Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine

Abstract

Injuries are the most common cause of death among young people, a leading cause of disability and years of life lost, and a major contributor to health care costs. The aim of this study is to present a review of effects and effectiveness of accident, violence and injury prevention and safety promotion. The framework for the presentation is a matrix including intervention areas and intervention levels. The NOMESCO classification of external causes of injuries has been used for the areas of intervention including 1. Reasons for contacts 2. Place of occurrence, 3. Age groups, 4. Gender, 5. Social groups, and 6 Ethnicity. In addition a seventh category has been added including areas of interventions like Products, Economics, Models etc The intervention levels include group, organisation, community and national level. Also the interventions can be mono factoral or multifactorial concerning the components of the intervention at each level. The strategy used for collecting the evidences on effect and effectiveness of the reports on interventions have been firstly to identify relevant literature by a search of computerised databases of the period of 1994 to 1997, citation in identified papers and previous reviews. Secondly a number of international research centres on safety promotion were identified and contacted by e-mail with a request for on—going or recently published systematic reviews in the field. Especially we have tried to approach Cochrane groups. The Cochrane Collaboration is an international network of individuals and institutions committed to preparing, maintaining, and disseminating systematic reviews of the effects of health care. Through Internet and requests on it’s discussion lists additional numbers of international groups currently working with systematic reviews were identified and contacted. Discussion and conclusion The critical question is whether the use of randomised controlled trials (RTC) to find best evidence also is appropriate for evaluation of prevention and health promotion interventions. Obviously it is very seldom that preventive actions can be assessed in terms of efficacy, the results produced under ideal conditions, but as effectiveness i.e. interventions deployed under routine practice or everyday situations. This is especially true when discussing community action for health promotion, interventions falling outside the RTC umbrella according to the true Cochrane proponents.

Keywords

Safety promotion, Evidenced based

Institution

Karolinska Institutet, Department of Public Health Sciences, Division of Social Medicine

Postaddress

Norrbacka

Postcode

SE-171 76

City

Stockholm

Country

Sweden

Contact

Haglund Bo J A

E-mail

bo.haglund@phs.ki.se

Phone

+ 46 8 517 779 64

Fax

+ 46 8 33 46 93