Childhood Injury Prevention Program Research Articles

Translating an Evidence-Based Injury Prevention Program for Implementation in a Home Visitation Setting

Safe N' Sound (SNS), a computer-based childhood injury prevention program, provides individually tailored information to parents about their child's injury risks with specific behavioral recommendations. We translated SNS for implementation in a home visitation organization in order to increase its capacity to effectively address injury prevention and decrease the burden of injury experienced by high-need families. The aim of this study was to identify behavioral and organizational barriers and facilitators to translating and implementing SNS in a home visitation setting. Nurse home visitors (NHVs) participated in semistructured interviews that examined perceptions of program implementation, intervention characteristics, individual characteristics of NHVs, and recommendations for improving implementation. The utility of the program for promoting injury prevention systematically and its alignment with the organization's mission were facilitators of successful implementation. Barriers included NHVs' concerns about overburdening clients and missed educational opportunities related to injury risks not addressed by the program and delayed delivery of educational reports. Findings illustrate the dynamic interactions of intervention characteristics with organizational and individual factors and suggest that customizing implementation to organizational capacity and specific needs may better support successful program implementation in home visitation settings.

Role of a child death review team in a small rural county in California

Humboldt County is one of California's most rural counties. Located in far Northern California, it is 6–7 h by car from the nearest major urban areas of San Francisco and...

Translation of an Evidence-Based Tailored Childhood Injury Prevention Program

This article describes the process of translating Safe n' Sound, a computer-based program for parents of young children, for a general clinic environment. Safe n' Sound is designed to reduce the risk of unintentional childhood injuries, the leading cause of death among children older than 1 year in the United States. The evidence-based program produces tailored information for parents and their healthcare provider about burns, falls, poisoning, drowning, suffocations, choking prevention, and car safety. To offer Safe n' Sound to a broader audience, we translated the program from the form used for efficacy testing to a stand-alone application. Notable steps in this translation included (1) conducting an organizational assessment to determine the needs of the clinic staff and feasibility of implementation, (2) modifying the program to reduce length, prioritize risk areas, and update content, (3) repackaging the program to minimize cost and space requirements, and (4) developing promotional and instructional materials. Factors contributing to the success of this effort include strong collaborative partnerships, the relative advantage of Safe n' Sound over traditional materials, the modifiable design of the program, and the support of the clinic staff and providers. Challenges and areas for future work are discussed.

The development of an instrument measuring unintentional injuries in young children in low-income settings to serve as an evaluation tool for a childhood home injury prevention program

Problem: Responding to the lack of standardized instrumentation, especially as applied in low-income contexts, the researchers decided that an instrument should be developed to serve as an evaluation tool for a childhood (unintentional) injury prevention program as well as a tool from which injury risks (poisonings, burns and falls) could be identified within households. Methods: Cross-sectional samples of 521 households in four low-income sites in Cape Town and Johannesburg, South Africa, participated in the three phases of the study. The generation of an item pool based on a table of specifications, subsequent scientific item reduction procedures, reviews from experts and pilot tests were used to develop the scales for measuring the injury risks. Results: The developed instrument complies with all the requirements for a valid and reliable measurement instrument. Conclusion: The instrument allows valid comparison of risks between communities, as well as before and after comparisons for an intervention program. Impact: The provision of this instrument may bring enormous benefits to research studies. It can also provide proactive, rather than reactive, information about injury risks before they develop into injuries and thus allows focusing of safety efforts for improvement of problematic areas in the households.

Taking it personally; Pediatricians join crusade to reduce teen driver deaths

For most Americans, the disproportionately high death toll among teen-age drivers — more than 5,000 teens die in car crashes each year — is more than a national tragedy. It's personal. For Richard Schieber, M.D., FAAP, it was the neighbor girl who baby-sat his own children. She received a brand new sports car for her 16th birthday. Soon after, she died behind the wheel. Dr. Schieber heads the childhood injury prevention program at the Centers for Disease Control and Prevention. He and other members of the AAP Committee on Injury and Poison Prevention (COIPP) are leading an Academywide effort to stop the carnage.

Evaluation of a community based childhood injury prevention program.

OBJECTIVES: This pilot study evaluates the effectiveness of a community based childhood injury prevention program on the reduction of home hazards. METHODS: High risk pregnant women, who were enrolled in...

Creating Safer Environments for Children

Discusses the goals and specific initiatives of the National SAFE KIDS Campaign, a nationwide childhood injury prevention program that works to protect children from birth through age 14. Its programs focus on bike helmet and bike safety awareness; scald burn prevention; residential fire detection and smoke alarm installation; and automobile seat belt use. (MDM) Language: en

The risk of childhood injury on Boston's playground equipment and surfaces.

The Childhood Injury Prevention Program of the Boston Department of Health and Hospitals conducted a survey of injury risk in Boston's playgrounds. A standardized checklist was used to assess a 25% sample of public playgrounds for hazards. Climbers accounted for 34% of the hazards observed and had the greatest proportion of significant hazards. The surfacing material in 100% of the playgrounds observed was unsafe. Urban children risk exposure to hazardous playground equipment frequently situated above unsafe surfacing material.

Injury Surveillance Using Hospital Discharge Abstracts Coded by External Cause of Injury (E Code)

Current knowledge of the patterns of injury in the United States derive principally from mortality statistics that constitute less than 0.1% of all injuries reaching medical attention. There presently exists no national system for the surveillance of nonfatal injuries. To illustrate the usefulness and feasibility of conducting injury surveillance using E-coded hospital discharge data, we examined the surveillance data from the Massachusetts Statewide Childhood Injury Prevention Program. By using E-coded hospital discharge data, we increased the number of cases available for analysis by 40-fold over deaths, and we were able to describe the epidemiologic characteristics of the important causes of nonfatal childhood injuries. We therefore propose the development of a national injury surveillance system based on the Uniform Hospital Discharge Data Set coded by both the nature of the injury (N Code) and external cause (E Code).

Injury Surveillance Using Hospital Discharge Abstracts Coded by External Cause of Injury (E Code)

Current knowledge of the patterns of injury in the United States derive principally from mortality statistics that constitute less than 0.1% of all injuries reaching medical attention. There presently exists no national system for the surveillance of nonfatal injuries. To illustrate the usefulness and feasibility of conducting injury surveillance using E-coded hospital discharge data, we examined the surveillance data from the Massachusetts Statewide Childhood Injury Prevention Program. By using E-coded hospital discharge data, we increased the number of cases available for analysis by 40-fold over deaths, and we were able to describe the epidemiologic characteristics of the important causes of nonfatal childhood injuries. We therefore propose the development of a national injury surveillance system based on the Uniform Hospital Discharge Data Set coded by both the nature of the injury (N Code) and external cause (E Code).

Prevention of childhood injuries: evaluation of the Statewide Childhood Injury Prevention Program (SCIPP).

We evaluated the effectiveness of a community-based injury prevention program designed to reduce the incidence of burns, falls in the home, motor vehicle occupant injuries, and poisonings and suffocations among children ages 0-5 years. Between September 1980 and June 1982, we implemented five injury prevention projects concurrently in nine Massachusetts cities and town; five sites, matched on selected demographic characteristics, were control communities. An estimated 42 percent of households with children ages 0-5 years were exposed to one or more of the interventions over the two-year period in the nine communities. Participation in safety programs increased three-fold in the intervention communities and two-fold in the control communities. Safety knowledge and practices increased in both intervention and control communities. Households that reported participatory exposure to the interventions had higher safety knowledge and behavior scores than those that received other community exposure or no exposure to intervention activities. We found a distinct reduction in motor vehicle occupant injuries among children ages 0-5 years in the intervention compared with control communities, associated with participatory exposure of about 55 percent of households with children ages 0-5 years. We have no evidence that the coordinated intervention programs reduced the other target injuries--although exposure to prevention messages was associated with safety behaviors for burns and poisonings.

State and Local Responses to Children's Injuries: The Massachusetts Statewide Childhood Injury Prevention Program

This paper identifies problems facing effective injury prevention, including the lack of media and professional attention, poor data systems on epidemiology and prevention of injuries, inadequate prevention strategies, and hampered implementation. As a partial solution to these problems, efforts are described for increasing the involvement of agencies at the local, state, and federal levels, especially those devoted to maternal and child health. One program, the Massachusetts Statewide Childhood Injury Prevention Program, is described to illustrate the role of one lead agency for designing and implementing a strategic plan for injury prevention that can overcome the obstacles noted. General perspectives are outlined for approaching injury prevention through state and local maternal and child health programs.

The Incidence of Injuries Among 87,000 Massachusetts Children and Adolescents: Results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System

This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2,239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admissions to deaths was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population.

The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980-81 Statewide Childhood Injury Prevention Program Surveillance System.

This study describes the incidence of fatal and nonfatal injuries occurring in 87,022 Massachusetts children and adolescents during a one-year period. A surveillance system for injuries at 23 hospitals captured 93 per cent of all discharges for ages 0-19 in the 14 communities under study. Sample data were collected on emergency room visits, hospital admissions, and deaths for all but a few causes of unintentional injuries. The overall incidence was 2,239 per 10,000. The true incidence rates are probably higher than those reported. The ratio of emergency room visits to admissions to deaths was 1,300 to 45 to 1. Injury rates varied considerably by age, sex, cause, and level of severity. Age-specific injury rates were lowest for infants and elementary school age children and highest for toddlers and adolescents. The overall ratio of male to female injury rates was 1.66 to 1. Injuries from falls, sports, and cutting and piercing instruments had a high incidence and low severity. Injuries from motor vehicles, burns, and drownings had lower incidence, but greater severity. Results provide evidence that both morbidity and mortality must be considered when determining priorities for injury prevention. Current prevention efforts must be expanded to target injuries of higher incidence and within the adolescent population.