Injuries are the leading health problem of children in this nation, responsible for more loss of life than the next nine causes of death. Children less than four years of age are at greatest risk. Yet there is a dearth of research on the process by which injury occurs. Only a small handful of studies have explored how parents attempt to socialize injury prevention in young children--these studies reveal that parents with toddlers intervene to prevent injury more often than for any other reason. However, literally nothing is known about what elicits these prevention attempts or how successful they are. Using techniques developed in the investigators' previous work on participant event monitoring of injury, the present proposal seeks to establish a developmentally rich data set. Such data would describe the situations under which injuries occur and steps parents take to prevent further injuries. Drawing from a conceptual model the investigators recently proposed, derived from epidemiological injury data, the project will examine relevant factors that have been shown to influence injury risk in an attempt to elucidate some of the behavioral mechanisms that underlie injury. Instead of the molar concepts suggested by past studies, however, the investigators have selected specific maternal and child variables that could be the focus for preventive intervention in the future. Both background (stable) and situational (fluctuating) factors will be considered, initial analyses will provide answers to basic and vital questions regarding common elicitors of intervention, patterns of injury and near injury, consequences evoked by parents, and effectiveness of safety rules. Structural equation modeling will examine between family patterns and hierarchical linear modeling will be used to explore both between and within family patterns. Simulations will also be used to hold situational factors constant across families to allow more sensitive examination of the role of background variables. The investigators' work, as well as pilot recruitment with the proposed population, documents the feasibility of this proposal; 13 published studies from the initial funding period suggest the importance and utility of the proposed findings. The proposed studies would offer the first scientific study of the environmental, parental and child-based variables that predict minor injury in childhood.
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