Primary Care-Based Injury Prevention Program Reduces Pediatric Injuries: Daily Dose

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Patient Care brings primary care clinicians a lot of medical news every day—it’s easy to miss an important study. The Daily Dose provides a concise summary of one of the website's leading stories you may not have seen.

Last week, we reported on findings from a study published in Pediatrics that examined the impact of a primary-care based injury prevention program on reported injuries in the first 2 years of life.

The study

The Injury Prevention Program (TIPP) was designed by the American Academy of Pediatrics in 1983 to help pediatricians identify at-risk parental behaviors and counsel them on anticipatory guidance to prevent injury. There have been no previous experimental studies analyzing the effectiveness of TIPP.

Researchers conducted a stratified, cluster-randomized controlled trial, known as the Greenlight Study, in a large, diverse sample of children to compare participants who received an obesity prevention intervention to a group that focused on injury prevention using TIPP.

The study was conducted at 4 academic medical centers — 2 that trained their pediatric residents and implemented TIPP screening and counseling materials at all well-child checks (WCCs) for ages 2 to 24 months, and 2 that implemented obesity prevention. At each WCC, parents reported the number of child injuries since the previous WCC.

The findings

A total of 781 parent-infant dyads were included in the analysis: 349 in the TIPP group and 432 in the control group. Among the cohort, 51% were Hispanic, 28% were non-Hispanic Black, and 87% were insured by Medicaid.

Reported injuries were significantly less likely at TIPP sites compared with non-TIPP sites throughout the follow-up, with adjusted ORs of 0.77 (95% CI, 0.66-0.91) at 4 months, 0.6 (95% CI, 0.44-0.82) at 6 months, 0.32 (95% CI, 0.16-0.62) at 12 months, 0.26 (95% CI, 0.12-0.53) at 18 months, and 0.27 (95% CI, 0.14-0.52) at 24 months.

Authors' comment

"Further research is needed to determine if the use of TIPP results in reduction of serious injury and to examine the mechanisms by which TIPP leads to a reduction in injuries, including the role of parent attitudes, knowledge, and behaviors."

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