1
|
Daugherty J, Peterson A, Waltzman D, Breiding M, Chen J, Xu L, DePadilla L, Corrigan JD. Rationale for the Development of a Traumatic Brain Injury Case Definition for the Pilot National Concussion Surveillance System. J Head Trauma Rehabil 2024; 39:115-120. [PMID: 38039498 DOI: 10.1097/htr.0000000000000900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Current methods of traumatic brain injury (TBI) morbidity surveillance in the United States have primarily relied on hospital-based data sets. However, these methods undercount TBIs as they do not include TBIs seen in outpatient settings and those that are untreated and undiagnosed. A 2014 National Academy of Science Engineering and Medicine report recommended that the Centers for Disease Control and Prevention (CDC) establish and manage a national surveillance system to better describe the burden of sports- and recreation-related TBI, including concussion, among youth. Given the limitations of TBI surveillance in general, CDC took this recommendation as a call to action to formulate and implement a robust pilot National Concussion Surveillance System that could estimate the public health burden of concussion and TBI among Americans from all causes of brain injury. Because of the constraints of identifying TBI in clinical settings, an alternative surveillance approach is to collect TBI data via a self-report survey. Before such a survey was piloted, it was necessary for CDC to develop a case definition for self-reported TBI. OBJECTIVE This article outlines the rationale and process the CDC used to develop a tiered case definition for self-reported TBI to be used for surveillance purposes. CONCLUSION A tiered TBI case definition is proposed with tiers based on the type of sign/symptom(s) reported the number of symptoms reported, and the timing of symptom onset.
Collapse
Affiliation(s)
- Jill Daugherty
- Author Affiliations: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, Georgia (Drs Daugherty, Peterson, Waltzman, Breiding, Chen, Xu, and DePadilla); and Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus (Dr Corrigan)
| | | | | | | | | | | | | | | |
Collapse
|
2
|
Daugherty J, Waltzman D, Breiding M, Peterson A, Chen J, Xu L, Womack LS, DePadilla L, Watson K, Corrigan JD. Refinement of a Preliminary Case Definition for Use in Traumatic Brain Injury Surveillance. J Head Trauma Rehabil 2024; 39:121-139. [PMID: 38039496 DOI: 10.1097/htr.0000000000000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
OBJECTIVE Current methods used to measure incidence of traumatic brain injury (TBI) underestimate its true public health burden. The use of self-report surveys may be an approach to improve these estimates. An important step in public health surveillance is to define a public health problem using a case definition. The purpose of this article is to outline the process that the Centers for Disease Control and Prevention undertook to refine a TBI case definition to be used in surveillance using a self-report survey. SETTING Survey. PARTICIPANTS A total of 10 030 adults participated via a random digit-dial telephone survey from September 2018 to September 2019. MAIN MEASURES Respondents were asked whether they had sustained a hit to the head in the preceding 12 months and whether they experienced a series of 12 signs and symptoms as a result of this injury. DESIGN Head injuries with 1 or more signs/symptoms reported were initially categorized into a 3-tiered TBI case definition (probable TBI, possible TBI, and delayed possible TBI), corresponding to the level of certainty that a TBI occurred. Placement in a tier was compared with a range of severity measures (whether medical evaluation was sought, time to symptom resolution, self-rated social and work functioning); case definition tiers were then modified in a stepwise fashion to maximize differences in severity between tiers. RESULTS There were statistically significant differences in the severity measure between cases in the probable and possible TBI tiers but not between other tiers. Timing of symptom onset did not meaningfully differentiate between cases on severity measures; therefore, the delayed possible tier was eliminated, resulting in 2 tiers: probable and possible TBI. CONCLUSION The 2-tiered TBI case definition that was derived from this analysis can be used in future surveillance efforts to differentiate cases by certainty and from noncases for the purpose of reporting TBI prevalence and incidence estimates. The refined case definition can help researchers increase the confidence they have in reporting survey respondents' self-reported TBIs as well as provide them with the flexibility to report an expansive (probable + possible TBI) or more conservative (probable TBI only) estimate of TBI prevalence.
Collapse
Affiliation(s)
- Jill Daugherty
- Author Affiliations: Division of Injury Prevention, Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Atlanta, Georgia (Drs Daugherty, Waltzman, Breiding, Peterson, Chen, Xu, Womack, and DePadilla); United States Public Health Service, Commissioned Corps, Washington, District of Columbia (Drs Breiding and Womack); Centers for Disease Control and Prevention (CDC), National Center for Chronic Disease Prevention & Health Promotion, Division of Population Health, Atlanta, Georgia (Dr Watson); and Department of Physical Medicine and Rehabilitation, The Ohio State University, Columbus (Dr Corrigan)
| | | | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Waltzman D, Daugherty J, Haarbauer-Krupa J, Zheng X, Jorge C, Basile KC. Association Between Lifetime Sexual Violence and Recent Traumatic Brain Injury Among Adults: 2017 Connecticut Behavioral Risk Factor Surveillance System. J Interpers Violence 2024; 39:1351-1367. [PMID: 37804158 PMCID: PMC10962142 DOI: 10.1177/08862605231203962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Sexual violence (SV) is a critical public health problem that is associated with numerous negative health consequences, including immediate- and long-term physical and mental health conditions and health-risk behaviors. Some of these health-risk behaviors (e.g., substance use, unsafe driving practices, poor mental health, lower impulse control, and abnormal brain circuitry) might increase the risk for sustaining a traumatic brain injury (TBI). A TBI causes neurological or neuropsychological changes and may also lead to various symptoms that affect a person's cognition, mobility, behavior, and mental health. Determining if those who have experienced SV are at increased risk of sustaining a TBI in their lifetime is critical given the high prevalence and health impacts of SV, the potential vulnerability to TBI after SV, and the known detrimental effects of TBI. This exploratory study examined data from the 2017 Connecticut behavioral risk factor surveillance system and found that lifetime SV victimization (controlling for age and sex) was associated with increased odds of reporting a recent TBI in the past 12 months (adjusted odds ratio [AOR] = 2.1; 95% confidence interval [CI] [1.03, 4.21]). Further research is needed to better understand how SV history is related to the risk of sustaining a TBI. Healthcare professionals can support patients who experience SV by providing resources to help reduce associated physical and mental health conditions and health-risk behaviors.
Collapse
Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Juliet Haarbauer-Krupa
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Xi Zheng
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Celeste Jorge
- Connecticut Department of Public Health, Hartford, CT, USA
| | - Kathleen C. Basile
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
4
|
Daugherty J, Yuan K, Sarmiento K, Law R. Are there seasonal patterns for emergency department visits for head injuries in the USA? Findings from the National Electronic Injury Surveillance System-All Injury Program. Inj Prev 2024; 30:46-52. [PMID: 37802643 PMCID: PMC10844889 DOI: 10.1136/ip-2023-044971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023]
Abstract
INTRODUCTION Previous international research suggests that the incidence of head injuries may follow seasonal patterns. However, there is limited information about how the numbers and rates of head injuries, particularly sports- and recreation-related head injuries, among adults and children evaluated in the emergency department (ED) vary by month in the USA. This information would provide the opportunity for tailored prevention strategies. METHODS We analysed data from the National Electronic Injury Surveillance System-All Injury Program from 2016 to 2019 to examine both monthly variation of ED visit numbers and rates for head injuries overall and those due to sports and recreation. RESULTS The highest number of head injuries evaluated in the ED occurred in October while the lowest number occurred in February. Among males, children ages 0-4 years were responsible for the highest rates of head injury-related ED visits each year, while in females the highest rates were seen in both children ages 0-4 and adults ages 65 and older. The highest number of head injuries evaluated in the ED due to sports and recreation were seen in September and October. Head injury-related ED visits due to sports and recreation were much more common in individuals ages 5-17 than any other age group. CONCLUSION This study showed that head injury-related ED visits for all mechanisms of injury, as well as those due to sports- and recreation-related activities, followed predictable patterns-peaking in the fall months. Public health professionals may use study findings to improve prevention efforts and to optimise the diagnosis and management of traumatic brain injury and other head injuries.
Collapse
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Keming Yuan
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Royal Law
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
5
|
Waltzman D, Sarmiento K, Daugherty J. Factors That May Influence Americans' Views on When Children Should Start Playing Tackle Football. J Athl Train 2024; 59:22-29. [PMID: 37459380 PMCID: PMC10783471 DOI: 10.4085/1062-6050-0004.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
CONTEXT American football is associated with the largest number of emergency department visits for pediatric sport-related traumatic brain injury, including concussions. Tackling is responsible for almost two-thirds of football concussions. Some have recommended implementing age restrictions on tackling in youth football. OBJECTIVE To determine whether the public would support age restrictions and the factors that may drive such support. DESIGN Cross-sectional study. SETTING Summer wave of Porter Novelli's 2020 US ConsumerStyles survey. PARTICIPANTS A total of 4053 adults. MAIN OUTCOME MEASURE(S) Respondents answered questions about a good age for children to start playing tackle football, past football playing history, concerns about safety, and the benefits and risks of playing football. RESULTS Most respondents believed that middle (32.8%) or high (27.8%) school was a good age to start playing tackle football. About 1 in 5 (19.8%) respondents reported that children should never play tackle football. Certain groups of individuals were more likely to support children starting to play tackle football at high school age or above or to say that they should never play tackle football, including those with a bachelor's degree or higher (rate ratio [RR]HS+ = 1.41, 95% CI = 1.14, 1.76; RRNEVER = 2.70, 95% CI = 1.93, 3.78), those who did not have children under 18 (RRHS+ = 1.54, 95% CI = 1.26, 1.90; RRNEVER = 1.54, 95% CI = 1.14, 2.07), those who were not football fans (RRNEVER = 3.07, 95% CI = 2.32, 4.06), and those who were very (RRHS+ = 3.94, 95% CI = 2.87, 5.42; RRNEVER = 11.52, 95% CI = 7.32, 18.15) or somewhat (RRHS+ = 1.88, 95% CI = 1.41, 2.52) concerned about the safety of children. CONCLUSION Despite acknowledging the benefits of playing football, many adults expressed concern about safety and endorsed high school age and older or never as a good age to start playing tackle football, highlighting a disconnect with current football program practices regarding age.
Collapse
Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, Atlanta, GA
| | | | | |
Collapse
|
6
|
Daugherty J, Waltzman D, Sarmiento K. Provision of Concussion Information From Coaches and the Presence of Athletic Trainers: Findings From the 2021 YouthStyles Survey. J Athl Train 2023; 58:611-617. [PMID: 36645830 PMCID: PMC10569249 DOI: 10.4085/1062-6050-0454.22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Coaches play an important role in concussion safety, and their views on concussion influence those of their athletes and the athletes' reporting behaviors. In this 2021 survey of youth, we examined how often coaches provide concussion safety information to their athletes and the association between coaches' provision of concussion information to athletes and the presence of athletic trainers (ATs) at a team's games and practices. More than 4 in 10 youth who played sports reported that their coaches did not provide any sort of concussion education or information to them in the past 12 months. Among those youth who always or sometimes had ATs at practices or games, 76.3% received some type of coach education on concussion in the past 12 months, compared with 31.9% of those who rarely or never had ATs at practices or games (P < .0001). Increasing access to ATs and adapting current concussion training and educational materials for coaches to increase coach-athlete communication may be beneficial.
Collapse
Affiliation(s)
| | - Dana Waltzman
- Centers for Disease Control and Prevention, Atlanta, GA
| | | |
Collapse
|
7
|
Waltzman D, Sarmiento K, Daugherty J, Lumba-Brown A, Klevens J, Miller GF. Firearm-Related Traumatic Brain Injury Homicides in the United States, 2000-2019. Neurosurgery 2023; 93:43-49. [PMID: 36727717 PMCID: PMC10391713 DOI: 10.1227/neu.0000000000002367] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/15/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is a leading cause of homicide-related death in the United States. Penetrating TBI associated with firearms is a unique injury with an exceptionally high mortality rate that requires specialized neurocritical trauma care. OBJECTIVE To report incidence patterns of firearm-related and nonfirearm-related TBI homicides in the United States between 2000 and 2019 by demographic characteristics to provide foundational data for prevention and treatment strategies. METHODS Data were obtained from multiple cause of death records from the National Vital Statistics System using Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for the years 2000 to 2019. Number, age-adjusted rates, and percent of firearm and nonfirearm-related TBI homicides by demographic characteristics were calculated. Temporal trends were also evaluated. RESULTS During the study period, there were 77 602 firearm-related TBI homicides. Firearms were involved in the majority (68%) of all TBI homicides. Overall, men, people living in metro areas, and non-Hispanic Black persons had higher rates of firearm-related TBI homicides. The rate of nonfirearm-related TBI homicides declined by 40%, whereas the rate of firearm-related TBI homicides only declined by 3% during the study period. There was a notable increase in the rate of firearm-related TBI homicides from 2012/2013 through 2019 for women (20%) and nonmetro residents (39%). CONCLUSION Firearm-related violence is an important public health problem and is associated with the majority of TBI homicide deaths in the United States. The findings from this study may be used to inform prevention and guide further research to improve treatment strategies directed at reducing TBI homicides involving firearms.
Collapse
Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | - Jill Daugherty
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | | | - Joanne Klevens
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| | - Gabrielle F. Miller
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, Georgia, USA
| |
Collapse
|
8
|
Daugherty J, Sarmiento K, Waltzman D, Schmidt J. Special Report from the CDC Healthcare provider influence on driving behavior after a mild traumatic brain injury: Findings from the 2021 SummerStyles survey. J Safety Res 2023; 85:507-512. [PMID: 37330900 PMCID: PMC10440851 DOI: 10.1016/j.jsr.2023.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/13/2023] [Indexed: 06/19/2023]
Abstract
INTRODUCTION Research shows that a mild traumatic brain injury (mTBI) impairs a person's ability to identify driving hazards 24 h post injury and increases the risk for motor vehicle crash. This study examined the percentage of people who reported driving after their most serious mTBI and whether healthcare provider education influenced this behavior. METHODS Self-reported data were collected from 4,082 adult respondents in the summer wave of Porter Novelli's 2021 ConsumerStyles survey. Respondents with a driver's license were asked whether they drove right after their most serious mTBI, how safe they felt driving, and whether a doctor or nurse talked to them about when it was ok to drive after their injury. RESULTS About one in five (18.8 %) respondents reported sustaining an mTBI in their lifetime. Twenty-two percent (22.3 %) of those with a driver's license at the time of their most serious mTBI drove within 24 h, and 20 % felt very or somewhat unsafe doing so. About 19 % of drivers reported that a doctor or nurse talked to them about when it was safe to return to driving. Those who had a healthcare provider talk to them about driving were 66 % less likely to drive a car within 24 h of their most serious mTBI (APR = 0.34, 95 % CI: 0.20, 0.60) compared to those who did not speak to a healthcare provider about driving. CONCLUSIONS Increasing the number of healthcare providers who discuss safe driving practices after a mTBI may reduce acute post-mTBI driving. PRACTICAL APPLICATIONS Inclusion of information in patient discharge instructions and prompts for healthcare providers in electronic medical records may help encourage conversations about post-mTBI driving.
Collapse
Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway NE MS S106-9, Atlanta, GA 30307, USA.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway NE MS S106-9, Atlanta, GA 30307, USA
| | - Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway NE MS S106-9, Atlanta, GA 30307, USA
| | - Julianne Schmidt
- University of Georgia Concussion Research Laboratory, Department of Kinesiology, 110 Carlton Street, Athens, GA 30602, USA
| |
Collapse
|
9
|
Daugherty J, Treves-Kagan S, Gottfredson NC, Miedema S, Haarbauer-Krupa J. Does binge drinking mediate the relationship between four adverse childhood experiences and adult traumatic brain injury? Results from the National Longitudinal Survey of Youth 1979 Cohort. Inj Prev 2023; 29:111-115. [PMID: 36323501 PMCID: PMC10083702 DOI: 10.1136/ip-2022-044710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Adverse childhood experiences (ACEs) are associated with increased risk of sustaining a traumatic brain injury (TBI). Alcohol use may play an important role in this relationship. This study examines whether binge drinking mediates the relationship between four ACEs and TBIs sustained in adulthood. METHODS Using the National Longitudinal Survey of Youth, 1979 cohort, we conducted longitudinal mediation analyses (n=6317). Interviews occurred annually from 1979 to 1994 and biennially until 2016. We evaluated the direct and indirect effects of individual ACEs (ie, experiencing physical violence, low parental warmth, familial alcoholism and familial mental illness; reported retrospectively) and a cumulative ACEs score on mean level of binge drinking (calculated across waves) and having a TBI in adulthood. To establish temporality, we included binge drinking that was measured at age 18 or older and before any reported TBI. RESULTS Cumulative ACEs, familial alcoholism and physical abuse exposure were significantly associated with having a TBI through binge drinking, although this only explained a small part of the association between ACEs and TBI. Other ACEs were not significantly associated with binge drinking or TBI. CONCLUSION The results indicate that while ACEs and adult TBI risk were significantly associated, lifetime binge drinking explains only a small part of the association. Future research could examine alternative social, biological and behavioural mechanisms along the pathway between ACEs and TBI. Determining this mechanism will allow public health practitioners to design and implement effective TBI prevention programmes for those at higher risk of injury due to ACE exposure.
Collapse
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah Treves-Kagan
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Nisha C Gottfredson
- Department of Health Behavior, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Stephanie Miedema
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Juliet Haarbauer-Krupa
- Division of Injury Prevention, National Center for Injury Prevention and Control, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| |
Collapse
|
10
|
Wulz A, Miller G, Navon L, Daugherty J. Emergency Department Visits by Incarcerated Adults for Nonfatal Injuries - United States, 2010-2019. MMWR Morb Mortal Wkly Rep 2023; 72:278-282. [PMID: 36928175 PMCID: PMC10027404 DOI: 10.15585/mmwr.mm7211a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
During 2010-2019, U.S. correctional authorities held 1.4-1.6 million persons in state and federal prisons annually, and 10.3-12.9 million persons were admitted to local jails each year (1,2). Incarcerated persons experience a disproportionate burden of negative health outcomes, including unintentional and violence-related injuries (3,4). No national studies on injury-related emergency department (ED) visits by incarcerated persons have been conducted, but a previous study demonstrated a high rate of such visits among a Seattle, Washington jail population (5). To examine nonfatal injury-related ED visits among incarcerated adults, CDC analyzed 2010-2019 National Electronic Injury Surveillance System-All Injury Program (NEISS-AIP) data. During 2010-2019, an estimated 733,547 ED visits by incarcerated adults occurred in the United States. The proportion of ED visits resulting from assault* and self-harm among incarcerated adults was five times as high as those among nonincarcerated adults. Among incarcerated adults, men and adult persons aged <65 years had the highest proportion of assault-related ED visits. Falls accounted for the most ED visits among incarcerated adults aged ≥65 years. A higher proportion of ED visits by incarcerated women than incarcerated men were for overdose or poisoning. These findings suggest that injuries among incarcerated adults differ from those among nonincarcerated adults and might require development and implementation of age- and sex-specific prevention strategies for this population.
Collapse
Affiliation(s)
- Avital Wulz
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Gabrielle Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Livia Navon
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| |
Collapse
|
11
|
Daugherty J, Sarmiento K, Breiding M. Comparison of self-reported lifetime concussions and mild traumatic brain injuries among adults. Brain Inj 2023; 37:1-8. [PMID: 36760062 PMCID: PMC10409868 DOI: 10.1080/02699052.2023.2175909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/12/2022] [Accepted: 01/30/2023] [Indexed: 02/11/2023]
Abstract
INTRODUCTION The reliability of self-reported brain injury data relies on how well people interpret the questions. OBJECTIVE This study examines how different yet commonly used questions may impact traumatic brain injury (TBI) estimates. METHODS Self-report data were collected from 4,053 respondents in the summer wave of Porter Novelli's 2020 ConsumerStyles survey. Respondents were randomized to be asked about lifetime experience of either concussion or mild TBI (mTBI) and then asked follow-up questions. RESULTS Approximately 25.5% of respondents reported sustaining a concussion in their lifetime while 17.2% reported an mTBI. The circumstances of the injuries, such as location and mechanism of injury, were similar. A greater percentage of individuals who were asked about concussions (91.1%) reported receiving a diagnosis for their most serious injury compared to those who were asked about diagnosis of an mTBI (69.9%). DISCUSSION A greater percentage of respondents reported a lifetime history of concussion than mTBI. More respondents with a lifetime history of concussion reported receiving a diagnosis. These results suggest that the terminology used can impact reporting. These findings suggest that there is a meaningful difference in the understanding of the terms 'concussion' and 'mild TBI,' with people perceiving mTBI as a more serious injury.
Collapse
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Atlanta, Georgia, United States of America
| | - Kelly Sarmiento
- Division of Injury Prevention, Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Atlanta, Georgia, United States of America
| | - Matthew Breiding
- Division of Injury Prevention, Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Atlanta, Georgia, United States of America
| |
Collapse
|
12
|
McAvoy K, Halstead M, Radecki L, Shah A, Emanuel A, Domain S, Daugherty J, Waltzman D. Return to Learn ECHO: Telementoring for School Personnel to Help Children Return to School and Learning After Mild Traumatic Brain Injury. J Sch Health 2022; 92:1194-1201. [PMID: 36375807 PMCID: PMC9680044 DOI: 10.1111/josh.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 06/06/2022] [Accepted: 07/08/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Return to learn (RTL) after mild traumatic brain injury (mTBI) presents unique challenges for school professionals. A multidisciplinary team approach is necessary yet training school professionals is logistically difficult. This paper describes an innovative pilot RTL program and its evaluation. METHODS Utilizing the telehealth/telementoring program Project ECHO® (Extension for Community Healthcare Outcomes), this study utilized a multidisciplinary team of subject matter experts to deliver five 1-hour sessions across 5 cohorts of school-based professionals (total of 133 participants). The evaluation used a mixed-methods approach of post-session and post-program participant surveys and post-program participant focus groups. RESULTS Participants who completed a post-program survey reported statistically significant improvements in essential aspects of RTL knowledge and self-efficacy. This included improvements in how to manage a student with an mTBI (44.8% to 86.9%), benefits of early return to school for students following mTBI (31.8% to 86.9%), and the importance of written RTL policies/procedures (55.1% to 97.1%). CONCLUSIONS This study demonstrates that RTL training via a telementoring approach may be a positive and effective way to train school-based professionals and improve knowledge and self-efficacy, especially when attending face-to-face trainings are difficult. This model has the potential to produce programmatic and systematic improvements for RTL education.
Collapse
Affiliation(s)
- Karen McAvoy
- Brain Injury Educational Consulting Colorado LLC631 Peterson StreetFort CollinsCO80524USA
| | - Mark Halstead
- Departments of Pediatrics and Orthopedic SurgeryWashington University20 Progress Point Parkway, Suite 114O'FallonMO63368USA
| | | | - Amy Shah
- ECHO InitiativesAmerican Academy of Pediatrics345 Park BlvdItascaIL60143USA
| | - Anjie Emanuel
- Child Safety, Health and WellnessAmerican Academy of Pediatrics345 Park BlvdItascaIL60143USA
| | - Stephanie Domain
- Child Safety, Health and WellnessAmerican Academy of Pediatrics345 Park BlvdItascaIL60143USA
| | - Jill Daugherty
- Centers for Disease Control and Prevention4770 Buford HighwayAtlantaGA30341USA
| | - Dana Waltzman
- Centers for Disease Control and Prevention4770 Buford HighwayAtlantaGA30341USA
| |
Collapse
|
13
|
Abstract
OBJECTIVE The objective of this study was to compare individuals who were not evaluated by a doctor or nurse for a self-reported concussion versus individuals who were evaluated for a concussion by demographic variables, concussion history, and concussion circumstances. SETTINGS AND PARTICIPANTS Data were collected from 2018 SpringStyles, a web-based panel survey of US adults 18 years or older ( n = 6427), fielded in March-April. DESIGN Cross-sectional. MAIN MEASURES Respondents were asked whether they believed they had sustained a concussion in their lifetime and details about their most recent concussion, including whether they were evaluated by a doctor or nurse. RESULTS Twenty-seven percent of adults in the survey reported a lifetime concussion ( n = 1835). Among those individuals, 50.4% were not evaluated by a healthcare provider for their most recent concussion. Not being evaluated was higher among individuals whose concussion was caused by a slip, trip, or fall (adjusted prevalence ratio [APR] = 2.22; 95% CI, 1.65-2.99), riding a bicycle (APR = 2.28; 95% CI, 1.58-3.27), being struck by or against something by accident (APR = 2.50; 95% CI, 1.88-3.34), or being struck by or against something during a fight or argument (APR = 2.89; 95% CI, 2.11-3.97), compared with individuals whose concussion was caused by a motor vehicle crash. No evaluation was also higher among individuals whose concussion occurred while engaging in a sports or recreational activity (APR = 1.39; 95% CI, 1.07-1.82) or engaging in regular activities around the house (APR = 1.65; 95% CI, 1.27-2.14), compared with individuals whose concussion occurred while working for pay. CONCLUSION More than a quarter of adults reported a lifetime concussion; however, half of them were not evaluated for their last concussion by a healthcare provider. Examination by a healthcare professional for a suspected concussion may prevent or mitigate potential long-term sequelae. Furthermore, current US surveillance methods may underestimate the burden of TBI because many individuals do not seek evaluation.
Collapse
Affiliation(s)
- Lindsay S Womack
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Womack, Breiding, and Daugherty); and Public Health Service, Rockville, Maryland (Dr Breiding)
| | | | | |
Collapse
|
14
|
Daugherty J, Waltzman D, Popat S, Horn Groenendaal A, Cherney M, Knudson A. Challenges and opportunities in diagnosing and managing mild traumatic brain injury in rural settings. Rural Remote Health 2022; 22:7241. [PMID: 35702034 PMCID: PMC9728081 DOI: 10.22605/rrh7241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2024] Open
Abstract
INTRODUCTION There is some evidence to suggest that Americans living in rural areas are at increased risk for sustaining a traumatic brain injury (TBI) compared to those living in urban areas. In addition, once a TBI has been sustained, rural residents have worse outcomes, including a higher risk of death. Individuals living in rural areas tend to live farther from hospitals and have less access to TBI specialists. Aside from these factors, little is known what challenges healthcare providers practicing in rural areas face in diagnosing and managing TBI in their patients and what can be done to overcome these challenges. METHODS Seven focus groups and one individual interview were conducted with a total of 18 healthcare providers who mostly practiced in primary care or emergency department settings in rural areas. Providers were asked about common mechanisms of TBI in patients that they treat, challenges they face in initial and follow-up care, and opportunities for improvement in their practice. RESULTS The rural healthcare providers reported that common mechanisms of injury included sports-related injuries for their pediatric and adolescent patients and work-related accidents, motor vehicle crashes, and falls among their adult patients. Most providers felt prepared to diagnose and manage their patients with TBI, but acknowledged a series of challenges they face, including pushback from parents, athletes, and coaches and lack of specialists to whom they could refer. They also noted that patients had their own barriers to overcome for timely and adequate care, including lack of access to transportation, difficulties with cost and insurance, and denial about the seriousness of the injury. Despite these challenges, the focus group participants also outlined benefits to practicing in a rural area and several ways that their practice could improve with support. CONCLUSION Rural healthcare providers may be comfortable diagnosing, treating, and managing their patients who present with a suspected TBI, but they also face many challenges in their practice. In this study it was continually noted that there was lack of resources and a lack of awareness, or recognition of the seriousness of TBI, among the providers' patient populations. Education about common symptoms and the need for evaluation after an injury is needed. The use of telemedicine, an increasingly common technology, may help close some gaps in access to services. People living in rural areas may be at increased risk for TBI. Healthcare providers who work in these areas face many challenges but have found ways to successfully manage the treatment of this injury in their patients.
Collapse
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Shena Popat
- NORC at the University of Chicago, Bethesda, MD, USA
| | | | | | - Alana Knudson
- NORC at the University of Chicago, Bethesda, MD, USA
| |
Collapse
|
15
|
Waltzman D, Sarmiento K, Daugherty J, Proescholdbell S. Examination of Behaviors and Health Indicators for Individuals with a Lifetime History of Traumatic Brain Injury with Loss of Consciousness: 2018 BRFSS North Carolina. N C Med J 2022; 83:206-213. [PMID: 35504710 PMCID: PMC9340785 DOI: 10.18043/ncm.83.3.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Evidence suggests that those who have sustained a traumatic brain injury (TBI) are at increased risk of adverse behaviors and health indicators, such as certain chronic physical and mental health conditions. However, little is known about the prevalence of these behaviors and health indicators among these individuals, information that could help decrease their risk of developing such conditions.METHODS Data (N = 4733) from the 2018 North Carolina Behavioral Risk Factor Surveillance System (BRFSS) were analyzed to determine the prevalence of behaviors and health indicators among individuals who report having a lifetime history of TBI with loss of consciousness (LOC).RESULTS North Carolinians who report a lifetime history of TBI with LOC were at increased risk of reporting a range of 3 negative health behaviors: less than always seatbelt use (adjusted odds ratio [AOR] = 1.7; 95% confidence interval [CI] = 1.2-2.4), HIV risk behaviors (AOR = 1.7; 95% CI = 1.1-2.6), and reporting less than 7 hours of sleep (AOR = 1.5; 95% CI = 1.2-1.8); more difficulty obtaining health care (not seeing a doctor due to health care cost in the past 12 months [AOR = 1.3; 95% CI = 1.0-1.8]; not getting a routine medical check-up in the past 12 months [AOR = 1.5; 95% CI = 1.2-2.0]); worse self-reported health (fair or poor general health [AOR = 1.8; 95% CI = 1.4-2.3]); and reporting fair or poor mental health (AOR = 2.1; 95% CI = 1.6-2.8) compared with individuals who did not report a history of TBI.LIMITATIONS There are several limitations to the study, such as the sample being biased toward more severe brain injuries. Additionally, because the data in the BRFSS are retrospective and cross-sectional, it is not possible to determine temporality and causality between TBI history and the behaviors and health indicators examined.CONCLUSION Despite these limitations, this paper is one of the first to directly examine the association between history of TBI with LOC and a range of current behaviors and health care utilization. Assessing positive and negative behaviors and health indicators can help identify and tailor evidence-based interventions for those who have a history of TBI.
Collapse
Affiliation(s)
- Dana Waltzman
- Behavioral scientist, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia.
| | - Kelly Sarmiento
- Health communication specialist, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Jill Daugherty
- Epidemiologist, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia
| | - Scott Proescholdbell
- Epidemiologist, North Carolina Department of Health and Human Services, Division of Public Health, Raleigh, North Carolina
| |
Collapse
|
16
|
Daugherty J, Sarmiento K, Waltzman D, Xu L. Traumatic Brain Injury-Related Hospitalizations and Deaths in Urban and Rural Counties-2017. Ann Emerg Med 2022; 79:288-296.e1. [PMID: 34742590 PMCID: PMC8860841 DOI: 10.1016/j.annemergmed.2021.09.433] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 08/11/2021] [Accepted: 09/20/2021] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE A better understanding of differences in traumatic brain injury incidence by geography may help inform resource needs for local communities. This paper presents estimates on traumatic brain injury-related hospitalizations and deaths by urban and rural county of residence. METHODS To estimate the incidence of traumatic brain injury-related hospitalizations, data from the 2017 Healthcare Cost and Utilization Project's National Inpatient Sample were analyzed (n=295,760). To estimate the incidence of traumatic brain injury-related deaths, the Centers for Disease Control and Prevention's National Vital Statistics System multiple-cause-of-death files were analyzed (n=61,134). Datasets were stratified by residence, sex, principal mechanism of injury, and age group. Traumatic brain injury-related hospitalizations were also stratified by insurance status and hospital location. RESULTS The rate of traumatic brain injury-related hospitalizations was significantly higher among urban (70.1 per 100,000 population) than rural residents (61.0), whereas the rate of traumatic brain injury-related deaths was significantly higher among rural (27.5) than urban residents (17.4). These patterns held for both sexes, individuals age 55 and older, and within the leading mechanisms of injury (ie, suicide, unintentional falls). Among patients with Medicare or Medicaid, the rate of traumatic brain injury-related hospitalizations was higher among urban residents; there was no urban/rural difference with other types of insurance. Nearly all (99.6%) urban residents who were hospitalized for a traumatic brain injury received care in an urban hospital. Additionally, approximately 80.3% of rural residents were hospitalized in an urban hospital. CONCLUSION Urban residents had a higher rate of traumatic brain injury-related hospitalizations, whereas rural residents had a higher rate of traumatic brain injury-related deaths. This disparity deserves further study using additional databases that assess differences in mechanisms of injury and strategies to improve access to emergency care among rural residents.
Collapse
Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA.
| | | | | | | |
Collapse
|
17
|
Waltzman D, Daugherty J, Sarmiento K, Haarbauer-Krupa J, Campbell H, Ferrell D. Prevalence of Suspected Concussions Among K-12 Students in Utah: Findings From Utah's Student Injury Reporting System. J Sch Health 2022; 92:241-251. [PMID: 34927246 PMCID: PMC8831567 DOI: 10.1111/josh.13126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND To inform prevention strategies, this study provides incidence, factors, and actions taken when a suspected concussion occurred in K-12 schools in Utah. METHODS Data were collected using Utah's Student Injury Reporting System (SIRS) from the academic years 2011-2012 to 2018-2019. SIRS is a unique online system that tracks injuries that occur in the school setting among K-12 students in Utah. Descriptive statistics were computed to characterize students with a suspected concussion. Chi-square (χ2 ) analysis looking at characteristics by school level was also conducted. RESULTS Over 63,000 K-12 students in Utah sustained an injury at school during the study period. Suspected concussions comprised 10% of all injuries. The prevalence of concussions was highest among males (60.6%) and elementary school students (42.6%) and most often occurred outdoors (57.6%) or on a playground/playfield (33.9%), and in sports- and recreation-related activities (75.1%) (specifically contact sports, 24.0%). Most students with a suspected concussion were absent 1 day or less from school (71.4%) but about 68% were seen by a medical professional. Further, there were differences by school level. Females and students playing contact sports had a higher percentage of suspected concussions as school level increased, whereas males and concussions sustained during school hours had a lower percentage of suspected concussions as school level increased. CONCLUSIONS SIRS enables schools in Utah to identify groups at risk for concussion, as well as activities most commonly associated with these injuries, within the school environment. Using this information, schools may implement targeted prevention strategies to protect students.
Collapse
Affiliation(s)
- Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Mail Stop: F62, Atlanta, GA, 30341
| | - Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Chamblee Campus, Bldg. 106/9110.17, Atlanta, GA, 30341
| | - Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Mail Stop: F62, Atlanta, GA, 30341
| | - Juliet Haarbauer-Krupa
- Traumatic Brain Injury Team, Applied Sciences Branch Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC), 4770 Buford Highway NE | MS S106-9, Atlanta, GA, 30341
| | - Hillary Campbell
- Violence and Injury Prevention Program, Utah Department of Health, Salt Lake City, UT
| | - Deanna Ferrell
- Violence and Injury Prevention Program (VIPP), Utah Department of Health, 288 North 1460 West, PO Box 142106, Salt Lake City, UT, 84114-2106
| |
Collapse
|
18
|
Daugherty J, Zhou H, Sarmiento K, Waltzman D. Differences in State Traumatic Brain Injury-Related Deaths, by Principal Mechanism of Injury, Intent, and Percentage of Population Living in Rural Areas - United States, 2016-2018. MMWR Morb Mortal Wkly Rep 2021; 70:1447-1452. [PMID: 34648483 PMCID: PMC8631284 DOI: 10.15585/mmwr.mm7041a3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Hong Zhou
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| |
Collapse
|
19
|
Daugherty J, Sarmiento K, Womack LS, Breiding M. Symptom profile of affirmative responses to a self-report concussion question, United States 2019. Brain Inj 2021; 35:1413-1417. [PMID: 34487455 PMCID: PMC8678211 DOI: 10.1080/02699052.2021.1972340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 05/19/2021] [Accepted: 08/20/2021] [Indexed: 10/20/2022]
Abstract
Information is limited about signs and symptoms experienced by individuals who self-report a concussion within surveys. The objective of this study was to assess the number and types of signs/symptoms adults experienced and whether or not medical attention was reported after sustaining a self-reported concussion in the past year. A sample of 3,624 adults responded to the web-based 2019 FallStyles survey. Respondents were asked if they had sustained a concussion in the past 12 months and if so, which (if any) signs/symptoms they experienced following the injury. The frequency and percentages of symptoms were calculated. Approximately 2.9% of respondents reported a concussion in the past year. Approximately two-thirds of respondents who reported sustaining a recent concussion stated that they experienced two or more signs/symptoms; the remaining one-third reported zero or one symptom. The findings suggest self-report concussion questions need additional improvement, particularly those that capture concussion using a single question, to improve the validity of self-reports.
Collapse
Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Lindsay S Womack
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| | - Matthew Breiding
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA, USA
| |
Collapse
|
20
|
Daugherty J, Thomas K, Waltzman D, Sarmiento K. State-Level Numbers and Rates of Traumatic Brain Injury-Related Emergency Department Visits, Hospitalizations, and Deaths in 2014. J Head Trauma Rehabil 2021; 35:E461-E468. [PMID: 32947502 PMCID: PMC7831129 DOI: 10.1097/htr.0000000000000593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To provide state-level traumatic brain injury (TBI)-related emergency department (ED) visit, hospitalization, and death estimates for 2014. SETTING AND PARTICIPANTS The Centers for Disease Control and Prevention's Core Violence and Injury Prevention Program and State Injury Indicators participating states. DESIGN Cross-sectional. MAIN MEASURES Number and incidence rates of TBI-related ED visits, hospitalizations, and deaths in more than 30 states. RESULTS The rates of TBI-related ED visits in 2014 ranged from 381.1 per 100 000 (South Dakota) to 998.4 per 100 000 (Massachusetts). In 2014, Pennsylvania had the highest TBI-related hospitalization rate (98.9) and Ohio had the lowest (55.1). In 2014, the TBI-related death rate ranged from 9.1 per 100 000 (New Jersey) to 23.0 per 100 000 (Oklahoma). CONCLUSION The variations in TBI burden among states support the need for tailoring prevention efforts to state needs. Results of this analysis can serve as a baseline for these efforts.
Collapse
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | |
Collapse
|
21
|
Sarmiento K, Kennedy J, Daugherty J, Peterson AB, Evans ME, Haberling DL, Billie H. Traumatic Brain Injury-Related Emergency Department Visits Among American Indian and Alaska Native Persons-National Patient Information Reporting System, 2005-2014. J Head Trauma Rehabil 2021; 35:E441-E449. [PMID: 32472829 PMCID: PMC7483258 DOI: 10.1097/htr.0000000000000570] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The American Indian/Alaska Native (AI/AN) population has a disproportionately high rate of traumatic brain injuries (TBIs). However, there is little known about incidence and common mechanisms of injury among AI/AN persons who seek care in an Indian Health Service (IHS) or tribally managed facility. METHODS Using the IHS National Patient Information Reporting System, we assessed the incidence of TBI-related emergency department visits among AI/AN children and adults seen in IHS or tribally managed facilities over a 10-year period (2005-2014). RESULTS There were 44 918 TBI-related emergency department visits during the study period. Males and persons aged 18 to 34 years and 75 years and older had the highest rates of TBI-related emergency department visits. Unintentional falls and assaults contributed to the highest number and proportion of TBI-related emergency department visits. The number and age-adjusted rate of emergency department visits for TBI were highest among persons living in the Southwest and Northern Plains when compared with other IHS regions. CONCLUSION Thousands of AI/AN children and adults are seen each year in emergency departments for TBI and the numbers increased over the 10-year period examined. Evidence-based interventions to prevent TBI-related emergency department visits, such as programs to reduce the risk for older adult falls and assault, are warranted.
Collapse
Affiliation(s)
- Kelly Sarmiento
- Divisions of Injury Prevention (Ms Sarmiento and Drs Daugherty and Peterson) and Overdose Prevention (Dr Evans), National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia (Mss Kennedy and Haberling); and Indian Health Service, Office of Environmental Health and Engineering, Division of Environmental Health Services, Injury Prevention Program, Washington, District of Columbia (Ms Billie)
| | | | | | | | | | | | | |
Collapse
|
22
|
Sarmiento K, Daugherty J, Waltzman D. Effectiveness of the CDC HEADS UP online training on healthcare providers' mTBI knowledge and self-efficacy. J Safety Res 2021; 78:221-228. [PMID: 34399918 PMCID: PMC8375598 DOI: 10.1016/j.jsr.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Revised: 01/25/2021] [Accepted: 04/23/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Many healthcare providers do not consistently implement recommendations contained in clinical guidelines on mild traumatic brain injury (mTBI). As such, the Centers for Disease Control and Prevention (CDC) created the HEADS UP to Healthcare Providers online training to promote uptake of five key recommendations in the CDC Pediatric mTBI Guideline. METHODS Using data from modules in the CDC HEADS UP to Healthcare Providers online training, healthcare providers' self-reported knowledge and self-efficacy prior to and immediately following completion of the training was analyzed. RESULTS Improvements for 8 out of the 10 knowledge questions had a high level of practical significance. The knowledge question with the highest level of practical significance pre- to post-test improvement was for the key guideline recommendation on neuroimaging (pre-test correct: 70.2%; post-test correct: 87.8%; (p < 0.0001, Cohen's g = 0.39). Four out of the six questions had a self-efficacy level increase of a high level of practical significance (r > 0.50) between the pre- and post-tests. The self-efficacy question with pre- to post-test improvement with the highest level of practical significance was "I am confident in my ability to manage the return to sports progression for my patients" (p < 0.001; r = 0.54). CONCLUSIONS The HEADS UP to Healthcare Providers online training led to significant improvements in knowledge and self-efficacy related to mTBI diagnosis and management. Expanded use of this training among healthcare providers who commonly provide care for pediatric patients with mTBI may be beneficial. Practical Applications: This study highlights several factors guideline developers may take into consideration when creating an implementation tool, such as using health behavior theories, working with partners and key stakeholders, and focusing on digital-based tools.
Collapse
Affiliation(s)
- Kelly Sarmiento
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, GA, United States.
| | - Jill Daugherty
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, GA, United States
| | - Dana Waltzman
- Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control (NCIPC), Division of Injury Prevention, Atlanta, GA, United States
| |
Collapse
|
23
|
Sarmiento K, Daugherty J, Haarbauer-Krupa J. Healthcare Providers' Self-Reported Pediatric Mild Traumatic Brain Injury Diagnosis, Prognosis, and Management Practices: Findings From the 2019 DocStyles Survey. J Head Trauma Rehabil 2021; 36:282-292. [PMID: 33656487 PMCID: PMC8249309 DOI: 10.1097/htr.0000000000000671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To assess adherence to 5 key recommendations in the Centers for Disease Control and Prevention evidence-based guideline on pediatric mild traumatic brain injury, this article presents results from the 2019 DocStyles survey. STUDY DESIGN Cross-sectional, web-based survey of 653 healthcare providers. RESULTS Most healthcare providers reported adhering to the recommendations regarding the use of computed tomography and providing education and reassurance to patients and their families. However, less than half reported routinely examining their patients with mild traumatic brain injury (mTBI) using age-appropriate, validated symptom scales, assessing for risk factors for prolonged recovery, and advising patients to return to noncontact, light aerobic activities within 2 to 3 days. Self-reported mTBI diagnosis, prognosis, and management practices varied by specialty. Only 3.8% of healthcare providers answered all 7 questions in a way that is most consistent with the 5 recommendations examined from the Centers for Disease Control and Prevention Pediatric mTBI Guideline. CONCLUSION This study highlights several important information gaps regarding pediatric mTBI diagnosis and management. Further efforts to improve adoption of guideline recommendations may be beneficial to ensure optimal outcomes for children following an mTBI.
Collapse
Affiliation(s)
- Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA
| | - Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA
| | - Juliet Haarbauer-Krupa
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, GA
| |
Collapse
|
24
|
Sarmiento K, Haileyesus T, Waltzman D, Daugherty J. Emergency Department Visits for Bicycle-Related Traumatic Brain Injuries Among Children and Adults - United States, 2009-2018. MMWR Morb Mortal Wkly Rep 2021; 70:693-697. [PMID: 33988186 PMCID: PMC8118151 DOI: 10.15585/mmwr.mm7019a1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - Dana Waltzman
- National Center for Injury Prevention and Control, CDC
| | | |
Collapse
|
25
|
Miller GF, Daugherty J, Waltzman D, Sarmiento K. Predictors of traumatic brain injury morbidity and mortality: Examination of data from the national trauma data bank: Predictors of TBI morbidity & mortality. Injury 2021; 52:1138-1144. [PMID: 33551263 PMCID: PMC8107124 DOI: 10.1016/j.injury.2021.01.042] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 01/21/2021] [Accepted: 01/23/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND There is evidence to suggest that traumatic brain injuries (TBI) are increasing in the United States. It is important to examine predictors of TBI outcomes to formulate better prevention and care strategies. RESEARCH DESIGN National Trauma Data Bank (NTDB) data from 2016 were used to report the percentage of TBI by age, sex, race/ethnicity, health insurance status, intent/mechanism of injury, Glasgow Coma Scale (GCS), disposition at emergency department, and trauma center level. Logistic regression models were run to estimate the adjusted odds ratios of patient and facility characteristics on length of hospital stay and in-hospital mortality (analyzed in 2020). RESULTS There were 236,873 patients with TBI in the NTDB in 2016. Most patients with a TBI were male, non-Hispanic white, and had sustained a TBI due to an unintentional injury. After adjusting for other factors, individuals age 0-17, those who self-pay, and those with intentional injuries had increased odds of a shorter hospital stay. Older individuals, non-Hispanic black or Hispanic patients, those who had sustained an intentional injury, and those who were not seen in a Level I trauma center had higher odds of mortality following their TBI. CONCLUSIONS Public health professionals' promotion of fall and other TBI prevention efforts and the development of strategies to improve access to Level I trauma centers, may decrease adverse TBI health outcomes. This may be especially important for older adults and other vulnerable populations.
Collapse
Affiliation(s)
- Gabrielle F Miller
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta GA, USA.
| | - Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta GA, USA.
| | - Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta GA, USA.
| | - Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC, Atlanta GA, USA.
| |
Collapse
|
26
|
Haarbauer-Krupa J, Lebrun-Harris LA, Black LI, Veliz P, Daugherty J, Desrocher R, Schulenberg J, Pilkey D, Breiding M. Comparing prevalence estimates of concussion/head injury in U.S. children and adolescents in national surveys. Ann Epidemiol 2021; 54:11-20. [PMID: 33227432 PMCID: PMC8157314 DOI: 10.1016/j.annepidem.2020.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/09/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND AND OBJECTIVES Reports on pediatric lifetime concussions/head injuries (LCHI) from national surveys have offered estimates on prevalence that range from 2.5% to 18% in the general population. The purpose of this study is to examine national surveys to compare methodologies and limitations pertaining to LCHI data collection. METHODS Three nationally representative surveys that measure LCHI in children, including the National Survey of Children's Health, the National Health Interview Survey, and the Monitoring the Future Survey were examined. Children were grouped by ages 3-17 years and adolescent ages 13-17 years, stratified by selected demographic characteristics. Participants in the surveys included parents (NSCH and NHIS) and adolescents (MTF survey). The primary outcome measure is an estimate of LCHI in children. RESULTS Estimates of prevalence of LCHI ranged from 3.6% to 7.0% for children ages 3-17 years and from 6.5% to 18.3% for adolescents 13-17 years. Survey modality, question wording, and respondent may contribute to differing estimates. Prevalence showed consistent variation by age, sex, and race/ethnicity across surveys. Associations were inconsistent between LCHI and insurance status, parental education, and household primary language. CONCLUSIONS Although there are methodological differences in capturing pediatric LCHI across surveys, the prevalence estimates and correlational associations generated can offer awareness about the burden of these injuries and insights to research and clinical care.
Collapse
Affiliation(s)
- Juliet Haarbauer-Krupa
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control, Atlanta, GA.
| | - Lydie A Lebrun-Harris
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD
| | - Lindsey I Black
- National Center for Health Statistics, Centers for Disease Control, Hyattsville, MD
| | - Philip Veliz
- School of Nursing, University of Michigan, Ann Arbor
| | - Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control, Atlanta, GA
| | - Rebecca Desrocher
- Bureau of Primary Health Care, Health Resources and Services Administration, Rockville, MD
| | - John Schulenberg
- Institute for Social Research and Department of Psychology, Survey Research Center, University of Michigan, Ann Arbor
| | - Diane Pilkey
- Maternal and Child Health Bureau, Health Resources and Services Administration, Rockville, MD
| | - Matthew Breiding
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control, Atlanta, GA
| |
Collapse
|
27
|
Waltzman D, Daugherty J, Sarmiento K, Proescholdbell S. Lifetime History of Traumatic Brain Injury With Loss of Consciousness and the Likelihood for Lifetime Depression and Risk Behaviors: 2017 BRFSS North Carolina. J Head Trauma Rehabil 2021; 36:E40-E49. [PMID: 32769836 PMCID: PMC7769859 DOI: 10.1097/htr.0000000000000603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Because of the growing concern about the potential effects of traumatic brain injuries (TBIs) on a child's developing brain and the potential impact of lifetime depression and risk behaviors associated with TBI, further exploration is warranted. SETTING AND PARTICIPANTS Data (N = 4917) from the 2017 North Carolina Behavioral Risk Factors Surveillance System (BRFSS). DESIGN Cross-sectional. MAIN MEASURES Examine whether a lifetime history of TBI with loss of consciousness (LOC) or having a history of TBI with LOC prior to 18 years of age was associated with a greater likelihood of lifetime depression, current binge drinking, and current cigarette and e-cigarette smoking. RESULTS Respondents with a history of TBI with LOC had 2.1 (95% CI, 1.6-2.8) times higher odds of lifetime depression and 1.7 to 1.8 (95% CI, 1.02-2.97) times higher odds of all risk behaviors than those without a lifetime history of TBI with LOC. There were no statistical differences between age of first TBI with LOC and lifetime depression, binge drinking, cigarette smoking, and e-cigarette use after controlling for key demographics. CONCLUSION These findings underscore the importance of increasing awareness among healthcare providers of the prevalence of lifetime depression and risk behaviors among individuals with a history of TBI and the need for improved screening and referrals to evidence-based services.
Collapse
Affiliation(s)
- Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia (Drs Waltzman and Daugherty and Ms Sarmiento); and Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina (Mr Proescholdbell)
| | | | | | | |
Collapse
|
28
|
Daugherty J, Waltzman D, Popat S, Groenendaal AH, Cherney M, Knudson A. Rural Primary Care Providers' Experience and Usage of Clinical Recommendations in the CDC Pediatric Mild Traumatic Brain Injury Guideline: A Qualitative Study. J Rural Health 2020; 37:487-494. [PMID: 33111356 DOI: 10.1111/jrh.12530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE In 2018, the Centers for Disease Control and Prevention (CDC) released an evidence-based guideline on pediatric mild traumatic brain injury (mTBI) to educate health care providers on best practices of mTBI diagnosis, prognosis, and management/treatment. As residents living in rural areas have higher rates of mTBI, and may have limited access to care, it is particularly important to disseminate the CDC guideline to rural health care providers. The purpose of this paper is to describe rural health care providers' experience with pediatric mTBI patients and their perceptions on incorporating the guideline recommendations into their practice. METHOD Interviews with 9 pediatric rural health care providers from all US regions were conducted. Interview transcripts were coded and analyzed for themes for each of the main topic areas covered in the interview guide. FINDINGS Common causes of mTBI reported by health care providers included sports and all-terrain vehicles. While health care providers found the guideline recommendations to be helpful and feasible, they reported barriers to implementation, such as lack of access to specialists. To help with uptake of the CDC guideline, they suggested the development of concise implementation tools that can be referenced quickly, integrated into electronic health record-based systems, and that are customized by visit type and health care setting (eg, initial vs follow-up visits and emergency department vs primary care visits). CONCLUSION Length, accessibility, and usability are important considerations when designing clinical tools for busy rural health care providers caring for pediatric patients with mTBI. Customized information, in both print and digital formats, may help with uptake of best practices.
Collapse
Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, Georgia
| | - Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, Atlanta, Georgia
| | - Shena Popat
- NORC at the University of Chicago, Bethesda, Maryland
| | | | | | - Alana Knudson
- NORC at the University of Chicago, Bethesda, Maryland
| |
Collapse
|
29
|
Daugherty J, DePadilla L, Sarmiento K. Assessment of HEADS UP online training as an educational intervention for sports officials/athletic trainers. J Safety Res 2020; 74:133-141. [PMID: 32951774 PMCID: PMC7644176 DOI: 10.1016/j.jsr.2020.04.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 04/24/2020] [Indexed: 05/28/2023]
Abstract
BACKGROUND Sports- and recreation-related concussions are a common injury among children. Sports officials (SOs) and athletic trainers (ATs) are integral to setting the stage for safe play and managing concussions when they occur, and significant numbers of both groups have completed the Centers for Disease Control and Prevention's HEADS UP online concussion training course. However, the utility of the course for these audiences has not been assessed. We hypothesized that sports officials' and athletic trainers' concussion-related knowledge, attitudes, and behavioral intentions will improve from pre- and post-test after completing CDC's HEADS UP online concussion training course. METHOD Respondents' concussion-related knowledge, attitudes, and behavioral intentions were assessed both before and after taking the training course. Differences between pre- and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score or McNemar's test. Effect sizes were interpreted. RESULTS The SOs and ATs who participated in the HEADS UP online training had a high level of concussion knowledge before taking the course: 90% or more of respondents could identify the correct response for at least seven of the 13 knowledge questions in the pre-test. Still, the course was effective at improving the respondents' knowledge about return-to-play protocols and concussion reporting. Further, SOs and ATs demonstrated improvement in their concussion-related attitudes and behavioral intentions between the pre- and post-test. CONCLUSION SOs' and ATs' concussion knowledge, attitudes, and behavioral intentions improved immediately following completion of the CDC HEADS UP online training. Future research could also focus on the long-term retention of this type of training. Practical Applications: This study provides insight into how to better focus concussion-related educational programs to fit SOs' and ATs' needs.
Collapse
Affiliation(s)
- Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Lara DePadilla
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Overdose Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| | - Kelly Sarmiento
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention, 4770 Buford Highway, Atlanta, GA 30341, United States.
| |
Collapse
|
30
|
Waltzman D, Daugherty J, Snedaker K, Bouton J, Wang D. Concussion reporting, return to learn, and return to play experiences in a sample of private preparatory high school students. Brain Inj 2020; 34:1193-1201. [PMID: 32697613 DOI: 10.1080/02699052.2020.1793388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVE The objective of this study is to describe concussion reporting and return to learn and play among high school students. METHODS Self-reported survey data of 1,999 New England private preparatory high school students who played sports or engaged in recreational activities were collected in 2018. Descriptive and bivariate statistics are presented. RESULTS Three in ten respondents (31.4%) reported ever sustaining a concussion and 22.0% did not report at least one concussion to an adult. The most common reasons for not reporting included wanting to keep playing their sport (58.0%) and not thinking the injury was that serious (53.6%). Girls and students in higher grades took longer to return to school and sports. A quarter of students reported pretending to have a faster recovery in order to return to school or sports. CONCLUSION Private school students who play sports or engage in recreational activity may be at risk of sustaining concussions and may not report their symptoms due to a lack of understanding the seriousness of concussion, not wanting to fall behind in school, or out of desire to continue playing their sport. Teachers, coaches, and parents can stress reporting as the first step in recovery.
Collapse
Affiliation(s)
- Dana Waltzman
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention , Atlanta, GA, USA
| | - Jill Daugherty
- Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Division of Injury Prevention , Atlanta, GA, USA
| | | | - Jason Bouton
- PINK Concussions , Norwalk, CT, USA.,King School , Stamford, CT, USA
| | - David Wang
- Elite Sports Medicine, Connecticut Children's Medical Center , Hartford, CT, USA.,Sports Medicine, Quinnipiac University, Hamden, CT, USA
| |
Collapse
|
31
|
Daugherty J, Waltzman D, Snedaker KP, Bouton J, Zhang X, Wang D. Concussion Experiences in New England Private Preparatory High School Students Who Played Sports or Recreational Activities. J Sch Health 2020; 90:527-537. [PMID: 32369871 PMCID: PMC7393617 DOI: 10.1111/josh.12899] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 09/03/2019] [Accepted: 01/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Sports- and recreation-related (SRR) activities are a major cause of adolescent concussions. Most adolescent SRR concussion research has been conducted among public school students. As private schools are qualitatively different from public schools (eg, location, socioeconomic status, sports played), this study explores the concussion experiences of a large group of private high school students. METHODS We surveyed 2047 New England private preparatory high school students who played sports or engaged in a recreational activity in 2018 about the sports they played, and their self-reported concussion experiences (eg, age at first concussion, if concussions were sports- or recreation-related). Descriptive, bivariate, and multivariate statistics are presented. RESULTS One-third (33.0%) of students who reported engaging in sport- or recreation-related activities self-reported experiencing a concussion in their lifetime. A higher percentage of boys, students who played contact sports, and those who played multiple seasons of school sports reported a concussion. Sex, contact level of primary sport played, and age of first concussion were also significantly associated with reporting a sports- or recreation-related concussion. CONCLUSIONS A sizeable proportion of private preparatory high school students reported experiencing a concussion, with some students at higher risk. Private preparatory high school-specific concussion prevention strategies may be needed.
Collapse
Affiliation(s)
- Jill Daugherty
- Epidemiologist, , National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Dana Waltzman
- Behavioral Scientist, , National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - Katherine P Snedaker
- Founder and Executive Director, , PINK Concussions, 15 Shorefront Park, Norwalk, CT, 06854, USA
| | - Jason Bouton
- Head Athletic Trainer, , NEPSAC District 4 SMAC Representative, Founding Chair, FAA Athletic Trainers Organization, Adjunct Faculty, Sacred Heart University, 1450 Newfield Avenue, Stamford, CT, 06905, USA
| | - Xinjian Zhang
- Statistician, , National Center for Injury Prevention & Control, Centers for Disease Control & Prevention, 4770 Buford Highway, Atlanta, GA, 30341, USA
| | - David Wang
- Clinical Director, , Elite Sports Medicine, Connecticut Children's Medical Center, 399 Farmington Ave, Farmington, CT, 06032, USA
| |
Collapse
|
32
|
Sarmiento K, Daugherty J, DePadilla L, Breiding MJ. Examination of sports and recreation-related concussion among youth ages 12-17: results from the 2018 YouthStyles survey. Brain Inj 2020; 34:357-362. [PMID: 32013618 DOI: 10.1080/02699052.2020.1723165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Background: This paper sought to examine the frequency of self-reported sports- and recreation-related (SRR) concussion, as well as care-seeking behaviors and potential activity restrictions after concussions, in a sample of youth.Methods: A sample of 845 youth ages 12-17 years responded to the web-based YouthStyles survey in 2018. The survey measured the frequency of self-reported lifetime SRR concussion, the setting of their most recent SRR concussion, whether a doctor or nurse evaluated them, and the types of activity restrictions they experienced.Results: Forty-three percent of youth surveyed sustained their most recent concussion while playing on a sports team, 21.1% while playing on a community-based team, and 36.0% while engaged in a sport or recreational activity. Nearly half (45.3%) reported having to miss playing sports or participating in physical activity for at least one day; about two in ten (19.7%) reported having to miss time on their phone or computer for at least one day.Conclusion: Despite wide-spread efforts to promote protocols for SRR concussion among youth, a third of participants in this study did not seek medical care and more than half did not miss at least one day of sports or physical activity participation following a concussion.
Collapse
Affiliation(s)
- Kelly Sarmiento
- Division of Injury Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
| | - Jill Daugherty
- Division of Injury Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
| | - Lara DePadilla
- Division of Injury Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
| | - Matthew J Breiding
- Division of Injury Prevention, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia, USA
| |
Collapse
|
33
|
Daugherty J, Waltzman D, Sarmiento K, Xu L. Traumatic Brain Injury-Related Deaths by Race/Ethnicity, Sex, Intent, and Mechanism of Injury - United States, 2000-2017. MMWR Morb Mortal Wkly Rep 2019; 68:1050-1056. [PMID: 31751321 PMCID: PMC6871899 DOI: 10.15585/mmwr.mm6846a2] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Affiliation(s)
- Jill Daugherty
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Dana Waltzman
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Kelly Sarmiento
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| | - Likang Xu
- Division of Injury Prevention, National Center for Injury Prevention and Control, CDC
| |
Collapse
|
34
|
Daugherty J, DePadilla L, Sarmiento K. Effectiveness of the US Centers for Disease Control and Prevention HEADS UP coaches' online training as an educational intervention. Health Educ J 2019; 78:784-797. [PMID: 31530957 PMCID: PMC6747698 DOI: 10.1177/0017896919846185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Concussions are common among youth athletes. Responsibility for the recognition and management of concussion is often put on coaches. To equip coaches with appropriate knowledge and skills, the US Centers for Disease Control and Prevention (CDC) launched the HEADS UP: Concussion in Youth Sports online training. OBJECTIVES To determine whether HEADS UP coaches' training improves knowledge, attitudes and behavioural intentions. METHODS Knowledge questions were grouped into scales by level of difficulty. Differences between pre-and post-test scores were calculated based on the Wilcoxon Signed Rank Test Z-score and effect sizes were interpreted. RESULTS Coaches displayed a high level of knowledge in the pre-test. While lower difficulty questions did not show improvement from pre- to post-test, moderate and high difficulty questions did. Use of the training was associated with improved knowledge about symptom resolution, return-to-play recommendations and under-reporting of incidents of concussion. Coaches demonstrated improvement in five of the seven concussion-related attitude and behavioural intention items post training. CONCLUSION HEADS UP training improved coaches' knowledge on select topics and helped them feel more comfortable about responding to concussion among their athletes. This study provides insight into how to better focus future HEADS UP concussion health education efforts to fit coaches' informational needs.
Collapse
Affiliation(s)
- Jill Daugherty
- Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lara DePadilla
- Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kelly Sarmiento
- Division of Unintentional Injury Prevention, National Center for Injury Prevention & Control, US Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
35
|
Ibanez-Casas I, Jannoo D, Denardis D, De la Cruz F, Santiago S, Lozano-Ruiz A, Daugherty J. Effects of Cultural and Educational Variables on a Computerized Continuous Performance Task: the EMBRACED CPT. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz029.25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
The continuous performance tests (CPTs) are the gold standard to assess vigilance or sustained attention. Many studies have shown that educational level is significantly associated with performance on the CPTs. However, very few studies have made comparisons that included cultural factors (Miranda et al, 2008). Given the breadth of educational systems in different parts of the world, it could be expected that the effect of educational level will vary depending on the culture of origin. The aim of this study was to examine the effect of education on performance on a CPT task in 3 ethnically diverse groups (Hispanic, Non-Hispanic and Spanish).
Participants and Method
This study includes 57 participants in the EMBRACED project: 12 Hispanic Americans, 26 non-Hispanics Americans, and 19 Spaniards (8.3%, 30% and 57% with high education respectively). Educational level was defined as high (university degree and above) or low (less than a university degree). The EMBRACED CPT is computerized and demands the participant to touch the iPad screen each time a target is presented. In 3 blocks of 100 stimuli each, the number of hits, omissions, and commissions is recorded.
Results
A mixed between-within subjects analysis of variance was conducted to compare scores in the three blocks of the CPT in relation to the three cultural groups and by education levels. Results showed no interaction effects between cultural groups and education, and no main effects of education for any of the studied variables. However, there was a significant main effect for cultural group for hits (F = 4.676, P = .014) and omissions (F = 5.614, p = .006).
Conclusions
The overall results for education in this study were not significant and would need further study. The variability in cultural group revealed a consistent effect across all studied variables. The non-Hispanics scored higher in hits and the Spaniards had more omissions. These results justify the need for cultural adaptation of neuropsychological measures.
References
Miranda, M. C., Sinnes, E. G., Pompeia, S., & Francisco Amodeo Bueno, O. (2008). A comparative study of performance in the Conners' Continuous Performance Test between Brazilian and North American children. Journal of Attention Disorders, 11(5), 588-598.
Collapse
|
36
|
Sarmiento K, Daugherty J, DePadilla L. Youth and high school sports coaches' experience with and attitudes about concussion and access to athletic trainers by sport type and age of athlete coached. J Safety Res 2019; 69:217-225. [PMID: 31235231 PMCID: PMC6597176 DOI: 10.1016/j.jsr.2019.01.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/29/2019] [Indexed: 06/01/2023]
Abstract
INTRODUCTION Concussions are a commonly reported injury in youth and high school sports and much of the responsibility related to concussion identification and response for young athletes is allocated to sports coaches. This paper presents findings on concussion-related education, access to resources, experiences, and attitudes among a large number of youth and high school sports coaches across a variety of sports nationwide. METHODOLOGY Data were collected among coaches who completed the Centers for Disease Control and Prevention's (CDC) HEADS UP online concussion training pre-test between November 2016 and November 2017. Coaches' concussion-related education, access to resources, experiences, and attitudes were compared by age of athlete coached and level of contact of sport. Medium and large effect sizes were considered of practical significance for interpretation. RESULTS During the study period, 187,801 youth sports or high school sports coaches completed the CDC HEADS UP online training and corresponding pre-test. Access to previous concussion training significantly varied among respondents by age of athlete coached. For example, 27.4% of coaches of athletes aged 5 and younger had taken previous training compared to 72.9% of coaches of athletes aged 14-18. About one-quarter (27.4%) of all coaches reported ever having had to pull an athlete out of a game because of a possible concussion and 19.5% reported access to an athletic trainer at all games and practices. These variables differed significantly among coaches by age of athletes coached; coaches of older athletes were more likely to report access to an athletic trainer and having had to pull an athlete out of a game compared to coaches of younger athletes. No statistical differences by level of contact were considered to be of practical significance based on effect size. CONCLUSION Most coaches in this study report having access to education and hold attitudes consistent with best practices about concussion safety; however, overall access to concussion-related resources is limited. While differences in access to concussion-related education, experience, resources, and attitudes among coaches of varying levels of contact were small, medium to large variations were identified by age of athlete coached. Practical applications: Coaches bear an important part of the responsibility to prevent, identify, and manage concussions in young athletes. Tailored educational efforts may assist coaches of young athletes with recognition of concussion signs and symptoms and with feeling comfortable deciding whether an athlete needs to be evaluated for a possible concussion.
Collapse
Affiliation(s)
- Kelly Sarmiento
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States.
| | - Jill Daugherty
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Lara DePadilla
- Division of Unintentional Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| |
Collapse
|
37
|
Sarmiento K, Thomas KE, Daugherty J, Waltzman D, Haarbauer-Krupa JK, Peterson AB, Haileyesus T, Breiding MJ. Emergency Department Visits for Sports- and Recreation-Related Traumatic Brain Injuries Among Children - United States, 2010-2016. MMWR Morb Mortal Wkly Rep 2019; 68:237-242. [PMID: 30870404 PMCID: PMC6421963 DOI: 10.15585/mmwr.mm6810a2] [Citation(s) in RCA: 88] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
38
|
Abstract
INTRODUCTION/BACKGROUND Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease thought to be caused by repeated head impacts and associated with deficits in cognition. Despite research and media attention, there is little science-based information available for the public. Also unclear is what the public and particularly parents of youth athletes know about CTE. The U.S. Centers for Disease Control and Prevention (CDC) surveyed parents of young athletes to fill this gap. METHODS CDC analysed 12 CTE-related questions that appeared in Porter Novelli Public Service's 2017 SummerStyles opinion survey. Analyses focused on 674 parents of children who play in a youth sports programme. RESULTS Half of parents had at least one child who plays contact sports. About one-third of respondents reported being somewhat or very familiar with CTE. Most parents (81.7%) have not received educational materials on CTE from a school or sports programme. Healthcare providers were the preferred source of information about CTE (70%), followed by sports coaches (54%). DISCUSSION/CONCLUSION This analysis identified information needs related to CTE among parents of young athletes. These findings can be used by health educators to tailor educational materials to meet information needs. Educational materials that emphasize potential prevention strategies and symptom onset may be beneficial.
Collapse
Affiliation(s)
- Jill Daugherty
- a Centers for Disease Control and Prevention, National Center for Injury Prevention and Control , Division of Unintentional Injury Prevention , Atlanta , GA , USA
| | - Kelly Sarmiento
- a Centers for Disease Control and Prevention, National Center for Injury Prevention and Control , Division of Unintentional Injury Prevention , Atlanta , GA , USA
| |
Collapse
|
39
|
Nugent CN, Daugherty J. A Demographic, Attitudinal, and Behavioral Profile of Cohabiting Adults in the United States, 2011-2015. Natl Health Stat Report 2018:1-11. [PMID: 29874161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This report provides a profile of sexually experienced, cohabiting adults aged 18-44 in the United States based on 2011-2015 data from the National Survey of Family Growth (NSFG). Additionally, this report compares these cohabiting adults with those sexually experienced adults who are currently married and those who are unmarried and not currently cohabiting. Data are shown by selected demographic characteristics, attitudes, and family formation behaviors. NSFG data used in this report were collected through in-person interviews from September 2011 through September 2015 with nationally representative samples of 6,674 men and 8,292 women aged 18-44 who were sexually experienced. The overall response rate for the 2011-2015 NSFG was 71%: 72% for women and 70% for men.Overall, 17.1% of women and 15.9% of men aged 18-44 who were sexually experienced were cohabiting at the time of interview. Compared with those who were married or unmarried and not cohabiting, cohabiting women and men were more likely to have no high school diploma or GED. Both cohabiters and unmarried, noncohabiting individuals reported lower household incomes than married persons. Cohabiting women and men were more supportive of premarital cohabitation, the idea that living together before marriage may help prevent divorce, and of raising children in cohabiting unions, compared with married and unmarried, noncohabiting adults. Cohabiting individuals were more likely to report having had their first sexual intercourse before the age of 18 and having cohabited two or more times in the pastthan both married and unmarried, noncohabiting individuals. They were also more likely than married men and women to have had an unintended birth.
Collapse
|
40
|
Abstract
Background: Recently, there has been a strong emphasis on educating athletes, parents, coaches, and health care providers about concussions. However, not much is known about whether these efforts are affecting the general public’s level of concussion knowledge. Purpose: To determine what is currently known among the public about concussions and where education campaigns may be targeted in order to fill in the gaps. Methods: In order to achieve the project’s objective, CDC analyzed self-reported data from Porter Novelli’s 2017 SummerStyles survey, an annual survey of American adults aged 18 and older across the United States. The questions focused on personal concussion experiences, basic concussion knowledge, knowledge of prevention strategies, and perceived best sources of information about concussion. Results: Analysis of the data showed that approximately 18% of respondents reported that they had personally experienced a concussion in their lifetime, and about two-thirds of these respondents were evaluated by a health care provider after their injury. In terms of concussion knowledge, the majority were aware of common causes of concussion. While 94% knew that headache was a symptom of concussion, just over half were aware that sleep problems were as well. Most respondents (>78%) correctly identified that wearing seat-belts, preventing falls, and reducing participation in contact sports were ways to prevent a concussion, while installing baby-gates across stairs was less frequently known (65.5%) as a prevention technique. Nearly all of the respondents believed that a doctor or other health professional was a good source of information about concussions. These results varied by age, sex, race/ethnicity, and education. Conclusion: The results demonstrate that even though the public has a relatively high knowledge level of concussion, targeted education is needed to teach American adults about the symptoms and ways of getting a concussion.
Collapse
Affiliation(s)
- Dana Waltzman
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jill Daugherty
- National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA
| |
Collapse
|
41
|
Daugherty J, Miles I, Sarmiento K, Sansone C, Kroshus E, Bethea B. A Description and Evaluation of the Concussion Education Application HEADS UP Rocket Blades. Health Promot Pract 2018; 20:22-30. [PMID: 29597872 DOI: 10.1177/1524839918764670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Concussions are responsible for numerous emergency department visits and hospitalizations among children annually. However, there remains a great deal of confusion about how to prevent and manage concussions in youth. To teach children aged 6 to 8 years about concussion safety, the Centers for Disease Control and Prevention (CDC) created a mobile gaming application called HEADS UP Rocket Blades. This report introduces the game and presents findings on its evaluation. METHODS The aim of the game is to teach children what a concussion is, its commons signs and symptoms, how to prevent one, and what to do if one occurs. An early version of the game went through two rounds of usability testing with children and parents to obtain initial impressions and make improvements. RESULTS The first round of usability testing focused on the mechanics of the game. Based on feedback from this session, CDC and the developers simplified the messaging and adjusted the game's level of difficulty. The second round focused on the gaming experience. The children indicated that they enjoyed playing, and nearly all were able to relay at least one learning objective. CONCLUSIONS Parents and children rated Rocket Blades as a good learning tool and indicated that they would download it for personal use.
Collapse
Affiliation(s)
- Jill Daugherty
- 1 Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Isa Miles
- 2 Banyan Communications, Atlanta, GA, USA
| | - Kelly Sarmiento
- 1 Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | | |
Collapse
|
42
|
Febo-Vazquez I, Copen CE, Daugherty J. Main Reasons for Never Testing for HIV Among Women and Men Aged 15-44 in the United States, 2011-2015. Natl Health Stat Report 2018:1-12. [PMID: 29616900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
This report presents the percentage of men and women aged 15-44 in the United States who have never been tested for HIV outside of blood or blood product donation based on 2011-2015 data from the National Survey of Family Growth (NSFG). Additionally, this report describes the main reasons reported for having never been tested for HIV. Data are shown by selected demographic characteristics and HIV risk-related behaviors.
Collapse
|
43
|
Daugherty J, Martinez G. Birth Expectations of U.S. Women Aged 15-44. NCHS Data Brief 2016:1-8. [PMID: 27736631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Data from the National Survey of Family Growth •Among U.S. women aged 15-44 in 2013-2015, 50% expected to have a child in the future. •In 2013-2015, differences were seen by age in women's expectations to have a child in the future, regardless of the number of biological children they have had. •In 2013-2015, women on average expected to have 2.2 children in their lifetime. This estimate has decreased since 2002. •A smaller percentage of never married, not cohabiting women expected to have a child within 2 years from the time of interview (5%) compared with currently married (19%) and currently cohabiting (16%) women. •Eighty-two percent of women who already had two or more children did not expect to have more children in the future. Birth expectations have been shown to be related to sexual activity, contraceptive use, and fertility (1-3). While most U.S. women believe that having two children is ideal (4), this varies by sociodemographic characteristics. Using data from the National Survey of Family Growth (NSFG), this report describes women's birth expectations, number of children expected, and when they expected their next child to be born. Data are shown by age, marital or cohabiting status, and number of children. Selected trends are also shown using NSFG data from 2002, 2006-2010, 2011-2013, and 2013-2015.
Collapse
|
44
|
Daugherty J, Mejia A, Leonard B, Kuwabara H, Hidalgo Ruzzante N, Bueso Izquierdo N, Fasfous A, Pérez García M, Puente A. C-73Relevance of Subjective Socioeconomic Status Measures for Cross-Cultural Neuropsychological Performance: The EMBRACED Project. Arch Clin Neuropsychol 2016. [DOI: 10.1093/arclin/acw043.222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
45
|
Daugherty J, Copen C. Trends in Attitudes About Marriage, Childbearing, and Sexual Behavior: United States, 2002, 2006-2010, and 2011-2013. Natl Health Stat Report 2016:1-10. [PMID: 27019117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVE This report describes attitudes about marriage, childbearing, and sexual behavior among men and women aged 15-44 in the United States based on the 2002, 2006-2010, and 2011-2013 National Survey of Family Growth (NSFG). METHODS Data for all three survey periods were collected through in-person interviews with nationally representative, independent samples of men and women in the household population of the United States. The overall response rate for NSFG was 79% in 2002, 77% in 2006-2010, and 73% in 2011-2013. Attitudinal items examined in this report include those related to marriage, divorce, cohabitation, parenthood, and sexual behavior. Where data from all three survey periods were available, differences were tested using trend analysis. Data from the 2002 survey were not available for some attitude items, and in these cases, comparisons were made only between the 2006-2010 and 2011-2013 surveys. Attitudinal differences by age group were analyzed using 2011-2013 data. All results are shown separately for women and men. RESULTS From 2002 to 2011-2013, there was an increase in the percentages of men and women who agreed with premarital cohabitation, nonmarital childbearing, the right for gay and lesbian adults to adopt children, same-sex sexual relations, and premarital sex for those aged 18. There was a decrease in the percentages of men and women who agreed with divorce. There was no change in the percentages of men and women who agreed with premarital sex for those aged 16. There was no change from 2006-2010 to 2011-2013 in attitudes regarding marriage, cohabitation and the risk of divorce, the necessity of having children for one's happiness, and raising children in a cohabiting union. Several of the attitudinal items varied significantly by age group for both men and women.
Collapse
|
46
|
Daniels K, Daugherty J, Jones J, Mosher W. Current Contraceptive Use and Variation by Selected Characteristics Among Women Aged 15-44: United States, 2011-2013. Natl Health Stat Report 2015:1-14. [PMID: 26556545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This report describes current contraceptive use among women of childbearing age (ages 15-44) during 2011-2013. Current contraceptive use is defined as use during the month of interview, not for a specific act of sexual intercourse. This report's primary focus is describing patterns of contraceptive use among women who are currently using contraception, by social and demographic characteristics. Data from 2002 and 2006-2010 are presented for comparison. METHODS-Data for the 2011-2013 National Survey of Family Growth (NSFG) were collected through in-person interviews in respondents' homes. The 2011-2013 NSFG, a nationally representative survey conducted by the Centers for Disease Control and Prevention's National Center for Health· Statistics, was based on interviews with 10,416 women and men aged 15-44 in the U.S. household population. This report is based on the sample of 5,601 women interviewed in 2011-2013, with a response rate of 73.4%. RESULTS-Among women currently using contraception, the most commonly used methods were the pill (25.9%, or 9.7 million women), female sterilization (25.1 %, or 9.4 million women), the male condom (15.3%, or 5.8 million women), and long-acting reversible contraception (LARC)-intrauterine devices or contraceptive implants (11.6%, or 4.4 million women). Differences in method use were seen across social and demographic characteristics. Comparisons between time points reveal some differences, such as higher use of LARC in 2011-2013 compared with earlier time points.
Collapse
|
47
|
Daniels K, Daugherty J, Jones J. Current contraceptive status among women aged 15-44: United States, 2011-2013. NCHS Data Brief 2014:1-8. [PMID: 25500343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Nearly all women use contraception at some point in their lifetimes, although at any given time they may not be using contraception for reasons such as seeking pregnancy, being pregnant, or not being sexually active. Using data from the 2011-2013 National Survey of Family Growth (NSFG) on contraceptive use in the month of the interview, this report provides a snapshot of current contraceptive status among women aged 15-44 in the United States. In addition to describing use of any method by age, Hispanic origin and race, and educational attainment, patterns of use are described for the four most commonly used contraceptive methods: the oral contraceptive pill, female sterilization, the male condom, and long-acting reversible contraceptives, which include contraceptive implants and intrauterine devices.
Collapse
|
48
|
Houry D, Hankin A, Daugherty J, Smith LS, Kaslow N. Effect of a Targeted Women's Health Intervention in an Inner-City Emergency Department. Emerg Med Int 2011; 2011:543493. [PMID: 22203904 PMCID: PMC3235772 DOI: 10.1155/2011/543493] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2011] [Accepted: 10/19/2011] [Indexed: 11/27/2022] Open
Abstract
Objective. To evaluate the effect of an Emergency Department (ED) based, educational intervention for at-risk health behaviors. Methods. A randomized trial over a one-year period. African American women, aged 21-55, presenting to the ED waiting room were eligible. Each participant took a computer-based survey on health risk behaviors. Participants who screened positive on any of four validated scales (for IPV, nicotine, alcohol, or drug dependence) were randomized to standard information about community resources (control) or to targeted educational handouts based upon their screening results (intervention). Participants were surveyed at 3 months regarding contacts with community resources and harm-reduction actions. Results. 610 women were initially surveyed; 326 screened positive (13.7% for IPV, 40.1% for nicotine addiction, 26.6% for alcohol abuse, and 14.4% for drug abuse). 157 women were randomized to intervention and 169 to control. Among women who completed follow-up (n = 71), women in the Intervention Group were significantly more likely to have contacted local resources (37% versus 9%, P = 0.04) and were more likely to have taken risk-reducing action (97% versus 79%, P = 0.04). Conclusion. Targeted, brief educational interventions may be an effective method for targeting risk behaviors among vulnerable ED populations.
Collapse
Affiliation(s)
- Debra Houry
- Department of Emergency Medicine, Emory University, Atlanta, GA 30322, USA
| | - Abigail Hankin
- Department of Emergency Medicine, Emory University, Atlanta, GA 30322, USA
| | - Jill Daugherty
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - L. Shakiyla Smith
- Department of Emergency Medicine, Emory University, Atlanta, GA 30322, USA
| | - Nadine Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA 30322, USA
| |
Collapse
|
49
|
Hankin A, Smith LS, Daugherty J, Houry D. Correlation Between Intimate Partner Violence Victimization and Risk of Substance Abuse and Depression among African-American Women in an Urban Emergency Department. West J Emerg Med 2010; 11:252-6. [PMID: 20882145 PMCID: PMC2941362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Revised: 04/18/2010] [Accepted: 04/21/2010] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To assess rates of substance abuse (including tobacco, alcohol, and drug abuse) as well as rates of intimate partner violence (IPV) among African-American women seen in an urban emergency department (ED). METHODS Eligible participants included all African-American women between the ages of 21-55 years old who were seen in an urban ED for any complaint and triaged to the waiting room. Eligible women who consented to participate completed a computer-based survey that focused on demographic information and general health questions, as well as standardized instruments to screen for alcohol abuse, tobacco abuse, and illicit drug use. This analysis uses results from a larger study evaluating the effects of providing patients with targeted educational literature based on the results of their screening. RESULTS Six-hundred ten women were surveyed; 430 women reported being in a relationship in the past year and among these, 85 women (20%) screened positive for IPV. Women who screened positive for IPV were significantly more likely to also screen positive for tobacco abuse (56% vs. 37.5%, p< 0.001), alcohol abuse (47.1% vs. 23.2%, p < 0.001), and drug abuse (44.7% vs. 9.5%, p<0.001). Women who screened positive for IPV were also more likely to screen positive for depression and report social isolation. CONCLUSIONS African-American women seen in the ED, who screen positive for IPV, are at significantly higher risk of drug, alcohol, tobacco abuse, depression and social isolation than women who do not screen positive for IPV. These findings have important implications for ED-based and community-based social services for women who are victims of intimate partner violence.
Collapse
Affiliation(s)
- Abigail Hankin
- Emory University, Department of Emergency Medicine, Atlanta, GA,Address for Correspondence: Abigail Hankin, MD, MPH, Department of Emergency Medicine, 49 Jesse Hill Jr. Dr, Atlanta, GA 30303.
| | | | | | | |
Collapse
|
50
|
Rothbaum BO, Houry D, Heekin M, Leiner AS, Daugherty J, Smith LS, Gerardi M. A pilot study of an exposure-based intervention in the ED designed to prevent posttraumatic stress disorder. Am J Emerg Med 2008; 26:326-30. [PMID: 18358945 DOI: 10.1016/j.ajem.2007.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2007] [Revised: 07/18/2007] [Accepted: 07/19/2007] [Indexed: 11/19/2022] Open
Abstract
Early interventions to prevent PTSD have been limited in scope and effectiveness. This pilot study examines the feasibility and preliminary effectiveness of a model for brief preventive intervention: 1-session individualized exposure-based therapy delivered in the emergency department (ED). Eligible patients who experienced exposure to a traumatic event in the previous 24 hours were screened and assigned to assessment-only (n = 5) or intervention (imaginal exposure, n = 5) conditions. Both groups returned for 1-week follow-up. Results indicate that patients receiving this intervention reported slightly decreased levels of depression at 1-week follow-up and were rated lower on clinician-rated global severity of symptoms than patients in the assessment-only condition. The level of subject participation and ED staff support in this pilot study argues for feasibility of data collection, intervention, and follow-up with this population. Results also offer evidence that the intervention did not appear to harm participants and in fact may be helpful.
Collapse
Affiliation(s)
- Barbara Olasov Rothbaum
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30329, USA.
| | | | | | | | | | | | | |
Collapse
|