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Keeping children safe at home: protocol for three matched case–control studies of modifiable risk factors for falls
  1. Denise Kendrick1,
  2. Asiya Maula1,
  3. Jane Stewart2,
  4. Rose Clacy1,
  5. Frank Coffey3,
  6. Nicola Cooper4,
  7. Carol Coupland1,
  8. Mike Hayes5,
  9. Elaine McColl6,
  10. Richard Reading7,
  11. Alex Sutton4,
  12. Elizabeth M L Towner8,
  13. Michael Craig Watson9,
  14. on behalf of the Keeping Children Safe Study Group*
  1. 1Division of Primary Care, Tower Building, University Park, Nottingham, UK
  2. 2Nottinghamshire Healthcare NHS Trust, Nottingham, UK
  3. 3Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
  4. 4Department of Health Sciences, University of Leicester, Leicester, UK
  5. 5Child Accident Prevention Trust, Child Accident Prevention Trust, London, UK
  6. 6Newcastle Clinical Trials Unit, The Medical School, Newcastle University, Newcastle upon Tyne, UK
  7. 7Norfolk and Norwich University Hospital, Colney Lane, Norwich, UK
  8. 8Centre for Child and Adolescent Health, University of the West of England, Bristol, UK
  9. 9School of Nursing, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
  1. Correspondence to Dr Asiya Maula, Division of Primary Care, Tower Building, University Park, Nottingham NG7 2RD, UK; asiya.maula{at}


Background Childhood falls result in considerable morbidity, mortality and health service use. Despite this, little evidence exists on protective factors or effective falls prevention interventions in young children.

Objectives To estimate ORs for three types of medically attended fall injuries in young children in relation to safety equipment, safety behaviours and hazard reduction and explore differential effects by child and family factors and injury severity.

Design Three multicentre case–control studies in UK hospitals with validation of parental reported exposures using home observations. Cases are aged 0–4 years with a medically attended fall injury occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression to adjust for potential confounding variables. Unmatched analyses will use unconditional logistic regression, adjusted for age, sex, deprivation and distance from hospital in addition to other confounders. Each study requires 496 cases and 1984 controls to detect an OR of 0.7, with 80% power, 5% significance level, a correlation between cases and controls of 0.1 and a range of exposure prevalences.

Main outcome measures Falls on stairs, on one level and from furniture.

Discussion As the largest in the field to date, these case control studies will adjust for potential confounders, validate measures of exposure and investigate modifiable risk factors for specific falls injury mechanisms. Findings should enhance the evidence base for falls prevention for young children.

  • Falls
  • case-control study
  • risk factors

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  • * The Keeping Children Safe Study Group is listed in appendix 1.

  • Funding This project is funded by a National Institute for Health Research (NIHR) programme grant RP-PG-0407-10231.

  • Disclaimer This paper presents independent research commissioned by the National Institute for Health Research (NIHR) under its Programme Grants for Applied Research funding scheme (RP-PG-0407-10231). The views expressed in this paper are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by Nottingham 1 Ethics Committee - R/N - 09/H0407/14.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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