Burn education intervention: a controlled study

Systematically developed health education should be based on a thorough knowledge of the determinants of the behavioural risk factors. Compared to other health-related behaviours, safety behaviour has some specific characteristics, which complicate studying its determinants. First, there is a multitude of circumstances leading to injuries, which means that it is not possible to pinpoint one desired behaviour to be linked with the prevention of injuries. Secondly, people are often not familiar with (the advantages and disadvantages of) all the possible preventive measures. Thirdly, the usefulness of preventive measures may depend on housing situations. So far, no elegant way of coping with these problems in examining the determinants of safety behaviour seems to have been suggested in the literature. In this article an approach to the study of determinants of safety behaviour is presented. The general description of this approach is illustrated by a study on the determinants of the behavioural risk factors for burn injuries in young children, which was conducted among Dutch and Turkish parents of children aged 0–4 years. The results indicate, for instance, that parents who implemented the safety behaviour reported that safety behaviour had become habitual to them.

Traditionally, burn prevention efforts have been directed at public education and numerous burn prevention campaigns have been undertaken during the past 30 years. How successful have these campaigns been? Contrary to burn mortality, statistical data on burn morbidity are extremely difficult to obtain because little national or international data is available. An analysis of the absolute death rates caused by fire and flames for various countries from 1975 through 1986 seems to indicate that world-wide burn mortality has not decreased. On the contrary, in many countries the rates have increased, whereas in countries like the USA, UK, France and FR Germany, the decrease has been disappointingly low. Furthermore, one wonders if the decrease in mortality rates experienced by these countries is the result of effective prevention programmes or if these could be attributed to advances in technology and improved medical care. Burn prevention campaigns aimed at public education have failed to provide the expected decrease in burn injuries. Education may increase knowledge but does not necessarily lead to behavioural and/or lifestyle change. A restructuring of our burn prevention programmes is needed. Modern techniques of motivational theory must be used to promote public concern and action for individual behaviour change, pertinent legislation and product safety.