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Injury prevention training: a cluster randomised controlled trial assessing its effect on the knowledge, attitudes, and practices of midwives and health visitors
  1. A Woods1,
  2. J Collier2,
  3. D Kendrick1,
  4. K Watts3,
  5. M Dewey4,
  6. R Illingworth1
  1. 1Division of Primary Care, University of Nottingham
  2. 2Division of Child Health, University of Nottingham
  3. 3Division of Midwifery, University of Nottingham
  4. 4Trent Institute for Health Services Research, University of Nottingham
  1. Correspondence to:
 Amanda Woods
 Division of Primary Care, 1401 Tower Building, University Park, Nottingham NG7 2RD, UK;


Objective: To evaluate the effectiveness of injury prevention training.

Design: Cluster randomised controlled trial.

Setting: Primary care facilities in the East Midlands area of the United Kingdom.

Subjects: Midwives and health visitors.

Intervention: Evidence based training session on the risks associated with baby walkers.

Main outcome measures: The primary outcome measures were knowledge of baby walker use and walker related injury, attitudes towards walkers and towards walker education, and practices relating to walker health education.

Results: Trained midwives and health visitors had greater knowledge of the risks associated with baby walkers than untrained midwives and health visitors (difference between the means 0.22; 95% confidence interval (CI) 0.12 to 0.33). Trained health visitors had more negative attitudes to baby walkers (difference between the means 0.35; 95% CI 0.10 to 0.59) and more positive attitudes towards baby walker health education (difference between the means 0.31; 95% CI 0.00 to 0.62) than untrained health visitors. Midwives who had been trained were more likely to discuss baby walkers in the antenatal period than those who were not trained (odds ratio 9.92; 95% CI 2.02 to 48.83).

Conclusions: Injury prevention training was associated with increased knowledge, more negative attitudes towards walkers, and more positive attitudes towards walker education. Trained midwives were more likely to give advice antenatally. Training did not impact on other practices. Larger trials are required to assess the impact of training on parental safety behaviours, the adoption of safety practices, and injury reduction.

  • training effectiveness
  • midwives
  • health visitors
  • knowledge
  • attitudes
  • practice
  • baby walkers

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