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Appendix: Goals and Actions

Data and Surveillance

Goal: Improve existing data collection systems.

Actions:

  • Improve data quality (completeness and validity), with a focus on using E-codes to better understand the circumstances surrounding injuries.
  • Evaluate and improve key data systems to represent the breadth and diversity of the U.S. population.
  • Standardize data collection and reporting key data systems such as child death reviews. Child death reviews can be most effective if they utilized standard data collection methods and when they are used to inform decision making about interventions.
  • Enhance collaboration among key agencies and organizations that collect data. Better collaboration on data systems can create a more comprehensive understanding of child injuries to inform program and policy decisions.

Goal: Upgrade and enhance data systems to address gaps in data.

Actions:

  • Use stakeholders to identify specific deficiencies and gaps in data.
  • Add additional injury questions or modules into existing national and state surveillance systems.
  • Collect better data on true economic costs and long-term disability.
  • Collect more information about circumstances (e.g., activity at the time of injury, use of protective equipment) through approaches such as case studies and qualitative methods.
  • Assess data needs for states, local communities, and underrepresented populations, and develop strategies to address such needs.
  • Improve links among injury databases through sharing information, improving and sharing linking algorithms and approaches, and supporting the development of new technologies.

Goal: Improve access to data.

Actions:

  • Use stakeholder input to understand data access barriers.
  • Assess and address barriers for timeliness of data release/availability.
  • Develop online access systems for key databases; systems should include enhanced functionality to query, analyze, and display data.
  • Encourage sharing designs, protocols, procedures, software, and programs for data access systems.
  • Develop and maintain a central, Web-based clearinghouse for key population-based databases.

Goal: Improve analysis, interpretation, and dissemination of surveillance data.

Actions:

  • Build capacity by training local public health practitioners and agencies to conduct analysis and interpret results.  This can be done by federal agencies, state or local health departments, or nongovernmental organizations with an expertise in this area.
  • Develop plans for regular analysis and reports of key surveillance data.
  • Tailor data reports for specific audiences and develop dissemination strategies for key decision makers.
  • Support the use of local data, such as data from local hospital systems, to evaluate local prevention efforts.

Research

Goal: Fill gaps in knowledge about preventing child injuries by conducting multidisciplinary research on risk and protective factors, intervention effectiveness, and knowledge translation. 

Actions:

  • Conduct interdisciplinary research on the causes of child injury and basic descriptive epidemiology on emerging hazards.
  • Conduct research on risk-taking behavior of children and the relationship among developmental status, parent and caregiver behaviors and sociodemographics, and their influence on child injury.
  • Conduct engineering and behavioral science research to delineate the factors influencing child injury occurrence and severity to inform intervention development.
  • Conduct quantitative, qualitative, multifaceted, and economic analyses to identify the most efficacious, effective, and cost-effective interventions for children and youth.
  • Use advanced statistical tools, methodologies, and comparative effectiveness trials in child injury research and incorporate evaluation components into all programmatic funding.
  • Incorporate participatory and community-based methods and include end users in the design and conduct of child injury research.
  • Conduct dissemination research to understand how to successfully promote effective prevention strategies (e.g., using social media and the Internet).

Goal: Harmonize and coordinate child injury research at the national and state levels.

Actions:

  • Develop a national research agenda for child injury prevention and a plan to enhance partnerships for conducting research.
  • Increase the number of agencies and components of the federal government that include child injury in their research portfolios.
  • Increase the number of child injury researchers and research grants through broad cross-agency program announcements, joint funding mechanisms, public-private initiatives, and through including child injury into child health funding opportunity announcements (FOAs).
  • Use existing activities (e.g., National Children’s Study) and sources of funding (e.g., Children’s Trust and Prevention Funds and home visiting funds) to support child injury prevention research.
  • Increase support to states and territories to conduct primary research and program evaluation and coordinate multi-state research initiatives.
  • Establish a national clearinghouse for child injury research findings and applications.

Goal: Conduct research to reduce disparities in child injury.

Actions:

  • Identify the key indicators related to child injury disparities and develop strategies to reduce them.
  • Include child injury research in federal and state funding that addresses strategies to reduce health disparities in the population.
  • Support the preparation of a report on the status of health and injury disparities among children and youth, and mechanisms and programs to reduce such disparities.

Communication

Goal: Develop and use targeted, compelling, and consistent child injury prevention messages.

Actions:

  • Create or implement local and national campaigns on child safety (such as CDC’s Protect the Ones You Love initiative, www.cdc.gov/safechild). 
  • Create a bank of messages by topics and themes that are relevant to the public and timed to events and seasons (e.g., holiday shopping and toy safety at the end of the year). Stories can then be used to bring key messages to life.
  • Establish Web-based, comprehensive communication tool kits for child injury topics. The tool kits can include links to ready-to-use messaging and materials (including various languages and reading levels, and pieces tailored for hard-to-reach or at-risk populations), research studies, contact information for experts, sources for local and national statistics, issue briefs, and links to government agencies and other organizations.
  • Develop and implement a coordinated message strategy across all child injury topics (one resource for this is Adding Power to Our Voices: Framing Guide for Communicating about Injury.

Goal: Use relevant, audience-specific communication channels and sources to deliver child injury prevention messages.

Actions:

  • Find local young people and parents who have been injured, or had a near-miss experience, who are willing to speak out publicly about the importance of injury prevention. 
  • Create a network (at local, state, and/or national levels) of available professional spokespeople (such as pediatricians, trauma surgeons, emergency personnel, lawyers, judges, educators) and victim and safety advocates who are trained to deliver compelling, evidence-based messages to the media.
  • Use local businesses that value safety for injury prevention events and distribution sites (e.g., smoke alarms available at fire houses or child safety seat checks at local auto dealers).
  • Encourage children’s hospitals and other health care facilities to use their communication channels (e.g., the phone system’s on-hold message or televisions in waiting areas) to share safety information.
  • Sponsor local injury prevention events to raise awareness about a specific cause (e.g., a bike-a-thon to raise money to provide children with helmets).
  • Identify opportunities for media coverage in unexpected places (e.g., a national automotive writer can cover car seat use or ways to keep teenagers from driving while texting, or a sports program or channel can reach out to teens about recreational safety).

Goal: Strengthen and engage local, state, and national partnerships and coalitions to support the implementation of communication strategies.

Actions:

  • Create a task force (at local, state, and/or national levels) of nongovernmental organizations, decision makers, researchers, public health agencies, safety experts, and other stakeholders to share knowledge, expertise, and resources.
  • Generate a collaborative plan for refining, prioritizing, and implementing communication recommendations in the NAP at the state or local level.
  • Develop a shared system to track and publicize progress made in adopting, implementing, or enforcing recommendations in the NAP. These can be used in partner briefings. 
  • Identify and partner with organizations for which safety is already part of their mission and highlight their efforts as examples others should follow.

Education and Training

Goal: Educate the public about injury risks and effective strategies to prevent child injuries.

Actions:

  • Integrate injury prevention education into broader child health promotion efforts such as the Maternal, Infant and Early Childhood Home Visitation Programs.
  • Educate decision makers (e.g., lawmakers, school administrators, business leaders) about the burden of child injuries, the importance of prevention, its cost savings potential, and public health benefit.
  • Strengthen the translation of knowledge into practice by establishing or strengthening collaborations between researchers, people working in injury prevention, and those working directly with children and families.
  • Educate textbook and periodical publishers, newspaper editors, and free-lance writers about the importance of child injury prevention and provide them with materials to develop stories and features about child injury prevention.

Goal: Develop and test evidence-based materials, tools, and resources to educate and train target audiences.

Actions:

  • Develop specific materials for schools of education, public health, medicine, allied medical fields, law enforcement, and others and incorporate them into existing professional training.
  • Develop health and safety education curricula and programs for use in preschool, elementary, middle, and high schools (within the framework of a comprehensive school health education program).
  • Develop resources to assist concerned citizens, parents, school personnel, health and safety professionals, and others to promote child injury prevention in their communities.
  • Develop criteria for national, state, and local report cards on child injuries to focus communities on improving their scores.
  • Establish a clearinghouse to catalogue and provide access to accurate educational information and resources for professionals and the public.
  • Catalogue all available school and professional curricula related to child injury prevention and create an evaluation framework for assessing quality and accuracy.

Goal: Implement and disseminate child injury education and training programs in allied health professions.

Actions:

  • Improve coverage of child injury prevention in undergraduate and graduate education and training programs.
  • Incorporate child injury prevention information in health, education, and safety professionals training by offering continuing education credits.
  • Include child injury prevention into minimum standards for competency for selected credentialing, licensing, and certification in health and safety.
  • Provide ongoing education and training for disaster and injury response, including first aid and CPR, for all school and childcare/foster care personnel and students.
  • Develop consortia among education, training, and technology services and providers.

Goal: Develop venues for delivering child injury education programs in schools and communities, and among new professionals.

Actions:

  • Establish child injury prevention internship opportunities at agencies and organizations at the national, state, and local levels.
  • Develop training modules on child injury program implementation, evaluation, risk communication, and advocacy.
  • Use technology such as the Internet to improve access to child injury prevention training.
  • Improve the training of professionals around child injury data collection, and its value for documenting the problem and monitoring child injury trends (e.g., law enforcement, medical examiners, medical practitioners, county and state child death review representatives).
  • Provide training that is relevant to child injury in fields such as engineering, architecture, environmental science, and transportation safety.
  • Provide education and training in child injury prevention and emergency response to all expectant mothers and their families, pre- and post-term.

Goal: Use community-based organizations to educate the public about strategies for child injury prevention.

Actions:

  • Support nonprofit organizations to promote child injury prevention education at local, state, and national levels.
  • Integrate prevention education into community health programs that serve new residents, immigrants, and low-income families.
  • Integrate child safety education into pediatric visits, well-baby visits, and at post-partum discharge.
  • Design and disseminate child safety education materials to educate employees about family safety off-the-job through corporate health and wellness programs.
  • Engage community-based organizations, voluntary groups, non-governmental organizations, and merchants in sponsoring injury prevention events and educational campaigns.  

Health Systems and Health Care

Goal: Identify opportunities in health care reform to improve child health through injury prevention.

Actions:

  • Implement child injury prevention programs through community-based prevention funding and through Bright Futures.
  • Support the inclusion of child injury risk assessment, counseling, and remediation in the Maternal, Infant and Early Childhood Home Visitation Program.
  • Develop guidelines for adopting and promoting best practices in child injury prevention throughout the health care system.
  • Augment state and local health department capacity to address child injury prevention.
  • Accelerate the translation and implementation of evidence-based interventions into the health care setting.

Goal: Integrate child injury prevention into the medical home movement.

Actions:

  • Create and implement injury prevention quality measures that apply to the medical home.   
  • Support the development of injury indicators for children and youth in the medical home.
  • Create partnerships between health care providers and those serving disadvantaged populations to increase availability and affordability of child safety devices for reducing injury disparities. Establish partnerships for integrated follow-up care after discharge from the hospital.
  • Promote safety devices, like child safety seats, as “durable medical equipment” so they can be prescribed and are reimbursable expenses.
  • Implement quality improvement measures for injury prevention in health plans and for medical care in the medical home, hospital, and outpatient settings (e.g., Health care Effectiveness Data and Information Set [HEDIS], National Committee for Quality Assurance [NCQA], Early and Periodic Screening, Diagnosis, and Treatment [EPSDT], and National Quality Forum [NQF]).

Goal: Expand effective health care-based services and systems to improve injury outcomes for children and youth.

Actions:

  • Increase universal access to poison control centers, comprehensive trauma care systems, pre-hospital care, and preventive services.
  • Expand the scope and reach of EMSC to adequately serve rural residents and disadvantaged high-risk children and youth.
  • Enhance the capacity of maternal and child health care practices throughout the United States to fully support child injury prevention.
  • Integrate injury prevention programs, such as Bright Futures into patient safety, well-child visits, WIC services, and hospital discharge planning.
  • Create comprehensive statewide networks for home- or clinic-based care for every seriously injured child.

Goal: Increase the development and use of advanced technologies in the health care environment to prevent injuries and improve child injury outcomes.

Actions:

  • Use medical information systems and EHR to improve the speed, efficiency, and quality of care for injured children and adolescents.
  • Explore the use of linked data systems to improve treatment decisions and outcomes for injured children and adolescents.
  • Advance the use of technology-based preventive and therapeutic interventions to improve care, treatment, and rehabilitation from injury.
  • Define standards for the use of advanced technologies to improve awareness of major risks of injury during gestation and in the first year of life.  

Policy

Goal: Identify child injury prevention needs and priorities for policy leaders and decision makers.

Actions:

  • Track and assess child injury prevention policies and environmental supports.
  • Conduct environmental and health impact assessments to highlight child injury prevention needs and identify potential for policy-level interventions to reduce the injury burden.  For example, health impact assessments of a proposed neighborhood development could highlight the need for additional crosswalks so children can safely walk and bike to school.
  • Develop a set of “policy priorities” to improve the safety of children within communities based on the data that show where children are at greatest risk of injury.
  • Conduct policy development workshops, lectures, and summits on the leading causes of child injuries and deaths for decision makers to improve policy-based decisions.  
  • Estimate the impact and cost savings from policy-oriented child injury interventions.
  • Improve national leadership training for child injury policy analysis, implementation, and evaluation.

Goal: Support the adoption and implementation of evidence-based laws and policies that prevent child injuries.

Actions:

  • Develop a clearinghouse that identifies federal, state, and organizational policies designed to protect children from injury.
  • Integrate child injury prevention into other policy initiatives at the organizational, local, tribal, state, and national levels.  For example, policy initiatives designed to increase physical activity and reduce obesity could also integrate injury prevention components.
  • Support new policies that address injuries at and around child care settings, schools, and worksites employing youth.
  • Expand and improve product safety, housing, and neighborhood/infrastructure policies that influence children’s health, safety, and mobility. For example, policies that require four-sided fencing for homes with swimming pools are important in preventing drowning.
  • Increase the capacity of states, local coalitions, and formal alliances to support policies that prevent childhood injuries.
  • Increase the role of the private sector in developing and implementing effective policies to protect children. For example, businesses that house child care centers can implement policies within their playgrounds or other care settings that increase the safety of these spaces.

Goal: Support compliance with and enforcement of existing child injury prevention policies.

Actions:

  • Increase employers’ and adolescent workers’ awareness of regulations and standards that address the prevention of workplace injuries to youth and the importance of enforcement.
  • Establish training capacity to provide technical assistance to law enforcement personnel in best practices to enforce child safety policies.
  • Develop and improve compliance with a standardized methodology for conducting child death reviews in accordance with a state’s authorizing legislation, and encourage all states to investigate all injury-related child deaths. 

 

 
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