Identifying facilitators and barriers for home injury prevention interventions for pre-school children: A systematic review of the quantitative literature

Abstract

Injuries are the leading cause of childhood death internationally; steep social gradients exist in mortality and morbidity. The majority of pre-school injuries occur in the home, but implementing research into practice for injury prevention has received little attention. This review describes key facilitators and barriers when implementing injury prevention interventions by expanding the Cochrane systematic review of home safety education for injury prevention (Kendrick 2007). Papers included in the 2007 review, updated in 2009 using the same search and review strategy, were used. Each paper was screened to ensure that children under 5 years, intervention details, and process measures and/or barriers and facilitators were included. Two authors independently reviewed each paper and extracted data. Themes were identified and framework analysis used in an iterative process. 99 papers were identified, 42 excluded and 57 included in the analysis. Seven facilitators and six barriers were identified. Facilitators related to the approach used, focused messages, minimal changes, deliverer characteristics, equipment accessibility, behaviour change and including incentives. The barriers included complex interventions, cultural, socio-economic, physical and behavioural barriers, and deliverer constraints. Barriers and facilitators should be addressed when implementing injury prevention interventions and studies should explicitly explore factors that help or hinder the process.