55 The importance of context: factors influencing the implementation of parental safety practices in the home: a qualitative study

<h3>Background</h3> Home injuries are common in childhood, but there are effective interventions, such as providing education and safety equipment which have been shown to improve home safety and reduce injuries. For these interventions to be effective, parents need to change their home environment, home safety behaviours or other aspects of parenting. There are many barriers and facilitators to making these changes and understanding how these operate in context will help develop more effective interventions. <h3>Objective</h3> To explore the factors influencing implementation of parental home safety practices to prevent child injury. <h3>Methods</h3> Semi-structured interviews with parents of children aged under 5 taking part in a controlled before-and-after study evaluating an evidence-based home safety promotion programme (Stay One Step Ahead) in Nottingham, UK. The programme was provided by health visitors, children’s centre staff and family mentors (lay home visitors). Parents were recruited from 4 intervention areas and 5 control areas which didn’t receive the home safety programme. Interviews were transcribed verbatim, coded independently by 2 researchers and analysed using thematic analysis. <h3>Results</h3> 24 parents (12 intervention and 12 control) took part in interviews. The key themes that arose were the child (developmental stage, personality, behavioural needs), parent (supervision, teaching, safety practices, relationships with health professionals, experiences, learning, attitudes), physical environment (home characteristics, safety equipment) and community (group activities, availability of support, information delivery). Some factors could be either a barrier or facilitator, depending on context. Interactions were also found between factors. The key difference between intervention and control areas was the positive relationships built between parents and family mentors which supported parents to make home safety changes. <h3>Conclusions</h3> A wide range of context-specific and interacting factors influence the implementation of safety practices within the home. It is important to understand these influential factors and how they operate within different settings in order to inform development of effective interventions to prevent child injuries.