Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial

Introduction Previous interactive education interventions for child injury prevention are suboptimal for implementation in rural areas. This study evaluated the effectiveness of a standardised school-based interactive education intervention to prevent unintentional injury for rural preschoolers.Meth...

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Main Authors: Jie Li, Guoqing Hu, David C Schwebel, Min Zhao, Peishan Ning, Wanhui Wang, Jieyi He, Weiqiang Li
Format: Article
Language:English
Published: BMJ Publishing Group 2025-07-01
Series:BMJ Global Health
Online Access:https://gh.bmj.com/content/10/7/e019050.full
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author Jie Li
Guoqing Hu
David C Schwebel
Min Zhao
Peishan Ning
Wanhui Wang
Jieyi He
Weiqiang Li
author_facet Jie Li
Guoqing Hu
David C Schwebel
Min Zhao
Peishan Ning
Wanhui Wang
Jieyi He
Weiqiang Li
author_sort Jie Li
collection DOAJ
description Introduction Previous interactive education interventions for child injury prevention are suboptimal for implementation in rural areas. This study evaluated the effectiveness of a standardised school-based interactive education intervention to prevent unintentional injury for rural preschoolers.Methods A 9-month single-blinded cluster randomised controlled trial was conducted in rural China, involving 12 preschools with 2518 preschoolers aged 3–6 years old. The control group received routine education, and the intervention group added the standardised Safety Experience Room intervention. The primary outcome was unintentional injury incidence rate among preschoolers during the 9-month period. The secondary outcome was the proportion of preschoolers correctly answering questions about the prevention knowledge of road traffic injury, falls and drowning. Principal data analyses were conducted using an intention-to-treat approach. Adjusted ORs (aORs) with 95% CIs were calculated based on generalised linear mixed models and bootstrapped SEs with 1000 replications. Sensitivity analyses were employed based on the full analysis set to assess the impact of missing values on principal findings.Results Compared with the control group, the intervention group had a significantly lower unintentional injury incidence rate (aOR=0.78, 95% CI: 0.64 to 0.94) and higher proportions of correct answers to the 18 injury prevention questions (with aORs ranging from 1.78 to 22.10) after adjusting for socio-demographic factors and baseline values of the outcome variables. Sensitivity analyses supported the principal findings.Conclusion The 9-month interactive intervention decreased unintentional injury incidence and substantially increased preschooler’s safety knowledge in rural China, offering an effective option for implementing or integrating in multifactorial interventions in resource-limited areas.Trial registration number Chinese Clinical Trial Registry, CHiCTR2000038025.
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spelling doaj-art-cff5fa55da5c407c8b6d47a6bb046e012025-08-20T03:17:40ZengBMJ Publishing GroupBMJ Global Health2059-79082025-07-0110710.1136/bmjgh-2025-019050Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trialJie Li0Guoqing Hu1David C Schwebel2Min Zhao3Peishan Ning4Wanhui Wang5Jieyi He6Weiqiang Li7Department of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, ChinaDepartment of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, ChinaDepartment of Psychology, The University of Alabama at Birmingham, Birmingham, Alabama, USADepartment of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, ChinaDepartment of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, ChinaDepartment of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, ChinaClinical Trials Center, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou, ChinaDepartment of Epidemiology and Health Statistics, Hunan Provincial Key Laboratory of Clinical Epidemiology, Xiangya School of Public Health, Central South University, Changsha, Hunan, ChinaIntroduction Previous interactive education interventions for child injury prevention are suboptimal for implementation in rural areas. This study evaluated the effectiveness of a standardised school-based interactive education intervention to prevent unintentional injury for rural preschoolers.Methods A 9-month single-blinded cluster randomised controlled trial was conducted in rural China, involving 12 preschools with 2518 preschoolers aged 3–6 years old. The control group received routine education, and the intervention group added the standardised Safety Experience Room intervention. The primary outcome was unintentional injury incidence rate among preschoolers during the 9-month period. The secondary outcome was the proportion of preschoolers correctly answering questions about the prevention knowledge of road traffic injury, falls and drowning. Principal data analyses were conducted using an intention-to-treat approach. Adjusted ORs (aORs) with 95% CIs were calculated based on generalised linear mixed models and bootstrapped SEs with 1000 replications. Sensitivity analyses were employed based on the full analysis set to assess the impact of missing values on principal findings.Results Compared with the control group, the intervention group had a significantly lower unintentional injury incidence rate (aOR=0.78, 95% CI: 0.64 to 0.94) and higher proportions of correct answers to the 18 injury prevention questions (with aORs ranging from 1.78 to 22.10) after adjusting for socio-demographic factors and baseline values of the outcome variables. Sensitivity analyses supported the principal findings.Conclusion The 9-month interactive intervention decreased unintentional injury incidence and substantially increased preschooler’s safety knowledge in rural China, offering an effective option for implementing or integrating in multifactorial interventions in resource-limited areas.Trial registration number Chinese Clinical Trial Registry, CHiCTR2000038025.https://gh.bmj.com/content/10/7/e019050.full
spellingShingle Jie Li
Guoqing Hu
David C Schwebel
Min Zhao
Peishan Ning
Wanhui Wang
Jieyi He
Weiqiang Li
Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial
BMJ Global Health
title Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial
title_full Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial
title_fullStr Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial
title_full_unstemmed Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial
title_short Effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural China: a cluster randomised controlled trial
title_sort effectiveness of a standardised and interactive intervention to prevent preschooler unintentional injury in rural china a cluster randomised controlled trial
url https://gh.bmj.com/content/10/7/e019050.full
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