Preventing Childhood Falls at Home: Meta-Analysis and Meta-Regression
Background
Childhood falls are an important global public health problem, but evidence on their prevention has not been quantitatively synthesized. Despite social inequalities in childhood injury rates, there is a lack of evidence examining the effect of fall-prevention practices by social group.
Methods
A systematic review of literature was conducted up to June 2004 and meta-analysis using individual patient data to evaluate the effect of home-safety interventions on fall-prevention practices and fall-injury rates. Meta-regression examined the effect of interventions by child age, gender, and social variables. Included were 21 studies, 13 of which contributed to meta-analyses.
Results
Home-safety interventions increased stair-gate use (OR=1.26; 95% CI=1.05, 1.51), and there was some evidence of reduced baby-walker use (OR=0.66; 95% CI=0.43, 1.00), but little evidence of increased possession of window locks, screens, or windows with limited opening (OR=1.16, 95% CI=0.84, 1.59) or of nonslip bath mats or decals (OR=1.15; 95% CI=0.51, 2.62). Two studies reported nonsignificant effects on falls (baby-walker–related falls on flat ground [OR=1.35; 95% CI=0.64, 2.83] or down steps or stairs [OR=0.70; 95% CI=0.14, 3.49]) and medically attended falls (OR=0.78; 95% CI=0.61, 1.00).
Conclusions
Home-safety education and the provision of safety equipment improved some fall-prevention practices, but the impact on fall-injury rates is unclear. There was some evidence that the effect of home-safety interventions varied by social group.
aDivision of Primary Care, University of Nottingham, Nottingham, England
bSchool of Nursing, University of Nottingham, Nottingham, England
cBroxtowe and Hucknall Primary Care Trust, Hucknall Health Centre, Nottingham, England
dDepartment of Health Sciences, University of Leicester, Leicester, England
eWestern Cape Department of Health, Southern Life Centre, Cape Town, South Africa
Address correspondence and reprint requests to: Denise Kendrick, MSc, DM, Division of Primary Care, University of Nottingham, Floor 13, Tower Building, University Park, Nottingham NG7 2RD, UK
ABSTRACT