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Using change theory to elucidate complexities in child safety
  1. JC Simpson1,
  2. R McGee2,
  3. G Fougere3
  1. 1Injury Prevention Research Unit, University of Otago, Dunedin, New Zealand
  2. 2Preventive & Social Medicine, University of Otago, Dunedin, New Zealand
  3. 3Public Health, University of Otago, Wellington, New Zealand

    Abstract

    Background As a rich nation, New Zealand ranks poorly for child safety. Despite proven interventions reducing specific causes of unintentional injury, serious events occur and in the home environment, many young children experience injuries for which there is no proven intervention. From a health promotion perspective, lack of progress often indicates complexity, so obtaining insights into dynamic environments, such as the home, to improve design and delivery of initiatives for children safety becomes crucial.

    Aims To understand influences on parents' perceptions of, and responses to, injury risk, from the perspective of experienced practitioners, and analyse emergent themes utilising a theory of change.

    Methods Using an interpretive methodology, experiences, perceptions and beliefs of parents and community professionals working with young families were examined. ‘Downstream’ and ‘upstream’ influences were qualitatively identified. This presentation reports on the downstream aspects explored using Bandura's Social Cognitive Theory.

    Results Influences identified were complex and interactive. The dynamic nature of the home environment was an underlying theme affecting the implementation and effectiveness of interventions. Some influences are well-recognised (knowledge of child development and safety strategies, and supervision style) while others are discussed rarely (parental fatigue). Bandura's Social Cognitive Theory proved a ‘good fit’, and in particular, the concepts of reciprocal determinism, observational learning, expectations and emotional coping provide new insights.

    Contribution to the Field Child safety strategies often require social and behavioural changes. This study identified influences that affect managing child safety in a dynamic environment that can be used to develop effective strategies for child safety.

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