Injury Prevention Experts Research Articles

One Step Closer to Safer: Counseling Outcomes from American Academy of Pediatrics Firearm Safe Storage Education Training

To assess pre- and post-self-reported counseling outcomes for Safer: Storing Firearms Prevents Harm, an American Academy of Pediatrics universal firearm safe storage counseling training for pediatric clinicians providing health maintenance in outpatient settings. Safer was developed by a national multidisciplinary committee of firearm injury prevention experts with input from firearm-owning families and launched in June 2021. Pediatric clinicians completed baseline and one-month post-training surveys after signing up for the Pedialink course from February through June 2022. Primary outcomes included self-reported measures of counseling self-efficacy and frequency. Wilcoxon matched-pairs signed-rank tests compared outcome distributions at baseline and follow-up. Two adjusted, multilevel mixed-effects regression models were conducted. Of 230 clinicians who completed baseline surveys, 146 (64%) completed one-month post surveys. Regional representation included Southeast=67 (46%), Northeast=24 (16%), Midwest=21 (14%), Pacific=15 (10%), Southwest=11 (8%), and Rocky Mountain=8 (5%). At follow-up, there was significant improvement in both the distribution of self-efficacy [median [(1st Quartile-3rd Quartile)=50 (20-70) at baseline and 80 (60-85) at follow-up; p<0.001] and self-reported counseling frequency [median (1st Quartile-3rd Quartile)=10 (0-50) at baseline and 50 (10-80) at follow-up; p<0.001]. Adjusted regression model results suggested that self-efficacy significantly improved from baseline to follow-up (time coefficient 25.3; 95% CI=[21.0, 29.5]; p<0.001) as did counseling frequency (time coefficient 13.6; 95% CI=[9.2, 18.0]; p<0.001). Significant improvement in self-reported counseling self-efficacy and frequency was demonstrated one month following Safer training.

Financial Impact of Embedded Injury-Prevention Experts in US Army Initial Entry Training.

The US Army embedded injury-prevention experts (IPEs), specifically athletic trainers and strength and conditioning coaches, into initial entry training (IET) to limit musculoskeletal (MSK) conditions and their negative consequences. However, little is known about the financial impact of IPEs. To assess whether IPEs were associated with fewer sunk training costs due to MSK-related early discharges from service. Retrospective cohort study. Database of US Army soldiers' administrative, medical, and readiness records. A total of 198 166 soldiers (age = 20.7 ± 3.2 years, body mass index = 24.4 ± 3.5 kg/m2) who began IET during 2014 to 2017. Early discharge from service was defined as occurring within 6 months of beginning IET. All IET sites employed IPEs from 2011 to 2017, except for 2 sites during April to November 2015. Soldiers who began IET at these 2 sites during these times were categorized as not having IPE exposure. All others were categorized as having IPE exposure. The unadjusted association between IPE access and MSK-related early discharge from service was assessed using logistic regression. Financial impact was assessed by quantifying differences in yearly sunk costs between groups with and those without IPE exposure and subtracting IPE hiring costs. Among 14 094 soldiers without IPE exposure, 2.77% were discharged early for MSK-related reasons. Among 184 072 soldiers with IPE exposure, 1.01% were discharged. Exposure to IPEs was associated with reduced odds of MSK-related early discharge (odds ratio = 0.36, 95% CI = 0.32, 0.40, P < .001) and a decrease in yearly sunk training costs of $11.19 to $20.00 million. Employing IPEs was associated with reduced sunk costs because of fewer soldiers being discharged from service early for MSK-related reasons. Evidence-based recommendations should be developed for guiding policy on the roles and responsibilities of IPEs in the military to reduce negative outcomes from MSK conditions and generate a positive return on investment.

Preventing Knee Injuries: Exercises to Keep You From Getting Sidelined.

Recently, injury prevention experts developed a guideline for rehabilitation clinicians to use to help you avoid getting another knee injury. Here, we explain what the guidelines say about which exercises you should do to stay injury-free, how often to do the exercises, and when to do the exercises. J Orthop Sports Phys Ther 2023;53(2):105. doi:10.2519/jospt.2023.0503.

Perceptions of implementation of Massachusetts sports concussion regulations: results of a survey of athletic directors

BackgroundIn 2011 the Massachusetts Department of Public Health issued regulations pursuant to 2010 Massachusetts youth sports concussion legislation that provided policies and procedures for persons engaged in the prevention, training, management, and return-to-activity for students who sustain head injury during interscholastic athletics, including Athletic Directors (ADs).MethodsA survey instrument was developed with participation from injury prevention experts at the Boston University School of Medicine, the Massachusetts Department of Public Health, and ADs. An electronic survey was sent to all AD members of the Massachusetts Interscholastic Athletic Association to assess their perceptions of implementation of the sports concussion law.ResultsResponse rate was 75% (260/346). The mean rating on a 0–10 scale (10 being “very important”) on importance of the law for student safety was 9.24, and the mean rating of the law’s impact on workload was 5.54. Perceived impact on workload varied as a function of whether or not the school also employed an athletic trainer (t = 2.24, p = 0.03). Most respondents (88%) reported that their school had a concussion management team, and 74% reported that they were informed “always” (31%) or “often” (43%) when a student-athlete experienced a head injury in a venue other than extracurricular sports. Most respondents (95%) endorsed that “all” or “most” school nurses were “very knowledgeable” about the law and regulations. Approximately half of all respondents endorsed that “all” or “most” teachers and guidance counselors were “very knowledgeable” about the law and regulations; 76% endorsed that “all” or “most” of students’ physicians were “very knowledgeable” about the law and regulations; 59% endorsed that “all” or “most” parents were “very knowledgeable” about the law and regulations. Sixty-six percent endorsed that student-athletes with concussion “often” (10%) or “sometimes” (56%) misrepresent their symptoms to accelerate return-to-play; and, 70% perceived that student-athletes with concussion “often” (15%) or “sometimes” (55%) misrepresent their symptoms to avoid academics.ConclusionsADs perceive the sports concussion legislation as very important to student safety and positively assess implementation of the law and associated regulations. More effort is needed to increase understanding of the law among stakeholders including teachers, parents, and physicians.

Using Geospatial Mapping to Determine the Impact of All-Terrain Vehicle Crashes on Both Rural and Urban Communities.

IntroductionDeaths and injuries from all-terrain vehicle (ATV) crashes result in approximately 700 deaths each year and more than 100,000 emergency department (ED) visits. Common misconceptions about ATV crashes are a significant barrier to injury prevention efforts, as is the lack of key information about where and how crashes occur. The purpose of this study was to determine ATV crash patterns within a state, and to compare and contrast characteristics of these crashes as a function of crash-site rurality.MethodsWe performed descriptive, comparative, and regression analyses using a statewide off-road vehicle crash and injury database (2002–2013). Comparisons were performed by rurality as defined using the Rural Urban Commuting Area (RUCA) coding system, and we used geographic information system (GIS) software to map crash patterns at the zip code and county levels.ResultsATV crashes occurred throughout the state; 46% occurred in urban and 54% in rural zip code areas. Comparisons of rider and crash characteristics by rurality showed similarities by sex, age, seating position, on vs. off the road, and crash mechanism. Conversely, helmet use was significantly lower among victims of isolated rural crashes as compared to other victims (p=0.004). Crashes in isolated rural and small rural areas accounted for only 39% of all crashes but resulted in 62% of fatalities. In both rural and urban areas, less than one-quarter of roadway injuries were traffic related. Relative crash rates varied by county, and unique patterns were observed for crashes involving youth and roadway riders. During the study period, 10% and 50% of all crashes occurred in 2% and 20% of the state’s counties, respectively.ConclusionThis study suggests that ATV crashes are a public health concern for both rural and urban communities. However, isolated rural ATV crash victims were less likely to be helmeted, and rural victims were over-represented among fatalities. Traffic was not the major factor in roadway crashes in either rural or urban areas. Unique crash patterns for different riding populations suggest that injury prevention experts and public policy makers should consider the potential impact of geographical location when developing injury prevention interventions.

Youth injury prevention in Canada: use of the Delphi method to develop recommendations.

BackgroundThe Health Behaviour in School-aged Children Survey is one of very few cross-national health surveys that includes information on injury occurrence and prevention within adolescent populations. A collaboration to develop a Canadian youth injury report using these data resulted in, Injury among Young Canadians: A national study of contextual determinants. The objective of this study was to develop specific evidence-based, policy-oriented recommendations arising from the national report, using a modified-Delphi process with a panel of expert stakeholders.MethodEight injury prevention experts and a 3-person youth advisory team associated with a Canadian injury prevention organization (Parachute Canada) reviewed, edited and commented on report recommendations through a three-stage iterative modified-Delphi process.ResultsFrom an initial list of 27 draft recommendations, the modified-Delphi process resulted in a final list of 19 specific recommendations, worded to resonate with the group(s) responsible to lead or take the recommended action. Two recommendations were rated as “extremely important” or “very important” by 100 % of the expert panel, two were deleted, a further two recommendations were deleted but the content included as text in the report, and four were merged with other existing recommendations.ConclusionsThe modified-Delphi process was an appropriate method to achieve agreement on 19 specific evidence-based, policy-oriented recommendations to complement the national youth injury report. In providing their input, it is noted that the injury stakeholders each acted as individual experts, unattached to any organizational position or policy. These recommendations will require multidisciplinary collaborations in order to support the proposed policy development, additional research, programming and clear decision-making for youth injury prevention.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-2600-x) contains supplementary material, which is available to authorized users.

Adaptive nature of coordinated road traffic injury prevention responses in some OECD countries

This study examines the context of coordinated responses, triggers for coordinated responses, and preference for or choice of coordinating strategies in road traffic injury prevention at a local level in some OECD countries. This aim is achieved through a mixed-methodology. In this respect, 22 semi-structured interviews were conducted with road traffic injury prevention experts from five OECD countries. In addition, 31 professional road traffic injury prevention stakeholders from seven OECD nations completed a self-administered, online survey. It found that there was resource limitation and inter-dependence across actors within the context of road traffic injury prevention at a local level. Furthermore, this study unveiled the realization of resource-dependency as a trigger for coordinated responses at a local level. Moreover, the present examination has revealed two coordinating strategies favored by experts in road traffic injury prevention – i.e. self-organizing community groups, which are deemed to have a platform to deliver programs within communities, and the funding of community groups to forge partnerships. However, the present study did not appear to endorse other strategies such as the formalization of coordinated responses or a legal mandate to coordinate responses.In essence, this study appears to suggest a need to manage coordinated responses from an adaptive perspective with interactions across road traffic injury prevention programs being forged on a mutual understanding of inter-dependency arising out of resource scarcity. In fact, the role of legislation and top-down national models in local level management of coordinated responses is likely to be one of identifying opportunities to interact with self-organized community groups and fund partnership-based road traffic injury prevention events.

Sports-related genitourinary injuries presenting to United States emergency departments.

To describe epidemiologic features of sports-related genitourinary (GU) injuries and determine patient cohorts and particular sporting activities associated with increased GU injury risk. The National Electronic Injury Surveillance System, a data set validated to provide a probability sample of injury-related US emergency department (ED) presentations, was analyzed to characterize GU injuries between 2002 and 2010. A total of 13,851 observations were analyzed to derive national estimates. Between 2002 and 2010, an estimated 137,525 individuals (95% confidence interval, 104,490-170,620) presented to US EDs with GU injuries sustained during sporting activities. Nearly three-quarters of injuries occurred in the pediatric population. The most common product involved was a bicycle, representing approximately one-third of injuries in both adult and pediatric populations. Injuries related to team sports such as football, baseball or softball, basketball, and soccer were also common, particularly among boys where they represented a combined third of all injuries. Eighty-nine percent of all patients were evaluated and treated in the ED without inpatient admission. The large majority of injuries involved the external genitalia (60%), and significant injuries of paired GU organs (kidneys and testicles) requiring inpatient admission were rare (8.5%). Sports-related GU injuries are most commonly sustained during the use of a bicycle. However, there are other associated activities with identifiable high-risk cohorts, products, and situations. Consumers, practitioners, and injury-prevention experts can use our epidemiologic data to prioritize and develop strategies aimed at the prevention and limitation of such injuries, particularly when counseling at-risk cohorts, such as those with solitary kidneys or testicles.

The development of a framework to integrate evidence into a national injury prevention strategy.

Injury is the leading cause of death from birth to age 34 in Canada (Statistics Canada, 2008). In 2013, a national injury prevention organization in Canada initiated a research-practitioner collaboration to establish a framework for incorporating evidence in the organization's decision-making. In this study, we outline the development process and provide an overview of the framework. The process of development of the evidence-synthesis framework included consultation with national and international injury prevention experts, a review of the research literature to identify existing models for incorporating research evidence into public health practice and extensive interactions with the organization's leadership and staff. A framework emphasizing four types of research evidence was recommended: (i) epidemiologic evidence describing the burden and cause of injury, (ii) evidence concerning the effectiveness of interventions, (iii) evidence on effective methods for implementing promising interventions at a population level, and (iv) evidence and theory from the behavioral sciences. Through the evidence-synthesis process the framework prioritizes highly synthesized evidence-based strategies and draws attention to important research gaps. This study describes a novel opportunity to operationalize an organization's commitment to integrate evidence into practice. The framework provides guidance on how to use evidence strategically to maximize the potential impact of prevention efforts. Opportunities for further evaluation and dissemination are discussed.

An educational video to promote multi-factorial approaches for fall and injury prevention in long-term care facilities.

BackgroundOlder adults living in long term care (LTC) settings are vulnerable to fall-related injuries. There is a need to develop and implement evidence-based approaches to address fall injury prevention in LTC. Knowledge translation (KT) interventions to support the uptake of evidence-based approaches to fall injury prevention in LTC need to be responsive to the learning needs of LTC staff and use mediums, such as videos, that are accessible and easy-to-use. This article describes the development of two unique educational videos to promote fall injury prevention in long-term care (LTC) settings. These videos are unique from other fall prevention videos in that they include video footage of real life falls captured in the LTC setting.MethodsTwo educational videos were developed (2012–2013) to support the uptake of findings from a study exploring the causes of falls based on video footage captured in LTC facilities. The videos were developed by: (1) conducting learning needs assessment in LTC settings via six focus groups (2) liaising with LTC settings to identify learning priorities through unstructured conversations; and (3) aligning the content with principles of adult learning theory.ResultsThe videos included footage of falls, interviews with older adults and fall injury prevention experts. The videos present evidence-based fall injury prevention recommendations aligned to the needs of LTC staff and: (1) highlight recommendations deemed by LTC staff as most urgent (learner-centered learning); (2) highlight negative impacts of falls on older adults (encourage meaning-making); and, (3) prompt LTC staff to reflect on fall injury prevention practices (encourage critical reflection).ConclusionsEducational videos are an important tool available to researchers seeking to translate evidence-based recommendations into LTC settings. Additional research is needed to determine their impact on practice.

HEALTHY ALCOHOL POLICY AS AN INJURY PREVENTION STRATEGY

Alcohol's contribution to injury at both individual and population level is indisputable, and it is commonly identified as the most important single risk factor. Reduction in hazardous patterns of drinking...

NCIPC's contribution to global injury and violence prevention: Past, present, and future

Injuries and violence impact millions across the globe each year. For the past 20years, the National Center for Injury Prevention and Control (NCIPC) at the Centers for Disease Control and Prevention (CDC) has assembled the largest cadre of injury and violence prevention experts in the world to reduce the burden of injuries and violence domestically and to inform global injury and violence prevention efforts. This article focuses on NCIPC's global injury and violence prevention work that involves: increasing awareness of the preventability of injury and violence, partnerships to promote injury research and best practices; establishing standards and guidance for data collection; building capacity through training and mentoring; and supporting evidence-based strategies. To decrease the global burden, the authors propose priority setting to maximize the development and sustainability of financial and human resources for injury and violence prevention. Impact on Industry: The authors call for increased capacity and resources for global injury and violence prevention.

The mortuary as a source of injury data: Progress towards a mortuary data guideline for fatal injury surveillance

To help bridge the obstacle of inadequate injury fatality data in low and medium income countries (LMICs) a simple cost effective system for mortuary surveillance of fatal injuries is being developed in consultation with the WHO. This will inform, direct and monitor injury prevention (IP) interventions and policies in LMICs. This article uses CDC's ‘attributes of a successful surveillance system’ to describe the process, the barriers and solutions in development of this mortuary data guideline. The consultative process utilised generated feedback from key stakeholders including forensic pathologists, Ministry of Health officials and injury prevention experts. An International Advisory Group was also convened to guide the guideline development. These assisted the adjustment of the proposed guideline to maximise flexibility, acceptability and stability; whilst minimising resource implications. Representativeness and the securing of government support perhaps remain the most significant challenges. Consultation with the advisory group and the wider stakeholders has been effective in developing a widely acceptable, user-friendly, low resource data form to gather useful data. Further strategies to overcome barriers need to be developed over the course of the pilot study and this should be done in consultation with the advisory group and stakeholders.

Vancouver Charter: bringing ski and snowboard helmet legislation to Canada

The Vancouver Charter on Skiing Safety is based on skiing and snowboarding safety and the Turin Charter (approved in the context of the 2006 Turin Winter Olympic Games) and was...

The Mortuary as a source of injury data: progress towards a mortuary data guideline for fatal injury surveillance

BackgroundInjury is a substantial and preventable public health problem accounting for 10% of deaths worldwide, of which 90% are estimated to occur in low and middle income countries (LMICs). To...

Sight on the effectiveness of injury prevention interventions

Injury prevention practitioners and experts, policy makers and health professionals seek information on what works and what doesn't work for the prevention of injuries. There is a need to build...

Decades of water safety training culturally "irrelevant" to First Nation people

Canada’s Aboriginal people and others at high risk of drowning are among those least served by conventional water safety training, say injury prevention experts. “There’s been a longstanding stigma that Aboriginal people are too stupid or don’t want to learn about water safety, and that’s

Teen perceptions of good drivers and safe drivers: implications for reaching adolescents

Objective:To understand definitions of the phrases “good driver” and “safe driver” among teen pre-drivers and early drivers in order to appropriately tailor messages about driving safety.Design:Qualitative study using freelisting, an...

“Operation Child-Safe”: A Strategy for Preventing Unintentional Pediatric Injuries at a Hurricane Katrina Evacuee Shelter

Children represent a vulnerable population, and special considerations are necessary to care for them properly during disasters. Comprehensive disaster responses include addressing the unique needs of children during mass-casualty incidents, such as the prevention of unintentional injuries. Early in the morning of 04 September 2005, approximately 1,600 Hurricane Katrina and/or flood survivors from New Orleans, including approximately 300 children, arrived at Camp Gruber, an Oklahoma National Guard base in Eastern Oklahoma. The primary function of Camp Gruber to train support personnel for the Oklahoma National Guard. This is not a child-safe environment. It was hypothesized that the camp contained numerous child injury hazards and that these hazards could be removed systematically using local child injury prevention experts, thereby preventing unintentional injuries to the displaced children. On 08 September, "Operation Child-Safe" was launched by the Pediatric Injury Response Team to identify and remove pediatric injury hazards from Camp Gruber. Injury prevention experts from the Safe Kids Tulsa Area (SKTA) Chapter, the closest pediatric injury prevention group in the region, spearheaded the operation. Several visits were required to remove all of the injury hazards that were identified. Many hazards were identified and removed immediately, while others were addressed in a formal letter to the Camp Gruber Commander for required consent to implement changes. Hazards identified in the camp included, but were not limited to: (1) dangerous chemicals; (2) choking hazards; (3) open electrical outlets; and (4) missing smoke detectors. Bicycle helmets, car seats, strollers, portable cribs, and other safety-related items were passed out to families in need. A licensed daycare facility also was established in order to give the adult guardians a break from constant supervision. Over the course of one month, only one preventable injury (minor head injury) was reported during camp operations, and this particular injury occurred two days before "Operation Child-Safe" was initiated (Day 3 of camp operations). In the aftermath of an event that displaces large numbers of people, it is likely that children will be exposed to numerous injury hazards. Volunteers with expertise in child injury prevention are needed to make an evacuee shelter safer for children.

Severity of alcohol-related motor vehicle crashes in British Columbia: case – control study

The objective of the present study was to compare the injury severity and vehicle damage severity rates of alcohol-related crashes with rates of non-alcohol-related crashes in British Columbia (BC). Injury severity rates and vehicle damage severity rates were taken from 2002 Insurance Corporation of British Columbia traffic collision data. The data were computed in order to compare the differences in injury severity and vehicle damage severity rates of alcohol-related vs. non-alcohol-related motor vehicle crashes. Case – control methods were used in this study to analyse the risk of alcohol-related crashes compared to non-alcohol-related crashes in BC. Odds ratios (OR) and 95% CI were calculated to estimate relative risks. In the case – control analysis, the risk of fatal collision was increased for those drinking and driving compared with those driving sober (OR 4.70; 95% CI 3.15 – 7.01). Risk of injury collision was increased for those drinking and driving compared with those driving sober (OR 1.32; 95% CI 1.19 – 1.37). Importantly, the risk of vehicle damage severity was increased for those drinking and driving compared with those driving sober (write-off vehicle OR 4.24; 95% CI 3.70 – 4.86, severely damaged vehicles OR 1.98; 95% CI 1.77 – 2.21). The study reinforces existing literature to suggest that current evidence is sufficient to show an increased risk of injury and fatality to drivers and occupants in alcohol-related crashes. This paper not only emphasizes this well-known relationship, but also such consequences as increased vehicle damage severity. The connection between drinking and severity of motor vehicle crashes is popularly believed and has now received substantial scientific support. There is strong justification for injury prevention experts and policy-makers to step up motor vehicle crash injury prevention advocacy by implementing evidence-based policies to reduce rates of alcohol-impaired driving in the province of BC. Most unintentional injuries in BC are related to motor vehicle crashes. Significant improvements can be made in these statistics by: increasing the use of occupant protection (safety belt and child restraint seats); reducing alcohol-related injuries through multiple strategies including corrections in the physical environment, extensive enforcement of drinking and driving laws and health promotion/education.