Table 2.

Main themes emerging in synthesis of nine articles on barriers to, and facilitators of, prevention of unintentional injury to children in the home

Level	Type of barrier	Main barriers identified	Main facilitators identified
1. External: legal, policy or organisational	Legal/policy/health services	Weak legislation. Absence of policy drivers influencing resources	Policy drivers and legislation. Multi-agency partnerships, linking with other health messages or initiatives
	Information and communication with households	Lack of appropriate information to parents/households about legislation and policies	Good communication between organisations and target audiences. Involving local people (eg, mothers) to be trained in health initiatives. Targeting of population (eg, schoolchildren) to share information
	Socioeconomic circumstances	Disempowering effects of living in rented or overcrowded living conditions
2. Physical or environmental	Housing	Practical barriers due to poor quality (often rented) housing	Stable and child-friendly accommodation. Control/ownership of home environment
	Equipment and maintenance	Lack of maintenance of smoke alarms	Landlords' attention to safety issues. Provision of appropriate and durable equipment. Maintenance of and confidence in other safety devices
	Training		Training in installation and equipment use/replacement
	Cost	Cost of installing safety devices. Costs of accessing treatment
3. Individual	Understanding of risk	Lack of awareness of risk. Fatalism about nature of injuries	Awareness of risk
	Mothers' safeguarding work		Mothers' work in safeguarding children. Mothers' commitment to vigilance. Teaching children about safety
	Cultural background	Cultural differences in experiences and expectations. Cultural practices in different cultural context. Language barriers	Culturally sensitive information and advice systems
	Social/relational	Relationship with partner. Mistrust of officials. Fear of being accused of abuse or neglect. Not trusting neighbours/non-family to look after child	Social connectedness rather than isolation. Building trust in officials via peer education