Research at the Injury Prevention Center is focused on reducing injuries through prevention and educational programs that serve the community. Our researchers design, implement and evaluate innovative interventions that reduce injury among children and adults. Such interventions may target violence prevention, a safe home environment, safety in recreational activities, or responsible driving. Our research guides the development of action plans used for teaching the community about injury prevention. Public awareness and education is a critical step in our programs’ success.
Connecticut Injury Surveillance System
Lapidus (PI), Campbell , Rogers, Borrup, Gallo, Saleheen
We collect and maintain several large databases to describe the epidemiology of injury among Connecticut residents. The data include:
- Connecticut death certificates (1996-2010), all ages, all causes
- Connecticut Hospital Discharge Data (1990-2006, persons <20 years, all causes, 2006-2010 all ages, all causes)
- Connecticut Hospital Emergency Department Visits (1995-2006, persons <20 years, all causes, 2006-2010, all ages, all causes)
- Connecticut Motor Vehicle Crash File (1999-2010)
Our geographic information system (GIS) allows us to spatially analyze and map fatal and non-fatal injuries at the county, town, census tract, census block, or street address level. Our GIS system also allows us to integrate and correlate injury data with other geographic, census, and economic data. Injury surveillance information is disseminated broadly via newsletters, fact sheets and the Internet.
Identifying risk factors for ATV injury among children (a multi-state study)
Campbell (PI), Borrup, Saleheen, Lapidus
This is a study of children ≤15 years of age who sustain injuries while driving or riding on all-terrain vehicles (ATVs) that require hospitalization. A 27-item survey collects:
- Demographic, temporal and location information
- Previous experience riding at crash location
- Riding position
- Presence of passenger
- ATV use
- ATV riding experience
- ATV description, presence of adult supervision
- Immediate cause of crash, estimated speed
- Use of protective equipment
- ATV ownership
- Helmet ownership
- ATV instruction
- Town and county of residence
- Attitudes toward ATV injury prevention and continued riding
Descriptive statistics are calculated for all variables for each study site. Comparisons between sites are analyzed using appropriate statistical methods. Pooled data will be analyzed to determine risk factors and circumstances contributing to injury. Study sites include: Connecticut Children's Medical Center (Hartford, CT), UMass Memorial (Worcester, MA), and Arkansas Children's Hospital (Little Rock, AR).
The Mature Driver Safety Study: A randomized controlled trial to determine the efficacy of a community-based screening and referral initiative using AAA’s Roadwise Review
Lapidus (PI), Fortin-McCue, Saleheen, Borrup, Chaudhary. Funded by Connecticut Department of Transportation and Jefferson House.
Motor vehicle crashes among mature drivers age 65 and older is an important traffic safety and public health issue. Accurately assessing declines in driving abilities and relating them to increased crash risk has been a goal of traffic safety professionals for many years. This is a randomized, controlled trial that aims to determine the efficacy of a community-based screening and referral initiative.
This study will determine the referral compliance rate and self-reported changes in driving behavior (e.g., reduction in nighttime, bad weather, or high-volume roads driving) among mature drivers who complete AAA's Roadwise Review screening, compared to a group who receive driver educational materials and are delayed screening for one month.
Fall Prevention Knowledge, Attitude, and Practice Among Municipal Health Department and Senior Center Directors
Lapidus (PI), Fortin-McCue, Fortinsky
Falls among adults 65 years or older is a major public health problem. At the state level, fall prevention efforts are widely viewed as a shared responsibility between the public health infrastructure and aging networks. The objective of this study is to describe municipal health department and senior center directors' knowledge of, attitude about, and provision of practice-related services for older adult fall prevention programs in Connecticut.
This will be an online survey study of 51 municipal health department directors and 178 senior center directors/senior coordinators. The survey will be done in collaboration with the Connecticut Association of Directors of Health, the Connecticut Association of Senior Center Personnel, and the Connecticut Department of Social Services, Division on Aging. The 16-question online survey consists is based upon a published survey of employees of senior- serving organizations in Washington State by Laing et al.
The results from this survey will provide a better understanding of how fall prevention and current fall prevention activity is viewed among critically important local leaders including municipal health department directors and senior center directors.
Referring Emergency Department Patients and Visitors to a Community Based Mature Driver Safety Program
Delgado (PI), Finnegan, Pachecho, Pappas, Fortin-McCue, Lapidus
More than 110 million people a year are seen as patients in U.S. emergency departments (ED) and most often, one or more family, friends or co-workers accompany them. The usual ED visit often has inevitable time periods of waiting, which can potentially be a valuable resource for promoting community based services.
It is common practice in many emergency departments to promote awareness of community-based services, such as alcoholism, sexually transmitted diseases and several types of cancer, using informational flyers or brochures available to patients or visitors. However, there are no reported emergency department information and referral protocols addressing mature drivers. The goals of this study are to:
- Examine the feasibility of a student research assistant (SRA) administered referral of mature drivers among adult non-emergent patients and visitors in an urban academic medical center ED
- Determine the outcomes for those participants who are offered referral to a community based mature driver screening program
During their four hour shifts in the emergency department SRAs will approach patients and visitors who appear to be at least middle-aged (40-65 years old) and are not in acute distress. From an opening script, the SRAs will introduce themselves and check on the patient's/visitor's eligibility for the study by age.
All patients approached will be offered a Mature Driver Safety Program (MDSP) referral sheet. After providing informed consent, participants will be asked a series of questions concerning their driving. All participants will receive a copy of their consent form and the study information sheet along with their MDSP referral sheet. Next, the SRA will collect the data and fill out a MDSP Fax Referral Form. With the participant's permission, the SRA will send the completed MDSP Fax Referral Form to the MDSP. The participant will be offered a telephone referral for a representative of the MDSP to call them within 24 hours, and complete the referral. The data from the results of the driving questions will be collected in a central repository using REDCap, the web-based, HIPAA-compliant system from Vanderbilt University. Descriptive data will be reported for this project.
If successful, the proposed study will provide a valuable community referral source to screen mature drivers for impairments and provide referrals and recommendations to address them.
Investigating Pediatrician Beliefs and Practices in Youth Suicide Prevention
Woods (PI), Rzepski, Borrup, Rogers, Lapidus
The American Academy of Pediatrics (AAP) has provided clinical guidelines for assessing suicide risk and providing care to suicidal adolescents. However, research has yet to investigate pediatrician attitudes, practices, and reported barriers in response to child and/or adolescent suicidal behavior. The specific goals of this study are to:
- Provide descriptive information on pediatrician attitudes, practices, and reported barriers when working with children and adolescents reporting suicidal ideation
- Identify the degree to which pediatrician attitudes and knowledge of risk factors for suicidal behavior influence the extent to which pediatricians implement interventions and identify barriers for children and adolescents reporting suicidal ideation
Primary, cross-sectional data will be collected from pediatricians across the state of Connecticut, obtained from an online survey sent to all pediatricians who have an email address registered with the Connecticut Chapter of the American Academy of Pediatrics. Eligible participants will also be sent a link to complete the survey through the monthly posting of the Connecticut AAP e-newsletter. Descriptive data will be collected describing demographic characteristics of the population (e.g. age, gender, race, professional training, primary practice site), attitudes, knowledge, intervention practices, and barriers to working with children and youth reporting suicidal ideation.
Responses will be scored on a Likert-type rating scale. Pediatricians will also respond to open-ended questions examining risk factors perceived to be most closely related to suicide risk and specific ages in which a patient may have completed suicide, as well as the age in which pediatricians begin assessing for suicide risk.
Information obtained from this study will confirm or disconfirm the importance of feelings of confidence and awareness for risk factors when intervening to improve mental health outcomes for children and adolescents reporting suicidal ideation.
A Pilot Descriptive Study of Behavioral Health Patients in the Pediatric Emergency Department
Rogers (PI), Lapidus, Borrup, Kaminer, Mangini, Parker, Brinkley. Funded by Connecticut Children’s Medical Center Friends.
The specific aims of this initial pilot descriptive study are to:
- Describe the demographic characteristics, diagnosis, and disposition of adolescent behavioral health patients presenting to the pediatric emergency department (PED)
- Describe the subset of adolescent patients with suicide and ideation/attempt presenting to the PED
- Determine the baseline proportion of caregivers who receive PED means restriction discharge instructions for their adolescents with suicidal ideation/attempt
- Determine the feasibility, ease, and completeness of abstracting data from the Child and Adolescent Psychiatric Intake and Evaluation form