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Awarded Research Grant to Prevent Unintentional Injuries

A Dynamic Model of Supervision and Injury among Children

FOA Number: CE04-048 - Research Grants to Prevent Unintentional Injuries
Project Period: 8/1/04–7/31/07
Application/Grant Number: 1-R49-CE000230-01
Principal Investigator: Robert Cole, PhD
University of Rochester
School of Nursing
601 Elmwood Avenue Box SON
Rochester, NY 14642
Phone: 585-275-0508
Fax: 585-273-1270


This project will develop and validate a new, comprehensive, and developmentally sensitive measure of supervision. Supervision is widely believed to be a critical component of injury prevention, yet there is relatively modest empirical support for this position. It is believed current measures are inadequate to capture the complexity of the construct of supervision. This limited support also may result from an over-reliance on maternal self-report. The investigators seek to expand the current focus on how adults structure supervision (through the creation of rules and the direct monitoring of their children) to include how adults assess the risk inherent in a situation and their role in ameliorating this risk, and how they implement their approach to supervision. The Health Belief Model will be employed to establish the factors that influence adults’ assessment of risk and whether or not they need to act to reduce that risk. Children may be injured in situations not because of a failure of supervision per se, but rather because of a failure to appreciate the risk or the opportunity to intervene. In addition, effective supervision has a dynamic aspect requiring sensitivity to subtle cues to changes in the child's location or behavior and a willingness and ability to act quickly. Finally, the supervision framework must facilitate the child's internalization of safety rules and behaviors. As children grow and spend more time in unsupervised settings, it is the internalization of these rules that will provide ongoing injury prevention.

In this project, a new self-report measure will be developed of this expanded conceptualization of supervision as well as an observational measure of supervision for parents of preschool children and a child self-report measure of risk-taking and rule compliance for older children. Content validity will be assessed through an expert panel and racially and sociodemographically diverse focus groups. The value of the observation and child self-reports will be determined by examining (a) predicted developmental changes, (b) concordance among the three sources of data, (c) predicted differences among known groups, and (d) the correlation with self-reported medically attended injuries.