Navigation path

Additional tools

  • Print version
  • Decrease text
  • Increase text

Risk Watch

Evidence level:
Best PracticePromising PracticeEmergent Practice
Evidence of Effectiveness:
Enduring Impact:
Review criteria and process

Recommendation Pillars

Improve the responsiveness of health systems to address the needs of disadvantaged children

Countries that have implemented practice

United Kingdom

Age Groups

Young Children (age 0 to 5), Middle Childhood (age 6 to 12), Teenagers (age 13 to 19)

Target Groups


Years in Operation

2012  - still operating

Type of Organization Implementing Practice

Private Human Services Organization, City or Town Government

Practice Overview

Risk Watch is an injury prevention and safety education programme aimed at children ages three to 14 (the evaluation which studied the effects of the program assessed the impact of the program on children between the ages of 7 and 10 only).  Developed by the National Fire Protection Association in the USA and adapted for use in the UK, the program aims to develop children’s risk-assessment and injury-reduction skills .  The curriculum varies by age based on developmental stages as well as the risks faced by different age groups.  The program focuses on eight areas of injury prevention, including:

  • motor vehicle safety
  • fire and burn prevention
  • choking and suffocation prevention
  • poisoning prevention
  • prevention of falls
  • weapons injury prevention
  • bike and pedestrian safety, and
  • water safety.

Risk Watch is designed to be flexible in its delivery; it can be integrated into a school’s core curriculum, or can be offered as a stand-alone unit.


There are several other similar injury prevention programs that have been implemented in the UK which have shown promise in other trials.  However, the specific Risk Watch curriculum has not been evaluated among another population with methods that meet EPIC criteria.

Evidence of Effectiveness

Evaluation 1

Kendrick, Denise, Lindsay Groom, Jane Stewart, Michael Watson, Caroline Mulvaney, and Rebecca Casterton (2007). ‘‘Risk Watch’’: Cluster randomised controlled trial evaluating an injury prevention program. Injury Prevention 13:93–98

This study examined the impact of Risk Watch in 20 schools in Nottingham County in the UK. The curriculum was implemented in one class per participating school, of grades 3 (age 7–8), 4 (age 8–9) or 5 (age 9–10).  Outcomes measured included safety knowledge and safety behaviors, as indicated by student responses to a questionnaire.  Researchers also observed safety skills, where students were required to demonstrate skills such as what to do in a fire and how to cross a road safely.

Summary of Results for Evaluation 1




Treatment Group

Control Group

Outcomes improved (statistically significant)

Safety knowledge



Fire and burn prevention knowledge score



Safety behaviours



Never play with matches

The odds that children in the treatment group report never playing with matches are 1.84 times higher than children in the control group

Observed safety skills



Percentage of all safety actions performed correctly



Percentage of fire and burn prevention actions performed correctly



Outcomes with no effect


Safety knowledge



Poisoning prevention knowledge score



Bike and pedestrian safety knowledge score



Safety behaviours



Has smoke alarm at home

Results not reported for safety behaviours

Has smoke alarm at home

Never cooks food without adult present

Never gets medicine without asking adult

Never plays on stairs

Always wears helmet if rides bike

Always wears reflective clothing in dark

Never runs across road if car coming

Uses zebra crossing, if there is one near every time crosses road

Observed safety skills



Percentage of bike and pedestrian safety skills performed correctly



Percentage of poisoning prevention skills performed correctly



Outcomes worsened (statistically significant)


Safety knowledge



Prevention of falls knowledge (% getting all correct)



Issues to consider

Risk Watch received an “Emerging” rating.  A well-designed trial found that it improved several outcomes, in particularly fire and burn prevention knowledge, behaviors, and skills.  The trial did find one outcome significantly worse for the intervention group than the control group: the percentage of children getting all of the prevention of falls knowledge questions correct was higher in the control group than in the intervention group, despite the fact that these scores were similar at baseline. Authors do not discuss this finding, however with the large number of outcomes observed, it is possible that this difference is due to chance rather than a negative outcome of the programme itself.

Evaluation Details

The study summarized above was a group-randomized controlled trial.  Twenty  schools in Nottingham County in the United Kingdom were divided into thirds by the percentage of children receiving free school meals, and were then randomly allocated within strata to treatment or control groups. Children in one class per participating school, of grades 3 (age 7–8), 4 (age 8–9) or 5 (age 9–10) whose parents gave consent were eligible to participate. At baseline, 240 children in 11 schools were assigned to the treatment group, and 219 children from 9 schools were assigned to the control group.

Intervention group children were more likely to come from families without access to a car (26.6% vs. 14.2% in control group). Otherwise, groups were comparable on a broad range of demographics at baseline.  All outcomes reported were measured at baseline and at follow-up, roughly 4 months after the baseline assessment and immediately following the conclusion of the program. The treatment and control groups were statistically equivalent at baseline on all measures of safety knowledge, behaviors, and skills.

Enduring impact

Long-term outcomes have not been assessed for this program.


Kendrick, Denise, Lindsay Groom, Jane Stewart, Michael Watson, Caroline Mulvaney, and Rebecca Casterton (2007). ‘‘Risk Watch’’: Cluster randomised controlled trial evaluating an injury prevention program. Injury Prevention 13:93–98

Contact Information


Dr. Denise Kendrick


Division of Primary Care, University of Nottingham


Floor 13, Tower Building, University Park, Nottingham, NG7 2RD