All ETDs from UAB

Advisory Committee Chair

David Schwebel

Advisory Committee Members

Colleen Fisher

Robin Gaines Lanzi

Leann Long

Despina Stavrinos

Document Type


Date of Award


Degree Name by School

Doctor of Philosophy (PhD) College of Arts and Sciences


Objective: Unintentional childhood injuries present a substantial public health burden in low- and middle-income countries (LMIC) including Uganda. Interventions to reduce this risk should be responsive to children’s unique developmental, environmental, and sociocultural context. This project had three primary objectives: 1) Analyzing caregiver reports of child injury events in rural Uganda to identify perceived causal and preventative factors; 2) Identifying Ugandan first and sixth graders’ developmental safety needs by comparing hazard recognition and past-year injuries among these students; and 3) Evaluating the impact of the Careful Cubs intervention on Ugandan first graders’ personal safety knowledge, skills, and beliefs. Methods: 1) Caregivers completed semi-structured oral interviews exploring perceptions of unintentional childhood injury events. Descriptive statistics and qualitative analyses informed by grounded theory identified perceived causal and preventative factors. 2) First and sixth graders reported past-year injury history and completed a hazard recognition task. Safety skills and injury history were compared between grades. 3) First graders at three rural Ugandan schools participated in Careful Cubs. Safety knowledge, skills, and beliefs were compared between pre- and post-intervention. iii Results: 1) Caregivers most often attributed injuries to child risk-taking, but also identified social, environmental, and chance factors. Teaching children safety rules was the most common injury prevention strategy used by caregivers. 2) First graders had lower rates of hazard recognition than sixth graders, with poor recognition of a majority of hazards. Cuts, falls, and burns accounted for the most injuries among all students. 3) Students at all three schools improved safety skills and beliefs. Students at two schools improved safety knowledge. Among teachers, Careful Cubs’ acceptability and lesson fidelity were high. Conclusions: Locally-targeted interventions addressing context-specific risk factors may be effective in reducing unintentional childhood injuries. Personal safety interventions may be most effective when included in holistic public health interventions to also improve children’s supervision and environmental safety.



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