Eldersafety.org

Comprehensive Injury Prevention Approach

Injuries Are Not Accidents!

Motor vehicle crashes are a significant cause of serious injury to seniors and are a major threat to their long-term health. Injuries are often believed to be caused by unpredictable accidents (consider the term "car accident") that affect an individual because of bad luck or misfortune. In reality, these injuries are not accidents at all.

For example, it is not an unavoidable accident when a drunk driver causes a crash. If the driver had not been drunk, it is unlikely the crash would have occurred. As you can see, crash-related injuries are the result of a predictable set of risk factors. Once we understand these risk factors, we can develop targeted approaches to preventing them.

There are numerous models available to help practitioners design interventions that prevent traffic-related injuries and deaths:

General Model for Injury Control
Epidemiological Model
Spectrum of Prevention
The Three Es of Prevention: Education, Engineering, and Enforcement
Haddons Matrix

To Learn More

Learn more about injury prevention and control on VincentWEB.

The General Model for Injury Control

This simple injury prevention model describes the basic principles of injury control.

• First, you monitor injury incidence by collecting data on what injuries are occurring, whether they are fatal or nonfatal, and what costs are associated with them.

• Once you have collected this data, you need to identify the injury risk factors so you can determine how and where to intervene. Risk factors can be social, genetic, or environmental.

• Next you use the information to determine where, how, and with whom to intervene.

• Finally, after the intervention it is important to evaluate the effort and determine if it affected the incidence of the injury.

Epidemiological Model

The epidemiological model focuses on the environment, the host or human, and the agent or vector and how they interrelate.

This model is central to our analyses of public health problems. It allows us to uncover multiple causes and devise multiple solutions that prevent injuries. When designing interventions, we should consider options for dealing with all three factors and for the points at which they interrelate.

The Spectrum of Prevention

The Spectrum of Prevention is a framework that helps practitioners develop and structure comprehensive injury prevention initiatives. The spectrum is comprised of six interrelated action levels:

1. strengthening individual knowledge and skills,

2. promoting community education,

3. educating providers,

4. fostering coalitions and networks,

5. changing organizational practices, and

6. influencing policy and legislation.

As you move to higher levels in the spectrum, your program has the potential to affect many more people. The Spectrum of Prevention was developed by Larry Cohen at the Prevention Institute in Oakland, California.

The Three Es of Prevention: Education, Enforcement, and Environment

The Three Es of Prevention look at three key types of interventions you can employ:

• educational interventions;

• enforcement activities and enactment of laws; and

• interventions that address the environment or product engineering.

Educational interventions are probably the most familiar to people. Education attempts to initiate behavioral changes by informing a target group about potential hazards, explaining risks, and persuading people to adopt safer behavior. It can also be used to inform policy makers about issues and as part of social norm change.

Education will not always cause individuals to alter their behavior, but it can make them more receptive to additional injury prevention strategies. Educational interventions may be most effective when combined with other strategies, such as a policy change.

Enforcement attempts to reduce dangerous behaviors through legislation and its enforcement. Legislation can target behaviors by individuals, manufacturers, and local governments.

Examples of state and local injury laws include:

• regulating the color and speed capacity of school buses;

• mandating that buildings be constructed to meet codes and standards;

• requiring people to report child abuse; and

• restricting the sale of alcohol to minors.

All these laws would be useless if they were not enforced. In addition, education plays a key role in informing people of their responsibilities under these laws.

Environmental interventions make changes to the environment or product design (engineering) to automatically protect everyone. This is sometimes called a passive or automatic intervention because it requires no work on the part of the individual.

Interventions that do not require direct action or change by the individual are usually more effective than those that do. Examples of environmental interventions include: retro-reflective traffic signs and roadway markings, child-resistant pill bottles, or providing soft surfaces for playgrounds.

Remember, the most effective prevention strategies combine tactics from each of these categories.

For example, increasing child safety seat usage is best accomplished by effectively combining all three Es:

• Enforcement/enactment–enact child safety seat laws, include consequences for violating them, and support enforcement.

• Education–inform people of the new law.

• Engineering/environment–mandate child safety seat locks in car designs.

Haddons Matrix

Developed by William Haddon Jr., the first administrator of what is now NHTSA, Haddons Matrix is a conceptual model for developing injury prevention strategies. The matrix is a very useful tool for choosing where and when to conduct interventions.

Haddons Matrix looks at injuries in terms of casual and contributing factors, as well as in terms of a time sequence consisting of pre-event, event, and post-event phases. This matrix is an excellent way to help identify major modifiable factors that lead to unhealthy outcomes.

The matrix itself is divided into a series of cells. Each cell represents an opportunity to think through the prevention possibilities. A breakdown of Haddons Matrix and intervention examples are below.

Haddons Matrix Explained

Example of a Crash Involving Older Driver

• A member of the Injury Prevention Web family of sites. Copyright ©2005. Funded by the California Office of Traffic Safety through the Business, Transportation and Housing Agency.
• 
•