Insufficient evidence so far to support the community approach to burns and scalds prevention

Turner C, Spinks A, McClure RJ, Nixon J

Published Online:

July 8, 2009

Multi-strategy, community-based interventions are widely promoted for reducing injury rates. The efficacy of this approach is difficult to assess and there have been few research studies of good quality. The current review sought to review studies evaluating the success of community-based programmes specifically intended to reduce burn and scald injury in children. Only four studies were identified that met the inclusion criteria and two of these found a reduction in rates of burns and scalding. More high-quality research studies are needed in this area, therefore, to support the continued use of the community approach.

Abstract (click to read)

Background:

Burns and scalds are a significant cause of morbidity and mortality in children. Successful counter-measures to prevent burn and scald-related injury have been identified. However, evidence indicating the successful roll-out of these counter-measures into the wider community is lacking. Community-based interventions in the form of multi-strategy, multi-focused programmes are hypothesised to result in a reduction in population-wide injury rates. This review tests this hypothesis with regards to burn and scald injury in children.

Objectives:

To assess the effects of community-based interventions, defined as coordinated, multi-strategy initiatives, for reducing burns and scalds in children aged 14 years and under.

Search strategy:

We searched the Cochrane Injuries Group's specialised register, CENTRAL, MEDLINE, EMBASE, CINAHL, PsycINFO, National Research Register and the Web of Knowledge. We also handsearched selected journals and checked the reference lists of selected publications. The searches were last updated in May 2007.

Selection criteria:

Included studies were those that reported changes in medically attended burn and scald-related injury rates in a paediatric population (aged 14 years and under), following the implementation of a controlled community-based intervention.

Data collection and analysis:

Two authors independently assess studies for eligibility and extracted data. Due to heterogeneity between the included studies, a pooled analysis was not appropriate.

Main results:

Of 39 identified studies, four met the criteria for inclusion. Two of the included studies reported a significant decrease in paediatric burn and scald injury in the intervention compared with the control communities. The failure of the other two studies to show a positive result may have been due to limited time-frame for the intervention and/or failure to adequately implement the counter-measures in the communities.

Authors' conclusions:

There are a very limited number of research studies allowing conclusions to be drawn about the effectiveness of community-based injury prevention programmes to prevent burns and scalds in children. There is a pressing need to evaluate high-quality community-based intervention programmes based on efficacious counter-measures to reduce burns and scalds in children.

It is important that a framework for considering the problem of burns and scalds in children from a prevention perspective be articulated, and that an evidence-based suite of interventions be combined to create programme guidelines suitable for implementation in communities throughout the world.

This record should be cited as:

Turner C, Spinks A, McClure RJ, Nixon J. Community-based interventions for the prevention of burns and scalds in children. Cochrane Database of Systematic Reviews 2004, Issue 3. Art. No.: CD004335. DOI: 10.1002/14651858.CD004335.pub2

Assessed as up to date:

July 19, 2007

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Primary Review Group:

Injuries Group

Health topics:

Orthopaedics & trauma > Prevention of injuries > Burns

Public health > Prevention of injuries > Burns

Cochrane Summaries^beta

Independent high-quality evidence for health care decision making

Insufficient evidence so far to support the community approach to burns and scalds prevention

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