Background Falls account for approximately 50% of infant injury hospitalizations, and caretaker behavior is central to preventing infant falls. Behavior theory–informed interventions for injury prevention have been suggested, but to date, few have been reported. The potential of using smartphones for injury prevention intervention delivery is also underexploited. Objective This study aims to develop a behavior theory– and evidence-based as well as user-centered digital intervention as a mobile app for parents to prevent infant falls following agile development practices. Methods Infant falls while feeding was selected as the fall mechanism to demonstrate the approach being taken to develop this intervention. In phase 1, the Behaviour Change Wheel was used as a theoretical framework supported by a literature review to define intervention components that were then implemented as a mobile app. In phase 2, after the person-based approach, user testing through think-aloud interviews and comprehension assessments were used to refine the content and implementation of the intervention. Results The target behaviors identified in phase 1 were adequate rest for the newborn’s mother and safe feeding practices defined as prepare, position, and place. From behavioral determinants and the Behaviour Change Wheel, the behavior change functions selected to achieve these target behaviors were psychological capability, social opportunity, and reflective motivation. The selected behavior change techniques aligned with these functions were providing information on health consequences, using a credible source, instruction on performing each behavior, and social support. The defined intervention was implemented in a draft Android app. In phase 2, 4 rounds of user testing were required to achieve the predefined target comprehension level. The results from the think-aloud interviews were used to refine the intervention content and app features. Overall, the results from phase 2 revealed that users found the information provided to be helpful. Features such as self-tracking and inclusion of the social and environmental aspects of falls prevention were liked by the participants. Important feedback for the successful implementation of the digital intervention was also obtained from the user testing. Conclusions To our knowledge, this is the first study to apply the Behaviour Change Wheel to develop a digital intervention for child injury prevention. This study provides a detailed example of evidence-based development of a behavior theory–informed mobile intervention for injury prevention refined using the person-based approach.
Background: Falls are the most common mechanism of hospitalised injury in children under 12 months and commonly result in traumatic brain injuries. Epidemiological studies exploring infant falls demonstrate the burden but lack the contextual information vital to the development of preventive interventions. The objective of this study was to examine contextual information for falls involving children under 12 months.Methods: Online parenting forums provide an unobtrusive rich data source for collecting detailed information about fall events. Relevant discussions related to fall incidents were identified and downloaded using site-specific google search queries and a programming script. A qualitative descriptive approach was used to analyse the incidents and categorise contextual information into ‘pre-cursor events’ and ‘influencing factors’ for infant falls.Results: 461 infant fall incidents were identified. Common fall mechanisms included: falls from furniture; falls when being carried or supported by someone; falls from baby products and falls on the same level. Across the spectrum of fall mechanisms, common precursor events were: infant rolling off; being alone on furniture; product misuse; caretaker falling asleep while holding the infant; and caretaker tripping/slipping while carrying the infant. Common influencing factors included: infant’s rapid motor development; lapses in caretaker attention; and trip hazards.Conclusions: The findings define targets for intervention to prevent infant falls and suggest the most viable intervention approach may be to target parental behaviour change. Online forums have provided rich information critical for preventive interventions aimed at changing behaviour.
Background Falls represent the most common mechanism of injury requiring hospitalization among children under 12 months, and they commonly result in traumatic brain injury. Epidemiological studies exploring infant falls demonstrate the experienced burden, but they lack contextual information vital to the development of preventive interventions. Objective The objective of this study was to examine contextual information for falls involving children under 12 months, using online parenting discussion forums. Methods Online parenting forums provide an unobtrusive rich data source for collecting detailed information about fall events. Relevant discussions related to fall incidents were identified and downloaded using site-specific Google Search queries and a programming script. A qualitative descriptive approach was used to analyze the incidents and categorize contextual information into “precursor events” and “influencing factors” for infant falls. Results We identified 461 infant fall incidents. Common fall mechanisms included falls from furniture, falls when being carried or supported by someone, falls from baby products, and falls on the same level. Across the spectrum of fall mechanisms, common precursor events were infant rolling off, infant being alone on furniture, product misuse, caretaker falling asleep while holding the infant, and caretaker tripping/slipping while carrying the infant. Common influencing factors were infant’s rapid motor development, lapses in caretaker attention, and trip hazards. Conclusions The findings define targets for interventions to prevent infant falls and suggest that the most viable intervention approach may be to target parental behavior change. Online forums can provide rich information critical for preventive interventions aimed at changing behavior.
BACKGROUND Falls are the most common mechanism of hospitalised injury in children under 12 months and commonly result in traumatic brain injuries. Epidemiological studies exploring infant falls demonstrate the burden but lack the contextual information vital to the development of preventive interventions. The objective of this study was to examine contextual information for falls involving children under 12 months. OBJECTIVE The objective of this study was to examine contextual information for falls involving children under 12 months using online parenting discussion forums. METHODS Online parenting forums provide an unobtrusive rich data source for collecting detailed information about fall events. Relevant discussions related to fall incidents were identified and downloaded using site-specific google search queries and a programming script. A qualitative descriptive approach was used to analyse the incidents and categorise contextual information into ‘pre-cursor events’ and ‘influencing factors’ for infant falls. RESULTS 461 infant fall incidents were identified. Common fall mechanisms included: falls from furniture; falls when being carried or supported by someone; falls from baby products and falls on the same level. Across the spectrum of fall mechanisms, common precursor events were: infant rolling off; being alone on furniture; product misuse; caretaker falling asleep while holding the infant; and caretaker tripping/slipping while carrying the infant. Common influencing factors included: infant’s rapid motor development; lapses in caretaker attention; and trip hazards. CONCLUSIONS The findings define targets for intervention to prevent infant falls and suggest the most viable intervention approach may be to target parental behaviour change. Online forums have provided rich information critical for preventive interventions aimed at changing behaviour.
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