Evaluation of a Child Safety Program Based on the Safe Community Model in Canada

Abstract

Abstract BACKGROUND: Despite national safety programs, unintentional injuries remain an important health problem in children and adolescents. Cycling, pedestrian and young drivers injuries are particularly influenced by specific community and city aspects. The World Health Organization (WHO) developed community based programs that have been effectively implemented as complements to national safety programs to prevent injuries. OBJECTIVES: The aim of this study was to evaluate the effectiveness of a local program based on a WHO Safe Community model to reduce cycling, pedestrian and young drivers injuries. DESIGN/METHODS: A population based quasi-experimental design was used. Pre-implementation and post-implementation data of cycling and pedestrian injury rates (0-15 years) and young drivers injury rates (16-24 years) were collected in the intervention area (Sherbrooke) and in two control communities (Trois-Rivières and Gatineau) in Québec, Canada. RESULTS: Sherbrooke, Gatineau and Trois-Rivières had respectively 69, 82 and 119 cycling and pedestrian injury rate per 100000 children-year in the pre implementation period. Despite its already lower pre-implementation rate, Sherbrooke showed a statistically significant reduction in the post-implementation injury rate compared to Trois-Rivières (Sherbrooke: 49:100000 children-year (OR comparing pre-post rates 0.70 ; 95%CI : 0.45-1.08) and Trois-Rivières 80:100000 children-year (OR comparing pre-post rates 0.68; 95%CI: 0.46-1.0). Gatineau showed a cycling and pedestrian post-implementation injury rate of 63:100000 (OR 0.77; 95%CI: 0.58-1.02). Sherbrooke had the largest young drivers injury reduction with rates of 2912:100000 young driver-year (pre) to 2121: 100000 young driver-year (post) (OR 0.73; 95%CI: 0.66-0.8). Gatineau and Trois-Rivieres showed respectively young drivers injury rate lowering from 2383: 100000 to 2099: 100000 young driver-year (OR 0.88; 95%CI: 0.81-0.95) and from 3447: 100000 to 3295: 100000 young driver-year (OR 0.96; 95%CI 0.87-1.05). CONCLUSION: Safe Community program established in Sherbrooke was associated with favorable results in injury prevention. Despite its lower pedestrian and cycling injury rate before the intervention, post-implementation injury rate in Sherbrooke was significantly lower compared to Trois-Rivieres. Concerning young drivers injury rates, Sherbrooke showed the biggest reduction, compared to Trois-Riviere and Gatineau. In addition to national injury prevention programs, communities should be encouraged to adopt WHO safe community programs to reduce to a minimum unintentional injury rates in children and adolescents.