Evaluation of Early Childhood Home Visiting to Prevent Medically Attended Unintentional Injury




Alonzo T. Folger, Katherine A. Bowers, Judith W. Dexheimer, Ting Sa, Eric S. Hall, Judith B. Van Ginkel, and Robert T. Ammerman

Brief Type

Journal Publication


  • Healthy Families America (HFA)


Study objective: We evaluated the influence of home visiting on the risk for medically attended unintentional injury during home visiting (0 to 3 years) and subsequent to home visiting (3 to 5 years). Methods: A retrospective, quasi-experimental study was conducted in a cohort of mother-child pairs in Hamilton County, OH. The birth cohort (2006 to 2012) was linked to administrative home visiting records and data from a population-based injury surveillance system containing records of emergency department (ED) visits and hospitalizations. Cox proportional hazard regression was used to compare medically attended unintentional injury risk (0 to 2, 0 to 3, and 3 to 5 years) in a home-visited group versus a propensity score–matched comparison group. The study population was composed of 2,729 mother-child pairs who received home visiting and 2,729 matched mother-child pairs in a comparison group. Results: From birth to 2 years, 17.2% of the study population had at least one medically attended unintentional injury. The risk for medically attended unintentional injury from aged 0 to 2 and 0 to 3 years was significantly higher in the home visited group relative to the comparison group (hazard ratio 1.17, 95% confidence interval 1.01 to 1.35; hazard ratio 1.15, 95% confidence interval 1.00 to 1.31, respectively). Additional injuries in the home-visited group were superficial, and the increased risk for medically attended unintentional injury was observed for ED visits and not hospitalizations. Conclusion: Home-visited children were more likely to have a medically attended unintentional injury from birth to aged 3 years. This finding may be partially attributed to home visitor surveillance of injuries or greater health care-seeking behavior. Implications and alternative explanations are discussed. (author abstract)

Data Collection Methods

  • Program administrative record reviews



For More Information

Folger, A. T., Bowers, K. A., Dexheimer, J. W., Sa, T., Hall, E. S., Van Ginkel, J. B., & Ammerman, R. T. (2017). Evaluation of early childhood home visiting to prevent medically attended unintentional injury. Annals of Emergency Medicine, 70(3), 302-310. doi: 10.1016/j.annemergmed.2017.01.029
Author Contact Information:
Alonzo T. Folger


  • Participant, Family, and Program Outcomes