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Partnering for injury prevention: Evaluation of a curriculum-based intervention program among elementary school children*

https://doi.org/10.1053/jpdn.2001.23148Get rights and content

Abstract

A randomized pretest and posttest comparative design was used to evaluate the outcome of implementing Think First for Kids (TFFK), an injury prevention program for children grades 1, 2, and 3, among intervention and controls schools. The study showed that children often lack basic knowledge regarding safety and do not recognize behaviors considered high risk for injury. By using multivariate analysis, the intervention children had a significantly greater increase in knowledge about the brain and spinal cord and safe behaviors to prevent traumatic injury, and a decrease in self-reported, high-risk behaviors (p <.001) when compared with control subjects, adjusting for the covariates gender, socioeconomic status, and race/ethnicity. African American and Hispanic children, although displaying the lowest test scores at baseline, had the largest absolute improvement in posttest scores. The TFKK prevention program addresses the leading causes of trauma among children including sports, motor vehicle crashes, falls, drowning, and pedestrian injuries. Copyright © 2001 by W.B. Saunders Company

Section snippets

Review of the literature

School health education is one of the most important ways to address enduring public health problems, such as injury (Institute of Medicine, 1997; Polivka & Ryan-Wenger, 1999; Public Health Service, 1994). Several curricular interventions have been successful in influencing behaviors, such as reducing rates of tobacco and alcohol use among youth and decreasing unintentional pregnancies (Connell & Turner, 1985; Pentz et al., 1989; Vincent, Clearie, & Schluchter, 1987). Schall (1994) suggests

Methodology

A randomized pretest and posttest comparative design was used for this study, the school being the unit of assignment. The study was conducted in two urban school districts in San Diego County, California. The data were collected within the classroom setting for both the intervention and control schools.

Results

There were 2,465 student participants for the pretests and posttests. Statistical analysis was restricted to the 1,977 students who had linked pretests and posttests (80% match) (grade 1, 697; grade 2, 639; and grade 3, 641). The attrition rate of 20% was caused by absenteeism resulting in a missed pretest or posttest. Regarding participant ethnicity 52% were white, 16% African American, 18% Hispanic, and 3% Asian. All grades showed diverse racial/ethnic representation. The intervention and

Discussion

The TFFK study provides data on the baseline level of knowledge and behavior relating to safety among a diverse elementary school population in San Diego County. The data shows that students at all grade levels lack some basic knowledge that would help them reduce their risk of injury, and that many students are engaging in unsafe behaviors that put them at high risk. Multivariate analysis shows that students receiving the TFFK intervention had significantly greater improvements in posttest

Conclusion

Children in grades 1, 2, and 3 often lack basic knowledge about safety and do not recognize behaviors considered high risk for injury. Defining baseline profiles of knowledge and recognition, which varied by race/ethnic group, will help one to become efficient in the use of prevention resources. The data shows that even in states that have implemented bicycle helmet laws and have high visibility water sports, such as California, there are new concepts provided in the TFFK curriculum that

Acknowledgements

We are indebted to the San Diego Unified and Santee School Districts for the staff time and willingness to participate in this study. We would also like to thank the National Think First Foundation for its support.

References (36)

  • D.P. Losh
  • D.S. Main et al.

    Preventing HIV infection among adolescents: Evaluation of a school-based education program

    Preventive Medicine

    (1994)
  • E. Schall

    School-based health education: What works

    American Journal of Preventive Medicine

    (1994)
  • A. Bandura

    Social learning theory

    (1977)
  • A. Bandura

    Model of causality in social learning theory

  • California Department of Health Services

    From vision to intervention: A strategic plan to prevent disabilities in California

    (1997)
  • California Department of Health Services

    Strategic plan for injury prevention and control in California

    (1997)
  • D.B. Connell et al.

    The impact of instructional experience and the effects of curriculum instruction

    Journal of School Health

    (1985)
  • EPIC Proportions

    Injury among California's children and adolescents: Who's at risk?

    (1997)
  • A.C. Gielen

    Health education and injury control: Integrating approaches

    Health Education Quarterly

    (1992)
  • J.A. Grunbaum et al.

    Characteristics of health education among secondary schools: School health profiles 1996

    Morbidity and Mortality Weekly Report

    (1998)
  • Institute of Medicine

    Schools and health: Our nation's investment

    (1997)
  • E.G. Krug et al.

    The impact of an elementary school-based violence prevention program on visits to the school nurse

    American Journal of Preventive Medicine

    (1997)
  • A.T. Lavin et al.

    Creating an agenda for school-based health promotion: A review of 25 selected reports

    Journal of School Health

    (1992)
  • K.Y. Lian et al.

    Longitudinal data analysis using generalized linear models

    Biometrika

    (1986)
  • K.D. Liller et al.

    The more health bicycle safety project

    Journal of School Health

    (1995)
  • National Center for Injury Prevention and Control

    Leading Causes of Death, U.S

  • National Center for Injury Prevention and Control

    Unintentional injury prevention fact sheet on childhood injury

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    *

    Address reprint requests to Dorothy L. Zirkle, RN, MSN, Sharp HealthCare/Grossmont Hospital, 5555 Grossmont Center Drive, La Mesa, CA 91942. E-Mail: [email protected]

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