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University of Arkansas

College of Education

Division of Health Science

Spring 1997

HLSC 699Seminar: Injury as a Public Health Problem (3 Credits)

6:00 to 8:50 pm Tuesday

RoomHPER 315

Instructor Chester S. Jones, Ph.D.

Room HPER 214

Office Hours: TuTh 8:30-9:30am and MTu 4:00-6:00 pm or by appointment

Phone: 575-4009

E-mail: csjones@comp.uark.edu

Homepage: http://comp.uark.edu/~csjones

Course Outline

Course Description:

This course is designed to give the graduate student an introduction to the relatively new field of injury and violence prevention. This course will introduce the student to some of the literature, data sources, methods, and problems in this area of health education. Types of injuries to be discussed include transportation, home, occupational, farm, recreational and sport, homicide, suicide, domestic violence, and childhood.

Required Text:

The Injury Fact Book. Susan Baker. (1991). New York: Oxford University Press.

Recommended Texts:

Injury Prevention: Meeting the Challenge. National Committee for Injury Prevention and Control. (1989). New York: Oxford University Press.

Centers for Disease Control. (1992). Position Papers from the Third National Injury Control Conference, Setting the National Agenda for Injury Control in the 1990's. US Department of Health and Human Services.

Committee of Trauma Research, Commission on Life Sciences, National Research Council and the Institute of Medicine. (1985). Injury in America: a continuing public health problem. National Academy Press.

Centers for Disease Control. (1988). Injury Control. A Review of the Status and Progress of the Injury Control Program at the Centers for Disease Control. National Academy Press.

Rice DP, MacKenzie EJ and Associates. (1989). Cost of Injury in the United States: A Report to Congress. Institute for Health and Aging, University of California (San Francisco) and Injury Prevention Center, The Johns Hopkins University.

Department of Health and Human Services. (1991). Healthy People 2000, National Health Promotion and Disease Prevention Objectives. DHHS Publication No. (PHS) 9150212.

Rosenberg ML, Fenley MA (Eds). (1991).Violence in America: a public health approach. Oxford University Press.

Robertson LS. (1992). Injury Epidemiology. Oxford University Press.

Course Objectives

After the completion of this course the student will be able to:

1. Describe the social and public health contexts in which injuries occur;

2. Identify and describe, in epidemiological terms, the nature and magnitude of major injury problems;

3. Give examples of the major biological, psychological, socio-cultural, political and economic aspects of injury occurrence and injury control;

4. Critically evaluate types and effectiveness of alternative approaches to injury control;

5. Critically appraise the injury literature with particular attention to the methodological issues; and,

6. Formulate and conduct a small scale research project addressing some aspect of injury control.

ContentTopics Covered:

Week 1-January 14

-Historical, Current and Future Perspectives of Injury Prevention

-Overview of Injury Problem

-Approaches to injury control (Haddon's Matrix)

Readings:

Brown ST, Foege WH, Bender TR, Axnick N. Injury prevention and control: Prospects for the 1990's. Annu Rev Public Health 1990;11:251-66.

Dana Lescohier, Susan S. Gallagher, and Bernard Guyer: Not by accident. Issues in Science and Technology 6(4):35-42, 1 990.

Julian A. Waller: Reflections on a half century of injury control. American Journal of Public Health 84:664-670,1994.

Week 2-January 21

-Countermeasures and Interventions

-Health Behavior's role in injury

Readings:

Spiegel, C.N., & Lindaman, F.C. (1977). Children Can't Fly: A program to prevent childhood morbidity and mortality from window falls. American Journal of Public Health, 67, 1143-1147.

Gielen, A.C. (1992). Health education and injury control: Integrating approaches. Health Education Quarterly, 19, 203-218.

Pless, I.B., & Arsenault, L. (1987). The role of health education in the prevention of injuries to children. Journal of Social Issues, 43, 87-103.

Brian A. Jonah: Accident risk and risk-taking behavior among young drivers. Accident Analysis and Prevention. 18:255-271, 1986.

Waxweiler, R.J., Harel, Y., & O'Carroll, P.W. (1993). Measuring adolescent behaviors related to unintentional injuries. Public Health Reports, 108-Supplement 1, 11-14.

Week 3-January 28

-Regulation/Policy as Intervention

-Consumer Product Safety

-Environmental Considerations to Injury

Literature Critique

Readings:

Phillip L. Graitcer, Arthur L. Kellermann, and Tom Christoffel: A review of educational and Iegislative strategies to promote bicycle helmets. Injury Prevention 1 :xxx-xxx, 1995.

Abraham B. Bergman and Frederick P. Rivara: Sweden's experience in reducing childhood injuries. Pediatrics 88:69-74, 1991.

Andrew McGuire: Fires, cigarettes, and advocacy. Law, Medicine and Health Care 17:73-77, 1989.

D. M. Fergusson, and F. T. Shannon: Attitudes of mothers of five-year old children to compulsory child health provisions. New Zealand Medical Journal 96:338-340, 1983.

Steven R. Lowenstein, et al: Facts versus values: Why legislators vote against injury control laws. The Journal of Trauma 35:786-793, 1993.

Trinkoff, A., & Parks, P.L. (1993). Prevention strategies for infant walker-related injuries. Public Health Reports, 108, 784-788.

Langlois J, Waller B, Teret S. Bailey L, Hershey J, Peeler M (1991) The Impact of Specific Toy Warning Labels. JAMA. 265:2848-2850.

Week 4-February 4

-Injury Surveillance and Measurement Issues

-Injury Epidemiology

Literature Critique

Readings:

Peter Cummings, Thomas D. Koepsell, and Beth A. Mueller: Methodological challenges in injury epidemiology and injury prevention research. Annual Review of Public Health 16:381-400, 1995.

Julian A. Waller: Some questions about numbers. Chapter 6 in Waller, Injury Control: A Guide to the Causes and Prevention of Trauma, Lexington, MA, Lexington Books, 1985.

Waller, A.E., Baker, S.P., and Szocka, A. Childhood injury deaths: National analysis and geographic variations. American Journal of Public Health, 1989, 79, pp 310-315.

Scheidt, P.C., Harel, Y., Trumble, A.C. et al. The epidemiology of nonfatal injuries among U.S. children and youth. 1995, American Journal of Public Health, 1995, 85, pp 932- 938.

Guyer, B., & Gallagher, S. An epidemiological framework for understanding injuries. An approach to the epidemiology of childhood injuries, 6-15.

Stallones, R. Theory and methods of epidemiologic study of home accidents. Annals of the New York Academy of Sciences (1963); 107: 647-658.

Week 5-February 11

-Review of Injury Research

-Critique of Injury Research

-Biomechanics of Injury

-Guest Speaker: Dr. Ro Dibrezzo, HKRD

Readings:

Leon S. Robertson: Characteristics of agents and vehicles of injury. Pages 23-44 in Injuries: Causes, Control Strategies, and Public Policies, Lexington, MA, Lexington Books, 1983.

Janet A. Holden: Why do safety belts work? Traffic Safety 89(1):11-13, 1989.

R. Martinez and J. Gardner: Falls. From Injuries: Patterns and Preventions, Cal/ACEP', 1988, pages 58-63.

Leon S. Robertson: Car design and risk of pedestrian death. American Journal of Public Health 80:609-61 0, 1 990.

Week 6-February 18

-Review Student Research Proposals

-Injury Interventions I

Readings:

Week 7-February 25

-Injury Interventions II

-Unintentional Injuries I:

Drownings

Falls

Literature Critique

Readings:

Quan L, Gore EJ, Wentz K, Allen J, Novack AH. Ten-year study of pediatric drownings and near-drownings in King County, Washington: lessons in injury prevention. Pediatrics 1989;83:1035-40.

Diekema DS, Quan L, Holt VL. Epilepsy as a risk factor for submersion injury in children. Pediatrics 1993;91:612-6.

Wintemute, G.J. (1990). Childhood drowning and near-drowning in the United States. American Journal of Diseases in Children, 144, 663-669.

Orlowski, J.P. (1989). Its time for pediatricians to 'rally' round the pool fence. Pediatrics, 83, 1065-1066.

Liller, K.D., Kent, E.B., Arcari, C., & McDermott, R.J. (1993). Risk factors for drowning and near-drowning among children in Hillsborough County, Florida. Public Health Reports, 108, 346-353.

Milliner, N., Pearn, J., & Guard, R. (1980). Will fenced pools save lives? The Medical Journal of Australia, 2, 510-511.

Mosenthal, A., Livingston, D., Elcavage, J., Meritt, S., & Stucker, S. (1995). Falls: Epidemiology and strategies for prevention. Journal of Trauma, 38(5): 753-756.

Week 8-March 4

-Unintentional Injuries II:

Farm Injury

Occupational

Recreation and Sports

-Guest Speaker: Tom Jackson, Psychology

Literature Critique

Readings:

Purschwit. MA. Field WE. (1990). Scope and Magnitude of Injuries in the Agricultural Workplace. American Journal of Industrial Medicine. 18: 179-192.

Schenker MB, Lope. R. Wintemute G. (1995). Farm-related Fatalities Among Children in California. I 980-89. American Journal of Public Health. 85: 89-91.

Bernhardt JH, Langley RL. (1992). Accidental Occupational Farm Fatalities in North Carolina: 1984-1988. The Journal of Rural Health. 8: 60-69.

Kraus JF. Homicide while at work: persons, industries, and occupations at high risk. Am J Public Health 1987;77:1285-9.

Stout N, Bell C. Effectiveness of source documents for identifying fatal occupational injuries: a synthesis of studies. Am J Public Health 1991;82:725-8.

Jeffrey J. Sacks, et al: Playground hazards in Atlanta child care centers. American Journal of Public Health 80:986-988, 1990.

Chun Z, & Roseman J. (1995). Agriculture-related residual injruies: Prevalence, type, and associated factors among Alabama farm operators1990. The Journal of Rural Health. 11(4): 251-258.

Week 9-March 11

-Mid-Term

-Unintentional Injuries III:

Fires and Burns

Firearms

Poisoning

Literature Critique

Readings:

Runyan CW, Bangdiwala SI, Linzer MA, Sacks JJ, Butts J. Risk factors for fatal residential fires. N Eng J Med 1992;327:859-863.

Ballard JE, Koepsell TD, Rivara F. Association of smoking and alcohol drinking with residential fire injuries. Am J Epidemiol 1992; 135:26-34.

Clarke A, Walton WW. Effect of safety packaging on aspirin ingestion by children. Pediatrics 1979;63:687-693 .

Wysowski DK, Schober SE, Wise RP, Kopstein A. Mortality attributed to misuse of psychoactive drugs, 1979-88.

Chafee-Bahamon C, Lovejoy FH. Effectiveness of a regional poison center in reducing excess emergency room visits for children's poisonings. Pediatrics 1983; 72: 164-9.

Becker, T.M., Olson, L., & Vick, J. (1993). Children and firearms: A gunshot injury prevention program in New Mexico. American Journal of Public Health, 83, 282-283.

Week 10-March 18

-Unintentional Injuries IV:

Transportation

Motor Vehicle

Pedestrian

Bicycle/Motorcycle

-Guest Speaker: Dr. Irwin, Emergency Physician

Literature Critique

Readings:

Campbell BJ, Campbell F. (1988). Injury Reduction and Belt Use Associated with Occupant Restraint Laws. Graham J. (Ed.) Preventing Automobile Injury. Dover, MA: Auburn House Publishing. Pages 24-50.

Chorba T. (1991). Assessing Technologies ror Preventing Injuries in Motor Vehicle Crashes.

International Journal of Technology Assessment. 7:296-31.

Rivara FP. Child pedestrian injuries in the United States. Current status of the problem, potential interventions, and future research needs. Am J Dis Child 1990;144:692-696.

Leon S. Robertson: How to save fuel and reduce injuries in automobiles. Journal of Trauma 31:107-109, 1991.

Thompson, R.S., Rivara, F.P., & Thompson, D.C. (1989). A case-control study of the effectiveness of bicycle safety helmets. The New England Journal of Medicine, 320, 1361-1367.

Week 11-April 1

-Intentional Injuries

Homicide

Suicide

-Guest Speaker: Dan Smith, Psychology

Literature Critique

Readings:

Brent DA, Perper JA, Allman CJ, Moritz GM, Wartella ME, Zelenak JP. The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study. JAMA 1991;266:2989-995.

Rosenberg MA, Mercy JA, Houk VN. Guns and adolescent suicides. JAMA 1991;266:3030.

Fingerhut, Ingram, and Feldman: Firearm and nonfirearm homicide among persons 15 through 19 years of age. JAMA 267:3048-3053, 1992.

Philip J. Cook and Michael J. Moore: Violence reduction through restrictions on alcohol availability. Alcohol, Health & Research World 17:151-156, 1993.

Stephen P. Teret, Garen J. Wintemute, and Peter L. Beilenson: The firearm fatality reporting system: A proposal. JAMA 267:3073-3074, 1992.

James A. Mercy, et al: Public health policy for preventing violence. Health Affairs 12(4):7- 29, 1 993.

Week 12-April 8

-Youth and Domestic Violence

-Child Abuse

-Guest Speaker: Marnie Glaeberman

Literature Critique

Readings:

Kotch JB, Browne D, Ringwalt CL, et al. (In press) Risk Of Child Abuse or Neglect in a Cohort of High Risk Infants. Child Abuse and Neglect.

Sedlack AJ (1991). National Incidence and Prevalence Of Child Abuse and Neglect: 1988. Revised Report. Rockville. MD: Westat, Inc. (Chapter 7).

Olds DL and Kitman H. (1990). Can Home Visitation Improve the Health Of Women and Children at Environmental Risk? Pediatrics. 86: 108-110.

Barber-Maddell R, Colm A, Schlosser P. (1988). Prevention of Child Abuse: A Public Health Agenda. Journal of Public Health Policy, 167-176.

Brayden RM, Altemeier WA. Dietrich MS, et al. (1993). A Prospective Study Of Secondary Prevention Of Child Maltreatment. Journal Of Pediatrics. 172:511-516

Howze D and Kotch J. ( I984). Disentangling Life Events, Stress and Social Support: Implications for the Primary Prevention Of Child Abuse and Neglect. Child Abuse and Neglect 8: 401-409.

Straus MA and Gelles RJ. (1986). Societal Change and Change in Family Violence from 1975 to 1985 as Revealed by Two National Surveys. Journal of Marriage and the Family. 18: 466-479.

Panel on Research on Child Abuse and Neglect, National Research Council. (1991) Understanding Child Abuse and Neglect. Washington, DC: National Academy Press. Chapters 5 (Prevention) and 7 (Interventions and Treatment).

Week 13-April 15

-Domestic Violence

-Guest Speaker: Pat Koski, Sociology

Literature Critique

Readings:

Stark E and Flitcraft A (1991). Spouse Abuse. Violence in America: A Public Health Approach. New York: Oxford University Press. (Chapter 6).

American Psychological Association. (1994). The Prevalence Of Intimate Violence No Safe Haven: Male Violence Against Women at Home, at Work, and in the Community. Washington DC: America Psychological Association Press. (Chaptcr 3).

Kurz D. (1989). Social Science Perspectives on Wife Abuse: Current Debates and Future Directions. Gender and Society. :489-505.

Campbell J and Fishick N (1991) Abuse of Female Partners. Nursing Care Of Survivors of Family Violence. St. Louis: Mosby Press. (Chapter 3).

Week 14-April 23

-Program Evaluation

-Literature Critique

Readings:

Bergman, A.B., Rivara, F.P., Richards, D.D., & Rogers, L.W. (1990). The

Seattle Children's Bicycle Helmet Campaign. American Journal of Diseases in Children, 144, 727-731.

DiGuiseppi, C.G., Rivara, F.P., Koepsell, T.D., & Polissar, L. (1989).

Bicycle helmet use by children-Evaluation of a community-wide helmet campaign. The Journal of the American Medical Association, 262, 2256-2261.

Dannenberg, A.L., Gielen, A.C., Beilenson, P.L. Wilson, M.H., & Joffe,

A. (1993). Bicycle helmet laws and educational campaigns: An evaluation of strategies to increase children's helmet use. American Journal of Public Health,

83, 667-674.

Pendergrast, R.A., Ashworth, C.S., DuRant, R.H., & Litaker, M. (1992). Correlates of children's bicycle helmet use and short-term failure of school-level interventions. Pediatrics, 90, 354-358.

McLoughlin, E., Vince, C.J., Lee, A.M., & Crawford, J.D. (1982). Project Burn Prevention: Outcome and implications. American Journal of Public Health, 72, 241-247.

Katcher, M.L. (1987). Prevention of tap water scald burns: Evaluation of a multi-media injury control program. American Journal of Public Health, 77,1195 -1197.

Week 15-May 6

-Students Presentations

Course Policies:

1. Attendance is required for all scheduled class meetings. There are no exceptions to this rule. Each student will be given three unexcused and excused absences. After that, each absence is worth 10 points subtracted from final grade.

2. An examination must be taken on the day it is scheduled. There will be no make-up dates and no exceptions.

3. An assignment is due on the date in questions. Any assignment submitted after this point will not be accepted.

LECTURE information and TEXT content are equally weighted. However, information found in the TEXT should be viewed as important in regard to forming the basis for test questions and for clarifying, emphasizing and supplementing information from the LECTURES. Class discussion, participation and attendance are extremely important. You are expected to attend every class.

Each unexcused absence will result in a deduction of points from the allotted amount given to attendance. However, you are permitted one (1) excused absence if extenuating circumstances should arise. In any case, the professor should be notified via personal appearance, phone call or hand written note with student ID# and signature.

Evaluation: ( A total of 350 possible points)

Knowledge Base (50 points)

Mid-Term (50 points)

Final (50 points)

Writing/Communication/Interpersonal Skills (300 points)

Research Paper/Presentation (100 points)

10 Literature Critiques (20 points each)

Grading Scale:

Knowledge Base (15%)

Writing Skills (36%)

Communication/Interpersonal Skills (7%)

A = 100 to 90

B = 89 to 80

C = 79 to 70

D = 69 to 60

F = 59 and below

Assignments:

Research Project. (Due May 6, 1996)

1. Choose an injury issue/problem.

2. Do a literature review relative to research completed in this area. Select at least 3 studies related to your topic.

3. Based on what you find and the relative epidemiological evidence, develop a potential strategies and solution to countering this injury problem.

Guidelines:

APA style, 5 page minimum, double spaced.

Format:

Introduction

Literature Review

Discussion of Epidemiological Studies

Personal Perspective on Studies

Summary

Literature Critiques.

Students will critique ten (10) articles in peer-reviewed journals that deal with some aspect of injury epidemiology or program intervention. Examples of journals that can used include: American Journal of Public Health, New England Journal of Medicine, Medical Care, etc.

Guidelines

2-3 pages in length

Format

Introduction

Purpose of Study

Methodology used

Results

Implications of findings

Personal perspective of study

Presentation. Last week of semester

Students will present the findings of their research report by oral, poster, or group format.

Suggested Areas for Student Papers:

Childhood/Adolescent Farm Injuries

Animal Bites

Cellular Telephone Usage and Motor Vehicle Crashes

Injury/Drowning Related to SCUBA diving

Suicide through the use of Prescription Drugs

Deaths and Injury Related to Elevators

Equestrian Injury and Fatality

Public Transportation Crashes (Bus, Taxi Drivers...) & Alcohol Use

Lighting Strikes and Related Injuries/Fatalities

The Elderly Driver and Injury/Fatality Risks

Motor Vehicle Crashes Due to Falling Rocks or Other Debris

Childhood Injuries in Day Care Settings

Injuries to Children Riding as Bicycle Passengers

Supermarket Checkers/Scanners and Repetitive Trauma (e.g. Carpal Tunnel Syndrome)

Occupational Deaths due to Electrocution

Weapons in grade school (guns, knives) and injury due to fights.

Drunk Pedestrian Injuries and Fatalities

Domestic Violence in Massachusetts

Carbon monoxide poisoning in the home and the presence of carbon monoxide detectors

Liability and drunk boating related injury and fatality

Injury and Fatality among smoke jumpers