The Role of Guardians in Preventing Accidental Injuries among Rural Children: A Mixed-Methods Study

Liheng Huang^1,2Dehong Luo^1,2*

• ¹College of Eduction Sciences, Huaihua University, Huaihua, China
• ²Wulingshan Area Basic Education Research Center, Huaihua, China

Background: Accidental injuries are a leading public health concern among for children, particularly in rural areas of low-and middle-income countries. Guardians are important in the prevention of accidental injuryies prevention, yet few studies have systematically examined guardianship-related factors in rural areas of China. This study investigates the association between guardian-related factors and accidental injuries among children in Hunan Province and proposes a three-stage prevention strategyies.A mixed-methods approach was used. Study I adopted a quantitative approach withdesign, collecting data collected through electronic questionnaires from 432 guardians of primary school children across five cities in Hunan Province. Logistic regression and chi-square analyses were performed using statistical software (SPSS) to assess associations between guardian-related factors and reported accidental injuries among children. Study II used the a qualitative approach, interviewingwith 30 guardians from 15 counties interviewed using a semistructured guide. Thematic analysis was conducted using NVivo software, followed by Colaizzi's phenomenological analysis. Findings were synthesized using the Haddon Matrix to frame develop three-stage preventive countermeasures. Findings: Study I revealed that guardians who had implemented injury prevention measures were less likely to report child injuries (OR=0.463, P<0.05). However, most guardians lacked consistent preventive actions. Study II identified four key contributing factors contributing to accidental injuriesy among children in the rural areas: hazardous environmental factors, inadequate safety education for guardians, children's own behaviors, and lack of regulatory and systemic safety infrastructure management in rural areassafety infrastructure. Conclusion: Guardian-related factors are critical in the prevention ofsignificantly influence the prevention of accidental injuries among rural children in the rural contexts. By iIntegrating quantitative and qualitative evidence within the Haddon Matrix model, this study proposes threestage (pre-, during-and post-injury) preventive measures were proposed to reduce the risks and enable a practical, theory-driven framework for injury prevention strategy.