The CDC Research Agenda states, "Supervision is generally considered one of the strongest yet least understood protective factors against many types of home and community injuries." This statement highlights the paradox of the concept of supervision. The absence of supervision has frequently been cited as a contributing factor for injury. Yet, it is unclear what this concept means to the health professionals who recommend supervision as an injury prevention strategy or to parents who must implement the strategies. Recent studies have also noted lower rates of pediatric injury among Latino children compared to Non-Latino Whites. The explanation of these findings is unclear. This study will use the combined approaches and methods of anthropology, injury epidemiology, and observational research to explore concepts and behaviors regarding supervision for injury prevention. Considering the current lack of understanding of what constitutes effective supervision for preventing injury, it is vital that we define cultural models to lay a foundation for enhancing "supervision" as an injury prevention strategy. The overall goals of this study are to 1) determine the cultural meaning of supervision;2) determine if there is a shared cultural model(s) regarding supervision for injury prevention among the following groups: health professionals, Latina mothers and non-Latina white mothers;3) determine if the model(s) is consistent with field observations of supervision in the context of injury hazards in the natural environment;4) determine if deviation from the model(s) predicts inappropriate supervision for injury prevention;and 5) establish if the cultural model(s) can be used to guide anticipatory counseling in the health care setting. In-depth ethnographic interviews will be conducted with Spanish and English speaking Latina mothers, non-Latina White mothers, pediatricians and nurses. Cultural consensus methods will be used to determine if there is a shared cultural meaning of supervision as an injury prevention strategy. Drowning and pedestrian injuries are leading causes of death for toddlers for which supervision is a critical prevention strategy. Observations of parents supervising toddlers near these serious injury hazards in a park will be conducted and compared to the cultural model. Small group discussions with mothers and health professionals will be conducted to validate our findings and operationalize concepts of supervision. These findings will enhance understanding of supervision concepts that are necessary for developing culturally appropriate injury prevention interventions and strategies.

R01HD050637

2007-04-01

2011-09-30