Cumulative effect of risk and protective factors on unintentional injury for Chinese rural children: a nested case-control study

Abstract

Background Childhood unintentional injuries are the leading cause of death and disability for children. Despite the risk factors that lead to the occurrence of injuries have been identified, the relationship between cumulative effect of risk/protective factors and unintentional injuries is unclear. The aim of this study was to explore the cumulative effect of risk factors as well as protective factors and their interaction on unintentional injury to rural children. Methods We used a nested case-control study design from a cohort database. The study comprised 1696 children aged 6 to 14 years. Among them, 424 were cases with unintentional injury and 1272 were their matched control. After controlling for the significant sociodemographic variables, linear and logistic regression analyses were performed. Results The risk of unintentional injury increased with the increasing number of risk factors - RFI from 1 to 3 (ORRFI(1) = 0.978, 95% CI 0.739–1.296), (ORRFI(2) = 1.720, 95% CI 1.233–2.397), (ORRFI(3) = 5.162, 95% CI 3.129–8.517). PFI (1) was associated with lower risk of injury, but this association was at the edge of significance (p = 0.052). The increased risk in those with PFI (2) was not significant (p = 0.254). The severity of the unintentional injury significantly increased with the increasing number of the risk factors (p < 0.01), and significantly decreased with both the increasing number of protective factors (p = 0.001) and interaction of the risk and protective factors (p < 0.01).The interaction of RFI and PFI could explain 32.2% of the unintentional injury severity. Conclusions According to the findings of the present study, cumulative risk factors and protective factors, as well as their interaction were associated with the occurrence and/ or severity of unintentional injury in children.

Determination of risk factors associated with unintentional injury in children: Case‐control study

“…Some descriptive and cross‐sectional studies (Aydoğdu et al., 2019; Elmas et al., 2020; Gündüz & Aytekin, 2015) reported similar or different mean scale scores compared to the results of the study. One study reported a difference between the case and control groups in terms of mothers' knowledge, attitudes and skills toward unintentional injuries and reported that mothers in the control group had more protective attitudes (Zhang et al., 2021). This finding does not coincide with the findings in the literature, which may be attributed to the difference in the sample or the research design.…”

“…Children from disadvantaged backgrounds are more likely to experience unintentional injuries and die (Campbell et al., 2019; Henery et al., 2021). Children with malnutrition and chronic diseases are more susceptible to the negative consequences of these injuries (Zambon & Loring, 2014). In addition, children with disabilities have a high risk of unintentional injury due to their individual abilities and behaviors (Shi et al., 2015).…”

“…Determining the risk factors for childhood unintentional injury is important to reduce mortality and morbidity rates (İnce et al., 2014). The rate of having an unintentional injury is approximately five times higher in children with three or more risk factors compared to those with one risk factor (Zhang et al., 2021). There is a strong correlation between socioeconomic status, the age and development of the child, and unintentional injuries (Hyder et al., 2009).…”

“…Despite the studies (Campbell et al., 2019; Henery et al., 2021; Shi et al., 2015) and prevention efforts, injuries continue to affect children, and mortality and morbidity rates are high. In addition, there are a limited number of case‐control studies (Ghebreab et al., 2021; Zhang et al., 2021) conducted to determine the risk factors and maternal attitudes associated with unintentional injuries in children. This study may contribute to a better understanding of the risk factors associated with unintentional injuries in children and to take precautions against them.…”

Risk factors of in-home unintentional injuries among 0-6-year-old children in Changsha city of China: a cross-sectional survey based on Bronfenbrenner’s ecological system theory

“…In addition, the combined effects of different factors on the IUIs occurrence had been observed. Zhou [ 18 ] and Zhang [ 19 ] have reported that higher levels of parental knowledge, attitudes and kills on supervising predicted lower injury risks when children were engaging in unusual behavior. Other studies [ 20 , 21 ] on child injuries in farms have found that disquieting behavior for children aged 0 ~ 6 was more likely to lead to injury in high-risk environments.…”