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Injury prevention in Safe Communities
  1. Brian D Johnston
  1. Correspondence to Dr Brian D Johnson, University of Washington, Harborview Medical Center, 325 Ninth Avenue, PO Box 359774, Seattle, WA 98104, USA; ipeditor{at}bmjgroup.com

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In this issue, Istre and colleagues report results from an intervention to increase child restraint use in a multi-ethnic Dallas neighbourhood (see page 3).1 This was an impressive undertaking, couched in the theory and principles of community-based prevention interventions. Investigators conducted formative work with community stakeholders, some of which is detailed in a linked, online white paper. Modifications to intervention design based on these qualitative assessments included a focus on schools as points of neighbourhood cohesion and the use of car seats ‘blessed’ by local religious organisations.

The intervention was studied using a quasi-experimental design not uncommon in community-based efforts. As suggested by Langley et al, the outcomes of interest were not relatively rare injury occurrences, but rather the observed prevalence of important injury-risk reduction behaviours.2 Results were based on almost 10 000 individual child restraint use observations. Analysis accounted for the clustered, multi-levelled nature of the intervention and data collection activities.3

The results are presented as an example of ‘the Safe Communities model approach to injury prevention.’ The Safe Communities movement is a worldwide effort through which several hundred cities or municipalities have been (or are working to become) certified as safe communities.4 In general, this requires communities to …

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