Completed Projects

Rural-Urban Differences in Injury Hospitalizations (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Jeffrey Coben, MD

The objective of this project was to determine the incidence, causes, and costs of hospitalized injuries among rural residents in the United States and compare these with urban populations utilizing data from the Healthcare Cost and Utilization Project.  The findings from these analyses have demonstrated the substantial burden imposed by injury and the significantly increased risk for those residing in rural locations.  Overall, injury hospitalization rates increased with increasing rurality.  While hospitalization rates for assaults were highest in large urban counties, the rates for unintentional injuries from motor vehicle traffic, falls, and poisonings were higher in rural populations.  Rates for self-inflicted injuries from poisonings cuttings and firearms were also higher in rural counties, and, on a per-capita basis, hospital charges were highest for rural populations.

The Black-White Suicide Paradox: A Multilevel Multiple Cause-of Death Evaluation. (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Ian Rockett, PhD

This cross-sectional study utilized data from the Web-based Injury Statistics Query and Reporting System, and corresponding multiple-cause-of-death data from the National Center for Health Statistics public-use files.  The original study population was expanded to encompass Hispanics.  Results supported the likelihood that the suicide rate gap between blacks and Hispanics on the one hand, and whites on the other, was at least a partial artifact of serious disparities in suicide certification.  A second important finding was that the type of injury mechanism differentially predicted potential suicide misclassification.

Understanding the Long-Term Consequences of Injury among Older Adults. (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Mary Carter, PhD

This study utilized data from the Medicare Current Beneficiary Survey to examine the long-term risks of injury on Medicare beneficiaries’ healthcare cost and use patterns, risk of institutionalization and death, and disability-levels over time.   This study represents one of the most comprehensive, longitudinal studies of injury among older adults conducted to date.  Overall, findings from this project suggest that the consequences of sentinel injury among older adults is substantial, with results confirming that the effects of injury continue to influence Medicare cost and use patterns, risk of institutionalization and death, and disability levels for periods of time that extend long after the injury episode has “resolved” and over periods of time much longer than previously measured.

How often do Catastrophic Injury Victims Become Medicaid Recipients? (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Ted Miller, PhD

The goal of this project was to describe the incidence of catastrophic injuries and the potentially long-term financial and disability burdens imposed on the government through increased Medicaid recipients.  Using 2003 data from the Center for Medicare and Medicaid Services, we determined that around 7,000 people aged 21-64 were added to the Medicaid rolls in 2003 due to catastrophic injury in the 14 states included in our study. An estimated 6,312 conversions to Medicaid occurred around the time of admission to an acute care hospital. Overall, we found a conversion rate of 2.55% for injury hospital admissions.

Adaptive Measures of Family Violence. (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: William Gardner, PhD 

The goal of the project was to improve the detection of violence towards children.  Based on data from the National Study of Child and Adolescent Well-being, two established child violence exposure instruments were converted into computerized adaptive surveys that will facilitate a child’s self-report of violence more efficiently and accurately.  These new adaptive scale instruments will be significantly more efficient and accurate than the instruments they replace and avoid exposing subjects to highly sensitive and potentially damaging notions.  Future plans include research and clinical applications to administer and test these new instruments in a variety of settings.

Epidemiological Analysis of Prescription Drug Misuse in West Virginia (Performed under contract from Marshall University; Funded by the West Virginia Division of Criminal Justice Services for 2009-2011)

PI: Jeffrey Coben, MD

This project is one component of a larger initiative designed to better understand the epidemiology of prescription drug misuse in West Virginia. The Governor, by authority of Executive Order #04-08, has designated West Virginia's Partnership to Promote Community Well-Being (Partnership) as the Commission with oversight of the State's Purdue Pharma Asset Forfeiture Funds. The Controlled Substance Advisory Board Workgrou of the Partnership has identified several potential data sources that it believes can add to the understanding of prescription drug misuse in West Virginia. Through a subcontract, the Prinicipal Investigator has been tasked with examining a specific database, West Virginia's Controlled Substance Monitoring Program (CSMP). A secondary analysis of the CSMP dataset is being conducted. Five years of data (2005-2009) are being obtained and analyzed. For each controlled substance prescription included in the dataset, the following variables are included: 1) the name, pharmacy prescription number and Drug Enforcement Administration (DEA) controlled substance registration number of the dispensing pharmacy; 2) the name, address and birth date of the person for whom the prescription is written; 3) the name and DEA controlled substances registration number of the practitioner writing the prescription; 4) the name and national drug code number of the Schedule II, III and IV controlled substance dispensed; 5) the quantity of the Schedule II, III and IV controlled substance dispensed; and 6) the date the prescription was filled.

PI: Jeffrey Coben, MD

The purpose of the Teen Dating Violence Prevention initiative is to strengthen the ability of the Pennsylvania Department of Health’s Violence and Injury Prevention Program by addressing teen dating violence as a public health issue. The Department selected Philadelphia as the site for this study based on its status as a high-risk urban area, along with the city’s capacity among existing teen dating violence prevention partners. This project, supported via a cooperative agreement with NCIPC, established a Teen Dating Violence Prevention Team (TDVPT), which brought together stakeholders to develop a plan for coordinating and expanding teen dating violence prevention efforts in the city. TDVPT activities included: 1) conducting an environmental and policy scan to better understand local leadership and support for teen dating violence prevention and current teen dating violence activities underway for Philadelphia; 2) conducting an assessment of evaluation capacity to identify gaps and needs for Philadelphia in prevention activities, surveillance, and policy initiatives; and 3) partnering with state and local leaders to promote and advance recommendations. 

Development and Evaluation of Targeted ATV Safety Educational Strategies for Rural Children (Performed under contract from Arkansas Children's Hospital Research Institute; Funded by the Maternal and Child Health Bureau’s Emergency Medical Services for Children Program for 2007-2010)
 

PI's: James Helmkamp, PhD (2007-2009); Maria Brann, PhD (2010)
 

Educational campaigns to increase use of bicycle helmets, seatbelts, and car seats have shown positive results in improving safe practices and decreasing injury number and severity.  We hypothesized that a carefully developed, targeted injury prevention educational program to encourage safe all-terrain vehicle (ATV) riding practices could yield similar results.  The purpose of this project was to develop and evaluate targeted educational materials for use in community-based ATV injury prevention through the use of targeted focus groups and the implementation of ATV safety materials in hunters’ education courses and public movie theaters.  The specific aims included: 1) conducting focus groups to determine general knowledge and perceptions about ATV safety as well as specific beliefs and practices with regard to ATV use in children; 2) evaluating the use of an ATV safety video in a hunter’s education course; and 3) evaluating the use of a movie theater to disseminate an injury prevention Public Service Announcement.
 

Identifying Rural Communities at Risk of Suicide (Funded by the American Foundation for Suicide Prevention for 2007-2009)

PI: Robert Bossarte, PhD

This study investigated community-level risk and protective factors for suicide in West Virginia in order to identify characteristics of rural communities that have comparatively high and low suicide rates. Informed by social capital theory, the study emphasized the role of social living environments in influencing suicide rates in communities, using area of residence as the unit of analysis. Data for all 55 counties in West Virginia on known and hypothesized risk and protective factors for suicide, including summary measures of social capital, as well as data on all suicide deaths, were obtained from the U.S. Census Bureau, U.S. Department of Agriculture, the National Healthcare Utilization Project, Religious Congregations and Membership study, Uniform Crime Reports, WV Department of Health and Human Resources, WV Department of Education, and Northeast Regional Center for Rural Development at Penn State University. The goals for this study were to: 1) compare risk for suicide among rural areas using analytic techniques including Poisson regression, cluster analysis, and principal components analysis; 2) provide information on differences in the association between suicide and county characteristics in rural areas; 3) construct a typology of risk for use in prevention activities and future analyses; and 4) compare the associations between social capital among adolescents/young adults and older adult populations.
 

All-terrain Vehicle (ATV) Safety and Injury Surveillance in West Virginia (Funded by the West Virginia Bureau for Public Health for 2007-2009)

PI:  James Helmkamp, PhD

The goals of this project were to continue statewide efforts to improve all-terrain vehicle (ATV) safety and help decrease the incidence of injuries and their resulting costs.  Specific objectives were to: 1) Establish and maintain a database that would allow a comprehensive examination of the demographic characteristics of persons involved in ATV crashes and the social and environmental circumstances that may influence these crashes; 2) liaise with key advocates who are stakeholders in improving ATV safety in West Virginia and engage them during the annual legislative process; 3) work with the Office of Emergency Medical Services to facilitate the use of the Trauma and Emergency Medical Information System to provide timely and accurate injury-related data to improve the state’s capacity to identify high-risk groups and situations, develop viable prevention programs, and inform policymakers; 4) assist in interpreting ATV-related data from the Office of the Chief Medical Examiner and in the preparation of peer-review manuscripts; and 5) develop, in collaboration with the WV Office of Emergency Medical Services and the Joint Community Trauma Program at the Ohio Valley Medical Center and Wheeling Hospital, training materials to assist EMS squads and trauma centers across the state to more effectively respond to ATV crashes and aid in helmet removal onsite.
 

Death and Injury from ATV and Bicycle Crashes: A 5-year Comparison of National Prevalence and Cost Estimates among Children and Adults (Funded by the Arabella Legacy Fund for 2007-2008)

PI:  James Helmkamp, PhD
 

The goals of this project were to examine the increasing trends associated with all-terrain vehicle (ATV)-related injuries, and compare these trends with similar data on bicycle-related injuries.  For the 5-year period 2000-2004, and for two age groups (children ≤15 years and adults ≥16 years) the following analyses were conducted: 1) for fatal injuries we identified the number of ATV-related fatalities, by year, and the estimated overall economic costs (i.e., quality of life, work-loss, and medical) resulting from these deaths; 2) similarly, we identified the number of bicycle-related fatalities, by year, and the estimated overall economic costs (i.e., quality of life, work-loss, and medical) resulting from these deaths; and 3) for nonfatal injuries we identified, by year and rate, the estimated prevalence and total hospital charges of ATV-related injury hospitalizations. The prevalence and hospital charges were subset by gender, primary payer (i.e., government, private/HMO, self-pay, and other), and principal diagnoses. Similar data were identified for bicycle-related injury hospitalizations.
 

Completed ICRC-supported Pilot Projects

Variations in Outcomes Following Hip Fracture Injury: Understanding the Effect of Hospital and Patient Volume Levels (PI = Mary Carter, PhD).

Human Head Response to Impact Loads and Post-traumatic Response (PI = Victor Mucino, PhD).

Exercise Interventions and Injuries: A Meta-analysis of Randomized Controlled Trials (PI = George Kelley, DA).

Suicide in the Context of Multiple Causes of Death (PI = Ian Rockett, PhD).

Internet Telemedicine Follow-up in Orthopaedic Trauma Patients (PI = Dina Jones, PhD).

Measurement of ATV Safety Behavior in Rural Communities (PI = Mary Aitken, MD, MPH).