Understanding the associations among parents teaching safety rules to children, safety behaviors and unintentional injuries in Chinese preschool children.

Child unintentional injuries are one of the most prominent global health threats and parents may play a vital role in these injuries. This study thus aims to explore the associations of parents teaching safety rules with preschool children's safety behaviors and unintentional injuries. A total of 62,922 children registered at 182 kindergartens in Longhua District of Shenzhen, China during the fall semester of 2016, were included in this cross-sectional study. Their parents were invited to complete a self-administered questionnaire covering information about socio-demographics, parents teaching safety rules to children, child safety behaviors and unintentional injuries. Logistic and linear regression models were carried out to test the associations among parents teaching safety rules, child safety behaviors, and child unintentional injuries. Whether child safety behaviors mediated the relationship between parents teaching safety rules and child unintentional injuries was assessed using Hayes' PROCESS macros for SPSS. Regression analyses revealed that the higher scores of both mothers' and fathers' teaching safety rules to children were significantly associated with the reduced risks of child unintentional injuries and the modest improvements in child safety behaviors, after adjusting for potential confounders. Furthermore, mediation analysis illustrated that child safety behaviors mediated 18.1% of the association between mothers teaching safety rules and child unintentional injuries and 30.3% of the association between fathers teaching safety rules and child unintentional injuries, respectively. These findings suggest that parents teaching safety rules to children is beneficial for mitigating unintentional injury risks among Chinese preschool children through improving child safety behaviors.