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Strengthen the Evidence for Maternal and Child Health Programs

New: MCHbest strategies database for sample ESMs

Evidence Tools
MCHbest. NPM 7: Injury Hospitilization

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Strategy. Home Visiting Interventions to Prevent Child Injury

Approach. Conduct home visiting programs that include safety discussions, informational materials, and free safety devices to reduce household hazards.

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Overview. Home visitors can play an essential role in raising awareness about injury hazards, identifying risk and protective factors in the home, and teaching parents and caregivers how to prevent injuries in a culturally competent and developmentally appropriate way.1, 2

Evidence. Moderate. Research shows that home visiting can be highly effective in preventing unintentional injuries that happen in and around the home, such as fires, burns and scalds, falls, poisoning and general home safety. Programs based on this strategy are likely to work. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).

Target Audience. Parents/caregivers.

Outcome. Reduction of unintentional child injuries in the home. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the “Intervention Results” for each study.

Examples from the Field. Access descriptions of ESMs that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM. You may also want to look at evidence that supports educational programs in other NPM topic areas that can be translated to this specific topic area.

Sample ESMs. Using the approach “Conduct home visiting programs with safety discussions, informational materials, and free safety devices to reduce household hazards,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework:

Quadrant 1:
Measuring Quantity of Effort
("What/how much did we do?")

  • Number of parents/caregivers who receive educational materials on how to reduce unintentional child injury in the home.
  • Number of parents/caregivers who receive free safety devices to prevent child injury in the home.
  • Number of parents/caregivers who participated in safety discussions with home visitors to reduce child injury in the home.

Quadrant 2:
Measuring Quality of Effort
("How well did we do it?")

  • Percent of parents/caregivers who receive educational materials on how to reduce unintentional child injury in the home.
  • Percent of parents/caregivers who receive free safety devices to prevent child injury in the home.
  • Percent of parents/caregivers who participated in safety discussions with home visitors to reduce child injury in the home.

Quadrant 3:
Measuring Quantity of Effect
("Is anyone better off?")

  • Number of parents/caregivers who report improvements in knowledge around reducing unintentional child injury in the home as a result of educational materials shared by home visitors. 
  • Number of parents/caregivers who report increased understanding of how to reduce child injury in the home as a result of safety discussions with home visitors. 
  • Number of parents/caregivers who report increasing their home’s safety environment as a result of free safety devices shared by home visitors.

Quadrant 4:
Measuring Quality of Effect
("How are they better off?")

  • Percent of parents/caregivers who report improvements in knowledge around reducing unintentional child injury in the home as a result of educational materials shared by home visitors. 
  • Percent of parents/caregivers who report increased understanding of how to reduce child injury in the home as a result of safety discussions with home visitors. 
  • Percent of parents/caregivers who increase the safety of their home environment.

Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4).

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.


References:

1 Duchossois GP, Nance ML, Garcia-Espana JF, & Flores J. Sustainability of an in-home fire prevention intervention. Journal of Trauma Nursing 2009; 16(4): 194–200.

2 Odendaal W, van Niekerk A, Jordaan E, Seedat M. The impact of a home visitation programme on household hazards associated with unintentional childhood injuries: A randomised controlled trial. Accident Analysis and Prevention 2009; 41(1): 183-190.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.