care records of each child in the study. Safety behaviour was measured by computing a safety practices score from self reported safety practices for each respondent to a postal baseline questionnaire survey of safety behaviours. The score was used to classify families into low, medium, and high risk of injury occurrence. Two further scores were calculated, firstly for those safety practices which required obtaining an item of safety equipment, and secondly those safety practices requiring behavioural change without cost implications. RESULTS High risk families were no more likely than low risk families to sustain an injury (odds ratio (OR) 1.08; 95% confidence interval 0.65 to 1.79). Medium risk families were also no more likely than low risk families to have a medically attended injury (OR 1.09; 0.73 to 1.61) suggesting no association between safety score and future medically attended injury. Similarly, compared to low risk families, medium risk (OR 0.93; 0.33 to 2.61) and high risk (OR 0.46; 0.08 to 2.43) families were no more likely to have a child admitted to hospital with an injury. There was no correlation between the total number of injuries sustained during the study period and the baseline safety practices score (Spearman's rho = 0.004; p = 0.917). Subgroup analyses for safety behaviours requiring passive and active safety measures did not reveal significant associations with injury outcomes. CONCLUSION Self reported safety behaviours do not appear to be good predictors of childhood unintentional injuries. Further research is required to ascertain valid proxy outcome measures for injury research.