Quantifying the effect of a community-based injury prevention program in Queensland using a generalized estimating equation approach.
OBJECTIVE
To develop a generalized estimating equation (GEE) model of childhood injury rates to quantify the effectiveness of a community-based injury prevention program implemented in 2 communities in Australia, in order to contribute to the discussion of community-based injury prevention program evaluation.


METHODS
An ecological study was conducted comparing injury rates in two intervention communities in rural and remote Queensland, Australia, with those of 16 control regions. A model of childhood injury was built using hospitalization injury rate data from 1 July 1991 to 30 June 2005 and 16 social variables. The model was built using GEE analysis and was used to estimate parameters and to test the effectiveness of the intervention.


RESULTS
When social variables were controlled for, the intervention was associated with a decrease of 0.09 injuries/10,000 children aged 0-4 years (95% CI -0.29 to 0.11) in logarithmically transformed injury rates; however, this decrease was not significant (p = 0.36).


CONCLUSIONS
The evaluation methods proposed in this study provide a way of determining the effectiveness of a community-based injury prevention program while considering the effect of baseline differences and secular changes in social variables.
Yorkston
Emily
E
School of Nursing, University of Queensland, Brisbane, Queensland, Australia. e.yorkston@uq.edu.au
Turner
Catherine
C
Schluter
Philip J
PJ
McClure
Rod
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services; D005260:Female; D006293:Health Promotion; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D016730:Program Development; D015397:Program Evaluation; D011793:Queensland; D012720:Severity of Illness Index; D040241:Social Marketing; D012944:Social Support; D013223:Statistics as Topic; D014947:Wounds and Injuries / Q000517:prevention & control*