Community-based interventions for the prevention of burns and scalds in children: Cochrane systematic review
Assessed as up to date: 2007/07/19
Burns and scalds are a significant cause of morbidity and mortality in children. Successful counter-measures to prevent burn and scald-related injury have been identified. However, evidence indicating the successful roll-out of these counter-measures into the wider community is lacking. Community-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to burn and scald injury in children.Objectives
To assess the effects of community-based interventions, defined as coordinated, multi-strategy initiatives, for reducing burns and scalds in children aged 14 years and under.Search methods
We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, National Research Register and the Web of Knowledge. We also handsearched selected journals and checked the reference lists of selected publications. The searches were last updated in May 2007.Selection criteria
Included studies were those that reported changes in medically attended burn and scald-related injury rates in a paediatric population (aged 14 years and under), following the implementation of a controlled community-based intervention.Data collection and analysis
Two authors independently assess studies for eligibility and extracted data. Due to heterogeneity between the included studies, a pooled analysis was not appropriate.Main results
Of 39 identified studies, four met the criteria for inclusion. Two of the included studies reported a significant decrease in paediatric burn and scald injury in the intervention compared with the control communities. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities.Authors' conclusions
There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children.
It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.
Turner Cathy, Spinks Anneliese, McClure Roderick J, Nixon Jim
Insufficient evidence so far to support the community approach to burns and scalds prevention
Multi-strategy, community-based interventions are widely promoted for reducing injury rates. The efficacy of this approach is difficult to assess and there have been few research studies of good quality. The current review sought to review studies evaluating the success of community-based programmes specifically intended to reduce burn and scald injury in children. Only four studies were identified that met the inclusion criteria and two of these found a reduction in rates of burns and scalding. More high-quality research studies are needed in this area, therefore, to support the continued use of the community approach.
Implications for practice
There is a paucity of research studies in the literature from which practitioners can draw an evidence-base regarding the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a need for practitioners to implement high-quality community-based intervention programmes, based on what research has shown to be efficacious counter-measures to reduce burns and scalds in children in research settings.
Implications for research
There is a clear need to direct future research on developing the evidence from a variety of community contexts to achieve population level improvements in burns/scalds injury outcomes. Comprehensive and methodologically rigorous evaluations that include quality measure of injury outcomes and a contemporary community control as part of the study design should be expected of any new programmes undertaken. It is important that a framework for considering the problem of burns and scalds in children be articulated from a prevention perspective. Also, an evidence-based suite of interventions should be combined to create programme guidelines suitable for implementation (with local adaptations) in communities throughout the world.Get full text at The Cochrane Library
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