Assessing Injury and Violence Prevention in North Carolina's Local Health Departments.
Injury and violence-related morbidity and mortality present a major public health problem in North Carolina. However, the extent to which local health departments (LHDs) engage in injury and violence prevention (IVP) has not been well described.



One objective of the current study is to provide a baseline assessment of IVP in the state's LHDs, describing capacity, priorities, challenges, and the degree to which programs are data-driven and evidence-based. The study will also describe a replicable, cost-effective method for systematic assessment of regional IVP.



This is an observational, cross-sectional study that was conducted through a survey of North Carolina's 85 LHDs.



Representatives from 77 LHDs (91%) responded. Nearly one-third (n = 23; 30%) reported that no staff members were familiar with evidence-based interventions in IVP, and over one-third (n = 29; 38%) reported that their LHD did not train staff in IVP. Almost one-half (n = 37; 48%) had no dedicated funding for IVP. On average, respondents said that about half of their programs were evidence-based; however, there was marked variation (mean, 52%; standard deviation = 41). Many collaborated with diverse partners including law enforcement, hospitals, and community-based organizations. There was discordance between injury and violence burden and programming. Overall, 53% of issues listed as top local problems were not targeted in their LHDs' programs.



Despite funding constraints, North Carolina's LHDs engaged in a broad range of IVP activities. However, programming did not uniformly address state injury and violence priorities, nor local injury and violence burden. Staff members need training in evidence-based strategies that target priority areas. Multisector partnerships were common and increased LHDs' capacity. These findings are actionable at the state and local level.
postdoctoral research fellow, Cancer Control Education Program, UNC Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina sheri_mouw@med.unc.edu.
Mary S
MS
Mouw
prevention specialist, North Carolina Coalition Against Domestic Violence, Durham, North Carolina.
Jennifer
J
Counts
program specialist, Johns Hopkins Center for Communication Programs, Baltimore, Maryland.
Corinne
C
Fordham
Oak Ridge Fellow, Oak Ridge Institute for Science and Education, Edgewood, Maryland.
Molly Merrill
MM
Francis
research manager, Campaign for Tobacco-Free Kids, Washington, DC.
Laura E
LE
Bach
associate professor, Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Suzanne
S
Maman
epidemiologist, Injury and Violence Prevention Branch, Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina.
Scott K
SK
Proescholdbell
D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D055317:Evidence-Based Practice / Q000379:methods / Q000706:statistics & numerical data; D006801:Humans; D009111:Local Government; D020380:Needs Assessment; D009657:North Carolina / Q000453:epidemiology; D017064:Process Assessment, Health Care; D011634:Public Health / Q000191:economics / Q000379:methods; D013192:Staff Development / Q000592:standards; D014754:Violence / Q000517:prevention & control / Q000706:statistics & numerical data; D000078329:Workforce; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology