Eight-year outcome of implementation of abusive head trauma prevention |
| |
| Institution: | 1. Department of Pediatrics, University of British Columbia; Canadian Institute for Advanced Research; British Columbia Children’s Hospital Research Institute, Canada;2. National Center on Shaken Baby Syndrome, United States;3. British Columbia Children’s Hospital Research Institute, Canada;4. Department of Pediatrics, University of British Columbia; British Columbia Children’s Hospital Research Institute, Canada;5. British Columbia Children’s Hospital Research Institute; Department of Statistics, University of British Columbia, Canada;6. Department of Pediatrics, University of British Columbia, Canada;7. Global Health Promotion, Tokyo Medical and Dental University, Japan;8. Department of Neurosurgery, University of British Columbia, Canada;1. Division of General Pediatrics, The Children''s Hospital of Philadelphia, Philadelphia, Pa;2. Division of PolicyLab, The Children''s Hospital of Philadelphia, Philadelphia, Pa;3. Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa;4. Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pa;5. Department of Pediatrics, Children''s Hospital of Pittsburgh of UPMC, Pittsburgh, Pa;6. Nationwide Children''s Hospital and The Ohio State University College of Medicine, Columbus, Ohio;7. Mayerson Center for Safe and Healthy Children and Cincinnati Children''s Hospital Medical Center, Cincinnati, Ohio;8. General Pediatric Division and Children''s Protection Program, Seattle Children''s Hospital and the University of Washington School of Medicine, Seattle, Wash;9. Department of Epidemiology and Graduate School of Public Health, Epidemiology Data Coordinating Center;10. Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, Pa;1. Centre for Automotive Safety Research, The University of Adelaide, Adelaide 5005, SA, Australia;2. SA Pathology, Hanson Institute Centre for Neurological Diseases, PO Box 14 Rundle Mall, Adelaide 5000, SA, Australia;3. School of Medical Sciences, University of Adelaide, Frome Road, Adelaide 5005, SA, Australia;1. Service de rééducation pour enfants après lesions cérébrales acquises, hôpitaux de Saint-Maurice, 14, rue du Val-d’Osne, 94410 Saint-Maurice, France;2. Laboratoire d’imagerie biomédicale (LIB), Sorbonne université, CNRS, Inserm, 75006 Paris, France;3. Groupe de recherche clinique handicap cognitif et réadaptation, Sorbonne université, 75006 Paris, France;1. Te Puaruruhau (Child Protection Team), Starship Children’s Health, Private Bag 92024, Auckland 1142, New Zealand;2. Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand;1. Department of Pediatrics, University of British Columbia, 4480 Oak Street, F507, Vancouver, British Columbia, Canada V6H3V4;2. Department of Psychiatry, University of British Columbia, Canada;3. Department of Psychology, University of Connecticut, USA;4. Department of Statistics, University of British Columbia, Canada;1. Department of Social Medicine, National Research Institute for Child Health and Development, Japan;2. Department of Global Health Promotion, Tokyo Medical and Dental University, Japan |
| |
| Abstract: | Low incidence rates and economic recession have hampered interpretation of educational prevention efforts to reduce abusive head trauma (AHT). Our objective was to determine whether the British Columbia experience implementing a province-wide prevention program reduced AHT hospitalization rates. A 3-dose primary, universal education program (the Period of PURPLE Crying) was implemented through maternal and public health units and assessed by retrospective-prospective surveillance. With parents of all newborn infants born between January 2009 and December 2016 (n = 354,477), nurses discussed crying and shaking while delivering a booklet and DVD during maternity admission (dose 1). Public health nurses reinforced Talking Points by telephone and/or home visits post-discharge (dose 2) and community education was instituted annually (dose 3). During admission, program delivery occurred for 90% of mothers. Fathers were present 74.4% of the time. By 2–4 months, 70.9% of mothers and 50.5% of fathers watched the DVD and/or read the booklet. AHT admissions decreased for <12-month-olds from 10.6 (95% CI: 8.3–13.5) to 7.1 (95% CI: 4.8–10.5) or, for <24-month-olds, from 6.7 (95% CI: 5.4–8.3) to 4.4 (95% CI: 3.1–6.2) cases per 100,000 person-years. Relative risk of admission was 0.67 (95% CI: 0.42–1.07, P = 0.090) and 0.65 (95% CI: 0.43-0.99, P = 0.048) respectively. We conclude that the intervention was associated with a 35% reduction in infant AHT admissions that was significant for <24-month-olds. The results are encouraging that, despite a low initial incidence and economic recession, reductions in AHT may be achievable with a system-wide implementation of a comprehensive parental education prevention program. |
| |
| Keywords: | Abusive head trauma Shaken baby syndrome Prevention Parental education Crying Shaking Infant abuse |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
