Safe Child Penarth: Experience with a Safe Community Strategy for Preventing Injuries to Children
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Injury Prevention 1998;4:63–68 63 FEATURED PROGRAMME Inj Prev: first published as 10.1136/ip.4.1.63 on 1 March 1998. Downloaded from Safe Child Penarth: experience with a Safe Community strategy for preventing injuries to children Alison Kemp, Nigel Gibbs, Gail Vafidis, Jo Sibert Abstract ownership and control of their own endeavours Objectives—To evaluate the process of and destinies”. In the mid-1970s, public health establishing a Safe Community project for physicians from the Karolinska Institute in children. Stockholm, developed this idea with injury Design—A descriptive study. prevention in mind and 12 criteria for a safe Setting—Penarth, a town (population community were established. Projects in Swe- 20 430) Vale of Glamorgan, South Wales. den using this approach have reduced injuries Subjects—3943 children and their families by as much as 20%.2–4 in Penarth. Safe Child Penarth (SCP) was a pilot in Main outcome measures—Whether the 12 which we applied the Safe Community criteria criteria for a Safe Community project to improve the safety of the children in a small (World Health Organisation) were met. town. In this paper we describe our process Implementation of the safety agenda set evaluation of SCP. by the community. Results—Safe Child Penarth met 10 of the http://injuryprevention.bmj.com/ 12 criteria for the Safe Community net- Setting work. All the items on the agenda were Penarth, is a town west of CardiV in South introduced in the initial two years of the Wales, UK. It has a town council, eight primary project. There were diYculties, however, and two secondary schools, and its own achieving sustained community owner- newspaper. All children under 5 years of age ship of the project. have a named health visitor and all schools, a Conclusions—The Safe Community con- designated school nurse. In 1991 the total cept stimulated work to improve child population was 20 430, including 3943 chil- safety in Penarth. Community safety dren under the age of 15 years (1246 under 5). 5 Department Of Child initiatives should involve all local agencies The Townsend index of relative deprivation Health, University of to identify the problems and work with the for Penarth for 1991 was 0.4 (Wales: 1.6). Fif- Wales College of community to set and meet the safety teen per cent of children lived in homes Medicine, Academic agenda. Partnership with the local au- equivalent to the most deprived in the country on September 30, 2021 by guest. Protected copyright. Centre, Llandough thority is valuable to improve the safety of (Townsend 1.6, range −4.5 to 8.9). Fifty eight Hospital and per cent of households were upper or middle Community NHS the environment. The experience gener- Trust, Penarth, South ated from Safe Child Penarth has been social class (I, II, III nm) and 37% were lower 6 Glamorgan CF64 2XX, used to develop a county wide, all age social class (III m–V). UK community safety project. A Kemp (Injury Prevention 1998;4:63–68) Method Penarth Town Council, Keywords: Safe Child Penarth; Safe Communities; local SCP was a joint project between the commu- South Glamorgan authority nity child health team and the Penarth Town N Gibbs Council. It was launched on 1 March 1993. Department of Child The bulk of the funding was provided by South Health, University of Injury prevention is a priority both nationally Glamorgan Health Authority. It financed a half Wales College of and internationally. This paper describes an time project coordinator and secretary and a Medicine attempt to evaluate the Safe Community proc- small publicity budget. Evaluation was under- G Vafidis ess, applied to child safety, in a South Wales taken by the Department of Child Health, town. University of Wales College of Medicine. The Department of Child Health, University of The Ottawa Charter for Health Promotion evaluation used the Criteria for a Safe Com- Wales College of sets out the philosophy behind community munity Network, laid out by the World Health Medicine and Penarth development.1 “Health promotion works Organisation (WHO) Collaborating Centre for Town Council, South through concrete and eVective community Safe Communities (table 1).7 Glamorgan action in setting priorities, making decisions, A multiagency steering group was coopted. J Sibert planning strategies and implementing them to Membership included the project coordinator, Correspondence to: achieve better health. At the heart of this proc- two town councillors, a health visitor, a school Dr Kemp. ess is the empowerment of communities, their nurse, two community paediatricians, a health 64 Kemp, Gibbs, Vafidis, et al Table 1 WHO criteria for a safe community Inj Prev: first published as 10.1136/ip.4.1.63 on 1 March 1998. Downloaded from 1. The existence of a cross sectorial group responsible for injury prevention 2. Involvement of the local community network 3. A programme covering all ages, environments, and situations 4. The programme must show concern for high risk groups and high risk environments and aim at particularly ensuring justice for vulnerable groups 5. Those responsible must be able to document the frequency and causes of injuries 6. The programme must be a long term programme rather than a short term project The community must also undertake to: 1. Utilise appropriate indicators to evaluate process and the eVects of change 2. Analyse the community’s organisations and their possibility of participation in the programme 3. Involve the health care organisation in both registration of injuries and the prevention programme 4. Be prepared to involve all levels of the community in solving the injury problem 5. Disseminate experiences both nationally and internationally 6. Be prepared to contribute to a strong network of safe communities promotion oYcer, police, home, road and fire (2) Community consultation at public meet- safety oYcers. The project coordinator was ings and in the local press. responsible for publicity, community liaison, (3) Public playgrounds surveillance system.9 data collection, resources, training, education, (4) Focus groups with socially disadvantaged and focus group work. parents. We drew up an injury profile from computer- We identified all the statutory and voluntary ised records of attendees at the local accident bodies involved with children in the town and and emergency department at CardiV Royal canvassed their availability to participate. Infirmary. Data were recorded by injury type Throughout the project we ran a persistent and location, child’s age, sex, and home advertising and public relations exercise to address. Injuries were mapped according to the achieve corporate ownership of the project. All electoral enumeration district of the home address. Census data from 1991 provider social primary schoolchildren had a “T shirt” embla- deprivation indices for each enumeration zoned with the SCP logo and commissioned a district,68 grouped into Penarth based quar- poster that was widely distributed. tiles, according to social deprivation scores. We set the safety agenda (see table 2) from Child safety provisions and public percep- our injury and safety profile. It acknowleded tion of the injury problem were documented anxieties expressed by residents and was based from a number of sources: on scientific evidence that the interventions http://injuryprevention.bmj.com/ (1) Preschool and school entry home safety proposed were eYcacious.10–23 Where possible, questionnaires. A safety score was allocated to outcomes were compared with groups matched each response. from a neighbouring town, Barry. Table 2 Safety agenda Needs assessment Intervention Evaluation In car safety 60% (range 27–68%) of children wear Interactive education to all Seat belt wearing increased to seat belts to and from eight primary primary schoolchildren: in car 72% recounted three and six schools safety leaflet given to all parents months later Safety outside Public meeting identified parking “Parking here could cost a child Schools with traYc wardens school problems outside schools: its life” signs erected. Police showed improved parking; two infringements identified outside eight advised on traYc control schools revised vehicular access schools on six occasions modification at school gates Child Parent questionnaire to assess the No intervention warranted on September 30, 2021 by guest. Protected copyright. pedestrian number of children walking to school; injuries 95% of 6 year olds, 92% of 9 year olds were taken to school by adult or older sibling Fire safety in 72% of 257 families had smoke alarms Fire safety education to all One year later 80% of 213 the home (79% of 168 control families) primary schoolchildren: 158 families had smoke alarms smoke alarms sold by local (matched responses) (86% of retailer in low cost scheme 168 controls) Cycle safety 87% 5 year olds own bicycle; 40% own Interactive cycle safety education No significant increase in cycle helmets (26% of controls). 90% of to all primary schoolchildren. helmet ownership/wearing or Penarth 9–11 year olds own bicycles Safe cycle race and cycling danger awareness (100% of control); 55% own helmets proficiency rewarded (controls 45%); 75% wear them (controls 27%); 100% aware of danger (89%, controls) Home safety Home safety audit: safety provision for Safety advice given to parents in Reassessment of home safety forthose5 89 (54%) of 8 month olds, 168 Penarth by health visitor, but provision one year later for 40 and under (90%) of 5 year olds in Penarth; for not to the control group: five Penarth children and 55 81 8 month olds and 81 5 year olds in workshops for socially deprived controls. Significant control area families in Penarth Family improvement in medicine Centre security, curly flexes, smoke alarms and window locks, bicycle helmets. Control group: significant improvement in cycle helmet ownership, no change for smoke alarms or window locks Playground All 19 playgrounds reviewed by local Parents and children empowered All 19 playgrounds met British safety authority.