Parents' attitudes as mediators between knowledge and behaviours in unintentional injuries at home of children aged 0-3 in Shanghai, Eastern China: a cross-sectional study

Xueqi Ma; Qi Zhang; Ruo Jiang; Jun Lu; Huiping Wang; Qinghua Xia; Jicui Zheng; Wei Deng; Fengshui Chang; Xiaohong Li

doi:10.1136/bmjopen-2021-054228

Parents' attitudes as mediators between knowledge and behaviours in unintentional injuries at home of children aged 0-3 in Shanghai, Eastern China: a cross-sectional study

BMJ Open. 2021 Dec 23;11(12):e054228. doi: 10.1136/bmjopen-2021-054228.

Authors

Xueqi Ma^{1

2}, Qi Zhang³, Ruo Jiang^{1

2}, Jun Lu^{1

2}, Huiping Wang⁴, Qinghua Xia⁵, Jicui Zheng⁶, Wei Deng¹, Fengshui Chang^{1

2}, Xiaohong Li^{7

2}

Affiliations

¹ School of Public Health, Fudan University, Shanghai, China.
² China Research Center on Disability, Fudan University, Shanghai, China.
³ School of Community and Environmental Health, Old Dominion University, Norfolk, Virginia, USA.
⁴ Preventive Health Department, Community Health Centre of Jiading Town, Shanghai, China.
⁵ Chronic Disease Prevention and Control Department, Changning District Center for Disease Control and Prevention, Shanghai, China.
⁶ Department of Neurosurgery, Children's Hospital of Fudan University, Shanghai, China.
⁷ School of Public Health, Fudan University, Shanghai, China lixh@fudan.edu.cn.

Abstract

Objective: Parental behaviours are important in preventing unintentional injury at home among young children. Previous research showed an inconsistent relationship between knowledge and behaviours, indicating that the mechanisms may vary for different behaviours. This study aimed to examine the mediating roles of different attitudes in the mechanism of knowledge acting on different behaviours.

Design: Cross-sectional study.

Setting: Eastern China.

Participants: Participants were recruited using stratified community-based sampling. A total of 488 parents of children aged 0-3 years participated in the study and 476 (97.5%) valid questionnaires were recovered.

Primary outcome measures: Parents' knowledge, attitudes (including injury attribution, preventability and responsibility) and behaviours (including supervision behaviours, risky behaviours and providing a safe home environment).

Results: The results of mediation analysis showed that the mediator variables were different for different behaviours and that all associations were positive. Parents' knowledge (β 0.19, 95% CI 0.13 to 0.24) and attitude of injury attribution (β 0.37, 95% CI 0.21 to 0.46) were directly associated with risky behaviours. Attitude of preventability was directly associated with parents' supervision behaviour (β 0.27, 95% CI 0.14 to 0.40). Parents' attitude of preventability mediated the positive association between knowledge, attitudes of injury attribution and responsibility, and supervision behaviours, as well as providing a safe home environment. In addition, the occurrence of child injuries at home was directly associated with home environment (β -0.41, 95% CI -0.82 to -0.01).

Conclusions: The current findings confirm that attitudes play varying mediating roles between knowledge and different behaviours. An important recommendation is that parents' attitudes, especially towards preventability and responsibility, need to be considered when health providers develop health education programmes targeted at improving parental supervision behaviours and providing a safe home environment.

Keywords: community child health; preventive medicine; public health.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Child, Preschool
China
Cross-Sectional Studies
Health Knowledge, Attitudes, Practice*
Humans
Infant
Infant, Newborn
Parent-Child Relations*
Parenting* / psychology
Parents* / psychology
Surveys and Questionnaires
Wounds and Injuries* / prevention & control