Keeping children safe at home

protocol for three matched case–control studies of modifiable risk factors for falls

Kendrick, Denise
Maula, Asiya
Stewart, Jane
Clacy, Rose
Coffey, Frank
Cooper, Nicola
Coupland, Carol
Hayes, Mike
McColl, Elaine
Reading, Richard
Sutton, Alex
M L Towner, Elizabeth
Craig Watson, Michael

¹Division of Primary Care, Tower Building, University Park, Nottingham, UK
²Nottinghamshire Healthcare NHS Trust, Nottingham, UK
³Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
⁴Department of Health Sciences, University of Leicester, Leicester, UK
⁵Child Accident Prevention Trust, Child Accident Prevention Trust, London, UK
⁶Newcastle Clinical Trials Unit, The Medical School, Newcastle University, Newcastle upon Tyne, UK
⁷Norfolk and Norwich University Hospital, Colney Lane, Norwich, UK
⁸Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
⁹School of Nursing, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK

Dr Asiya Maula, Division of Primary Care, Tower Building, University Park, Nottingham NG7 2RD, UK; [email protected]

* The Keeping Children Safe Study Group is listed in appendix 1.

Accepted March 14, 2012

Injury Prevention 18(3):p e3, June 2012. | DOI: 10.1136/injuryprev-2012-040394

Background

Childhood falls result in considerable morbidity, mortality and health service use. Despite this, little evidence exists on protective factors or effective falls prevention interventions in young children.

Objectives

To estimate ORs for three types of medically attended fall injuries in young children in relation to safety equipment, safety behaviours and hazard reduction and explore differential effects by child and family factors and injury severity.

Design

Three multicentre case–control studies in UK hospitals with validation of parental reported exposures using home observations. Cases are aged 0–4 years with a medically attended fall injury occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression to adjust for potential confounding variables. Unmatched analyses will use unconditional logistic regression, adjusted for age, sex, deprivation and distance from hospital in addition to other confounders. Each study requires 496 cases and 1984 controls to detect an OR of 0.7, with 80% power, 5% significance level, a correlation between cases and controls of 0.1 and a range of exposure prevalences.

Main outcome measures

Falls on stairs, on one level and from furniture.

Discussion

As the largest in the field to date, these case control studies will adjust for potential confounders, validate measures of exposure and investigate modifiable risk factors for specific falls injury mechanisms. Findings should enhance the evidence base for falls prevention for young children.