The advocacy in action study a cluster randomized controlled trial to reduce pedestrian injuries in deprived communities.

BACKGROUND: Road traffic-related injury is a major global public health problem. In most countries, pedestrian injuries occur predominantly to the poorest in society. A number of evaluated interventions are effective in reducing these injuries. Very little research has been carried out into the distribution and determinants of the uptake of these interventions. Previous research has shown an association between local political influence and the distribution of traffic calming after adjustment for historical crash patterns. This led to the hypothesis that advocacy could be used to increase local politicians knowledge of pedestrian injury risk and effective interventions, ultimately resulting in improved pedestrian safety. OBJECTIVE: To design an intervention to improve the uptake of pedestrian safety measures in deprived communities. SETTING: Electoral wards in deprived areas of England and Wales with a poor record of pedestrian safety for children and older adults. METHODS: Design mixedmethods study, incorporating a cluster randomized controlled trial. Data mixture of Geographical Information Systems data collision locations, road safety interventions, telephone interviews, and questionnaires. Randomization 239 electoral wards clustered within 57 local authorities. Participants 615 politicians representing intervention and control wards. Intervention a package of tailored information including maps of pedestrian injuries was designed for intervention politicians, and a general information pack for controls. OUTCOME MEASURES: Primary outcome number of road safety interventions 25 months after randomization. Secondary outcomes politicians interest and involvement in injury prevention cost of interventions. Process evaluation use of advocacy pack, facilitators and barriers to involvement, and success.

Domestic and travel-related foodborne gastrointestinal illness in a population health survey.

Routine surveillance data underestimate incidence of foodborne gastrointestinal (FGI) illness and provide little information on illness related to travel. We analysed data from the Welsh Health Survey to estimate population incidence, and to examine risk factors for FGI and factors associated with consulting a doctor. Reported frequency of any FGI in the 3 months before interview was 20.0% [95% confidence interval (CI) 19.5-20.4; equivalent to 0.8 episodes per person-year], and for travel-related FGI was 1.6% (95% CI 1.5-1.8). In the final model, sex, age group, marital status, self-reported health, long-term illness, smoking and alcohol consumption were all independent predictors of FGI. People who consulted a doctor were likely to be older, in poorer health, taking regular medication, or to report mental illness. FGI is common but risk factors for illness and consultation differ and impressions of the epidemiology of the disease based on surveillance data are therefore distorted.