Behavioural and environmental factors related to burn accidents in young children in the Netherlands: A qualitative study

BACKGROUND: Prevention programs can encourage parents to take safety measures to prevent burn injury in children under 5 years of age. The PRECEDE-PROCEED model of Green and Kreuter is a frequently used tool for stepwise development of effective prevention programs. In a previous study the first 2 phases of PRECEDE were completed. This follow-up study aimed to identify factors influencing the behaviour and environment of parents in the Netherlands, whose children under the age of 5 were involved in a burn accident and whose family was classified as at increased risk of burn injury.

METHODS: In this qualitative study, phase 3 of the PRECEDE-PROCEED model was completed. To this end, interviews on burn accidents were carried out until saturation of topics was reached. Eligible were parents of children who were treated in one of the three Dutch burn centres at the age of 0-4 years between May 2017 and December 2023 and in which the family was assessed as having an increased risk of sustaining burn injury. Interviews were independently transcribed and coded by two researchers.

RESULTS: A total of 27 interviews were conducted. Important predisposing factors were a lack of knowledge and risk awareness, underestimated abilities of the child, and a knowledge-driven adequate response. Important enabling factors were distraction, stress and fatigue, difficulties in securing the environment, poor Dutch language skills, an unfamiliar environment, permissive parenting style, and an outgoing character of the child. Reinforcing factors included thresholds in addressing others on unsafe behaviour and a lack of support.

CONCLUSION: The outcomes of this study provide a deeper understanding of the aetiology in burn accidents in children under 5 years of age in the Netherlands. The identified factors will be used to effectively design prevention programs for the population at risk.