基于app的护理人员预防学龄前儿童意外伤害的干预研究卡塔尔世界杯8强波胆分析聚类随机对照试验%A Ning， % Peishan %A Cheng，培霞%A Schwebel,David C %A Yang,Yang %A Yu,Renhe %A Deng,Jing %A Li,Shukun %A Hu,Guoqing %+中南大学湘雅公共卫生学院流行病学与卫生统计学系，长沙，410078，湘雅路110号，86 731 84805414huguoqing009@gmail.com %K意外伤害%K学龄前儿童%K集群随机对照试验%K应用程序%K移动健康%K干预%D 2019 %7 09.08.2019 %9原文Mhealth Uhealth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检验。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。主要结局是过去3个月内学龄前儿童的意外伤害发生率;这项措施是通过基线访问和3个月和6个月随访时的在线护理人员报告来评估的。次要结果测量包括照顾者自我报告的上周对儿童监督的态度和行为。 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 %M 31400105 %R 10.2196/13519 %U https://mhealth.www.mybigtv.com/2019/8/e13519/ %U https://doi.org/10.2196/13519 %U http://www.ncbi.nlm.nih.gov/pubmed/31400105