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Injury Prevention Anticipatory Guidance by Patient Age Group

Published:January 19, 2023DOI:https://doi.org/10.1016/j.acap.2023.01.008

      Objective

      Unintentional injuries remain a leading cause of death for children and adolescents older than 1 year. Injury prevention has long been a cornerstone of anticipatory guidance. Previous studies have established the sustained efficacy of injury prevention anticipatory guidance in pediatric primary care. This study examines the topical emphasis of injury prevention anticipatory guidance by patient age, with special attention given to the rate of water safety anticipatory guidance across four patient age groups.

      Methods

      A nationwide, random sample of AAP member pediatricians were surveyed on their experiences, attitudes, and practices related to injury prevention anticipatory guidance, including barriers to delivering anticipatory guidance.

      Results

      Of the respondents who reported providing direct patient care, 92% considered injury prevention anticipatory guidance a priority issue. The content of that injury prevention guidance varied considerably by patient age. Roughly half (53%) reported counseling families with adolescents on water safety/drowning prevention, which represents a statistically significant decrease relative to other patient age groups.

      Conclusions

      Reported injury prevention anticipatory guidance is high across different mechanisms of injury. However, fewer pediatricians deliver drowning prevention anticipatory guidance to adolescents than to younger patients. Targeted outreach and education to increase injury prevention anticipatory guidance, especially for adolescent patients, should be part of a multi-pronged approach to decrease drowning and other injury deaths.
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      References

      1. Centers for Disease Control and Prevention, National Centers for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS). Leading Causes of Death Reports, 1981-2020. Accessed March 2022. [https://wisqars.cdc.gov/fatal-leading].

        • Bass JL
        • Christoffel KK
        • Widome M
        • et al.
        Childhood injury prevention counseling in primary care settings: a critical review of the literature, 1993.
        Pediatrics. 1993; 92: 544-550https://doi.org/10.1542/peds.92.4.544
        • Barkin SL
        • Finch SA
        • Ip EH
        • et al.
        Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial.
        Pediatrics. 2008; 122: e15-e25https://doi.org/10.1542/peds.2007-2611
        • Gielen AC
        • Wilson MEH
        • McDonald M
        • et al.
        Randomized trial of enhanced anticipatory guidance for injury prevention, 2001.
        Arch Pediatr Adolesc Med. 2001; 155: 42-49https://doi.org/10.1001/archpedi.155.1.42
        • Yusuf S
        • Jones JL
        • Camp EA
        • et al.
        Drowning prevention counselling by paediatricians to educate caregivers on water safety, 2022.
        J Paediatr Child Health. 2022; 58: 1584-1593https://doi.org/10.1111/jpc.16049
      2. Bright Futures Periodicity Schedule Workgroup. 2022 Recommendations for Preventative Pediatric Health Care, July 2022.

        • Bandealy A
        • Herrera N
        Use of lethal means restriction counseling for suicide prevention in pediatric primary care, 2020.
        Preventive Medicine. 2020; 130e105855https://doi.org/10.1016/j.ypmed.2019.105855
        • Hoops K
        • Crifasi C.
        Pediatric resident firearm-related anticipatory guidance: why are we still not talking about guns?, 2019.
        Preventive Medicine. 2019; 124: 29-32https://doi.org/10.1016/j.ypmed.2019.04.020
        • Juang DD
        • McDonald DL
        • EA Johnson-Young
        • et al.
        Assessment of pediatric residents’ attitudes toward anticipatory counseling on gun safety, 2019.
        Children. 2019; 6: 122https://doi.org/10.3390/children6110122
        • Gielen AC
        • McDonald EM
        • Forrest CB
        • et al.
        Injury prevention counseling in an urban pediatric clinic: analysis of audiotaped visits, 1997.
        Arch Pediatr Adolesc Med. 1997; 151: 146-151https://doi.org/10.1001/archpedi.1997.02170390036007
        • Delnevo CD
        • Hausman AJ.
        Injury-prevention counseling among residents of internal medicine, 2000.
        Am J Prev Med. 2000; 19: 63-65https://doi.org/10.1016/s0749-3797(00)00156-2
        • Cohen LR
        • Runyan CW
        • Downs SM
        • et al.
        Pediatric injury prevention counseling priorities, 1997.
        Pediatrics. 1997; 99: 704-710https://doi.org/10.1542/peds.99.5.704
        • Quinlan KP
        • Sacks JJ
        • Kresnow M.
        Exposure to and compliance with pediatric injury prevention counseling–United States, 1994.
        Pediatrics. 1998; 102: e55https://doi.org/10.1542/peds.102.5.e55
        • Chen J
        • Kresnow M
        • Simon TR
        • et al.
        Injury-prevention counseling and behavior among US children: results from the second injury control and risk survey, 2007.
        Pediatrics. 2007; 119: e958-e965https://doi.org/10.1542/peds.2006-1605
        • O'Flaherty JE
        • Pirie PL.
        Prevention of pediatric drowning and near-drowning: a survey of members of the American Academy of Pediatrics, 1997.
        Pediatrics. 1997; 99: 169-174https://doi.org/10.1542/peds.99.2.169
        • IBM Corp
        IBM SPSS Statistics for Windows, Version 25.0.
        IBM Corp, Armonk, NY2017
      3. The American Board of Pediatrics, Data and Workforce. Continuing Certification Enrollment Surveys for 2018 to 2020. Accessed August 2022. [www.abp.org/content/results-continuing-certification-moc-enrollment-surveys-2018-2020].

        • Umapathi KK
        • Thavamani A
        • Dhanpalreddy H
        • Khatana J
        • Roy A.
        Incidence trends and predictors of in-hospital mortality in drowning in children and adolescents in the United States: A national inpatient database analysis, 2020.
        Clin Pediatr. 2020; 59: 134-141https://doi.org/10.1177/0009922819886871
        • Gaw CE
        • Berthet E
        • Curry AE
        • Zonfrillo MR
        • Arbogast KB
        • Corwin DJ.
        Pediatric health care provider perspectives on injury prevention counseling in acute and primary care settings, 2020.
        Clin Pediatr. 2020; 59: 1150-1160https://doi.org/10.1177/0009922820941237
        • Bae JY
        • Anderson E
        • Silver D
        • et al.
        Child passenger safety laws in the United States, 1978-2010: Policy diffusion in the absence of strong federal intervention.
        Soc Sci Med. 2014; 100: 30-37https://doi.org/10.1016/j.socscimed.2013.10.035
      4. National Child Passenger Safety Board. Board History. Accessed July 2022. [www.cpsboard.org/learn-about-the-board/history/].

        • Durbin DR
        • Hoffman BD
        Council on Injury, Violence, and Poison Prevention et al. Child passenger safety.
        Pediatrics. 2018; 142e20182460https://doi.org/10.1542/peds.2018-2460
        • Cull WL
        • O'Connor KG
        • Sharp S
        • Tang SS
        Response rates and response bias for 50 surveys of pediatricians, 2005.
        Health Serv Res. 2005; 40: 213-226https://doi.org/10.1111/j.1475-6773.2005.00350.x