Health and safety gone...scientific

Child with broken leg
The reason we became interested in this topic in the first place was because there was very little in the way of aggregate evidence to show whether or not these interventions were effective. We want to find out whether injury-prevention programmes represent a good area for investment.
Dr Elizabeth Orton
Researchers from the University of Nottingham will help local councils and clinical commissioning groups to make smarter investments by examining the efficacy of injury prevention programmes in schools. Educators in the United Kingdom spend a lot of time and money teaching pupils the value of health and safety, but in today’s economic climate, funding for such schemes is tighter than ever before. By investigating the extent to which these programmes are effective, the Nottingham-based team hopes to help policymakers to allocate financial resources in the wisest possible manner.

Injury prevention education programmes that aim to help children keep themselves and others safe are commonplace within UK schools, yet there has never been a comprehensive study into whether these interventions actually work. In light of this, the researchers will conduct a large-scale, systematic review of smaller studies that have been conducted, in order to find out whether school-based, injury-prevention education results in fewer visits to emergency departments.

In an interview with ScienceOmega.com, Dr Elizabeth Orton from the University’s Division of Primary Care explained why this study is likely to benefit children and cash-strapped local authorities alike. I began by asking how Dr Orton and her colleagues intend to test the efficacy of injury-prevention programmes.

"As we’ll be conducting a Cochrane Review, we won’t be doing any original research as such," she replied. "We’re not going to be collecting any data ourselves. Instead, we’ll be looking at studies that have already taken place and we’ll be compiling their results. There are inclusion and exclusion criteria for the types of study that we are interested in. We want to investigate research concerning injury-prevention education within school settings; where teachers or health and safety professionals have delivered the intervention. If a programme has been delivered at Cubs and Brownies, for example, it will not qualify for our study.

"We will use these studies to pool together relevant data," Dr Orton continued. "Data concerning things like injury-reduction levels or children’s knowledge of injury prevention before and after an intervention will be of greatest interest. Collecting data in this manner will allow us to make recommendations such as, ‘If an intervention is delivered in a primary school over this sort of time period, and it includes these elements, it is likely to reduce injuries in children or at least improve their knowledge of injury prevention’. The recommendations that we will be able to make will really depend on the kinds of study that are uncovered by our literature searches. Hopefully, we will collect a sufficient amount of data to conduct a meta-analysis. If we don’t, we can still describe the aspects of the different interventions that seem to be the most promising."

I went on to ask Dr Orton whether she knew how many pieces of related research her upcoming literature searches were likely to uncover. As she explained, whilst she and her colleagues have made approximations, the ultimate number could vary significantly.

"There haven’t really been any other systematic reviews carried out in the field of school-based, injury-prevention education," she said. "The reason we became interested in this topic in the first place was because there was very little in the way of aggregate evidence to show whether or not these interventions were effective. We want to find out whether injury-prevention programmes represent a good area for investment. I can’t yet say with any certainty how many smaller studies we’ll be able to pull together. It could be in the order of 10 to 15, or it could be in the order of 100. Our team has a lot of experience working in injury prevention, and there seems to be a gut feeling that we will probably find around 20 to 30 suitable examples. Of course, we won’t know for sure until we’ve completed our search."

Obviously, any indication of the efficacy of injury-prevention education will be welcomed by local authorities. In the year 2009/10, over 135,000 children were admitted to hospital following an injury in England alone.1 My final question to Dr Orton concerned the ways in which the findings of her study are likely to assist policymakers.

"This is a really important question and it’s very timely," she replied. "The public health function has moved away from primary care trusts – which are now being dissolved – into the hands of local authorities. The Public Health Outcomes Framework is one of the ways in which the government is trying to guide best practice in this area. One of the measures used to ensure that local authorities are paying attention to this Framework is the number of children admitted to hospital because of accidents. Our systematic review will judge the efficacy of injury-prevention education in schools. Based on our findings, we will either advise local authorities to continue to spend money on these interventions, or we will suggest that they look into alternative methods of injury prevention.

"The short-term purpose of the Cochrane Review is to help the commissioners responsible for buying these health services to make better choices," Dr Orton concluded. "In the long term, these choices will feed through and begin to benefit children."


1 Latest figures from the South West Public Health Observatory

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