Effectiveness of a WeChat group-based parental intervention in preventing unintentional injuries among children aged 0-3 years in the community: A randomized controlled trial in Shanghai, China (Preprint)

BACKGROUND Unintentional child injuries are a major public health problem and mobile social networking applications, such as WeChat, are potential ways to implement parent-based interventions to reduce it. OBJECTIVE The objective of our study was to evaluate the effectiveness of WeChat-group-based parental intervention programs in preventing unintentional injuries in children aged 0–3 years in China. METHODS This was a randomized controlled trial that ran from March 2019 to March 2020. Parents of children aged 0–3 years in Shanghai were recruited from two community health centers dedicated to regular child health examination in the central area of Jiading District and randomly allocated to an intervention group and a control group at a 1:1 ratio. Each parent completed surveys at recruitment and at 12 months. Generalized estimation equations were used to assess intervention effectiveness. Primary outcome was included unintentional injury incidence. Secondary outcomes included parents’ skills, beliefs, and behaviors. RESULTS A total of 365 parents were enrolled and 256 of them completed the trial. The parents’ unintentional injury knowledge was not statistically significant in the baseline (P=.56). Further, the change in unintentional injury incidence was not statistically significant in the intervention group; however, the intervention group performed better than the control group (OR=1.71, 95% CI 1.02 to 2.87) in this. The change in first aid skills for treating a tracheal foreign body was nearly statistically significant (P=.06). Changes in parents’ beliefs about injury attribution (β 0.091, 95% CI -0.028 to 0.210, P=.13) and responsibility (β 0.165, 95% CI -0.014 to 0.345, P=.07) were not statistically significant in both the intervention and control groups. Changes in preventability β 0.344, 95% CI 0.152 to 0.537, P<.001), daily supervision behavior (β 0.503, 95% CI 0.036 to 0.970, P=.04), and behaviors for preventing specific injuries (β 2.198, 95% CI 1.530 to 2.865, P<.001) were statistically significant in both the intervention and control groups. CONCLUSIONS The WeChat-group-based parental intervention can reduce the occurrence of unintentional child injuries by improving parents’ skills, beliefs, and behaviors. CLINICALTRIAL ChiCTR1900020753