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Interventions to change parental parenting behaviour to reduce unintentional childhood injury: a randomised controlled trial
  1. Tomoki Kawahara1,
  2. Satomi Doi1,2,
  3. Aya Isumi1,2,
  4. Manami Ochi1,3,
  5. Takeo Fujiwara1,4
  1. 1 Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan
  2. 2 Japan Society for the Promotion of Science, Chiyoda-ku, Tokyo, Japan
  3. 3 Department of Health and Welfare Services, National Institute of Public Health, Wako, Japan
  4. 4 Department of Social Medicine, National Center for Child Health and Development, Setagaya-ku, Japan
  1. Correspondence to Dr Takeo Fujiwara, Department of Global Health Promotion, Tokyo Medical and Dental University, Bunkyo-ku 113-8510, Tokyo, Japan; fujiwara.hlth{at}


Objective The previous study has shown the impact of paternal involvement in childcare on unintentional childhood injury; yet the causality is unknown. The purpose of this study is to investigate whether the intervention of an educational video on paternal involvement in childcare can prevent unintentional injury among young children.

Methods A randomised controlled trial of parents of children born at two obstetrics wards in Japan (n=451, intervention group: 223, control group: 228) was conducted. Parents in the intervention group watched an educational video that promote paternal involvement in childcare, while parents in the control group watched an educational video on the prevention of shaken baby syndrome. The participants were followed for up to 18 months after the birth of their child. The primary outcome of this study was unintentional injury at 3, 6, 12 and 18 months. The secondary outcome was paternal involvement in childcare based on maternal observation. Unintentional injury-free rates over time were assessed using the Cox proportional hazard model.

Results Children in the intervention group were less likely to have unintentional injury, such as burn (HR: 0.29 (95% CI: 0.09 to 0.87)) and caught by a door (HR: 0.66 (95% CI: 0.48 to 0.91)) compared with the control group. Fathers in the intervention group showed higher frequency of taking their children for a walk (coefficient: 0.19 (95% CI: 0.05 to 0.32)).

Conclusions Educational videos promoting paternal involvement in childcare is effective to prevent unintentional childhood injury.

  • behavior change
  • education
  • health education
  • public health
  • burn
  • drowning

Data availability statement

No data are available.

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  • Contributors TF conceptualised and designed the study, TK drafted the initial manuscript, and TF reviewed and revised the manuscript. SD, AI and MO coordinated and supervised data collection, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work. TF is responsible for the overall content as guarantor. TF accepts full responsibility for the finished work and the conduct of the study, had access to the data, and controlled the decision to publish.

  • Funding This study was supported by Grants-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS KAKENHI Grant Number15K12735), the Mitsubishi Foundation, Grants for Social Welfare Activities (121000012101X2564), a Research Development Grant for Child Health and Development from the National Center for Child Health and Development (25-13), and the Ministry of Health, Labour and Welfare (21DA1004 and 19AA100).

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.