An evaluation of evidence-based paediatric injury prevention policies across Canada.

Alison K Macpherson,Ian Pike,Shannon Piedt,Pamela Fuselli,Tara Middaugh-Bonney,Mariana Brussoni

doi:10.1186/s12889-015-1986-9

Abstract

BackgroundPolicies to reduce injury among Canadians can be controversial and there is variability in the enactment of injury prevention laws across the country. In general, laws are most effective when they are based on good research evidence, supported by widespread public awareness and education, and maintained by consistent enforcement strategies. The purpose of this study was to document and compare key informants’ perceptions of the quality, awareness, and enforcement of three evidence-based paediatric injury prevention policies (bicycle helmet legislation, child booster seat legislation, graduated driver licensing) among Canadian provinces and territories.MethodsWe identified best practices related to each policy, then developed an online survey to ascertain the extent to which each jurisdiction’s policy aligned with best practices, whether experts believed that the public was aware of the policy and whether it was enforced. The survey was distributed using a snowball sampling strategy to key informants across Canada.ResultsThirty-eight key informants responded to the bicycle helmet survey, with 73 and 35 key informants for the booster seat and graduated driver licensing surveys, respectively. Respondent’s perceptions of the policies varied substantially. Key informants indicated that residents are not always aware of legislation, and legislation is not consistently enforced. These results suggest that child health policy is not always guided by evidence.ConclusionsThere was variation between evidence and the policies related to paediatric injury prevention among Canadian provinces and territories. Experts generally rate their policies more highly when they align with evidence and best practice. There is room for improvement and harmonization of injury prevention policies.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1986-9) contains supplementary material, which is available to authorized users.

Highlights

Policies to reduce injury among Canadians can be controversial and there is variability in the enactment of injury prevention laws across the country
Helmet use has been shown to be higher in areas with legislation that applies to all ages compared to children alone [13], so the age group affected by the law was one of the questions included in the survey related to bicycle helmet legislation
There were a total of 146 responses to the surveys, with the majority of people completing the booster seat survey (73) followed by bicycle helmet (38) and Graduated driver licensing (GDL) (35)

Summary

Introduction

Policies to reduce injury among Canadians can be controversial and there is variability in the enactment of injury prevention laws across the country. Laws are most effective when they are based on good research evidence, supported by widespread public awareness and education, and maintained by consistent enforcement strategies. The purpose of this study was to document and compare key informants’ perceptions of the quality, awareness, and enforcement of three evidence-based paediatric injury prevention policies (bicycle helmet legislation, child booster seat legislation, graduated driver licensing) among Canadian provinces and territories. Despite evidence that bicycle helmet legislation increases helmet use and prevents head injuries [5], there is considerable opposition from some of the cycling public, and ongoing debate about the need for bicycle helmet laws. There is evidence to suggest that all ages helmet laws achieve higher levels of helmet use than laws that apply only to children [11,12,13], and that enforcing laws through fines and tickets results in increased helmet use [14, 15]

Objectives

Methods

Results