Objective To design and evaluate an intervention targeting urban indigenous Australian children in order to increase their self-efficacy, knowledge and attitudes towards safety.

Methods The Safe Koori Kids intervention was developed and delivered to 790 children primary school aged children (13% indigenous) in 24 middle and upper primary classes across five schools in Sydney, Australia. The intervention, consisting of five safety modules, was evaluated using a mixed-methods approach. A pre-test post-test research design was applied to evaluate changes in key outcomes namely child self-efficacy, knowledge and attitudes towards safety. Qualitative and quantitative data were collected from teachers.

Findings There was a significant increase (p<0.05) in self-efficacy among children from pre- to post-intervention for both Indigenous (6%) and non-Indigenous children (2%). Safety knowledge among Indigenous children increased from pre- to post intervention by 17% (p<0.01) and non-Indigenous children by 15%, (p<0.01). However, there were no significant improvements in attitudes towards safety (indigenous children 2%, p=0.288, non-Indigenous children 1%, p=0.0721). Overall, Indigenous children scored lower than non-Indigenous children post intervention on self-efficacy (75%:77%), knowledge (56%:63%) and attitudes towards safety (79%:84%). Teacher focus groups provided further evidence of the programs impact on children's safety knowledge and attitudes.

Conclusions The study contributes to our limited knowledge about effective child injury prevention for disadvantaged Indigenous minorities in high income countries. This is the first intervention of its type in an urban indigenous setting in Australia which has positively contributed to the resilience of indigenous children and families with respect to safety and their environment.