ContextualDeterminantsofChildhoodInjury:ASystematic ReviewofStudiesWithMultilevelAnalyticMethods

Background. The definition of injury that underpins the contemporary approachtoinjurypreventionis anetiological definition relating to bodily damage arising from transfer of energy to tissues of the body beyond the limits compatible with physiological function. Causal factors proximal to the energy transfer are nested within a more complex set of contextual determinants. For effective injury control,understandingofthesedeterminantsiscritical. Objectives. The primary aims of this study were to describe the area-level determinants that have been included in multilevel analyses of childhood injury and to quantify the relationships betweenthesearea-level exposuresand injuryoutcomes. Search methods. We conducted a systematic review of peerreviewed, English-language literature published in scientific journals between January 1997 and July 2014, reporting studies that employed multilevel analyses to quantify the eco-epidemiological causation of physical unintentional injuries to children aged 16 years and younger. We conducted and reported the review in accordance with the PRISMA guidelines. Selection criteria. We included etiological studies of causal risk factors for unintentional traumatic injuries to children aged 0 to 16 years.Methodologicalinclusioncriteriawereasfollows: