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dc.contributor.advisorMcGee, Rob
dc.contributor.advisorBray, Anne
dc.contributor.advisorFougere, Geoff
dc.contributor.authorSimpson, Jean C
dc.identifier.citationSimpson, J. C. (2010). Using the Eyes in the Back of our Heads: An Ecological Appraoch to Reducing Unintentional Injury to Young Children in the Home Environment (Thesis, Doctor of Philosophy). University of Otago. Retrieved from
dc.description.abstractThe rate of unintentional injury among children in New Zealand is not one of which we can be proud. Of children under 15 years, those aged 0-4 years carry the greatest burden and these children are injured at home more often than elsewhere. Measuring mortality, morbidity or controllable hazards, and determining risk factors, have been crucial starting points for developing interventions for child home injury. Some specific causes have been addressed successfully, but many predictable and preventable injuries still occur. From a health promotion perspective, this lack of progress would suggest that preventing injuries to young children at home is not a simple problem. Complexity is no excuse for inactivity, however. Children are vulnerable members of our society and are dependent on the behaviour and actions of others for their safety. It is crucial to identify how to design, develop and deliver initiatives that will bring about the changes needed to reduce child home injury. The use of the behavioural sciences has expanded the knowledge used in injury prevention beyond an epidemiological approach. Behaviour and context affect safety, and both are important elements in child home injury and its prevention. This study took an ecological approach to investigate the contextual and personal influences, and their interactions, of child injury prevention in the home environment. In particular, the influences on parents’ perceptions of the risk of injury to their young child at home, and their responses to that risk, were examined. These questions were explored with the real practitioners of home safety: mothers, and community-based health professionals and community workers who constantly engage with young families. Recognising these practitioners’ experience, observations, and views as legitimate knowledge shifted the focus from that commonly used in seeking to reduce child injury at home. The participants’ narratives offer additional valid and insightful perspectives to the problem. Green and Kreuter’s PRECEDE framework and Bronfenbrenner’s ecological thinking underpinned the study. A constructivist inquiry approach was used with semi-structured, open-ended interviews gathering common and diverse experiences, and observations, from face-to-face parent interviews and family worker focus groups. Analyses identified a set of themes, some of which supported findings from existing literature on influences on parental perceptions of, or responses to, the risk of child injury. Additional themes emerged indicating the influence of ‘upstream’ (from society, policy and systems, and community) and ‘downstream’ (from the personal and immediate environment) factors. The themes indicate that parents’ perceptions and responses are operating in a complex, dynamic environment where factors interact. Analyses on the downstream themes, using Bandura’s Social Cognitive Theory, resulted in key downstream influences being identified as fatigue, and knowledge of the child, of child development, and of safety management. Analyses on the upstream themes, using Rittel and Webber’s “wicked problem” model, found key themes such as lifestyle, understanding and valuing of caring, economics, and the changing nature of family. Recommendations suggest actions, based on the Ottawa Charter for Health Promotion, at both the downstream and upstream levels that would contribute to improving home safety for young children.
dc.publisherUniversity of Otago
dc.rightsAll items in OUR Archive are provided for private study and research purposes and are protected by copyright with all rights reserved unless otherwise indicated.
dc.subjectchild injury
dc.subjectecological approach
dc.subjecthealth promotion
dc.subjectwicked problems
dc.subjectbehavioural change theory
dc.titleUsing the Eyes in the Back of our Heads: An Ecological Appraoch to Reducing Unintentional Injury to Young Children in the Home Environment
dc.language.rfc3066en & Social Medicine of Philosophy of Otago
otago.openaccessAbstract Only
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