Prevention of unintentional childhood injury: A review of study designs in the published literature 2013-2016

The purpose of this review was to examine the range and quality of published injury prevention research, based on study design. Stratified random selection of journals (based on the average annual number of injury prevention publications) was conducted using a published inventory. Hand searches for empirical research articles on unintentional injury prevention in children and youth (0-19 years) over the four-year period 2013 to 2016, inclusive were conducted. Of the 380 studies identified, the majority were descriptive (133, 35%) or observational (163, 43%), with more than three quarters of the published studies using a "hypothesis-generating" study design. Only 12 (3%) studies were randomized controlled trials, and of the 44 experimental studies, 19 (43%) did not include a comparison group. Transportation injuries predominated, knowledge/attitude/behaviour outcomes were common, and the most common intervention approach was education. The majority of publications were from high-income countries. This review of injury prevention research in children and youth showed that descriptive studies predominate in the published literature, and hypothesis-testing study designs are relatively infrequent. The findings suggest a need for the injury field to support and promote rigorous analytic study designs. In other words, to enhance and strengthen the evidence base for injury prevention policy and practice, injury prevention researchers should consider a greater focus on determination of cause and effect and evaluation of the effectiveness of interventions, particularly engineering and legislative interventions.