Motor vehicle injury prevention in eight American Indian/Alaska Native communities: results from the 2010-2014 Centers for Disease Control and Prevention Tribal Motor Vehicle Injury Prevention Program.

OBJECTIVES: The aim of the study is to increase seat belt (SB) use and reduce motor vehicle (MV) injuries and death; eight tribal communities implemented evidence-based strategies from the Guide to Community Preventive Services during 2010-2014. STUDY DESIGN: SB use was measured through direct observational surveys and traffic safety activity data. Traffic safety activities included enhanced enforcement campaign events, ongoing enforcement of SB laws, and media. The number of MV injuries (including fatal and non-fatal) was measured through MV crash data collected by police. RESULTS: Percentage change increases in SB use were observed in all eight projects; average annual increases of three projects were statistically significant (ranging from 10% to 43%). Four of the eight projects exceeded their goals for percentage change increases in SB use. Approximately 200 media events and 100 enforcement events focused on SB use were conducted across the eight projects. Five projects had an annual average of ≥100 SB use citations during the project period. MV injuries (fatal and non-fatal combined) significantly decreased in three projects (ranging from a 10% to 21% average annual decrease). CONCLUSIONS: Increases in SB use and decreases in the number of MV injuries can be achieved by tailoring evidence-based strategies to tribal communities.

Public officials' perspectives on tracking and investigating symptoms reported near sewage sludge land application sites.

A majority of treated sewage sludge (biosolids) from U.S. wastewater treatment plants is applied to farmland as a soil amendment. Residents living close to treated farmland have reported becoming ill following land application of sludge. No systematic tracking or investigation of these reports or of land application practices that could affect off-site migration of chemical and biological constituents of the sludge has occurred, however. In the study described in this article, the authors conducted a web-based survey and phone interviews with officials at federal, state, and local regulatory and health agencies and municipal wastewater treatment plants for input on how to design and implement an investigation protocol for tracking and responding to reports of human illness near land application sites. Officials expressed a need for and interest in implementing a systematic, standardized investigation protocol and offered insights on aids and barriers to its use and collaboration among diverse agencies. Additional opinions and innovative solutions expressed in this article will assist interested users in the implementation of the investigation protocol.

Ride Safe: a child passenger safety program for American Indian/Alaska Native children.

BACKGROUND: In American Indian/Alaska Native (AI/AN) communities, child safety seat (CSS) use rates are much lower than in non-native communities. To reduce this disparity, Indian Health Service (IHS) staff developed, pilot-tested, and implemented Ride Safe, which provided education, training, and child safety seats for children aged 3-5 participating in Tribal Head Start Centers. METHODS: Focus groups, key informant interviews, and technical review guided program development and implementation. Progress reports and child safety seat use observations, conducted at the beginning and end of three program years (Fall 2003 to Spring 2006), assessed program reach and impact. To examine CSS use, we used three multiple logistic regressions, including a conservative intent to treat analysis. RESULTS: Ride Safe reached approximately 3,500 children and their families at 14 sites in six states, providing over 1,700 parents/family members with educational activities, 2,916 child safety seats, and child passenger safety (CPS) technician certification training for 78 Tribal staff. Children were 2.5 times (OR = 2.55, p < .01) as likely to be observed in child safety seats comparing Rounds 1 and 2 data, with the most conservative model showing that the odds of being observed restrained were 74% higher (OR = 1.74, p = or<.01) after implementation of the program. CONCLUSIONS: The Ride Safe Program effectively increased child safety seat use in AI/AN communities, however, observed use rates ranging from 30% to 71% remain well below the 2006 all US rate of 93%. Results from CSS educational and distribution/installation programs such as Ride Safe should be considered in light of the need to increase distribution programs and enhance enforcement activities in AI/AN communities, thereby reducing the disparity in AI/AN motor vehicle injuries and death.

Formative evaluation of AARP's Active for Life campaign to improve walking and bicycling environments in two cities.

AARP conducted a 2.5-year social-marketing campaign to improve physical activity levels among older adults in Richmond, Virginia and Madison, Wisconsin. This article presents formative evaluation findings from the campaign's policy/environmental change component. Evaluation data were abstracted from technical-assistance documentation and telephone interviews. Results include 11 policy and 14 environmental changes attained or in-process by campaign closure. Differences between the cities' results are explained through differences in program implementation (e.g., types of changes planned, formalization of partnerships). Project teams took less time deciding to pursue policy change than environmental change; however, planning the policy activities took longer than planning environmental-change activities. Recommendations for future policy/environmental change interventions focus on the selection of strategies; planning for administrative resources; formalizing partnerships to ensure sustainability of impact; ensuring training and technical assistance; and documenting progress. Similar intervention results may be attainable with a multi-year timeframe, adequate part-time coordination, and committed volunteers.

Child safety and booster seat use in five tribal communities, 2010-2014.

PROBLEM: Motor-vehicle crashes are a leading cause of death for American Indian/Alaska Natives (AI/AN) including AI/AN children. Child safety seats prevent injury and death among children in a motor-vehicle crash, yet use is low among AI/AN children. METHODS: To increase the use of child safety seats (CSS; car seats and booster seats), five tribal communities implemented evidence-based strategies from the Guide to Community Preventive Services during 2010-2014. Increased CSS use was evaluated through direct observational surveys and CSS event data. CSS events are used to check the installation, use, and safety of CSS and new CSS can be provided. RESULTS: CSS use increased in all five programs (ranging from 6% to 40%). Four out of five programs exceeded their goals for increased use. Among the five communities, a total of 91 CSS events occurred resulting in 1417 CSS checked or provided. CONCLUSIONS AND PRACTICAL APPLICATIONS: Evidence-based child passenger safety interventions are both feasible in and transferable to tribal communities.

Pharmacophore modeling, docking, and principal component analysis based clustering: combined computer-assisted approaches to identify new inhibitors of the human rhinovirus coat protein.

The development and application of a sophisticated virtual screening and selection protocol to identify potential, novel inhibitors of the human rhinovirus coat protein employing various computer-assisted strategies are described. A large commercially available database of compounds was screened using a highly selective, structure-based pharmacophore model generated with the program Catalyst. A docking study and a principal component analysis were carried out within the software package Cerius and served to validate and further refine the obtained results. These combined efforts led to the selection of six candidate structures, for which in vitro anti-rhinoviral activity could be shown in a biological assay.

Planning and the professional preparation of health educators: implications for teaching, research, and practice.

Planning skills are one of the seven essential responsibilities of health educators, according to the National Commission of Health Education Credentialing program; yet little information is available about who provides training in planning, what type of training is offered, and what planning models are taught. A survey of 253 accredited graduate and undergraduate health education programs (response rate = 56%) was undertaken to gather information about planning and the professional preparation of health educators. Results revealed that planning instructors were primarily full-time, experienced, and about one half were CHES certified. Overall, 88% (113/129) of respondents taught the PRECEDE-PROCEED model, and 62% (81/131) taught the planned approach to community health (PATCH) model. Few planning differences were found at the graduate and undergraduate levels. Content analysis of 56 course syllabi revealed that 80% (45/56) required students to complete a program plan proposal or document as the culminating project for the course. Implications for teaching, research, and practice are discussed.

Reliability and validity of two instruments designed to assess the walking and bicycling suitability of sidewalks and roads.

PURPOSE: Public health professionals hypothesize that when community environments provide suitable walking and bicycling conditions, community members will be more active. Measurement indicators and assessment instruments are needed to evaluate suitability. This study determined the reliability and validity of two instruments to assess the suitability of sidewalks for walking and roads for bicycling. METHODS: Two data collectors used walking and bicycling suitability assessment instruments to collect data on 31 road segments. In addition, three transportation experts used a 7-point Likert response system to subjectively evaluate walking and bicycling conditions for the same segments. Intraclass correlations determined the reliability of each assessment instrument and the reliability of the Likert response system. Pearson correlations (research staff assessments with expert assessments) were calculated to determine the criterion-related validity of the suitability measures. RESULTS: Intercoder reliability (intraclass) correlations for the walking and bicycling assessment instruments were r = .79 and .90, respectively. Intercoder reliability of the experts' Likert response system was r = .73 for the walking form and r = .77 for the bicycling form. Criterion-related validity (Pearson) correlations for the walking and bicycling assessment instruments were r = .58 and .62, respectively. CONCLUSION: Although some variables have lower reliability and validity than is ideal, the walking and bicycling suitability assessment instruments appear promising as instruments for community members and professionals to systematically assess key aspects of the physical environment.