Bass J L, Christoffel K K, Widome M, Boyle W, Scheidt P, Stanwick R, Roberts K
American Academy of Pediatrics, Elk Grove Village, IL.
Pediatrics. 1993 Oct;92(4):544-50.
The American Academy of Pediatrics (AAP) believes that health education, through office-based counseling, can contribute to childhood injury prevention. This report presents the results of a critical review of the scientific literature on the effectiveness of primary care-based counseling to prevent childhood unintentional injury.
A panel selected from the AAP Committee and the AAP Section on Injury and Poison Prevention searched the English-language scientific literature for all articles about childhood unintentional injury prevention counseling. A standardized format was developed to record data on each study. Two members of the panel independently reviewed each article. Articles that were original reports and in which unintentional injury prevention counseling took place in a primary care setting were included. Articles were encoded and analyzed by computer and then grouped by quality of evidence using the US Preventive Services Task Force (USPSTF) method of categorizing results of medical care evaluation. Articles were rated by strength of study design in order to compare studies within each USPSTF group.
Twenty articles met the criteria for inclusion. Of these, 18 showed positive effects of injury prevention counseling including five randomized/controlled, 10 non-randomized/controlled, two multiple time series, and one descriptive study. In 15 of the positive studies, physicians performed the counseling. Positive outcomes as measured by increased knowledge, improved behavior, or decreased injury occurrence were reported for both motor vehicle and non-motor vehicle injuries.
The literature review supports the recommendation of the AAP to include injury prevention counseling as part of routine health supervision. This recommendation has implications for health care reimbursement and care content.
美国儿科学会（AAP）认为，通过门诊咨询开展的健康教育有助于预防儿童伤害。本报告介绍了一项对科学文献的批判性综述结果，该综述涉及以初级保健为基础的咨询在预防儿童意外伤害方面的有效性。
一个由AAP委员会以及伤害与中毒预防科选出的小组，在英文科学文献中搜索所有关于儿童意外伤害预防咨询的文章。制定了标准化格式来记录每项研究的数据。该小组的两名成员独立评审每篇文章。纳入的文章需为原始报告，且意外伤害预防咨询是在初级保健环境中进行的。文章通过计算机进行编码和分析，然后使用美国预防服务工作组（USPSTF）对医疗保健评估结果进行分类的方法，按证据质量进行分组。根据研究设计的强度对文章进行评分，以便比较每个USPSTF组内的研究。
20篇文章符合纳入标准。其中，18篇显示伤害预防咨询有积极效果，包括5篇随机对照研究、10篇非随机对照研究、2篇多次时间序列研究和1篇描述性研究。在15篇有积极结果的研究中，由医生进行咨询。对于机动车伤害和非机动车伤害，均报告了知识增加、行为改善或伤害发生率降低等积极结果。
文献综述支持AAP将伤害预防咨询纳入常规健康监督的建议。这一建议对医疗保健报销和护理内容具有影响。
