title: Can the reduction of pediatric injury rates be sustained using a community-based approach?
abstract: BACKGROUND
  Injuries are the leading cause of morbidity and mortality in US residents aged 1 to 44 years. Community-based interventions are effective in reducing injuries. Using this approach, investigators significantly reduced injuries in Avondale, Ohio, between 1999 and 2004 compared with three control communities (42 vs. 15%, respectively). The objective of this study was to determine if injury reduction was sustained through the 5 years after initial implementation of injury prevention (IP) efforts in Avondale compared with the same three control communities.
  
  
  METHODS
  Injury prevention interventions implemented in Avondale, Ohio, during previous study years were sustained. Two new playgrounds were built, but no other new interventions were introduced. Control communities had no programs introduced by the team during the study period. Data were obtained from the Hamilton County Injury Surveillance System from 2005 to 2009 for deaths, hospitalizations, and emergency department visits due to injury for children 0 to 19 years old. Data from the study community were compared with those of the same three control communities as in our previous work, with similar demographics and socioeconomic characteristics, as well as with data obtained previously from 1999 to 2004. Census data based on annual estimates were used to calculate injury rates.
  
  
  RESULTS
  The injury rate in Avondale decreased from 17,073 to 11,284 injuries per 100,000 children per year during the 11-year period (33.9% reduction). The injury rate in the control communities decreased from 14,436 to 12,381 injuries per 100,000 children per year in the same period (14.2% reduction). The difference in the injury rate decrease between the intervention and control communities was statistically significant, p < 0.001. From 2005 to 2009, the lower injury rate was sustained in Avondale, p = 0.58.
  
  
  CONCLUSIONS
  Community-based strategies to prevent injuries to children in high-risk communities can be successful in reducing overall injury rates. These efforts can result in sustained injury reduction over time despite no new interventions being introduced.
authors.forename: Wendy J
authors.initials: WJ
authors.lastname: Pomerantz
authors.forename: Michael A
authors.initials: MA
authors.lastname: Gittelman
authors.forename: Mona
authors.initials: M
authors.lastname: Ho
authors.forename: Richard W
authors.initials: RW
authors.lastname: Hornung
mesh_terms: D000056:Accident Prevention; D000293:Adolescent; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009820:Ohio; D011314:Preventive Health Services / Q000458:organization & administration*; D015397:Program Evaluation; D013997:Time Factors; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000517:prevention & control*; D055815:Young Adult