Unintentional poisoning is a major cause of nonfatal injuries in children aged 0–24 months. Associations between self-reported habits on the child safe storage of medication and cleaning products and family, and psychosocial factors were assessed, using a model based on the Protection Motivation Theory. By identifying correlates of safety behavior in this manner, more insight in factors which influence this behavior is obtained. Health promotion activities in order to promote safety behavior should address these factors in order to increase the effectiveness of the health message. Data were gathered from a cross-sectional survey using self-administered questionnaires, mailed to a population sample of 2470 parents with toddlers. The results indicate that the promotion of safe storage of medication and cleaning products should address the family situation, personal cognitive factors as well as social factors. Interventions should particularly focus on parents' self-efficacy of storing poisonous products in a child safe manner and on the vulnerability of their child in their home concerning an unintentional poisoning incident. 1. Introduction Unintentional poisonings, which mostly occur at home, are a major cause of nonfatal injuries in children aged 0–24 months [1]. In 2003, 49.6% of all the reported poisonings exposures in the USA occurred among preschool children [2]. The annual incidence of poisoning in Dutch children aged 1-2 years is 3 per 1000 children, which is much higher compared to other age groups, for example, one-year-olds have a six-fold risk of poisoning compared to four-year-olds [3]. Most cases of poisoning in children aged 1-2 years occur due to unsafe storage of medicines and cleaning products (e.g., detergents, chloride, and other cleaners) [3]. Unintentional poisonings in this age group can be largely prevented by taking preventive action. Examples of preventive action could include, according to guidelines, the use of child-resistant packaging, child-safe storage of potentially poisonous products, and extra attention and supervision when the possible hazardous products are in use [1, 4–8]. Efforts should be made to promote poisoning preventive actions, including child-safe storage of potentially poisonous products (e.g., placed above adult eye level, or in a locked cabinet) [1, 4–8]. Previous research showed a large variation in characteristics between parents who do and do not store medications or cleaning products child safe [9]. In order to develop effective intervention strategies to improve parental safety behavior, more insight
References
[1]
J. Vincenten, Priorities for child safety in the European Union: Agenda for Action, European Child Safety Alliance, Amsterdam, The Netherlands, 2004, http://www.eurosafe.eu.com/csi/catalogus.nsf/wwwEurosafe/150F23CA817A0762C12571EA002BE634/$file/ECSA_priorities.pdf.
[2]
W. A. Watson, T. L. Litovitz, and T. L. Litovitz, “2003 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System,” American Journal of Emergency Medicine, vol. 22, no. 5, pp. 335–404, 2004.
[3]
Dutch Injury Surveillance System (LIS), Database of 1999–2003, Consumer Safety Institute, Amsterdam, The Netherlands, 2003.
[4]
J. L. Hoy, L. M. Day, J. Tibballs, and J. Ozanne-Smith, “Unintentional poisoning hospitalisations among young children in Victoria,” Injury Prevention, vol. 5, no. 1, pp. 31–35, 1999.
[5]
A. D. Woolf, A. Saperstein, and S. Forjuoh, “Poisoning prevention knowledge and practices of parents after a childhood poisoning incident,” Pediatrics, vol. 90, no. 6, pp. 867–870, 1992.
[6]
B. H. Azizi, H. I. Zulkifli, and M. S. Kassim, “Circumstances surrounding accidental poisoning in children,” Medical Journal of Malaysia, vol. 49, no. 2, pp. 132–137, 1994.
[7]
E. Petridou, N. Kouri, A. Polychronopoulou, K. Siafas, M. Stoikidou, and D. Trichopoulos, “Risk factors for childhood poisoning: a case-control study in Greece,” Injury Prevention, vol. 2, no. 3, pp. 208–211, 1996.
[8]
G. B. Rodgers, “The effectiveness of child-resistant packaging for aspirin,” Archives of Pediatrics and Adolescent Medicine, vol. 156, no. 9, pp. 929–933, 2002.
[9]
T. M. J. Beirens, E. F. van Beeck, R. Dekker, J. Brug, and H. Raat, “Unsafe storage of poisons in homes with toddlers,” Accident Analysis and Prevention, vol. 38, no. 4, pp. 772–776, 2006.
[10]
J. Brug, A. Oenema, and I. Ferreira, “Theory, evidence and intervention mapping to improve behavioral nutrition and physical activity interventions,” International Journal of Behavioral Nutrition and Physical Activity, vol. 2, article 2, 2005.
[11]
E. Wortel, G. H. de Geus, and G. Kok, “Behavioral determinants of mothers' safety measures to prevent injuries of pre-school children,” Scandinavian Journal of Psychology, vol. 36, no. 3, pp. 306–322, 1995.
[12]
L. B. Trifiletti, A. C. Gielen, D. A. Sleet, and K. Hopkins, “Behavioral and social sciences theories and models: are they used in unintentional injury prevention research?” Health Education Research, vol. 20, no. 3, pp. 298–307, 2005.
[13]
R. W. Rogers and S. Prentice-Dunn, “Protection motivation theory,” in Handbook of Health Behavior Research I: Personal and Social Determinants, D. S. Gochman, Ed., vol. 1, pp. 113–132, Plenum Press, New York, NY, USA, 1997.
[14]
R. Rogers, “Cognitive and physiological processes in fear-based attitude change: a revised theory of protection motivation,” in Social Psychophysiology: A Sourcebook, J. Cacioppo and R. Petty, Eds., pp. 153–76, Guilford, New York, NY, USA, 1983.
[15]
B. A. Morrongiello and S. Kiriakou, “Mothers' home-safety practices for preventing six types of childhood injuries: what do they do, and why?” Journal of Pediatric Psychology, vol. 29, no. 4, pp. 285–297, 2004.
[16]
E. Sellstr？m and S. Bremberg, “Perceived social norms as crucial determinants of mother's injury- preventive behaviour,” Acta Paediatrica, vol. 85, no. 6, pp. 702–707, 1996.
[17]
I. Ajzen, Attitudes, Personality and Behaviour, Open University Press, Milton Keynes, UK, 1988.
[18]
R. B. Cialdini, C. A. Kallgren, and R. R. Reno, “A focus theory of normative conduct: a theoretical refinement and re-evaluation of the role of norms in human behaviour,” in Advances in Experimental Social Psychology, M. P. Zanna, Ed., pp. 201–234, Academic Press, San Diego, Calif, USA, 1991.
[19]
J. Cohen, Statistical Power Analysis for the Behavioral Sciences, Erlbaum, Hillsdale, NJ, USA, 2nd edition, 1988.
[20]
H. de Vries, M. Dijkstra, and P. Kuhlman, “Self-efficacy: the third factor besides attitude and subjective norm as a predictor of behavioural intentions,” Health Education Research, vol. 3, no. 3, pp. 273–282, 1988.
[21]
B. A. Morrongiello, L. Ondejko, and A. Littlejohn, “Understanding toddlers' in-home injuries: I. Context, correlates, and determinants,” Journal of Pediatric Psychology, vol. 29, no. 6, pp. 415–431, 2004.
[22]
D. Kendrick, R. Hapgood, and P. Marsh, “Do safety practices differ between responders and non-responders to a safety questionnaire?” Injury Prevention, vol. 7, no. 2, pp. 100–103, 2001.
[23]
Statline, Statistics Netherlands-Statline, Centraal Bureau voor de Statistiek, Heerlen, The Netherlands, 2006.
[24]
H. Raat, J. M. Landgraf, R. Oostenbrink, H. A. Moll, and M.-L. Essink-Bot, “Reliability and validity of the Infant and Toddler Quality of Life Questionnaire (ITQOL) in a general population and respiratory disease sample,” Quality of Life Research, vol. 16, no. 3, pp. 445–460, 2007.
[25]
L. H. Chen, A. C. Gielen, and E. M. McDonald, “Validity of self reported home safety practices,” Injury Prevention, vol. 9, no. 1, pp. 73–75, 2003.
[26]
D. C. Schwebel and C. M. Brezausek, “The role of fathers in toddlers' unintentional injury risk,” Journal of Pediatric Psychology, vol. 29, no. 1, pp. 19–28, 2004.
[27]
M. Watson, D. Kendrick, and C. Coupland, “Validation of a home safety questionnaire used in a randomised controlled trial,” Injury Prevention, vol. 9, no. 2, pp. 180–183, 2003.
