Effects of improved access to safety counseling, products, and home visits on parents' safety practices: results of a randomized trial

Arch Pediatr Adolesc Med. 2002 Jan;156(1):33-40. doi: 10.1001/archpedi.156.1.33.


Objective: To present the results of an intervention trial to enhance parents' home-safety practices through pediatric safety counseling, home visits, and an on-site children's safety center where parents receive personalized education and can purchase reduced-cost products.

Design: Pediatricians were randomized to a standard- or an enhanced-intervention group. Parents of their patients were enrolled when the patient was 6 months or younger and observed until 12 to 18 months of age.

Setting: A hospital-based pediatric resident continuity clinic that serves families living in low-income, inner-city neighborhoods.

Participants: First- and second-year pediatric residents and their patient-parent dyads.

Interventions: Parents in the standard-intervention group received safety counseling and referral to the children's safety center from their pediatrician. Parents in the enhanced-intervention group received the standard services plus a home-safety visit by a community health worker.

Outcomes: Home observers assessed the following safety practices: reduction of hot-water temperature, poison storage, and presence of smoke alarms, safety gates for stairs, and ipecac syrup.

Results: The prevalence of safety practices ranged from 11% of parents who stored poisons safely to 82% who had a working smoke alarm. No significant differences in safety practices were found between study groups. However, families who visited the children's safety center compared with those who did not had a significantly greater number of safety practices (34% vs 17% had > or 3).

Conclusions: Home visiting was not effective in improving parents' safety practices. Counseling coupled with convenient access to reduced-cost products appears to be an effective strategy for promoting children's home safety.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Attitude to Health
  • Counseling / standards*
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Promotion / methods
  • Health Promotion / standards
  • Health Services Accessibility / standards*
  • Health Services Research
  • Home Care Services, Hospital-Based / standards*
  • Hospitals, Teaching
  • Hospitals, Urban
  • Humans
  • Infant
  • Infant Care / instrumentation
  • Infant Care / methods*
  • Infant Care / standards
  • Infant Equipment / economics
  • Infant Equipment / supply & distribution*
  • Male
  • Outcome Assessment, Health Care
  • Parents / education*
  • Parents / psychology
  • Pediatrics / standards*
  • Poverty
  • Program Evaluation
  • Referral and Consultation
  • Safety Management / standards*
  • Total Quality Management
  • Urban Health Services / standards