A randomised controlled trial of general practitioner safety advice for families with children under 5 years

BMJ 1998;316:1576-1579 ( 23 May )

General Practice

A randomised controlled trial of general practitioner safety advice for families with children under 5 years

Margaret Clamp, general practitioner, ^a Denise Kendrick, senior lecturer. ^b

^a Colwick Vale Surgery, Colwick, Nottingham NG4 2DU, ^b Division of General Practice, University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH

Correspondence to: Dr Kendrick Denise.Kendrick{at}nottingham.ac.uk

Objective: To assess effectiveness of general practitioner advice about child safety, and provision of low cost safetyequipment to low income families, on use of safety equipment andsafe practices at home.
Design: Randomised, unblinded, controlled trial with initial assessment and six week follow up by telephone survey.Twenty families from intervention and control groups were randomlyselected for a home visit to assess validity of responses to secondsurvey.
Setting: A general practice in Nottingham.
Subjects: 98% (165/169) of families with children aged under 5 years registered with the practice.
Interventions: General practitioner safety advice plus, for families receiving means tested state benefits, accessto safety equipment at low cost. Control families received usualcare.
Main outcome measures: Possession and use of safety equipment and safe practices at home.
Results: Before intervention, the two groups differed only in possession of fireguards. After intervention, significantlymore families in intervention group used fireguards (relativerisk 1.89, 95% confidence interval 1.18 to 2.94), smoke alarms(1.14, 1.04 to 1.25), socket covers (1.27, 1.10 to 1.48), lockson cupboards for storing cleaning materials (1.38, 1.02 to 1.88),and door slam devices (3.60, 2.17 to 5.97). Also, significantlymore families in intervention group showed very safe practicein storage of sharp objects (1.98, 1.38 to 2.83), storage of medicines(1.15, 1.03 to 1.28), window safety (1.30, 1.06 to 1.58), fireplacesafety (1.84, 1.34 to 2.54), socket safety (1.77, 1.37 to 2.28),smoke alarm safety (1.11, 1.01 to 1.22), and door slam safety(7.00, 3.15 to 15.6). Stratifying results by receipt of statebenefits showed that intervention was at least as effective infamilies receiving benefits as others.
Conclusions: General practitioner advice, coupled with access to low cost equipment for low income families, increaseduse of safety equipment and other safe practices. These findingsare encouraging for provision of injury prevention in primarycare.

Key messages

We assessed the effectiveness of general practitioner advice about child safety, and provision of low cost safety equipment to low income families, on safe practices at home
The intervention increased safe behaviour and use of safety equipment
The intervention was equally effective in families receiving means tested benefits as in those not receiving benefits
The effectiveness of this intervention should be evaluated over longer periods, in other practices, and when delivered by other members of the primary healthcare team

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