Most planners will encounter situations where it is not feasible to use a model in its entirety or when it is necessary to combine parts of different models to meet specific needs and situations. What is most critical for injury prevention professional is a working knowledge of the basic steps that most planning models have in common. The Generalized Model for Program Planning outlines these common steps: assessing needs, setting goals and objectives, developing an intervention, implementing the intervention, and evaluating the results. 1 This section will focus primarily on developing effective interventions in injury prevention.
National, State, and Local Roles
National, state and local level agencies and organizations all have different roles that contribute to injury prevention. Violence and injury prevention professionals can learn specific roles of national, state, and local level agencies at the CDC (Centers for Disease Control and Prevention). In Utah, there are many partners and resources that work towards injury prevention.
In Utah, injury prevention is primarily funded through the Maternal & Child Health (MCH) and Preventive block grants from the CDC with some grants available through the National Highway Traffic Safety Administration (NHTSA).
The Utah Department of Health (UDOH) Violence and Injury Prevention Program (VIPP) receives the MCH block grant and allocates funds among the 13 local health departments.
UDOH assists the 13 local health departments to establish long and short term goals.
Local health department injury prevention staff plan, implement, and evaluate injury prevention activities aimed at reaching long and short term goals .
Local health department injury prevention staff report outcomes to UDOH.
UDOH provides technical assistance, resources, and data reports to local health department staff.
UDOH collects outcome data to report back to CDC.
The Utah Department of Public Safety Highway Safety Office receives (UHSO) NHTSA funding and makes grants available to the 13 local health departments.
UHSO assists the 13 local health departments to establish long and short term goals.
Local health department injury prevention staff plan, implement, and evaluate long and short term goals aimed at preventing death and disabilities related to Highway Safety.
Local health department injury prevention staff report outcomes to UHSO.
UHSO provides technical assistance, resources, and data reports to local health department staff.
UHSO collects outcome data to report back to NHTSA.
Designing Injury Activities
When designing injury activities there are many factors to consider. The following tips will assist in designing injury prevention activities:
- Injury prevention professionals must be able to identify and prioritize injury problems. State and local staff can each prioritize significant injury problems by using various data resources located in section 2 (Access,interpret, use, and present injury and violence data). State and local staff can utilize coalitions, key leaders, and/or other injury staff to prioritize significant injury health risks. Many Safe Kids coalitions across the state conduct a needs assessment every three years in order to identify the leading causes of injury at a state and local level.
- Once priorities have been established, injury staff can describe levels where prevention activities can be focused. Do you want to target community, worksite, health care providers, individuals, or policy based interventions? It also helps to identify what resources the community has or are already being implemented that prevent injuries.
- There are many models to use that can help identify intervention opportunities while designing injury prevention activities. Two examples are:
1) Haddon Matrix: http://www.bmj.com/content/324/7346/1142.full
2) Haddon Matrix: http://injuryprevention.bmj.com/content/4/4/302.full
3) Social Ecological Model – http://www.sophe.org/ui/behavioral-main.shtml
- When designing injury prevention activities, consider using interventions that use education/behavior change, legislation/enforcement and technology/engineering to prevent injuries.
- For a given injury or violence problem, choose and justify an intervention based on relevant data, characteristics of the intended audience, a conceptual model or theory and evidence related to “best practice.”
- Design an implementation plan to include a description of the intended audience, goals and objectives, proposed activities, evaluation component, timeline and resources.
- Consider how cultural, socio-economical, political, and physical environment factors may influence an injury prevention effort.
Implementing Injury Activities
In the simplest terms, implementation means to carry out.2 There are many ways to implement or carry out an injury prevention activity. Program staff will need to consider ethical, cultural, safety, and legal issues when implementing program activities. The book Planning, Implementing, & Evaluating Health Promotion Programs, 5th Edition, describes 5 phases of program implementation that may help provide direction for how to carry out an injury prevention activity. A summary of the phases outlined in the book are as follows:
Adoption of the program: Planners should market the health promotion program to ensure that those in the priority population will want to participate in it.
Identifying & Prioritizing the tasks to be completed: Program staff will need to identify and prioritize a number of smaller tasks. A Gantt Chart may help with prioritizing tasks to be completed.
Establishing a system of management: Program staff will need to know how the program will be managed. Managing a program may include developing program budgets, expenses, time allocations, staff tasks, and role delineation.
Putting plans into action: There are three strategies of accomplishing this:
1) Piloting process
2) Phasing it in, in small segments
3) Initiating the total program all at once.
Program staff should keep in mind that limited time and resources may not always allow planners to work through all three strategies.
Ending or sustaining a program: Program staff will need to know how long to run a program. Either until a goal is met or resources have been exhausted. Also consider how the program will be sustained without resources dedicated to accomplishing a goal.
1. Planning, Implementing, Evaluating Health Promotion Programs; 5th Edition; McKenzie, Neiger, Thackaray; pg. 17
2. Planning, Implementing, Evaluating Health Promotion Programs; 5th Edition; McKenzie, Neiger, Thackaray; pg. 316