Search

In BC, the population of adults over 65 years of age is growing rapidly. The risk of injurious falls increases with age, resulting in a major threat to the quality of life of older adults. Fall-related injuries are the leading cause of injury-related deaths among seniors (>65 years) in BC, and there are over 13 000 hospitalizations per year, resulting in $485 million in direct healthcare costs. The majority of these falls occur among community living seniors. Public education on the magnitude of the problem, and the fact that falls and injuries are preventable with evidence informed strategies, is important for the implementation and sustained use of these prevention strategies. The FindingBalanceBC website has been providing falls prevention information to citizens across BC for the last 3 years. The purpose of our study was to evaluate the level of knowledge retention of visitors to the Finding Balance BC website, which promotes the Senior Falls Prevention Campaign, for the purposes of quality assurance and program improvement. During the month of November, visitors to the FindingBalanceBC website were invited to participate in the survey and those who expressed their consent were enrolled in the study. A questionnaire assessing knowledge of evidence-informed falls prevention strategies among seniors (exercise, vision check, medication review and home safety) based on the website content was prepared and pre-tested. Participants completed the questionnaire at the 4th week and 10th week following their first visit to the website. Respondent composite scores for each of the fall prevention strategies will be calculated and the respective scores for the 4th week and 10th week will be compared using paired t-tests. Results and policy implications will be presented at the conference.

Professional firefighters are exposed to a variety of injury hazards over the course of their occupation, including: extreme temperatures, toxic substances, strenuous physical labour, unstable structures, falling objects, extreme heights, violence and traumatic events. The purpose of this study is to describe the determinants of injury, disease and death among Canadian firefighters by age, gender, region, and employment status. A descriptive analysis of the Association of Workers’ Compensation Boards of Canada and WorkSafeBC data was undertaken to define priority issues for targeted intervention. Outcome measures included time-loss and fatality claims accepted by compensation boards between 2006 and 2015, and submitted by professional and volunteer firefighters over the age of 14 years. An analysis of AWCBC data revealed five principal determinants of injury and death among Canadian firefighters: cancer, traumatic injury, cardiovascular disease, respiratory disease and mental health. Cancer represented over 86% of all fatality claims, while traumatic injuries represented 90% of all time-loss claims among firefighters. Firefighter time-loss claims due to traumatic injury occurred at a rate of 1,661.3 per 1 00 000 firefighter population per year. Mental health was the third leading cause of time-loss claims among Canadian firefighters, occurring at a rate of 23.95 per 1 00 000 firefighter population per year. Volunteer firefighters in British Columbia reported lower rates of time-loss claims per 1 00 000 firefighter population than professional firefighters for traumatic injury, cancer, mental health, cardiovascular disease and respiratory disease. Given inherent limitations of claims data to analyze injury and death within an occupation, a dedicated national firefighter injury surveillance model is needed to support timely and responsive prevention and intervention, as well as specific research. The results of this study suggest that cancer, injury and mental health should be priority issues for researchers, employers and policy-makers working to improve firefighter health and safety.

Background In British Columbia (BC), there are approximately 430 deaths, 6500 hospitalizations and 79,000 injuries due to motor vehicle crashes each year. Direct and indirect costs of transport-related injury was estimated at $639 million in 2010. Currently, there is no single suite of indicators to describe and monitor road safety in BC, making it difficult to assess performance across communities within the province. Development and validation of indicators enables road safety to be consistently assessed. Objectives Identify and ultimately establish a suite of road safety indicators for monitoring and evaluating road safety performance in BC. Methods A review of relevant literature identified previously established evidence-based road safety indicators used successfully in other jurisdictions. Experts were consulted to identify preferred indicators specific to BC. A secondary feedback and validation process followed to reach consensus on appropriate indicators for further approval and consensus by experts and decision-makers in road safety. Results 107 indicators were identified through literature review and 60 preferred indicators were identified through expert consultation for the BC context. Indicators were grouped into four categories based on the Safe Systems Approach: Safe Roads, Safe Vehicles, Safe Speed, and Safe Road Users. Through analysis and synthesis of this information key content and themes were identified. Conclusion This work serves as foundational to the establishment of a suite of road safety indicators in BC by which to gauge road safety efforts. A suite of indicators will allow performance comparisons to be made between communities and local, regional, and provincial trends may be monitored over time. Policy implications Indicators will be used to recommend a data management framework for policy-relevant whole-system reporting that could drive policy and funding for province-wide improvements in road safety.

Fire is a leading cause of unintentional injuries in children and youth in Canada. Although evidence supports low socio-economic status (SES) as a significant predictor of unintentional injuries in general, far less attention has been paid specifically to the SES of residential fire related injuries among Canadian children and youth. This study aimed to determine the role of SES (low education, median income and average number of persons per dwelling (ANPD) in residential fire related injuries and deaths among children and youth in Canada. We used a cross-sectional study design on data from the National Fire Information Database, which includes 10 years (2005–2015) of microdata information on fire incidents and losses reported by provincial/territorial Fire Marshals and Fire Commissioners Offices across Canada. Census 2011 data at the CMA level, from Statistics Canada, provided the SES variables. We used a Poisson regression model to examine the relationship between SES and the rate of residential fire casualties, defined as deaths and injuries per fire incident, in children and youth (ages 0–16). We adjusted for province in the model. Per region, the risk of children and youth being injured or killed in a fire decreased by 95% for every additional person in the house (p This is one of the first studies addressing the role of SES in residential fire related injuries and deaths among children and youth across Canada. ANPD and median income were strongly associated with rate of fire casualties. This outcome has high clinical relevance and provides evidence to support informed interventions targeting children from small and poor families regarding residential fire prevention.

Background Injury resulted in 34 998 hospitalizations, 8 582 disabilities and 2 009 deaths, costing $3.7 billion in British Columbia (BC), Canada in 2010. Injury prevention strategies are essential for optimal population health. Recently established, BC Injury Prevention Committee (BCIPC), including provincial, regional and First Nations health authority representatives, provides guidance and recommendations on injury prevention to the Ministry of Health and the Provincial Health Officer. Objective To identify injury prevention priorities for recommendation and investment to the Ministry of Health and the Provincial Health Officer. Methods A mixed methods approach was used incorporating provincial injury data and findings from an evidence review and synthesis of effective injury prevention strategies. A facilitated two-stage modified Delphi process was undertaken with the injury prevention community in BC to rank injury prevention priorities. BCIP members then validated and finalized rankings using a pairwise comparison exercise to determine the top priorities for injury prevention investment and programming. Findings The top 3 injury priorities for BC were the prevention of: seniors’ falls; transport-related injuries; and, youth suicide and self-harm. Conclusion Priorities will be addressed in a staged approach over a 3 year period, starting with seniors falls and transport-related injuries. Policy implications As there is limited flexibility in resource allocation, efficiencies can be gained in planning by starting with the highest priorities and working across health authorities to address these priorities. The modified Delphi process supported committee members to reach consensus and express willingness to commit to Provincial action.

Background Sport and recreation-related injuries have a significant cost in terms of the impact on the health care system. As prevention researchers and practitioners, we have a responsibility to provide guidance toward prevention to those who participate in sport, and those that coach, treat, and parent children that participate in sport. There are effective interventions to reduce injury in many sport and recreational activities; however, the accessibility of this information, as well as the guidance required to implement it, is often not available and accessible to the public. Objective The objective of this project was to complete a large-scale systematic review and synthesis of the literature across 51 sport and recreational activities. The evidence was used to inform the development of an end-user driven, digital platform that provides injury prevention information and resources. Methods An evidence synthesis framework was used to guide a review of reviews of 51 sport and recreational activities by 18 injury prevention trainees from across Canada. Data collection included evidence on the incidence, risk factors, interventions and implementation and evaluation of interventions to reduce the risk of injury in sport. Evidence was critically appraised, extracted, synthesized and translated into clear messaging for use in an online tool. Findings The ‘Active and Safe’ platform provides web-based sport injury and prevention information. Navigation through the tool brings the user to a sport specific content page subdivided into 4 sections: 1) sport injury overview, 2) incidence, 3) risk factors, and 4) prevention. Users are given evidence-informed, actionable prevention messaging from a personalized sporting context. Conclusion and policy implications This user friendly, web and mobile accessible tool can increase the reach, awareness and implementation of prevention programming in sport and recreational activity.

Background Injuries are the leading cause of death for British Columbians during their first four decades of life costing $3.7 billion annually. Lack of transfer of national and provincial injury prevention efforts to the grass-root level and underutilization of proven preventive strategies at this level has been identified as one of the barriers for injury prevention in BC. Objective To implement a community mobilization outreach program to strengthen injury prevention efforts at the grass roots level. Methods A rapid environmental assessment was completed together with the development of an online directory mapping existing and potential injury prevention stakeholders and community groups working on injury prevention priorities across BC. This information was used to facilitate consistent communication, networking and collaboration, and to increase the efficiency and effectiveness of injury prevention initiatives. Findings The online directory served as a hub for forging new connections and greater collaboration among the stakeholder and community groups. Connecting and activating these channels enhanced community involvement in injury prevention initiatives. Provincial health authorities and community involvement in injury prevention programs such as, Safe Kids Week and National Teen Driver Safety Week increased significantly, ranging from 2- to 6-fold increases during the implementation of this grass-roots initiative. As well, a number of new organizations joined to support the effort. Conclusion Coordinating injury prevention efforts at the community level throughout the province has allowed stakeholders to co-build programs that are mutually supportive, reducing duplication of projects and programs and which facilitated the efficient allocation of limited resources. Policy implications More efforts should be taken to strengthen community network engagement and stakeholder relations. The evidence from this project indicates that a community mobilization outreach program can have significant positive effect on injury prevention efforts.

Background Reports of injury burden related to residential fires affecting children in Canada are outdated. Objective To explore the association between rates of injury and death among children ≤19 years old in Canada and the presence or absence of residential smoke alarms and sprinklers. Methods Using the National Fire Information Database (NFID), 2005 to 2015, a retrospective analysis was conducted to describe the relationship between residential fire protection features, and injury and death rates among children ≤19 years old within the Canadian provinces of British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario. Rates of injury and death per 10,000 fires were calculated and compared. Results Structures with a working smoke alarm were associated with lower death rates and higher injury rates, compared to those with no smoke alarms (7.2 vs 12.9, and 87.5 vs 34.5, respectively). Inactive smoke alarms were associated with the highest rates of death and injury (19.8 and 94.2, respectively). Structures with sprinkler protection were associated with no deaths and few injuries. Discussion The presence of activated smoke alarms and sprinklers were associated with low rates of death among children. While sprinklers appeared to be particularly effective, the presence of smoke alarms – activated or not – was associated with higher rates of injuries when compared with no smoke alarms. Smoke alarms reduced the risk of death, however their effectiveness has been debated in the literature, as children do not consistently respond appropriately to an activated smoke alarm. Sprinklers do not require children to respond; therefore, a combination of smoke alarms and sprinklers may offer the most protection for children. Maintenance of smoke alarms through regular testing, mandating sprinklers in new buildings, as well as promoting child knowledge in fire prevention and fire safety, may help to address the burden of fire-related injury and death among Canadian children.

Preventable is a social marketing campaign in British Columbia, Canada, that aims to change attitudes and behaviours related to preventable injuries, including those related to alcohol. The BC Liquor Distribution Board (BCLDB) partnered with Preventable on five alcohol-related injury prevention social media campaigns in 2017. The topics included: winter sports, moderate consumption, safe boating, binge drinking, and holiday party season. The objective of this study is to describe the attitudes towards alcohol consumption and injury prevention, and reactions to the campaign messages expressed by Facebook commenters. Content analysis was applied to all comments, excluding replies by Preventable, posted on Facebook during the five alcohol campaign periods in 2017. Emoticons, pictures, stickers, videos and GIFs were included in the analysis. A codebook was developed with 14 a priori and 18 emergent codes. Two independent coders coded each comment and discrepancies were discussed until consensus was reached. Percent agreement was calculated. Codes were ranked and compared between campaigns. Intercoder agreement was 95.6%. The analysis revealed that few commenters denied the association between alcohol consumption and injury risk. Comments on boating and winter sports campaigns revealed the most common reasons for rejecting the message were: consumption is integral to enjoying the activity, perceived paternalism, and a belief that rules or limits should not apply to those who can behave responsibly. The moderation campaign elicited comments exhorting the harms of alcohol and suggesting cannabis as a safer alternative. Few commenters on the moderation and binge drinking campaigns perceived the message as paternalistic or killjoy. Violating social norms was of moderate concern to commenters across campaigns. British Columbians appear to accept that alcohol consumption increases injury risk. However, consuming alcohol is considered an important part of certain leisure activities. Future campaigns might consider promoting moderation, rather than abstinence, in this context.

Background Until recently, fire statistics in Canada have been difficult to obtain. The National Fire Information Database (NFID) is a pilot project of the Canadian Association of Fire Chiefs and the Council of Canadian Fire Marshals and Fire Commissioners. For the first time, 10 years of fire information from across Canada is unified in a single database and available for research and analysis. Objective To illustrate fire-related injuries and deaths among Canadian children≤19 years old, and to compare age-related rates between 5 Canadian provinces. Methods All residential fire incidents causing injury and death to children≤19 years old within the Canadian provinces of British Columbia, Alberta, Saskatchewan, Manitoba, and Ontario, from 2005–2014 were included in the analysis. Rates per 10 000 fires were calculated and compared between age groups and across provinces. Results The rates of injury and death among the study population were 60.5 and 10.6, respectively. Children aged 0–4 and 15–19 suffered the highest rates of injuries and deaths. The rate of injury among 0–4 and 5–9 year-olds was highest in Ontario (32.0 and 18.6, respectively), while Alberta showed the highest rate of injuries among 10–14 and 15–19 year-olds (16.1 and 43.8, respectively). Finally, the death among 0–4 year-olds in Manitoba was 2.3 times higher than the Canadian average (8.3 vs 3.6). Discussion Rates of injury exceeded rates of death in every province, with the exception of 0–4 year olds in Manitoba. External factors, such as severity of the fire, response time of emergency services, and distance to the pediatric care facility, may contribute to this difference. The youngest children and oldest teens appear to be most at risk, indicating that developmental stage is an important consideration for strategic intervention. Further research is needed to clarify and address disparities between provinces.

Context The Concussion Awareness Training Tool (CATT) is a series of online educational modules and resources with the goal of standardizing concussion recognition, diagnosis, treatment, and management. Based upon the established principles of the Consensus Statement on Concussion in Sport and other evidence-based resources, this tool includes a new self-paced learning module for medical professionals to address current gaps and variations in practice for the initial assessment and management of acute concussion patients in the office setting. CATT for medical professionals originally launched in 2013, focusing on the recognition and diagnosis of concussion. Evaluation found physicians demonstrated significant positive change in concussion practices (p=0.001), and significant change in knowledge by those treating more than 10 concussions per year (p=0.039). Objective To support physicians and other medical professionals in treating and managing concussion. Key messages The new e-learning course covers medical assessment for concussion, concussion management, addressing persistent symptoms, and providing medical clearance following recovery. The course is available in both English and French. Beyond medical professionals, CATT also caters to coaches, players/participants, parents and school professionals. Resources for workers and workplaces are currently being developed. To date, over 100 relationships have been developed with organizations and key stakeholders in British Columbia and beyond,>15 000 print resources have been distributed,>30 000 coaches and parents and >3000 school professionals have completed CATT, and >15 sporting organizations and schools have mandated CATT training. Discussion and conclusions Concussion is an under-recognized, -diagnosed and -treated medical condition, requiring both physical and mental rest. The CATT addresses this gap by increasing knowledge and awareness among appropriate specific audiences (www.cattonline.com). Good concussion management can reduce related health problems and the risk of long-term brain damage, potentially lowering total health care costs among those who are injured.

Background Recreational boating-related injuries are a preventable cause of morbidity and mortality in Canada. Implementing a targeted social marketing campaign will encourage meaningful behaviour change and result in increased compliance with safe boating practices, and reduced incidence of injury. Objective To provide a foundation to guide the development of a targeted boating safety social marketing campaign, this phase of the project aimed to: (1) summarize the existing evidence related to the risk factors and interventions for recreational boating-related injury; and (2) describe the burden of recreational boating-related injury in British Columbia (BC). Methods: We conducted (1) a review of the English language literature related to recreational boating injury; and (2) a retrospective analysis of fatalities, hospitalizations, and emergency department visits caused by recreational boating-related injuries in BC from April 1, 2009 – March 31, 2014. Findings Alcohol consumption and low PFD use are widely established risk factors for recreational boating-related injury. Existing studies suggest that legislation and targeted educational initiatives may improve recreational boating safety practices and reduce injury. In BC, recreational boating-related injuries primarily occurred among adult males during the warmer months. Most injuries occurred during powerboat use. One third of individuals who were fatally injured in a recreational boating incident had consumed alcohol and the majority were not wearing a PFD at the time of the incident. Recreational boating-related deaths most frequently occurred in a lake. Conclusion A targeted social marketing campaign aimed at improving safe boating behaviors is warranted. The campaign should include messaging related to avoiding alcohol use and wearing a PFD while boating. High-risk groups for targeted messaging include males, teenagers, young adults, and middle-aged adults. The campaign should be developed with emphasis on the flat water recreational boating community, and delivery should occur during the warmer months of the year, especially July and August.

Background Shaken baby syndrome (SBS) is a devastating form of infant abuse, with significant impact on families and society. The Period of PURPLE Crying program in British Columbia (BC), a program to prevent infant abuse, offers crying education and materials to all parents of newborns through maternity and public health services and through an annual public education campaign. PURPLE was evaluated for its effectiveness to change knowledge and attitudes in a randomized control trial. Objectives The PURPLE program monitors a number of metrics, however, since the incidence of SBS is very low, achieving statistical power for the purposes of evaluating the effect of PURPLE is not attainable in a reasonable time frame. The presentation will present methods used to evaluate the PURPLE program in BC; discuss issues concerning program delivery fidelity; and provide practical solutions to overcome challenges. Methods The incidence of SBS among 0 to 24 month olds was identified through retrospective and prospective surveillance. Program delivery fidelity was monitored through regularly scheduled surveys of maternity and public health nurses, and parents. Changes in SBS hospitalization rates for 0–24 month olds pre- to post-implementation were measured. Findings A 35% reduction in SBS hospitalization rates was found following the implementation of the program. Survey results showed varying program fidelity by region which resulted in the development and implementation of action plans with key delivery stakeholders. Fidelity improved significantly as a result of this action plan. Conclusions Despite a low incidence of SBS, requiring decades of data collection to power an evaluation of the PURPLE program, there are metrics that can be applied to measure program process, impacts and fidelity.