Prevention of Childhood Injuries: Evaluation of the Statewide Childhood Injury Prevention Program (SCIPP) BERNARD GUYER, MD, MPH, SUSAN S. GALLAGHER, MPH, BEI-HUNG CHANG, MS, CAREY V. AzzARA, MA, L. ADRIENNE CUPPLES, PHD, AND THEODORE COLTON, SCD Abstract: We evaluated the effectiveness of a community-based injury prevention program designed to reduce the incidence of burns, falls in the home, motor vehicle occupant injuries, and poisonings and suffocations among children ages 0-5 years. Between September 1980 and June 1982, we implemented five injury prevention projects concurrently in nine Massachusetts cities and town; five sites, matched on selected demographic characteristics, were control communities. An estimated 42 percent of households with children ages 0-5 years were exposed to one or more of the interventions over the two-year period in the nine communities. Participation in safety programs increased three-fold in the intervention communities and two-fold in the control communities. Safety knowledge and practices increased in both intervention Introduction Injuries are the leading cause of death and a major cause of serious morbidity and disability among children and youth.' Yet, there have been relatively few efforts to carry out controlled community prevention trials. Schlesinger, et al, evaluated a health education program for families with children less than 7 years of age in a study community using a matched community as a control, but found no reduction in medically attended injuries.2 The other population-based intervention trials reported have focused on the prevention of specific injury types, such as burns3'4 and pedestrian injuries.5'6 We evaluated the effectiveness of the Statewide Childhood Injury Prevention Program (SCIPP)-a commu- nity-based injury prevention program designed to reduce the incidence of bums, falls in the home, motor vehicle occupant injuries, poisonings, and suffocations among children ages 0-5 years. Our rationale was that by combining the safety interventions available at the time we could reduce childhood injury rates. Methods Study Design The investigation involved concurrent implementation of five injury prevention projects in nine Massachusetts cities and towns with a total population of 139,810 persons and From the Massachusetts Department of Public Health; the Injury Pre- vention Center, Harvard School of Public Health; and Boston University School of Public Health. Address reprint requests to Bernard Guyer, MD, MPH, Associate Professor, Department of Maternal and Child Health, and Director, Injury Prevention Center, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115. He was formerly Principal Investi- gator, SCIPP. Ms. Gallagher is Research Associate in MCH and Director, Childhood Injury Prevention Resource Center, HSPH, and formerly Director, SCIPP. Ms. Chang is Statistician, Injury Prevention Center, HSPH. Mr. Azzara is formerly Assistant Director for Research, SCIPP. Dr. Cupples is Associate Professor, and Dr. Colton is Professor and Chief, both with the Section of Epidemiology and Biostatistics, Boston University SPH. This paper, submitted to the Journal January 10, 1989, was revised and accepted for publication April 20, 1989. © 1989 American Journal of Public Health 0090-0036/89$1.50 and control communities. Households that reported participatory exposure to the interventions had higher safety knowledge and behavior scores than those that received other community exposure or no exposure to intervention activities. We found a distinct reduction in motor vehicle occupant injuries among children ages 0-5 years in the intervention compared with control communities, associated with participatory exposure of about 55 percent of households with children ages 0-5 years. We have no evidence that the coordinated intervention programs re- duced the other target injuries-although exposure to prevention messages was associated with safety behaviors for burns and poisonings. (Am J Public Health 1989; 79:1521-1527). selection of five control communities with a population of 146,866, matched on demographic characteristics to the intervention communities. The injury prevention projects commenced in September 1980 and continued for a 22-month period, through June 1982. A surveillance system to collect data on incident cases of childhood injuries was established in September 1979, one year before the intervention began, and was maintained throughout the study period to August 1982.7 Telephone surveys of attitudes, knowledge, self- reported safety practices, and exposure to injury prevention projects were completed before the beginning of the inter- ventions in August 1980 and again after their completion in August 1982. Intervention Methods Five intervention programs were selected: * injury counseling for the parents of young children by pediatricians using the developmentally based Framingham Safety Surveys8; * school and community bum prevention education using the Project Bum Prevention curricula4; * household injury hazard identification and control through systematic home safety inspections by spe- cially trained local board of health staf9; * community-wide promotion of the Massachusetts Poi- son Control System's telephone information service and public education about poison prevention'0"'1; and * promotion of child automobile restraint use, particu- larly for children in preschools and infants leaving matemity hospitals. The primary target injuries, target age groups, and components for each project appear in Appendix A. The principal focus was families with children ages 0-5 years. Implementation of the projects occurred at health and edu- cational institutions that already served children and their families in the study communities. The five prevention programs were integrated in the same study communities to reinforce each other's preventive messages. Site Selecton The site selection process involved comparison of data on all 351 cities and towns in Massachusetts for: population AJPH November 1989, Vol. 79, No. 11 1521
Welcome message from author
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Related Documents
