In the U.S. unintentional injuries rank as the leading cause of death and a major cause of hospitalization
and disability for children beyond 1 year of age. Preschool-aged children are frequently injured at home. This
fact has led to an increasing focus on the nature and scope of supervision provided by caregivers of young
children. The proposed research aims to develop an evidenced-based, theoretically-motivated intervention to
improve the quality of supervision provided children by caregivers and to systematically evaluate the impact
of this intervention on both parent supervision and children's frequency of home injury.
Diverse literatures (persuasion research, therapeutic intervention strategies, behavioral change theories
and evidence) were consulted to determine when the program should be delivered, what should be the
focus, and how best to communicate information to maximize effectiveness. The intervention will be timed to
coincide with a teachable moment (proximal to a child injury occurrence); will comprise multiple components
that target key cognitions (vulnerability for injury, potential injury severity, benefits of close supervision for
prevention, self efficacy in supervising) and emotions (fear) that have been linked to risk decisions; and will
use a video-exposure format with numerous subsequent activities to promote motivation to change,
development of skills necessary for close supervision, and instantiation of this practice as a behavioral habit.
Participants will be primary caregivers of a child in one of two age groups (2-3 years, 4-5 years),
randomly assigned to groups, with intervention and control groups matched on key demographic factors.
Numerous behavioral, observational, and questionnaire measures of childhood injury and caregiver
supervision will be taken pre- and post-intervention (3, 6 and 12 months after).
Regression and ANOVA analyses will determine (1) if the intervention increases supervisory behaviors
and reduces children's injury rates; (2) if these effects persist through 3, 6 and 12 months post-intervention,
and (3) if other child or parent behavioral attributes that have been related to injury risk in prior research
moderate or mediate the extent of effectiveness of the intervention. The research addresses a substantive
gap in the injury-prevention literature and the findings will provide a solid foundation for future intervention
work on the important topic of how to promote caregiver supervision to reduce child-injury risk.