Targeted home injury prevention information can result in decreased childhood unintentional injury hazards in low-income community homes, according to a new study by researchers in the Johns Hopkins International Injury Research Unit (JH-IIRU) at the Johns Hopkins Bloomberg School of Public Health.  The study examined results from a pilot study of home hazard information dissemination tools used in a low-income neighborhood in Karachi, Pakistan. The researchers pilot-tested and compared the effectiveness of two tools—an educational pamphlet and an in-home tutorial—which were previously developed by the team specifically for the location.

Unintentional injuries result in more than 875,000 deaths in children under the age of 18, with 80% of those taking place in low- and middle-income countries (LMICs). In Pakistan, approximately one million unintentional injuries occur each year in children under five years of age. Young children spend a significant amount of time in the home, and as a result, a substantial amount of injuries occur in that setting. Often, challenging living conditions—like lack of barriers to cooking and washing areas, use of open fires and lack of safe storage for harmful substances—contribute to injuries as well.

Little is known about the best methods for dissemination of home safety information in LIMCs, despite the availability of a variety of proven effective methods for promoting home injury prevention to caretakers of young children in high income countries (HICs). This dearth of information in LMICs has resulted in limited ways for health professionals to share potential prevention knowledge with parents. The JH-IIRU study is one of only a very few to look at developing home injury prevention information dissemination tools targeted for a developing country.

"Unlike in the developed world, healthcare providers and public health educators in low- and middle-income countries don't have tailored targeted materials to share with parents of young children about how to prevent/reduce unintentional injury hazards in the home,” said JH-IIRU associated faculty, Aruna Chandran, the lead investigator on the study.  Other researchers included JH-IIRU research assistant Nukhba Zia, JH-IIRU director, Adnan Hyder and Junaid Razzak, from Aga Khan University Department of Emergency Medicine.

The study showed an overall significant decrease in potential home hazards after the introduction of either an educational pamphlet or an in-home tutorial. Additionally, in the immediate four-to-five months following the intervention, there were fewer childhood hazards present in the homes in the targeted community. The study also suggests that the use of an in-home tutorial may be a more effective method for the dissemination of childhood hazard prevention information.

 “This study showed that using newly developed tools, sharing such information can be effective at changing the home environment in a low-income urban setting, and that the use of a community-health worker going into the home might be the optimal way to do so.  We hope this will spur additional such studies to explore these issues further in Pakistan and other settings," said Dr. Chandran.

This pilot project demonstrates the potential utility of using home-visit tutorials to decrease home-hazards in a low-income neighborhood in Pakistan.

“Disseminating Childhood Home Injury Risk Reduction Information in Pakistan: Results from a Community-Based Pilot Study,” appears in the current issue of the International Journal of Environmental Research and Public Health.