Evaluating the impact of an injury prevention measure regarding different sociodemographic factors

Autor: Brockamp, Thomas, Koenen, Paola, Mutschler, Manuel, Köhler, Michael, Bouillon, Bertil, Schmucker, Uli, Caspers, Michael, Working Group Injury Prevention of the German Trauma Society(DGU), .
Rok vydání: 2017
Předmět:
Zdroj: Journal of Injury and Violence Research
Journal of Injury and Violence Research, Vol 10, Iss 1, Pp 25-33 (2018)
ISSN: 2008-4072
2008-2053
Popis: Young road users continue to be the most vulnerable group with a high incidence of mortality and morbidity in road traffic collisions (RTC).1-3 Although the child injury death rate is much lower among children from developed countries, injuries are still a major cause of death, accounting for about 40% of all child deaths.4,5 Road traffic injuries alone are the leading cause of death among 15 to 19-year-olds and the second leading cause among 10 to 14-year-olds. 6,7 In most regions of the world the problem of road traffic injuries is still increasing. However, RTCs not only affect the current low- and middle-income countries but also the industrialized regions in Europe and North America. 3 Each year, nearly 30,700 people die due to RTCs in Europe and approximately every two hours a person dies during RTCs in Germany. 8 The causes are largely known. Some of the reasons for most injuries are speeding, alcohol abuse and overestimation. 9,6,10 But lack of experience, life-style, and group pressure also figure prominently . 11,12 Injury prevention programs and licensing systems have increasingly been developed to counteract some of the negative effects of RTCs in youth. A lot of injury prevention strategies and methods have been set up to enlighten young road users about the consequences of trauma. Especially educational measures, community based measures as well as legislative measures were set up to reduce injuries in the young population. 13,14 Educational measures are known to reduce injury rates in the short term. 13,14 The P.A.R.T.Y. program (Prevent Alcohol and Risk Related Trauma in Youth) is an educational measure with a focus on young road users. It is a 1-day in-hospital injury awareness and prevention program for youth aged 14 years and older. The program provides information about trauma and its consequences and it may enable students to recognize potential injury-producing situations, make prevention-oriented choices and adopt behaviors that minimize unnecessary risk. Students spend about six hours of a single day in a trauma unit. The academic and nursing staffs of these trauma centers are specially trained in teaching the participants. The program starts with an interactive presentation held by a trauma surgeon who explains trauma and the way a severely injured patient is rescued and treated. Next, a session is presented by a local police officer, outlining risk-taking behaviors and possible consequences of bad choices, e.g. drug or alcohol use, no helmet use. Each presentation and discussion lasts about 20-30 minutes. After a break, students are divided into small groups and begin tours of the paramedic services, Emergency Department (ED), Intensive Care Unit (ICU), trauma ward and physiotherapy unit. The students are encouraged to touch and feel real equipment at mock bed spaces and to ask questions during the visit to the intensive care unit and trauma wards. The students are given the opportunity to meet and talk to injured survivors about their injuries and the choices that led to the experience of trauma. 15(Figure 1) Open in a separate window Figure 1 Structure of the P.A.R.T.Y. prevention program. Students start at the lecture room and finish the day with a talk to an injury survivor. The program is a component of the growing community effort to reduce traumatic intentional and unintentional injury and death in youth, resulting from alcohol, drug, and risk-related crashes and incidents.16,17 There is evidence that this program can positively influence the behavior of young road users to reduce road traffic collisions and the severity of injuries.18 Banfield and colleagues published a 10-year retrospective analysis of the effectiveness of the program. P.A.R.T.Y. participants were matched with subjects having the same age, gender, residential area, and initial year in database, who did not attend the program. There were fewer traumatic injuries in the study group than in the control group. This difference was stronger in females. They concluded that the P.A.R.T.Y. program effectively reduced the incidence of traumatic injuries among its participants .17 In 2012 Ho and colleagues published a retrospective cohort study including 3659 juvenile justice offenders. In a before and after survey of 225 participants, a significant proportion of them stated that they were more receptive to modifying their risk-taking behavior. The incidence of subsequent traffic or violence-related offences was significantly lower for those who had attended the program compared to those who had not. They concluded that participating in an injury education program involving real-life trauma scenarios was associated with a reduced subsequent risk of committing violence or traffic-related offences, injuries, and death for juvenile justice offenders.18 On the whole, an injury prevention measure needs to address several topics. The abuse of drugs and alcohol as well as the use of cell-phones and the benefit of using a helmet need to be discussed and knowledge about these topics needs to be mediated.19-22 However, the impact of injury prevention measures on young road users has not been well understood and long-term results are missing. To positively influence the behavior of young road users and to guide injury prevention measures, it is mandatory to analyze sociodemographic factors (i.e., gender, age, educational level) and to examine drivers' behavior to influence the high number of mortality and morbidity in RTCs.23 It is known that gender has been considered in relation to risky driving behavior in young drivers and it has been found that, in terms of risky behavior in road traffic, men are more willing to take risks than women.24,25 Yagil et al. reported that the rate of men's involvement in fatal road collisions is twice as high as women's.26 Furthermore, age is another negative predictor of risky driving behavior. It has been well established by studies and databases from various countries that young novice drivers are more frequently involved in traffic collisions than drivers in other age groups.1,6,23,7 In addition to these factors, the level of education also plays an influential role. There are noticeable differences in the social and socioeconomic distribution of RTCs, as measured in terms of either mortality or morbidity.27-29 Recent reviews show that the bulk of evidence accumulated so far strongly suggests that the risk of being injured is highest among people in less privileged socioeconomic groups or living in less privileged areas. 28-30 In this study, the P.A.R.T.Y. program was used to evaluate the influence on different sociodemographic factors: gender, age, residential area and level of education. A pre-post study design was used to describe the results of the first 2 years of evaluation of the P.A.R.T.Y. program in a Level-1-Trauma hospital in Germany. The results of the presented study can be used to optimize the prevention measure. The program should target road traffic users with a high risk of injury. In addition, improvements can be done to the program, to better address road users that are less strong affected by the program so far.
Databáze: OpenAIRE
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