A statewide assessment of youth sports- and recreation-related injuries using emergency department administrative records.

PURPOSE: Adequate levels of physical activity are essential for health, but participation in sports and recreational physical activities is associated with an increased risk of injury. The present study quantifies the impact of sports- and recreation-related injuries (SRIs) for middle and high school-aged Kentucky children. METHODS: The study describes unintentional injuries in 2010-2012 Kentucky emergency department (ED) administrative records for patients age 10-18 years. SRIs were identified based on external codes of injuries, according to the International Classification of Diseases, Ninth Revision, Clinical Modification. RESULTS: A total of 163,252 ED visits by 10- to 18-year olds occurred during the study period, of which 31,898 (20%) were related to participation in physical activity. Males accounted for 70% of the SRIs. The primary mechanisms for SRIs were strikings (55%), falls (26%), and overexertion (13%). Superficial contusions (25%), sprains/strains (33%), and fractures (18%) were the primary diagnoses. The total charges billed for SRIs exceeded $40 million, or 19% of the total charges billed for all unintentional injury-related ED visits in this age group. CONCLUSIONS: The present study revealed one fifth of all Kentucky ED visits, and ED charges billed for unintentional injury among youth aged 10-18 years were related to sport and recreation. In the absence of a dedicated SRI surveillance system, ED administrative records provide meaningful utility for conducting statewide assessments of adolescent SRIs.

Methods in public health services and systems research: a systematic review.

CONTEXT: Public Health Services and Systems Research (PHSSR) is concerned with evaluating the organization, financing, and delivery of public health services and their impact on public health. The strength of the current PHSSR evidence is somewhat dependent on the methods used to examine the field. Methods used in PHSSR articles, reports, and other documents were reviewed to assess their methodologic strengths and challenges in light of PHSSR goals. EVIDENCE ACQUISITION: A total of 364 documents from the PHSSR library met the inclusion criteria as empirical and based in the U.S. After additional exclusions, 327 of these were analyzed. EVIDENCE SYNTHESIS: A detailed codebook was used to classify articles in terms of (1) study design; (2) sampling; (3) instrumentation; (4) data collection; (5) data analysis; and (6) study validity. Inter-coder reliability was assessed for the codebook; once it was found reliable, the available empirical documents were coded. CONCLUSIONS: Although there has been a dramatic increase in the amount of published PHSSR recently, methods used remain primarily cross-sectional and descriptive. Moreover, although appropriate for exploratory and foundational work in a new field, these approaches are limiting progress toward some PHSSR goals. Recommendations are given to advance and strengthen the methods used in PHSSR to better meet the goals and challenges facing the field.

Characteristics of Kentucky local health departments that influence public health communication during times of crisis: information dissemination associated with H1N1 novel influenza.

OBJECTIVE: The purpose of this study was to investigate the association of selected characteristics of local health departments (LHDs) in Kentucky with the receipt of information by external stakeholders, specifically physicians and pharmacists, during the initial H1N1 outbreak of 2009. METHODS: This study utilized a cross-sectional survey to gather characteristic information from local health departments. In addition, cross sectional surveys of physicians and pharmacists were used to determine information receipt. All 54 LHDs in Kentucky were surveyed; however, only those physicians belonging to the Kentucky Family Physician Association or the Kentucky Ambulatory Network were surveyed. Also, pharmacists included in this survey were members of the Kentucky Pharmacist Association. Descriptive data analyses, including chi-square test of independence, were conducted, and generalized estimating equations were used to calculate odds ratios to depict associations related to information exchange in this study. RESULTS: Response rates for the study were as follows: LHDs 65% (35/54), physicians 18.5% (96/518), and pharmacists 21.1% (211/1000). Of the 35 participating LHDs the most common characteristic identified was the presence of a public information officer (PIO) and a pandemic influenza plan, 76% and 64%, respectively. Despite these factors, 72% of external stakeholders did not receive any information regarding H1N1 from the LHD. Generalized estimating equations also indicated that stakeholders in jurisdictions lacking a PIO had 6 (95% confidence interval, 1.3-26.95) greater odds of not receiving information from the LHD. External stakeholders in jurisdictions without a pandemic influenza plan had 3.38 (95% confidence interval, 0.80-1.17) increased odds of not receiving information but this association was not statistically significant. CONCLUSION: Observations from this study indicate a need to improve information exchange between LHDs and their external stakeholders, specifically physicians and pharmacists. Present results suggest the designation of a PIO may positively influence communication between LHDs and other health care providers, particularly physicians.