653 Developing a core list of action-oriented indicators for child unintentional injury prevention

<h3>Background</h3> Injuries are a leading cause of death in children in the 0–19-year age group. Despite this they have received comparatively less public and policy attention in previous decades due to a focus on infectious diseases. Health indicators are important tools for advocacy, monitoring, policymaking and public awareness. Indicators related to injury are comparatively few and focus mostly on road safety, making it hard for policymakers to direct their efforts and compare progress across countries. <h3>Objective</h3> We aimed to develop a more representative, detailed, and useful suite of policy-relevant indicators for childhood unintentional injuries to support and evaluate injury prevention initiatives across UNICEF country offices worldwide that better represent the childhood injury burden. <h3>Methods</h3> Our methodology involved an iterative 5-step mixed-methodology approach including (1) a comprehensive scoping review of the literature on existing indicators, (2) filtering of indicators according to pre-set criteria, (3) a modified Delphi process to generate expert consensus among a worldwide group of experts, (4) grouping indicators into tiers for implementation and (5) specification of meta-data for indicators. We confined our search to the top five causes of childhood injury. Candidate indicators were ranked through expert consensus based on validity, reliability, sensitivity, availability, accessibility, and universality and defined consensus as 60% or more agreement. <h3>Results</h3> 198 potential indicators were identified across all 5 injury causes over inputs, outputs, outcomes, and impacts. These indicators were reduced to a short list of 43 indicators. 131 stakeholders were invited to take part the consensus process. This worldwide group of injury experts (<i>n</i> = 74) ranked each indicator, including 10 on road injury, 8 on drowning, 7, 3 and 6 on burns, falls and poisoning respectively. Experts then sorted the list into three tiers for implementation. Impact and output indicators were the most common identified by experts. <h3>Conclusions</h3> This modified Delphi process with a global group of stakeholders generated consensus on a suite of injury indicators across the top five causes of injury death. A final tiered list of indicators with associated metadata was produced. These indicators will guide work on injury prevention worldwide and provide impetus for advocacy, and policymaking.