Abstract
Indicators can help decision-makers evaluate interventions in a complex, multi-sectoral injury system. We aimed to create indicators for road safety, seniors falls, and ‘all-injuries’ to inform and evaluate injury prevention initiatives in British Columbia, Canada. The indicator development process involved a five-stage mixed methodology approach, including an environmental scan of existing indicators, generating expert consensus, selection of decision-makers and conducting a survey, selection of final indicators, and specification of indicators. An Indicator Reference Group (IRG) reviewed the list of indicators retrieved in the environmental scan and selected candidate indicators through expert consensus based on importance, modifiability, acceptance, and practicality. Key decision-makers (n = 561) were invited to rank each indicator in terms of importance and actionability (online survey). The IRG applied inclusion criteria and thresholds to survey responses from decision-makers, which resulted in the selection of 47 road safety, 18 seniors falls, and 33 all-injury indicators. After grouping “like” indicators, a final list of 23 road safety, 8 seniors falls, and 13 all-injury indicators were specified. By considering both decision-maker ranking and expert opinion, we anticipate improved injury system performance through advocacy, accountability, and evidence-based resource allocation in priority areas. Our indicators will inform a data management framework for whole-system reporting to drive policy and funding for provincial injury prevention improvement.
Highlights
Injuries continue to be an important cause of death and disability in developed as well as developing nations [1]
Based on the in-depth search of peer-reviewed and grey international literature, as well as examination of key websites in the field of injury, three lists of injury indicators in the priority areas reported by key stakeholder organizations and other leading jurisdictions were developed
This paper addresses a knowledge gap in developing a suite of injury indicators that aligns with expert and decision-maker opinions and enables policy-relevant whole-system reporting
Summary
Injuries continue to be an important cause of death and disability in developed as well as developing nations [1]. In 2017, 521 million people worldwide sustained non-fatal injuries and 4.5 million died from injuries, with the main causes of death being road traffic injuries, self-harm, and falls [2]. In Canada, injuries are a public health concern and the leading cause of death among those aged 1 to 44 years [3]. Canadians visited emergency departments for injuries, leading to CAD 20.4 billion in direct health-care costs and CAD 29.4 billion in total economic costs to society [4]. Columbia (B.C.), injuries are responsible for over 2500 deaths, 9000 permanent disabilities, 38,000 hospitalizations, and 508,000 emergency department visits each year.
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