Prevention of Paediatric Acquired Brain Injury: An Interactive, Elementary-School Program
Morrongiello, Barbara A, Miron, Jennifer, Reutz, Rhonda, Canadian Journal of Public Health
Responding to a gap in existing programs that aim to prevent spinal cord and brain injuries among children, an interactive activity-based program was developed and implemented through local elementary schools, focusing on children 8 to 10 years of age. Evaluation involved a pretest/post-test design with a comparison group who had not experienced the program. Children who participated in the program showed increases in knowledge, self-reported changes in behaviour, and favourable shifts in attitudes about vulnerability to injury four months after exposure to the program. Control group children responded similarly to how children in the intervention group responded on the pretest measure.
En reponse aux lacunes que presentent les programmes existants dont l'objectif est la prevention de blessures i la colonne vertebrale et au cerveau chez les enfants, nous avons elabore un programme interactif a base d'activites destine aux enfants aggs de 8 a 10 ans et l'avons mis i l'essai dans des ecoles elementaires locales. L'evaluation consistait en un pre-test et en un post-test et mettait en jeu un groupe de comparaison n'ayant pas participe au programme. Quatre mois apres leur participation au programme, les enfants avaient de meilleures connaissances, rapportaient des changements dans leur propre comportement et avaient de meilleures attitudes sur la vulnerabilite aux blessures. Les enfants du groupe de controle avaient des reponses semblables a celles qu'avaient donnees les enfants du groupe d'intervention pendant leur pre-test.
In the United States and Canada, as in many other industrialized nations, unintentional injuries are the number one cause of death for children beyond one year of age, and a leading cause of visits to emergency departments.1-3 Each year in the United States approximately 422,000 people suffer head injuries,4 with about one third of these injuries occurring to children and adolescents.5 Head and spinal cord injuries among youth most often result from their being unrestrained in motor vehicle crashes, falling from heights, and diving in unsafe places, with males being more likely than females to experience such injuries.6 In addition to the catastrophic effects of such injuries on the lives of individuals and their families, the average lifetime costs of such injuries is estimated to be 1.2 million dollars per individual.7 Accordingly, many educational intervention programs have been developed to prevent head and spinal cord injuries; most programs aim to reduce both spinal cord and head injuries due to similarity in the causes of injury and demographic characteristics of those who experience such injuries.
Richards8 conducted a survey of programs on prevention of spinal cord and/or brain injury in Canada and the United States and identified 146 local and state programs, however, the efficacy of such programs is largely unknown.9 Moreover, those that have been evaluated typically show no10 or mixed results,11, 12 often producing changes in knowledge but not in children's reported injury-risk behaviours.13 Although a good case can be made that children's health-relevant attitudes and behaviour patterns are established early in life,14 the vast majority of programs to prevent brain and spinal cord injuries focus on junior- and high-school-aged children because these are the ages at which these types of injuries more often occur. Indeed, we could find only one program that was directed towards pre-adolescent children and had been formally evaluated. Richards and his colleagues developed a spinal cord injury prevention program that teachers implemented in the classrooms of first, third and fifth graders.15 Cartoon characters were used to convey curriculum content (falls and playground safety, bike safety, safe diving, vehicle safety). A pretest/post-test design with a comparison group was used to determine efficacy of the program. Evaluation results revealed that children exposed to the program showed a significant increase in knowledge of spinal cord injury and its prevention, however, there were no changes in behaviour, even in self-reported use of safety belts. …