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Cunningham R.M.,University of Michigan | Cunningham R.M.,Hurley Medical Center | Harrison S.R.,University of Michigan | McKay M.P.,George Washington University | And 5 more authors.
Annals of Emergency Medicine | Year: 2010

Study objective: We describe current alcohol screening and brief intervention practices in emergency departments (EDs) at Level I and Level II trauma centers and characterize ED directors' attitudes and perceived barriers associated with these practices among injured patients in the ED. Methods: ED directors at Level I and Level II trauma centers were surveyed about current alcohol screening and intervention practices in the ED, as well as knowledge, attitudes, and perceived barriers to these practices. Results: Nearly half (46.0%) of ED directors surveyed responded. The majority (64.5%) reported using a serum alcohol level to routinely screen for unhealthy alcohol use; only 23.6% routinely use standardized instruments. Sixty-five percent of ED directors support screening and 70% support intervention among injured ED patients. Only 15% reported having formal screening and intervention policies in their ED, and 9% reported offering brief alcohol intervention by trained personnel. The most commonly perceived barriers to implementation are provider time (83%) and financial resources (55%). Of injured patients identified as exhibiting alcohol misuse, few (12%) receive brief intervention conducted by trained personnel. Conclusion: Current alcohol screening and brief intervention practices are lagging behind national guidelines. Although the majority of ED directors support the idea of alcohol screening and intervention, these beliefs have not yet been translated to routine clinical care. © 2009 American College of Emergency Physicians.


Van Wieren A.J.,Brown University | Roberts M.B.,Center for Primary Care and Prevention | Arellano N.,Injury Prevention Center | Feller E.R.,Brown University | And 2 more authors.
Journal of Immigrant and Minority Health | Year: 2011

Despite generally lower socioeconomic status and worse access to healthcare, Latinos have better overall health outcomes and longer life expectancy than non-Latino Whites. This "Latino Health Paradox" has been partially attributed to healthier cardiovascular (CV) behaviors among Latinos. However, as Latinos become more acculturated, differences in some CV behaviors disappear. This study aimed to explore how associations between acculturation and CV behaviors among Latinos vary by country of origin. Combined weighted data from the 2005 and 2007 California Health Interview Survey (CHIS) were used to investigate associations between acculturation level and CV behaviors among Latinos by country of origin. Among all Latinos, increased acculturation was associated with more smoking, increased leisure-time physical activity, and greater consumption of fast foods, but no change in fruit/vegetable and less soda intake. These trends varied, however, by Latino sub-groups from different countries of origin. Country of origin appears to impact associations between acculturation and CV behaviors among Latinos in complex ways. © 2011 Springer Science+Business Media, LLC.


Baker S.P.,Injury Prevention Center
Injury Prevention | Year: 2010

The Frank A Calderone Prize in Public Health, the pre-eminent award in the field, is overseen by Columbia University's Mailman School of Public Health and presented to an individual who has made 'a transformational contribution in the field of public health'. The Prize recognises an individual who has accomplished extraordinary distinction in public health and/or who has made a specific contribution which has had long-term national or global implications. On 6 May 2010, the prize was awarded to Susan Baker. This is the first time the Prize has been bestowed upon an injury control researcher.


Ranney M.L.,Injury Prevention Center | Ranney M.L.,Brown University | Choo E.K.,Injury Prevention Center | Choo E.K.,Brown University | And 6 more authors.
Journal of Adolescent Health | Year: 2014

Purpose To elucidate key elements surrounding acceptability/feasibility, language, and structure of a text message-based preventive intervention for high-risk adolescent females. Methods We recruited high-risk 13- to 17-year-old females screening positive for past-year peer violence and depressive symptoms, during emergency department visits for any chief complaint. Participants completed semistructured interviews exploring preferences around text message preventive interventions. Interviews were conducted by trained interviewers, audio-recorded, and transcribed verbatim. A coding structure was iteratively developed using thematic and content analysis. Each transcript was double coded. NVivo 10 was used to facilitate analysis. Results Saturation was reached after 20 interviews (mean age 15.4; 55% white; 40% Hispanic; 85% with cell phone access). (1) Acceptability/feasibility themes: A text-message intervention was felt to support and enhance existing coping strategies. Participants had a few concerns about privacy and cost. Peer endorsement may increase uptake. (2) Language themes: Messages should be simple and positive. Tone should be conversational but not slang filled. (3) Structural themes: Messages may be automated but must be individually tailored on a daily basis. Both predetermined (automatic) and as-needed messages are requested. Dose and timing of content should be varied according to participants' needs. Multimedia may be helpful but is not necessary. Conclusions High-risk adolescent females seeking emergency department care are enthusiastic about a text message-based preventive intervention. Incorporating thematic results on language and structure can inform development of future text messaging interventions for adolescent girls. Concerns about cost and privacy may be able to be addressed through the process of recruitment and introduction to the intervention. © 2014 Society for Adolescent Health and Medicine. All rights reserved.


Amanullah S.,Brown University | Amanullah S.,Injury Prevention Center | Heneghan J.A.,Injury Prevention Center | Heneghan J.A.,Rainbow Hospitals | And 5 more authors.
Pediatrics | Year: 2014

BACKGROUND AND OBJECTIVE: Previous studies have reported concerning numbers of injuries to children in the school setting. The objective was to understand temporal and demographic trends in intentional injuries in the school setting and to compare these with intentional injuries outside the school setting. METHODS: Data from the National Electronic Injury Surveillance System-All Injury Program from 2001 to 2008 were analyzed to assess emergency department visits (EDVs) after an intentional injury. RESULTS: There were an estimated 7 397 301 total EDVs due to injuries sustained at school from 2001 to 2008. Of these, an estimated 736 014 (10%) were reported as intentional (range: 8.5%-10.7% for the study time period). The overall risk of an EDV after an intentional injury in school was 2.33 (95% confidence interval [CI]: 1.93-2.82) when compared with an EDV after an intentional injury outside the school setting. For intentional injury-related EDVs originating in the school setting, multivariate regression identified several demographic risk factors: 10- to 14-year-old (odds ratio [OR]: 1.58; 95% CI: 1.10-2.27) and 15- to 19-year-old (OR: 1.69; 95% CI: 1.01-2.82) age group, black (OR: 4.14; 95% CI: 2.94-5.83) and American Indian (OR: 2.48; 95% CI: 2.06-2.99) race, and Hispanic ethnicity (OR: 3.67; 95% CI: 2.02-6.69). The odds of hospitalization resulting from intentional injury-related EDV compared with unintentional injury-related EDVs was 2.01 (95% CI: 1.50-2.69) in the school setting. These odds were found to be 5.85 (95% CI: 4.76-7.19) in the outside school setting. CONCLUSIONS: The findings of this study suggest a need for additional prevention strategies addressing school-based intentional injuries. Copyright © 2014 by the American Academy of Pediatrics.

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