Racial and Ethnic Differences in Injury Prevention Behaviors Among Caregivers of Infants

Abstract

Introduction: African American and Latino children experience higher rates of traumatic injury and mortality, but the extent to which parents of different races and ethnicities disparately enact injury prevention behaviors has not been fully characterized. The objective of this study is to evaluate the association between caregiver race/ethnicity and adherence to injury prevention recommendations.

Methods: This was a cross-sectional analysis of caregiver-reported baseline data from the Greenlight study, a cluster-randomized pediatric obesity prevention trial. Data were collected between 2010 and 2012 in four academic pediatric practices and analyzed in 2015. Non-adherence to injury prevention recommendations was based on five domains: car seat safety, sleeping safety, fire safety, hot water safety, and fall prevention.

Results: Among 864 caregiver-infant pairs (17.7% white, non-Hispanic; 49.9% Hispanic; 27.7% black, non-Hispanic; 4.7 % other, non-Hispanic), mean number of non-adherent injury prevention behaviors was 1.8 (SD=0.9). In adjusted regression, Hispanic caregivers had higher odds of non-adherence to car seat safety (AOR=2.1, 95% CI=1.2, 3.8), and lower odds of non-adherence with fall prevention (AOR=0.4, 95% CI=0.3, 0.7) compared with whites. Black, non-Hispanic caregivers had higher odds of non-adherence to car seat safety (AOR=2.4, 95% CI=1.3, 4.4) and sleeping safety (AOR=2.1, 95% CI=1.3, 3.2), but lower odds of fall prevention non-adherence (AOR=0.5, 95% CI=0.3, 0.8) compared with whites.

Conclusions: A high prevalence of non-adherence to recommended injury prevention behaviors is common across racial/ethnic categories for caregivers of infants among a diverse sample of families from low-SES backgrounds.

Trial registration: ClinicalTrials.gov NCT01040897.

Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1. Rates of non-adherence to five injury prevention recommendations by caregiver race/ethnicity

Notes: χ2 indicates that car seat safety, sleeping safety, and fall prevention are all significantly different by caregiver race/ethnicity (p<0.001) and that hot water safety is significantly different by caregiver race/ethnicity (p<0.05). There is no difference in the percent of caregivers adherent to fire safety based on caregiver race/ethnicity.