David A. Sleet

Closing the gap between injury prevention research and community safety promotion practice: revisiting the public health model

[Extract] Injury is one of the most underrecognized public health problems in the world, with nearly 16,000 people dying from injuries each day. Together, unintentional injury and violence cause more than five million deaths per year, or 9% of the total global mortality—as many deaths as those caused by acquired immunodeficiency syndrome, malaria, and tuberculosis combined. Injury and violence account for eight of the 15 leading causes of death: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings, and falls.¹ These alarming statistics are all the more tragic because injury is preventable.

Research alone is not sufficient to prevent sports injury

This journal aims to promote, publish and promulgate high-quality, innovative research. As laudable as this is, it is not enough. Unless this research culminates in practical and cost-effective interventions capable of attracting the political and social support required to allow effective implementation, it will not prevent harm or save lives.1nnThe Public Health Model has been proposed as a framework to promote the progression of sports medicine research towards real-world application.2 ,3 In this four-stage model, research progresses in a stepwise manner from problem identification to adoption of effective interventions:4 nnUnfortunately, most sports injury research does not result in adequate dissemination or widespread use of effective interventions.5 ,6 The problem is not unique to sports medicine. In a review of 1210 articles published in 12 leading public health and health promotion journals, Oldenburg et al 7 found that 63% of publications were descriptive (Stages 1 and 2), 11% were concerned with method development and 16% were intervention-based (Stage 3), and only 5% were concerned with institutionalisation or policy implementation research, with less than 1% containing diffusion research (Stage 4).nnWhile researchers have generated considerable knowledge from surveillance, risk factor identification and efficacy and effectiveness studies, this knowledge needs to be adopted by those who can use it to improve sports medicine practice (eg, clinicians, coaches and sporting bodies).1 ,8nnSeveral gaps between injury prevention research and safety promotion practice hamper our efforts:9 nnThese gaps stem from the contrasting approaches that researchers, policy makers, practitioners and the community take to the scientific, practical and social challenges posed by …

Ecological approaches to the prevention of unintentional injuries

Background: Injury as a cause of significant morbidity and mortality has remained fairly stable in countries nwith developed economies. Although injury prevention often is conceptualised as a biomedical construct, such na reductionist perspective overlooks the importance of the psychological, environmental, and sociocultural nconditions as contributing factors to injury and its consequences. This paper describes the potential of nthe ecological model for understanding the antecedent causes of unintentional injuries and guiding injury nprevention approaches. We review the origins and conceptualise the elements of the ecological model and nconclude with some examples of applications of ecological approaches to the prevention of unintentional ninjury and promotion of community safety. nMethods: A review of the English-language literature on the conceptualization of ecological models in public nhealth and injury prevention, including the application of the ecological model in the prevention of falls and nroad traffic injuries and in the community safety promotion movement. nResults: Three dimensions are important in social-ecological systems that comprise key determinants of ninjuries: 1) the individual and his or her behaviour, 2) the physical environment, and 3) the social environment. nSocial and environmental determinants have profound impact on population health and in the causation of injuries. nConclusions: Social and environmental determinants of injury should be studied with the same energy, urgency, and intellectual rigor as physical determinants. Application of the ecological model in injury prevention shows the most promise in falls injury prevention, road traffic injury prevention, and community safety promotion.