Risk behaviors contributing to recent serious unintentional injuries among school-going adolescent boys in Kolkata: Application of zero-inflated count model

ABSTRACT

Background: Unintentional injuries have become a major noncommunicable disease burden, especially among the adolescents. Objective: The current study was conducted to estimate the effect of different aspects of daily activities of adolescence for sustaining serious unintentional injuries in the past 1 year. Methods: A cross-sectional survey with multistage sampling with validated pretested questionnaire was done among the school-going adolescent boys in Kolkata. Poisson regression was used to model the counts of serious injuries. To account for the excess of zero in the outcome, zero-inflated Poisson regression was performed. Results: Among the participants, 73.5% did not report any serious unintentional injury sustained in the past 1 year, 11.9% reported to have sustained serious unintentional injury once in the past 1 year, and rest had more than one count. Statistically significant higher chance of sustaining an episode of injury was found among frequent users of motorbike (incidence rate ratio [IRR] 1.183), frequently walking on roads (IRR 1.910), and frequently crossing major roads on bicycle (IRR 2.181) were observed. A statistically significant protective rate ratio was also obtained for those frequently obeying traffic signals while crossing roads (IRR 0.493) and frequent users of bicycles (IRR 0.384). Significantly lower rate ratio for sustaining a serious injury was observed with frequently getting into fight at home (IRR 0.343) and getting beaten up at school (IRR 0.595). Conclusions: The study revealed traveling in a car and obeying traffic rules were protective from sustaining serious injury. However, walking and participation in sports appeared to be risky, especially for sustaining another episode of serious injury.