Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial

OBJECTIVE: To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries. METHODS: This cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5–7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months. RESULTS: Unintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405–0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001). CONCLUSION: School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.