Follow-up household assessment for child unintentional injuries two years after the intervention: A community-based study from Karachi, Pakistan

BACKGROUND

Unintentional childhood injuries are a growing public health concern, and the home is the most common location for non-fatal injuries in children less than 5 years of age. This study describes the long-term effects of two injury prevention educational interventions for caregivers-an educational pamphlet and an in-home tutorial guide-by comparing the change in the prevalence of home injury hazards before and after the interventions.

METHODS

This was a pre- (June and July 2010) and post-study with short-term follow-up (November-December 2010) and long-term follow-up (November 2012- January 2013). Neighborhood one included households that received only educational pamphlets after completing a baseline assessment; neighborhood two included households that received an in-home tutorial guide after completing the baseline assessment and receiving the educational pamphlet. The main outcome of this study was the reduction in home injury hazards for children under 5 years of age.

RESULTS

A total of 312 households participated in the long-term phase to compare the effect of the interventions. Between the short-term to long-term follow-up, injury hazards significantly reduced in neighborhood two compared to neighborhood one. These included fall hazards (walker use) (IRR 0.24 [95% CI 0.08-0.71]), drowning hazards (open bucket of water in the courtyard and uncovered water pool) (IRR 0.45 [95% CI 0.85-0.98] and IRR 0.46 [95% CI 0.76-0.94]), burn hazards (iron, water heater within reach of child) (IRR 0.56 [95% CI 0.33-0.78] and IRR 0.58 [95% CI 0.32-0.91]), poisoning hazards (shampoo/soap and medicine within reach of child) (IRR 0.53 [95% CI 0.44-0.77] and IRR 0.7 [95% CI 0.44-0.98]) and breakable objects within reach of child (IRR 0.62 [95% CI: 0.39-0.99]).

CONCLUSION

An injury prevention tutorial to caretakers of children supplemented with pamphlets could significantly decrease the incidence of falls, drowning, burns, poisoning, and cut injury hazards for children under 5 years of age in their homes in a low-resource setting. This intervention has the potential to be integrated in existing public health programs, such as Lady Health Visitors (LHVs), to disseminate injury prevention information in routine home health visits.

Respecting alcohol, respecting the water: Young adult perspectives on how to reduce alcohol-influenced drownings in Australia

ISSUE ADDRESSED

Alcohol-influenced drowning among young Australians (aged 18-24 years) is a prominent health concern. However, effectiveness of targeted prevention campaigns for this age group is unknown, as this information is not typically published in peer-reviewed or easily accessed grey literature. Accordingly, future campaigns cannot build on prior efforts to address this health problem.

METHODS

Semi-structured interviews ascertained young Australian adults' perspectives on preventing alcohol consumption in aquatic settings, and their awareness of appropriate safety strategies and Australian national and state drowning prevention campaigns. Discussions were transcribed verbatim and thematically analysed using an interpretative phenomenological approach.

RESULTS

Twenty-three individuals (mean age 20.65 years) participated in an interview. Participants had poor understanding of alcohol-focused drowning prevention campaigns and used logos and names to decipher key campaign messages. Education was recommended as the preferred method for prevention, and participants suggested preferences for delivery (eg social media, in schools, humour and shock tactics). The safety strategies discussed appeared to be transferred from strategies used in other contexts, rather than related to the specific risks of aquatic scenarios.

CONCLUSIONS

Drowning prevention practitioners should ensure transparency and clarity of their campaign names and logos to enhance understanding of the messages. Practitioners should also consider using audience analysis during campaign design, delivery and evaluation, alongside best practice recommendations from literature, to enhance campaign suitability and effectiveness. SO WHAT?: Water safety practitioners and policy makers should acknowledge these findings when developing campaigns which address young adults' lack of awareness of safe aquatic behaviours to encourage a sustained behaviour change.

The Impact of Policy, Environmental, and Educational Interventions

Motor vehicle safety and tobacco control are among the greatest public health achievements of the 20th century, according to the Centers for Disease Control and Prevention. As the number of miles traveled in the United States multiplied 10 times from the 1920s to the 1990s, the annual motor vehicle crash death rate per vehicle mile traveled decreased by 90%. Similarly, tobacco-related deaths from heart disease, stroke, and cancer were rapidly mounting over the first two thirds of the 20th century. Then, in the last third of the century, tobacco consumption decreased by more than 50%, and rates of heart disease and stroke deaths, and later cancer deaths, declined similarly. This analysis addresses the central question of what lessons can be learned from these success stories that will help public health professionals successfully tackle new and emerging health behavior problems of today and tomorrow? Surveillance, research, multilevel interventions, environmental modifications, and strong policies were key to reducing motor vehicle- and tobacco-related health problems. Generating public support and advocacy, and changing social norms also played critical roles in promoting the safer and smoke-free behaviors. Lessons learned include the need for evidence-based practices and interventions that are ecologically comprehensive with an emphasis on changing environmental determinants and capitalizing on the concept of reciprocal determinism. The analysis concludes with a description of how the PRECEDE-PROCEED planning framework can be used to apply the lessons from motor vehicle safety and tobacco control to other public health threats.

How do public health practitioners in China perceive injury prevention? A survey

To report public health practitioners' perceptions of injury prevention in Changsha, China. We undertook a cross-sectional study at Changsha, Hunan, China. An anonymous self-reported survey was conducted to ascertain the proportion of respondents who answered negatively to questions about the value of injury prevention. Over 20% of respondents answered 'unpreventable' or 'don't know' to whether injuries from natural environmental disaster, homicide/assault, poisoning, animal bite, cut/pierce, suffocation and electric current were preventable. More than 40% of respondents answered 'no' or 'don't know' to whether the prevention of injuries from homicide/assault, cut/pierce, fall, suicide/self-harm, drowning, road traffic crash and fire/burn belonged to the job of public health. Only 48% of respondents supported building a division/office within the Centers for Disease Control and Preventions at all levels. Many public health practitioners in Changsha had misperception about injury prevention. Education and training are needed to correct their misperception.

A comparison of drivers with high versus low perceived risk of being caught and arrested for driving under the influence of alcohol

OBJECTIVES

To examine the beliefs, behaviors, and knowledge of drivers concerning drunk driving and to compare those with greater or lesser perceptions of risk of being caught driving while impaired.

METHODS

A random-digit-dial telephone survey was conducted of 850 licensed drivers throughout Maryland who reported their driving behaviors, crash history, beliefs about various alcohol countermeasures, and their knowledge of state alcohol laws.

RESULTS

Most drivers (72%) did not feel that it was very likely that they would be stopped by the police if they drove after having too much to drink (low-risk perceivers). High-risk perceivers (28%) felt that it was very likely that they would be stopped and most (70%) felt that it was very likely that they would be arrested and convicted. Less than half (45%) of the low-risk perceivers felt that they would be arrested and convicted if they drove impaired. High-risk perceivers were significantly more likely to be non-white, less likely to drive 10 mph above the speed limit, but were more likely have five or more tickets in their lifetime and believed that sobriety checkpoints are effective. They were also more aware of laws regarding mandatory use of ignition interlocks for repeat driving under the influence (DUI) offenders and the zero tolerance law for under-21-year-old drivers.

CONCLUSION

There is a need to elevate the perceived risk of being caught when driving while alcohol impaired. Despite several years of prevention programs, a substantial portion of Maryland drivers do not feel it very likely that they would be stopped by the police if they were to drive after drinking too much. Drivers who perceive these risks are more accepting of enforcement and treatment countermeasures and are more likely to report safer driving behaviors.

Psychosocial factors associated with lifetime experience of serious unintentional injury in South Korea

PURPOSE

The purpose of this study was to determine the prevalence of lifetime unintentional-injury experience and evaluate the quality of life of unintentional-injury victims, to provide useful data for the development of interventions aimed at decreasing the incidence of unintentional injuries. DESIGN, SAMPLE, AND METHODS: This study utilized data obtained from cross-sectional surveys of 24,327 Korean individuals aged 19-65 years, performed using face-to-face interviews. Demographic characteristics, unintentional-injury experience, attributes of health behavior, and health-related quality of life (HRQoL) questions were included in the study instruments.

RESULTS

About 11.8% of the subjects had experienced an unintentional injury that required hospitalization at least once in their lifetime. Being older, being male, having less education and lower income, working in a blue-collar job, and being enrolled in medical aid programs were associated with increased likelihood of having an unintentional injury. Among the HRQoL and risk-taking behavior variables, limitations in daily activities, suicide ideation, and binge drinking were significantly associated with injury experience.

CONCLUSION

Public health efforts to prevent unintentional injuries should target high-risk populations such as males, those with low incomes and education levels, and binge drinkers. Efforts should also be made to enhance the HRQoL of injury victims.

Cell phone users, reported crash risk, unsafe driving behaviors and dispositions: a survey of motorists in Maryland

INTRODUCTION

The purpose of this investigation was to identify risky driving behaviors and dispositions that distinguish drivers who use a cell phone while operating a motor vehicle from non-cell phone using drivers.

METHOD

Annual telephone surveys were used to identify drivers who reported using a cell phone while driving in the last month (n=1803) and were compared to those who said they did not use cell phones while driving (n=1578).

RESULTS

Cell phone using drivers were more likely to report driving while drowsy, going 20 mph over the speed limit, driving aggressively, running a stop sign or red light, and driving after having had several drinks. They were also more likely to have had a prior history of citation and crash involvement than non-cell phone using drivers. Cell phone using drivers also reported they were less careful and more in a hurry when they drive than non-cell phone using drivers.

CONCLUSION

Cell phone using drivers report engaging in many behaviors that place them at risk for a traffic crash, independent of the specific driving impairments that cell phone usage may produce. Strategies that combine coordinated and sustained enforcement activities along with widespread public awareness campaigns hold promise as effective countermeasures for these drivers, who resemble aggressive drivers in many respects.

Concerns, dispositions and behaviors of aggressive drivers: what do self-identified aggressive drivers believe about traffic safety?

INTRODUCTION

The purpose of this investigation was to identify beliefs, driving personality dispositions, and behaviors that distinguish self-defined aggressive drivers from non-aggressive drivers.

METHOD

Telephone surveys were used to identify self-reported aggressive drivers (n=305) who were compared to non-aggressive drivers (n=1,715) concerning their beliefs, driving behaviors, and self-described driving dispositions.

RESULTS

Aggressive drivers, compared to non-aggressive drivers, were less concerned about speeding, aggressive driving, and cell phone use while driving, yet were more likely to have had an encounter with another aggressive driver. They were also more likely to report that they had driven when they knew they had too much to drink, yet they felt less likely that they would be stopped by the police.

CONCLUSION

Aggressive drivers display many dispositions that define them as high risk drivers and public information/motivational campaigns alone will likely be ineffective with this group of drivers. Strategies that combine visible enforcement with widespread publicity campaigns appear to be necessary.

Exposure to the sobriety "Checkpoint Strikeforce" campaign in Maryland: impact on driver perceptions of vulnerability and behavior

OBJECTIVES

To compare drivers who were: (1) exposed to Maryland's sobriety "Checkpoint Strikeforce" campaign; (2) not exposed but were aware of it; and (3) neither exposed nor aware of it. This six-month campaign involved periodic road-side sobriety checkpoints, in which police attempted to detect and arrest drunk drivers and a series of radio Public Service Announcements (PSAs) that promoted public awareness.

METHODS

A statewide sample of 1725 drivers were interviewed by telephone to determine their exposure to and awareness of this campaign, as well as their beliefs and behaviors concerning drunk driving and seat belt usage.

RESULTS

Relatively few people (9.6%) were exposed in any way to the campaign; however almost 30% were aware of it. Significant increases in perceived vulnerability to arrest for drinking and driving were found among those who were exposed. There were no differences in reported drinking and driving, but seat belt usage in the last 30 days was higher among those who were exposed. There were no differences among those people who had been directly exposed to the campaign (i.e., personally gone through a sobriety checkpoint) and those who were indirectly exposed (i.e., knew a family member or someone else who went through a checkpoint).

CONCLUSIONS

Exposure to a sobriety checkpoint was associated with increased perceptions of drink-driving risk (i.e., likelihood of getting caught by the police), which was not dependent upon having personally experienced it. Awareness without exposure appears to be insufficient to change perceived risk. The need to increase the reach and frequency of the sobriety "Checkpoint Strikeforce" campaign is indicated.