BMJ Glob Health. 2025 Jul 7;10(7):e019050. doi: 10.1136/bmjgh-2025-019050.
ABSTRACT
INTRODUCTION: Previous interactive education interventions for child injury prevention are suboptimal for implementation in rural areas. This study evaluated the effectiveness of a standardised school-based interactive education intervention to prevent unintentional injury for rural preschoolers.
METHODS: A 9-month single-blinded cluster randomised controlled trial was conducted in rural China, involving 12 preschools with 2518 preschoolers aged 3-6 years old. The control group received routine education, and the intervention group added the standardised Safety Experience Room intervention. The primary outcome was unintentional injury incidence rate among preschoolers during the 9-month period. The secondary outcome was the proportion of preschoolers correctly answering questions about the prevention knowledge of road traffic injury, falls and drowning. Principal data analyses were conducted using an intention-to-treat approach. Adjusted ORs (aORs) with 95% CIs were calculated based on generalised linear mixed models and bootstrapped SEs with 1000 replications. Sensitivity analyses were employed based on the full analysis set to assess the impact of missing values on principal findings.
RESULTS: Compared with the control group, the intervention group had a significantly lower unintentional injury incidence rate (aOR=0.78, 95% CI: 0.64 to 0.94) and higher proportions of correct answers to the 18 injury prevention questions (with aORs ranging from 1.78 to 22.10) after adjusting for socio-demographic factors and baseline values of the outcome variables. Sensitivity analyses supported the principal findings.
CONCLUSION: The 9-month interactive intervention decreased unintentional injury incidence and substantially increased preschooler’s safety knowledge in rural China, offering an effective option for implementing or integrating in multifactorial interventions in resource-limited areas.
TRIAL REGISTRATION NUMBER: Chinese Clinical Trial Registry, CHiCTR2000038025.
PMID:40623794 | DOI:10.1136/bmjgh-2025-019050
