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  1. A Gielen,
  2. E Mcdonald,
  3. L Mckenzie
  1. Johns Hopkins Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA


    Background Effective child injury prevention involves taking an ecological approach, intervening at multiple levels of influence. Efforts to change the behaviour of individual children and/or caregivers can be strengthened by addressing environmental influences on injury risk. How to change the behaviour of those who shape these environments is a critical question.

    Purpose To inform research and practice, we provide three case examples of promoting safer environments for children through behaviour change in other audiences—health care providers, manufacturers, and legislators.

    Methods Literature review

    Results (1) The SAFE Home Project changed the delivery of paediatric anticipatory guidance and increased the use of home safety products. Important to success were high levels of institutional support, collaboration among key stakeholders, and the use of behaviour change theory in programme content. (2) Following scald burn educational efforts and the use of warning labels, manufacturers voluntarily agreed to preset new water heaters at 120°F. Motivating this change was concern about variations in requirements across states, a significant burden for companies. (3) Why state legislators vote for injury prevention policies was the subject of one behavioural science study. Constructs from the Theory of Planned Behaviour predicted voting behaviour.

    Significance As the injury field has matured and there are success stories, it is important to understand how these changes occur at all levels of an ecological framework. Behavioural science theory and methods represents a largely untapped potential for both understanding how change occurs and facilitating it in individuals whose decisions affect the safety of entire populations.

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