A review of best practice: Home visitation interventions for childhood injury reduction

This literature review identifies a selection of good practices associated with recent home visitation interventions reported to reduce childhood injury. This article also outlines a composite definition of home visitation for injury prevention and health promotion. The burgeoning injury surveillance and prevention sector has identified child injury in low-income South African communities as a public health priority, necessitating the identification, development and implementation of especially primary injury prevention interventions. Home visitation programmes have been implemented and evaluated for a number of decades. Essential good practices of home visitation are identified from these studies and publications. Initially, programme process and outcome evaluations were under utilised and poorly described. The more recent literature indicates that the success of home visitation programmes may depend on the following specific methodological components: (1) a supportive and trusting relationship between the visitor and the client; (2) a flexible and socially congruent approach to interaction with the client; (3) the contextualisation of the individual within his or her environment; (4) a long-term programme with frequent visits; and (5) the application of a multi-method injury prevention approach, incorporating epidemiological, environmental, enforcement, training as well as technological products into the initiative. The utilization of non-professional members of the community to perform home visits is also an important, but more contested issue identified in the literature. The article focuses on these good practice methodological elements, discusses possible useful combinations of these elements, but also points out some of their limitations. The results of some studies remain controversial, and further investigation is needed.