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38 Injury prevention as a byproduct
  1. Ronan A Lyons
  1. Swansea University Medical School

Abstract

Background It is plausible to suggest that population changes in injury incidence and outcomes require sustained changes in societal level determinants. However, social change takes time and effectiveness of the approach is difficult to demonstrate using standard research paradigms.

Description of problem To our knowledge there are no convincing reports in the scientific literature of successful, coordinated efforts to develop and implement a systems-level injury prevention interventions based on an initial elucidation of societal level determinants of that population’s level injury rates. In this presentation we describe work we conducted over many years in relation to a wide variety of injuries types, and an array of legal, policy and environmental interventions. Using empirical examples to illustrate our points, we aim in this presentation to i) develop a picture of what a systems level intervention might look like, ii) explain what ”implementation” means in this context and iii) discuss the challenges and potential benefits of a societal approach.

Results The presented examples demonstrate three findings. First, it is extremely difficult to encourage stakeholder committment to building interventions in the community ”from the ground up”; Targetted solutions to circumscribed, technical problems, are almost universally preferred. Second, targeted interventions, apparently successfull in terms of specific outcomes, may not in fact be successfull if all relevant outcomes are included in the effectiveness analyses. Third, for many types of injury we will achieve greater successful by not explicitly attempting to reduce injury risk (most people believe that injuries will not happen to them) but to engage the population in activities they value, such as increasing resilience and independence, and that produce fewer injuries as a byproduct.

Conclusions While the systemic approach to injury prevention has face validity as a concept. There is insufficient evidence of its effectiveness as a prescription for prevention practice.

  • Systems
  • Community-based
  • Methods
  • Populations

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