The factors related to the prevention of fall injuries among students in primary schools using the PRECEDE model.

Falls are considered one of the important causes of injuries and fatalities among children and adolescents. Students are continuously exposed to the risks of falls, in the school environment. Therefore, a thorough examination of student behaviours and the environmental conditions of schools is of significant importance for preventing fall-related injuries in students. This study aims to investigate the influential factors for preventing fall-related injuries among primary school students using the PRECEDE model. This cross-sectional study has been done among 428 primary school students from grades one to six in schools of Hamadan city, located in western Iran. The students were selected randomly through a multi-stage cluster sampling method and data collection has been done between December 2023 and February 2024. The data collection tool was a researcher-made questionnaire based on the PRECEDE model. The questionnaire was included three sections including demographic questions, questions related to the constructs of the PRECEDE model (preventive behaviour constructs; predisposing factors including knowledge and attitude; reinforcing factors; enabling factors; and environmental factors), and questions concerning the history of fall-related injuries at school. The data collection has been done through interviews with the students. Data were analyzed using SPSS24 software after collection. The results of this study revealed that out of 428 students, 131(30.6%) experienced falls, with ages ranging from 7 to 12 years and an average age of 9.5 ± 1.70 years. Among these, 54 (41.2%) were females and 77 (58.7%) were males. The findings indicate that males experienced more falls than females, and females exhibited better preventive behaviours than males (p = 0.002). Most falls occurred in the schoolyard (37.4%) and during recess time (40.5%). The most common types of injuries were abrasions (28.2%) and head injuries (24.4%). Additionally, the findings showed that parents' education level was significantly associated with preventive fall behaviours among students. Hence, the students with parents who had higher education levels (mothers' education with (p = 0.02) and fathers' education with (p = 0.03) demonstrated better preventive behaviours and were less at risk of falls. Among the constructs of the PRECEDE model, the predisposing factors of knowledge (p = 0.04) and attitude (p = 0.001), enabling factors (p = 0.02), and environmental factors (p = 0.03) had a significant relationship with fall-preventive behaviours. According to the statistical results, the attitude construct was the predictor of students' fall- preventive behaviours. The study results indicated that fall-related injuries in the studied group are high. Additionally, the PRECEDE model can help identify factors associated with fall prevention among students. Given the significant role of behaviour and the school environment in fall prevention in this study, implementing appropriate interventions to enhance students' attitudes and knowledge and creating a safe school environment can be very beneficial and effective in improving fall-preventive behaviours.