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Paraprofessional home visitation program to prevent childhood unintentional injuries in low-income communities: a cluster randomized controlled trial

¹ UNISA Institute for Social and Health Sciences, Lenasia, South Africa
² MRC-UNISA Crime, Violence and Injury Lead Programme, Cape Town, South Africa
³ UNISA Institute for Social and Health Sciences and MRC-UNISA Crime, Violence and Injury Lead Programme, Johannesburg, South Africa
⁴ Biostatistics Unit, Medical Research Council, Cape Town, South Africa

Ms L Swart, UNISA Institute for Social and Health Sciences, PO Box 1087, Lenasia 1820, South Africa, swartl{at}unisa.ac.za

Objective: To investigate the effectiveness of a paraprofessional home visitation program (HVP) to improve home safety and prevent injuries among children living in low-income settings.

Methods: The HVP was implemented in two low-income communities in South Africa. In each community, approximately 200 households were randomly selected for the trial. Eligible households were those with children aged 10 years. Intervention households received four visits, one every two weeks, by trained paraprofessionals that focused on a specific injury topic and consisted of: information dissemination about specific injury prevention practices; home inspection accompanied by information about home hazards; and the supply of safety devices. The key outcomes to measure the presence of home hazards were scores for burns (safety practices, paraffin, and electrical), poisoning, and falls.

Results: Significant reductions were found for injury risks related to burn safety practices. For injury risks related to electrical burns, paraffin burns, and poisoning, a decline was also noted although this was not statistically significant. No decline was noted for fall-related risks.

Conclusions: Subject to further replication and evaluation, home visits by paraprofessionals providing safety education, home inspection, and safety devices be considered for integration into a comprehensive child injury prevention strategy in low-income communities.