252604 Case Crossover Designs: Utility for Studying Child Injury Risk

Wednesday, November 2, 2011: 8:50 AM

Jennifer Kuhn, MS , Department of Psychology, Western Michigan University, Kalamazoo, MI
Amy Damashek, PhD , Department of Psychology, Western Michigan University, Kalamazoo, MI
A case crossover design is a methodology that is well-suited to studying the etiology of acute events, such as injuries (Maclure & Mittleman, 2000). Such designs are best utilized for events with an abrupt rather than an insidious onset. The design differs from a matched case-control approach in that each person in the study serves as their own control, thereby eliminating the influence of between-subject confounding variables (e.g., mental health). In a case crossover design, proximal factors (e.g., child activity level) preceding an acute event (e.g., injury) can be compared to factors preceding a time-matched non-event (e.g., a non-injury) for the same person in order to isolate variables that lead to an event occurrence. The authors will present results from a secondary data analysis of a study using a case crossover design to examine risk of unintentional childhood injury. Immediate risk of unintentional injury was predicted by two proximal factors, including caregiver type (i.e., mothers versus fathers) and caregiver supervision level. Caregivers reported on circumstances preceding injury events as well as circumstances preceding non-injury events that were matched by day and time to injury events. Results revealed that children were at increased risk for injury when supervised by fathers and that mothers' supervision was a stronger predictor of injury than fathers' supervision. The case crossover design allowed us to examine proximal risk for injury while controlling for several between subjects variables that may influence child injury risk (e.g., child impulsivity).

Learning Areas:
Public health or related research

Learning Objectives:
1. Participants will define what a case crossover design is and when it is appropriate to use. 2. Participants will identify how this approach might be applied to studying proximal risk factors for injury through a case example.

Keywords: Injury Risk, Pediatrics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I conduct research on childhood trauma and prevention of unintentional childhood injuries and is also interested in risk factors for and prevention of child maltreatment.
Any relevant financial relationships? No

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.