Factors influencing parental home safety practices in Nottingham, UK: a qualitative study of the Stay One Step Ahead programme

Background Home injuries among young children remain common despite interventions such as education and the provision of safety equipment. Implementation of these interventions is complex and context dependent. Understanding the specific barriers and facilitators that influence parents’ safety practices is essential for designing effective prevention programmes. Objective To explore factors influencing how parents of children under five implement home safety practices as part of the Stay One Step Ahead programme in Nottingham, UK. Methods Semi-structured interviews were conducted with parents (13 intervention, 12 control) participating in a controlled before-and-after evaluation of Stay One Step Ahead, a community-based home safety programme delivered by health visitors, children’s centre staff and family mentors (peer home visitors). Transcripts were coded by two researchers and analysed thematically using a realist-informed approach to identify how contexts and mechanisms shaped outcomes. Results Key themes related to contexts (child and family factors), mechanisms (information, skills, risk awareness) and outcomes (safety behaviours and home modifications). Context determined whether factors acted as barriers or facilitators. Supportive, trusting relationships with family mentors were particularly important in enabling parents to adopt and sustain home safety practices. Conclusions Context-specific factors strongly influence parents’ ability to implement home safety practices. Understanding how these factors operate can inform the design of effective, equitable child injury prevention programmes. Ongoing, relationship-based support from trusted professionals appears central to promoting and sustaining safer home environments for young children.