Amanda Woods

Measuring contamination in an injury prevention randomized controlled trial.

Bias due to contamination occurs when important parts of the intervention programme either actively or passively, affect the control group (Slymen and Hovell 1997, Murray 1998). Unless contaminatio...

Factors Associated with Women's Antenatal Plans to Use a Baby Walker: A Cross Sectional Study.

Objective The objective of these analyses was to explore maternal antnatal decisions about baby walker use, factors associated with these decisions and the relationship between antenatal plans to use a walker and postnatal walker use. Design Cross sectional study. Setting Mothers-to-be (n = 1174) participating in a cluster randomised controlled trial of an educational package to reduce walker use in 64 general practices in the East Midlands of the United Kingdom. Method Data on plans to use a walker, socio-demographic and ecnomic characteristics, partners views on walker use, knowledge of walker-related injury and attitudes towards walkers were collected at entry to the trial by means of a self-completion questionnaire. Data on post-natal walker use was collected by postal questionnaire nine months after delivery. Results The majority of mothers-to-be (74 per cent) had already decided whether or not to use a walker prior to the birth of their baby and onthird were planning to do so. Several factors were identified which may be useful for identifying mothers-to-be who are undecided about walker use antenatally; these include partners views on walkers, parity, houing tenure and attitudes towards walkers. Antenatal plans about walker use had high positive and negative predictive values for predicting posnatal walker use. Conclusion Education regarding walker use will be an important method for reducing walker use until walkers are no longer available to purchase first or second hand. The results of this study will assist health professionals in identifying which mothers-to-be are likely to be undcided about walker use and this group may be more receptive to health education than those who have already made a decision.

Baby walker safety - baby's minder or parent's problem? A qualitative analysis of clients' knowledge, attitudes and practices regarding baby walker use

Objective To investigate the range of knowledge, attitudes and practices of parents regarding baby walkers. Design A qualitative study using a focus group approach. Setting Three focus groups were held in community mother and toddler drop-in centres, and one in a hospital antenatal clinic. Methods Four focus groups were held over a two-month period in 2000. Parents from areas with differing levels of deprivation (including walker users and nonusers) and antenatal parents were recruited. Data were thematically analysed. Revisiting the data for conflicting evidence tested any themes. Results Some parents believe that walkers could help a child to walk and to build up strength in the legs and that walkers must be safe if British Safety Standards have been met. Other parents want to make life a little easier for themselves and appear to be prepared to take a calculated risk with their childs safety in order to achieve this. Walkers themselves are acknowledged by most parents as being involved in accidents but the blame is attributed to lack of supervision. Most nursery equipment alternatives are seen to have safety problems in their own right, but there is some support for engaging in floor play with children. All the above themes were identified in the discussions of both affluent and deprived walker users and nonusers. Conclusions Any education aimed at reducing walker-related injuries should include an explanation of ways to facilitate motor development, raise awareness of safety standards for walkers, acknowledge the difficulties of life with an active baby and emphasise the need for passive safety measures.