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Injury Prevention_Jan 23.doc

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Dalhousie University
Health Promotion
HPRO 3351
Julian Young

INJURY PREVENTION 1 Good Practice Model (foundation for the course) *Course slides (know for exam)  Center of the model covers the context  The next layer is called A Public Health Approach o Defining the problem o Identifying risk & protective factors o Selecting an Intervention o Implementing the program o Evaluating the program  Outer layer is called Engagement o Community o Other key stakeholders o Partnership o Political I.e. was a new initiative to enforce the law positively Define the problem: If you do not start out with a clear and focused problem definition, the program will get into trouble • What’s the policy and social context • What do we know about the injury issues (scope, burden, magnitude, societal impacts, etc)? • Create a problem statement Describing the Burden of Injury • Frequency o The number of injuries in a specific time period • Rates o The frequency of injuries within a given population, or within a given period of time (find rate-based calculations for the project i.e. rates per 100,000) o Total # of injuries x 100,000 Population o Rates based on exposure vs. population: o Not everyone in the population is equally likely to get hurt in a given way o Population based rates don’t take this into account o Can express rates in terms of exposure to risk instead, for example o # of MVC injuries/1000km driven vs. # of MVC injuries/ 1000 hours spent in a car • Costs INJURY PREVENTION 2 o Human costs  i.e. loss of independence, loss of relationships o Direct costs  i.e. hospital costs o Indirect costs  i.e. loss of productivity **know the difference between each category of ‘cost’ Total cost of injuries is $19.8 billion o Potential years of life lost (PYLL) is usually standardized to 75 i.e. Person who dies in a car crash at age 45 has 30 PYLL It’s a frequency, so it can be turned into a rate -Alberta has highest PYLL • Population-based Information about who died  Vital statistics (Deaths) o Population based o Basic information (age, sex, geography, date, cause and nature of injury)  Coroners’/Medical examiners reports o Coroner investigation o Basic information + individual reports can be quite detailed Information about all hospitalized injuries  Discharge Abstract Database o Administrative database of all acute care facilities o Minimal dataset of trauma registry contains these records for injury cases o Basic information (age, sex, geography, date, cause and nature of injury, treatment given, discharge status) o Population based Information about Major Injuries  Trauma registry Comprehensive Dataset o Collected by lead trauma facilities o Basic information (age, sex, geography, date, cause and nature of injury, treatment given, discharge status) + information on risk factors (i.e. blood alcohol concentration, seat belt use) o Not population based  Only those admitted to participating facilities  Only those admitted for trauma (i.e. poisoning is an injury but not a trauma) of sufficient severity) Information on Emergency Department Visits for Injury INJURY PREVENTION 3  National Ambulatory Care Reporting System (NACRS) o Population based for Ontario ED visits o Alberta has separate system o Basic information  Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) **for project o 14 select facilities (10 pediatric) o Detailed reports of circumstances surrounding injury… The ICD-10 CA  A standard coding system for diseases and health conditions, used internationally  Developed by the WHO  Captures nature of injury  Captures external cause of injury  Requires detailed documentation Injury Outcomes (iceberg) *on slides Where else to get information  Police/justice  Other health data  Surveys o Population health surveys contain information on some risk behaviours and also on injuries not reported elsewhere o Research surveys on special topics (i.e. student drug use survey, alcohol indicators report) General Issues  Population based versus not o Data sets may have different population definitions o Trade-off exist, between coverage and level of detail  Databases collected for particular purpose (not injury prevention) o i.e. hospital data is about resource utilization not causes of injury  Coding differences may exist within and between jurisdictions Injury Data Collection  Special surveys  Addition to existing collection tools  Special studies  Questionnaires, interviews, observation surveys, focus groups  Geographical Information Systems (G.I.S.) INJURY PREVENTION 4 When do you have enough data? {key for our injury project}  Data are the means, not the end  Decide at the beginning what data and information you need to define your problem and to move forward  When you find what you need, stop looking Don’t get stuck at this step! Consult Experts  Data analysis is an important part of your approach to injury prevention. Talk to the experts if you have any questions or require assistance with your analysis. Injury Prevention Project  Problem Statement (2-4 sentences/ paragraph in length)  Identifying the risk and protective factors (social determinants, conditions people face)  Good Practice Model Learning Outcomes • Identify risk and protective factors • Haddon’s matrix (on exam*) • Understand causation • Understand what is needed for…. Risk Factors –The Caus
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