ABSTRACT

The hallmark of the field of pediatrics has long been assumed to be the prevention of maladies that affect our nation’s young. Throughout much of medicine, particularly in pediatrics, prevention, rather than remediation, has been the preferred mode of practice. Numerous authors have identified injuries as a major etiological factor in brain damage and subsequent impaired cognitive functioning or mental retardation (Klauber, Barrett-Connor, Marshall, & Bowers, 1981). It is far easier to design transportation systems so that children are less likely to be injured than it is to design emergency transportation and hospitalization systems that can deal with brain damage after it has occurred. Historically, improvements in sanitation, pasteurization of milk, the ready availability of alternative sources of nutrition through commercially available infant formulas, immunization schedules, and the development of medications for many common childhood infectious diseases have substantially reduced the morbidity and mortality for children (Roberts & Brooks, 1987). Most of these advances have taken the form of more passive measures (measures that do not require much effort on the part of the recipient in order to realize a gain) as opposed to active measures (measures that do require effort on the part of the recipient). In fact, until these passive measures were in place, parents had to take active measures in the hope of preventing some of the problems associated with childhood. A review of the advances in the injury control literature, with suggestions for medicine in general, would be illustrative of the way that prevention strategies could be implemented. There have been several major areas in which pediatric health care has produced documented decreases in illnesses and deaths (Cataldo et al., 1986). This chapter reviews and discusses the published literature on improving parental compliance with injury control recommendations including legislative programs, active versus passive strategies, health education approaches, behavioral approaches, and group health education approaches. Each approach has been effective in encouraging parents to implement injury control strategies. Combinations of these approaches have probably produced the largest effects.