Current Projects
New Projects: (August 2007 - July 2012)
Development and Evaluation of an Intervention for Intimate Partner Violence in the Context of Nurse Home Visits (Harriet MacMillan, MD, MS, Professor, Departments of Psychiatry and Behavioural Neurosciences and Pediatrics, Offord Centre for Child Studies, McMaster University)
Intimate partner violence (IPV) is a widespread public health problem with devastating health and social consequences for women and children. The overall aim of this 5-year core project is to develop and evaluate an intervention to improve quality of life and reduce IPV among low-income women during pregnancy and in the first two years postpartum. It has the following aims: Project I: a) to develop a model of in-home IPV intervention (IPVI) for mothers enrolled in the Nurse-Family Partnership (NFP) home visitation program who are exposed to IPV (NFP + IPVI), using a qualitative case study methodology; b) to test the feasibility and acceptability of the intervention in a small sample of NFP clients and nurses. Project 2: to conduct a cluster randomized controlled trial of NFP+IPVI compared with NFP alone, to estimate the intervention’s effect on NFP clients’ quality of life and recurrence of IPV. Multilevel growth curve analysis will be used to estimate program effects. Expected outcomes of this study include the development of an IPV intervention that is theoretically-grounded, and preliminary evidence regarding its effectiveness. These results will be important because they will improve our understanding of IPV interventions, address a critical need of home visitation programs, and significantly advance the field of family violence.
Understanding the Long-term Consequences of Injury among Older Adults (Mary Carter, PhD, Associate Professor WVU Center on Aging, WVU Department of Community Medicine)
The goal of this 3-year core project is to conduct a longitudinal investigation to determine the extent to which individual-level factors (e.g., sociodemographic attributes, preexisting medical conditions) and environmental factors (e.g., living arrangements, home modifications) affect the long-term outcomes of older adults experiencing an injury. Specific aims include (1) to describe the longitudinal trajectories of functional status, healthcare service use and costs, (2) to examine the marginal effects of sentinel injuries on healthcare services use and aggregate medical costs, and (3) to investigate the effect of individual characteristics and environmental factors on the risk of injury and the medical service use and costs that follow such events. A secondary analysis of the Medicare Current Beneficiary Survey files linked with data from the Area Resource File is proposed. Data will be aggregated to the respondent level and will permit multiple cohorts of Medicare beneficiaries to be tracked. Descriptive techniques will be used to describe trajectories of ADL/IADL functioning, self-reported health, healthcare service use, and healthcare costs following injury. Multivariate linear growth models will be used to estimate trajectories of service use, costs, health and functional status. Survival models will be used to estimate the marginal effect of sentinel injuries on risk of institutionalization and death, while Markov outcome models will be used to estimate the effect of individual characteristics and environmental factors on risk of state transitions between injury free and injured states, over time. From a public health perspective, greater understanding of the significant risk factors of and long-term outcomes following injury among older adults will assist in improving strategies aimed at preventing injuries, targeting services and controlling costs.
Continuing Projects
Determining the Incidence, Severity and Medical Costs of ATV-related Injuries (Jim Helmkamp, PhD, Director, WVU ICRC, Research Professor, Department of Community Medicine, WVU SOM).
This large core project (September 2004 - June 2008) has continued a West Virginia focus but some aspects have been broadened to include national perspectives. Published manuscripts include collaborative papers with researchers at NCIPC (Ruth Shults, et al , Division of Injury Response; Pediatrics 2005; 116(5):608-612 ), NIOSH (Mike Goldcamp, et al, Division of Safety Research, Journal of Rural Health 2006; 22(4):308-313; and Bruce Lawrence, Pacific Institute for Research and Evaluation; Pediatrics 2007;119(1):223-225). Additional papers have been published in the West Virginia Medical Journal 2007; 103:30-31; Injury Prevention 2007; 13(6) 426-428 and the American Journal of Preventive Medicine 2008;34(1):39-45. . A comprehensive report comparing 5-year trends of ATV and bicycle related injuries and deaths and associated costs among adults and children was prepared for the Arabella Legacy Fund and Concerned Families for ATV Safety. Avalable here.
A report summarizing recent WV ATV Fatality and injury surveillance was provided to WV Governor Manchin in February 2008 and is available here.
Assessing the Impact of a Training Video on Reducing Injuries among WV Loggers (Priscah Mujuru, DrPH, RN, Assistant Professor, Department of Community Medicine and Institute of Occupational and Environmental Health, WVU SOM).
This small core project (September 2004 - June 2008) is designed to determine whether a video intervention provided to WV loggers during required training has had any impact on worker’s injuries as measured by workers’ compensation (WC) claims. The project has resulted in posters presented at the Second North American Congress of Epidemiology meeting in 2006 (American Journal of Epidemiology 2006 163(Suppl): S146/581). A paper was published American Journal of Industrial Medicine 2006; 49:1039-1045. Another manuscript has been submitted to the International Journal of Injury Control and Safety Promotion.
Measurement of ATV Safety Behavior in Rural Communities (Mary Aitken, MD, MPH, Associate Professor, Center for Applied Research and Evaluation, University of Arkansas Children’s Hospital).
This seed project is comparing the results of observational data from two different groups: (1) local community liaisons paired with study staff at pre-determined locations and times or (2) experienced volunteer ATV riders documenting behavior as they encounter other ATV riders during the normal course of daily events. Data analysis for this seed project is underway. Preliminary findings were presented at the 2007 Southern Society for Pediatric Research annual meeting and a paper at the 2007 Pediatric Societies annual meeting. A brief article describing preliminary results appeared in the July 2007 Pediatric News. Manuscripts are in preparation.
Rural – Urban Differences in Nonfatal Injuries (Jeffrey Coben, MD, Professor, WVY Departments of Emergency Medicine and Community Medicine, WVU ICRC)
Prior research has demonstrated important differences in injury mortality among rural and urban populations. In general, rural populations have disproportionately high injury mortality rates. However, few studies have examined differences in nonfatal injuries across rural and urban environments and populations. Previously published reports have generally been limited to individual states and/or specific mechanisms of injury. In a series of planned investigations, Dr. Coben and colleagues at the ICRC will conduct rural-urban comparisons for serious, nonfatal (hospitalized) injuries, non-lethal domestic violence, sexual assault, and other injury mechanisms. Preliminary results from this work have been presented at the 2007 Annual Meeting of the Society for Academic Emergency Medicine, the 2007 National Conference on Health and Domestic Violence, and the 2007 Annual meeting of the American Public Health Association.
Social Capital and Risk for Suicide in Rural Areas (Robert Bossarte, PhD, Assistant Professor, WVU Department of Community Medicine and Research Scientist, ICRC)
The objective of this two-year project (2007-2009) funded by the American Foundation of Suicide Prevention is to identify urban and rural differences in the county-level associations between social capital and rates of death from suicide. This objective will be accomplished by identifing urban and rural differences in the associations between markers of social integration and cohesion, collectively known as social capital, and rate of deaths from suicide for residents of West Virginia counties for the years 2000-2004 and by calculating an alternative measure of adolescent social capital for each West Virginia County. A poster summarizing results of preliminary analyses of the associations between social capital and U.S. suicide rates in urban and rural areas was presented at the 2007 meeting of the International Association of Suicide Prevention.
ATV Safety in West Virginia and Across the Country
The WVU ICRC has conducted extensive research detailing the frequency and circumstances of ATV deaths in West Virginia. The ICRC has been at the forefront of the ATV safety debate providing information and statistics to the general public, state lawmakers, the Consumer Federation of America, and the U.S. Consumer Product Safety Commission (CPSC), among others. Research conducted by the ICRC contributed significantly to the passage of West Virginia's first ATV safety law in 2004, after 7 years of unsuccessful attempts.
Not only has the popularity of ATVs increased precipitously across the state but so have the deaths associated with their use. In the 1990s, West Virginia averaged about 13 deaths per year. Since 2000, this figure has risen to 34 per year. Fifteen percent of these deaths are among children under 16, and 12% of all victims are riding as passengers. An overwhelming majority of victims were not wearing a helmet at the time of the fatal incident - not surprising since the helmet requirement (for riders under 18) only became effective on January 1, 2005.
ATV deaths and injuries are also a huge concern at the national level. The estimated number of ATV deaths has risen nearly 180% from 276 deaths in 1995 to 767 in 2004 (the most recent year that fatality data is available from the CPSC). Estimated nonfatal injuries requiring emergency room treatment rose over 150% from 53,600 visits in 1996 to 136,700 in 2005.
A recently released report, commissioned by the Arabella Legacy Fund and Concerned Families for ATV Safety, was conducted by Dr. Helmkamp. The objective of the study was to make a 5-year (2000-2004) comparison of national prevalence of death and injury resulting from ATV and bicycle crashes among children and adults and the costs associated with these events.
The initial release of fatality data brought national attention to the report on the July 31st CBS Early Show:
Links:
A Powerpoint presenteation of National Data is available here. Powerpoint file.
Details of the 218 ATV-related deaths in West Virginia from 2000-2006. Powerpoint file.
The Arabella study in its entirety can be found here.