@文章{信息:doi/10.2196/13519，作者=“宁、裴山、程、裴霞、施韦贝尔、David C、杨、杨、余、仁和、邓、静、李、舒坤、胡国清”，标题=“基于app的护理人员干预预防学龄前儿童意外伤害:群随机对照试验”，期刊=“JMIR Mhealth Uhealth”，年=“2019”，月=“8”，日=“09”，卷=“7”，号=“8”，页=“e13519”，关键词=“意外伤害;学龄前儿童;聚类随机对照试验;应用程序;移动健康;背景:在预防资源有限的国家，基于应用程序的干预措施有可能减少儿童伤害，但其有效性尚未得到严格审查。目的:本研究旨在评估基于app的学龄前儿童照顾者预防中国学龄前儿童意外伤害的干预效果。方法:于2017年12月至2018年6月进行为期6个月的整群随机对照试验。招募通过幼儿园进行，随机分为对照组(即基于app的育儿教育，不包括意外伤害预防)和干预组(即基于app的育儿教育，包括意外伤害预防)。通过学校线下招募长沙市20所幼儿园3-6岁幼儿保育员2920人。 The primary outcome was unintentional injury incidences among preschoolers in the past 3 months; this measure was assessed through an online caregiver-report at the baseline visit and at 3-month and 6-month follow-up visits. Secondary outcome measures included caregivers' self-reported attitudes and behaviors concerning child supervision during the last week. Generalized estimating equations (GEEs) were used to assess the effectiveness of the app-based intervention on responses at 3 and 6 months after adjusting for sociodemographic variables, baseline level of the outcome variable, and engagement with interventions in the assigned group. All analyses were intention-to-treat. A per-protocol sensitivity analysis was also conducted. Results: In total, 1980 of the 2920 caregivers completed the study. The mean age of participants was 32.0 years (SD 5.5) and 68.99{\%} (1366/1980) of them were female. During the 6-month follow-up visit, unintentional injury incidence did not change significantly in either group: incidence in the intervention group went from 8.76{\%} (94/1073) to 8.11{\%} (87/1073), P=.59; incidence in the control group went from 9.4{\%} (85/907) to 7.5{\%} (69/907), P=.15. The changes did not differ between the groups (odds ratio [OR] 1.14, 95{\%} CI 0.80-1.62). Changes in the average score in attitude concerning unintentional injury prevention were also similar between the groups (B .05, 95{\%} CI -0.03 to 0.13). Changes in unintentional injury prevention behaviors were greater in the intervention group than in the control group after the intervention (B .87, 95{\%} CI 0.33-1.42). Analyses of individual injury prevention behaviors showed that the intervention reduced three risky behaviors: unsafe feeding of children (OR 0.73, 95{\%} CI 0.60-0.89); incorrectly placing children in cars (OR 0.73, 95{\%} CI 0.57-0.93); and allowing children to ride bicycles, electric bicycles, or motorcycles unsupervised (OR 0.80, 95{\%} CI 0.64-0.99). The intervention also improved scores on three safety-focused behaviors: testing water temperature before giving children a bath (OR 1.26, 95{\%} CI 1.05-1.52); properly storing sharp objects (OR 1.24, 95{\%} CI 1.01-1.52); and safely storing medicines, detergents, and pesticides (OR 1.24, 95{\%} CI 1.02-1.51). Conclusions: The app-based intervention did not reduce unintentional injury incidence among preschoolers but significantly improved caregivers' safety behaviors. This app-based intervention approach to improve caregiver behaviors surrounding child injury risk offers promise to be modified and ultimately disseminated broadly. Trial Registration: Chinese Clinical Trial Registry ChiCTR-IOR-17010438; http://www.chictr.org.cn/showproj.aspx?proj=17376 (Archived by WebCite at http://www.webcitation.org/75jt17X84) International Registered Report Identifier (IRRID): RR2-10.1186/s12889-018-5790-1 ", issn="2291-5222", doi="10.2196/13519", url="https://mhealth.www.mybigtv.com/2019/8/e13519/", url="https://doi.org/10.2196/13519", url="http://www.ncbi.nlm.nih.gov/pubmed/31400105" }