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Doctoral Dissertation Awards and New Investigator Awards  

2003 New Investigator Abstracts

Reducing Older Driver Injuries at Intersections
Principal Investigator: Dominique Lord, PhD, Texas A&M Research Foundation, Texas Transportation Institute, College Station, TX 
There is a significant opportunity to ameliorate the greatest source of non-intentional injuries in the U.S. motor vehicle crashes through improved highway design practices, particularly at intersections, where the highest proportion of crashes result in serious injuries. Experience here and in other countries suggests that traffic conflicts and overall safety at intersections can be dramatically improved through the installation of modern roundabouts. But in the U.S., subjective data show that drivers, especially older drivers, fear what they perceive to be elevated demands and risks associated with roundabouts, and may avoid their use.

The intent of the planned research is to enhance the safety and mobility of persons aged 65 and over in the U.S. through more elder-friendly designs of roundabouts. The proposed study will be accomplished in four tasks that focus on: problem identification; selection of potential countermeasures; countermeasure evaluation; and documentation of research results, citing anticipated benefits in terms of the prevention of injuries related to automobile crashes involving older drivers. A product of this research will be recommendations for new guidelines for highway design developed for modern roundabouts, where the overall goal is to foster the use of these facilities by the group most at risk of injury due to intersection crashes. 

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Childhood Residential Injury and Caregivers Supervision
Principal Investigator: Kieran J. Phelan, MD, Children’s Hospital Medical Center, Cincinnati, OH 
Unintentional injury is the leading cause of death and disability in U.S. children and the home is the single most common location of injury. The first specific aim of this project involves the design, conduct, and analysis of a prospective 36-month randomized controlled trial to reduce residential unintentional injury. The intention-to-treat analyses of the longitudinal data will involve repeated measures, following children from birth to 36 months of age, the group at highest risk for residential injuries. In secondary analysis, the project will examine the effect of the intervention by levels of parental supervision to test whether the effect was greater for households with lower parental supervision.

The second specific aim will examine causal determinants of parental supervision and its ultimate effects on unintentional residential injury. Using a theoretical model of supervision, data developed in the first specific aim, together with validated measures of caregiver traits such as maternal depression (Beck Depression Inventory), parental health locus of control and child injury-risk behavior (Injury Behavior Checklist), will be used to examine determinants of supervision. Unintentional residential injury will be modeled by integrating the quality of residential hazards, caregiver beliefs about residential safety, caregiver locus of control and depression, the quantity and quality of supervision, and child injury-risk behavior. A structural equation model incorporating parental supervision, the burden of residential hazards, and children’s injury-risk behaviors will be developed to explain residential injury. Maternal depression and other caregiver characteristics will in turn explain parental supervision.

This project will provide the primary investigator with experience and expertise to understand injury prevention and residential supervision through a multi disciplinary approach. This proposal will leverage the support and resources of the Cincinnati Center for Children’s Environmental Health to further the science of injury control.

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Oceanfront Injury Prevention
Principal Investigator: Charles W. Pruitt, MD, Eastern Virginia Medical School, Norfolk, VA
Drowning is the second leading cause of unintentional injury and the fourth leading cause of fatal injury among children. To date, there are few studies that analyze the role of beach-related injuries in the spectrum of childhood injury and death. Furthermore, interventions to decrease beach injury have not been evaluated for efficacy, possibly due to a lack of quantitative measures of beach safety. The objective of this project is to decrease the overall childhood morbidity and mortality by creating a community injury prevention model to reduce beach-related injury risk behavior and disseminate the model to a national audience. In order to reduce drowning and other water-related injuries among children, the investigator will develop a multifaceted education intervention using a local working group composed of members of an existing successful coalition that has experience changing behavior at the community level. In addition, the investigator will develop quantitative measures of injury risk that can be used to evaluate the success of the intervention. Lastly, the investigator will conduct a pilot study of the intervention and safe beach indices by comparing outcomes before, during, and after implementation of the intervention at a single oceanfront beach in Virginia Beach, Virginia.

The project has three aims:

The primary outcome is to determine the effectiveness of a community-based coalition injury prevention model in decreasing childhood morbidity and mortality due to drowning and other beach-related injuries.

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Primary Prevention of Child Sexual Abuse
Principal Investigator: Alyssa Ann Rheingold, PhD, Medical University of South Carolina, Charleston, SC 
Changing community attitudes, knowledge, and behavior is a crucial first step towards primary prevention of CSA. The research plan for this award is divided into two complimentary studies to increase our understanding of the effects of a community-based media program aimed at raising awareness of the prevalence and consequences of CSA and educating the public about related prevention and response strategies. The primary goal of the first study is to conduct a controlled evaluation of mass media products developed by From Darkness to Light (DTL), a national non-profit organization seeking to protect children from sexual abuse. Participants will be assigned to one of four conditions: public service announcements, educational booklet, public service announcements plus educational booklet, and no media exposure. Participants will be surveyed immediately following exposure to the media products and one month later to determine the efficacy of the various prevention strategies for improving adults’ knowledge, attitudes, and preventive behaviors regarding CSA. The second study will assess the feasibility of this intervention by obtaining community members’ perceptions, opinions, and recommendations about the content and presentation of the media campaign by conducting six ethnically homogeneous focus groups. Results from these two studies will provide useful information for approaching the problem of CSA prevention and possible strategies for refining prevention messages. 

Safe Streets: GIS Analysis and Countermeasure Evaluation
Principal Investigator: Stanley Sciortino, PhD, San Francisco Department of Public Health, San Francisco, CA 
This project will extend the work of the Departments of Public Health and Parking and Traffic in the County of San Francisco to better understand pedestrian safety and pursue intervention strategies. A systematic analysis of pedestrian injury collision patterns is now needed in addition to pilot studies that evaluate the effectiveness and suitability of countermeasures. This project has three aims:

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Patient-Specific Modeling for Pediatric Head Injury-Biomechanics
Principal Investigator: Jiangyue Zhang, PhD, Medical College of Wisconsin, Milwaukee, WI 
Head injury in pediatric patients is a serious problem and poorly understood from a biomechanical perspective. These injuries are intrinsically linked to geometry and material properties of the brain and skull. This project will use patient-specific finite element models (FEMs), reconstructed from patient computer tomography (CT) scans, to study impact response and injury mechanisms in pediatric patients. 

The tissue level head injury criteria will be identified by comparing results from patient-specific FEMs to brain injuries in actual patients as found on CT scans. Parametric studies will also be performed to study the effects of head geometry and site of impact on impact response and injury mechanisms. The long-term objective of this project is to use a patient-specific FEM to investigate the brain injury of a specific pediatric patient at all ages. A family of patient-specific FEMs will be built for a pediatric population as a function of age. Patient-specific head injury studies will not only help clinicians understand how injuries occur in specific patients, but also help in the evaluation and development of safety protection devices for this population. As a short-term (one-year) goal, ten patients (ages five to seven months) will be selected and patient-specific FEMs will be reconstructed from patient CT scans by using MIMICS software and I-DEAS. Each model will be exercised under the known impact scenario obtained from the clinical history of the patient. The tissue level head injury criteria are obtained by comparing results from FEMs to brain injuries found in CT scans. The models will then be applied with the same traumatic loading to study injury differences because of geometry between these models. The difference in brain injury due to site of impact will also be studied by applying the load at different anatomic sites. 

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