Health education and injury control: integrating approaches

The prevention of injuries, a major public health problem, is of interest to a growing number of public health professionals from a variety of disciplines. Historically, there has been tension between those who propose injury prevention strategies that focus on the adoption of protective behaviors by individuals and those who propose strategies that circumvent the role of individual behavior by providing automatic or passive protection. This tension may be counterproductive to finding comprehensive solutions to injury problems, and a better understanding of the inherent strengths and limitations of each of these approaches is needed. The purposes of this paper are to: (1) describe the arguments over individual liberties and individual behavior that can occur in the design of injury prevention programs; (2) review the principles that typically guide the development of injury control programs and health education programs; and (3) integrate the two most widely used approaches in injury control and health education programs--Haddon's injury countermeasures and Green's PRECEDE framework--into one program planning framework that addresses both behavioral and nonbehavioral components of an injury problem. This unified framework is offered in the hope that its use will facilitate multidisciplinary, comprehensive approaches to developing injury prevention programs that are efficient and effective.