153707 Rules, compliance and injuries to preschool children

Tuesday, November 6, 2007: 1:00 PM

Robert Cole, PhD , University of Rochester School of Nursing, Rochester, NY
Harriet Kitzman, RN, PhD , University of Rochester School of Nursing, Rochester, NY
Christina Koulouglioti, RN, PhD , University of Rochester School of Nursing, Rochester, NY
Kimberly Arcoleo, MPH, PhD , College of Nursing & Healthcare Innovation, Arizona State University, Phoenix, AZ
Elizabeth Anson, MS , University of Rochester School of Nursing, Rochester, NY
Purpose: To examine the relationships between maternal rules and child compliance, both self-reported and observed, and medically attended unintentional injuries to preschool children. The primary hypothesis was that rules and committed child compliance are inversely related to injuries among young children. Methods: 278 mothers of three-year-old children were interviewed about the number and nature of rules of conduct for their children, their insistence on compliance and the mothers' assessment of the children's compliance. In addition, the mothers and their children were videotaped in several laboratory settings including one in which the children were permitted to play with only one of two sets of toys. Mothers' follow-through with this rule, their socialization and disciplinary strategies, and the children's compliance were all coded. Children's injuries were identified by comparing the mothers' report of child injuries and the abstraction of the children's medical record. Results: Mother's observed follow-through with the established rule and observed children's committed compliance were significantly and inversely related to the children's medically attended injuries even after controlling for education, socioeconomic status and race. In contrast, the self-reported measures of rules and assessment of children's compliance were not related to child injuries. Conclusions: While there was substantial variance in the mothers' reports of the number of rules, rule insistence and compliance, it was her actual follow-through that was protective of injuries. Similarly, only observed committed compliance, neither maternal reported compliance, nor observed situational compliance, while common at this age, were protective.

Learning Objectives:
1.Understand the aspects of rule setting and enforcement that are related to child unintentional injuries 2.Understand the type of child compliance that is protective 3.Articulate the value of direct observation of behavior to an understanding of injuries

Keywords: Injury Prevention, Children

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.