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Understanding a community's needs for an emergency department-based childhood injury prevention programme: a
Hamzah Majid Yusuf1, Efrat Rosenthal2, Aaron Kornblith2
1Emergency Medicine, Stanford Medicine, Stanford, California, USA hyusuf@stanford.edu.
Insights
Childhood injuries are preventable. This study analyzed injury data and stakeholder views to create a framework for an injury prevention program, identifying key risk factors and barriers to information sharing.
Area of Science:
- Public Health
- Pediatrics
- Injury Prevention
Background:
- Unintentional injuries are a leading cause of death in US children.
- Injury prevention programs are crucial for child safety.
Purpose of the Study:
- To develop a framework for a pediatric injury prevention program.
- To utilize local injury data and stakeholder insights.
Main Methods:
- Mixed-methods approach combining retrospective data analysis and qualitative interviews.
- Analyzed 10,193 injury encounters in an academic hospital system (2019-2020).
- Thematic analysis of interviews with 25 caregivers and 8 emergency department providers.
Main Results:
- Most common injuries: natural/environmental, falls, striking objects.
- Highest injury rates observed in Native Hawaiian/Pacific Islander and Hispanic/Latino children.
- Geographic areas with high injury rates correlated with lower household income.
- Identified key themes: injury risk perception, information dissemination, barriers, and provider counseling.
Conclusions:
- Significant disparities in injury burden exist based on demographics and geography.
- Findings will inform the design of a strategic pediatric injury prevention center.
- A community-focused program addressing unique needs and barriers can reduce injury rates.
Objective:
Unintentional injuries are the most common cause of childhood death in the USA and are preventable. We developed a framework for an injury prevention programme using local injury data and understanding stakeholder perspectives.
Methods:
We used a mixed-methods approach. We performed a retrospective cross-sectional analysis of children presenting to an academic hospital system between January 2019 and December 2020 with an injury-related diagnosis. The primary outcome was encounters with an injury-related ICD-10 code. We conducted a thematic analysis by interviewing caregivers and emergency department (ED) providers.
Results:
There were 10 193 unique injury-related encounters. Most common injuries were natural/environmental (22.9%), falls (20.0%) and striking an object (5.1%). Highest rates of injury were seen in children who identified as Native Hawaiian or Pacific Islander (154 injuries per 10 000 children per year), followed by Hispanic or Latino (148). Three out of 20 zip code areas represented 43.4% of all injuries and correlated with lower household income. Twenty-five caregivers and eight ED providers participated in interviews that resulted in four major themes: perceptions of injury risk, caregiver receipt of injury prevention information, barriers and provider counselling.
Conclusion:
Clear differences exist within the injury burden in San Francisco by demographics, geography and type of injury. The findings from the study will guide the first steps in designing a strategic paediatric injury prevention centre. The methods may guide future investigations into the dynamic needs of clinicians and caregivers regarding injury. A strategic programme focused on the community's unique needs and barriers may effectively reduce injury rates.
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