Injury is a leading cause of death and disability in Australia, yet most injuries can be prevented.1
Saving lives through helping people prevent injuries is what we do.
Preventing injuries can be achieved in many ways:
- Preventing injuries from occurring in the first place by removing a risk altogether
- Detecting early whether a risk is present and putting in place ways to mitigate or alter exposure to a risk
- Lessening the impact of an injury by responding as soon as an injury occurs by providing treatment, rehabilitation or support to prevent further injuries.
Public Health Approach to Injury Prevention
A common method to preventing injuries is the Public Health Approach to Injury Prevention, which consists of five stages.
- Surveillance – to work out what the issue is
- Determinants – to work out what might be causing or influencing the issue
- Interventions – to develop interventions to address the issue
- Implementation – to implement the intervention
- Evaluation – to evaluate the intervention to work out how addressed or influenced.
The first stage is surveillance and is a key step in any injury prevention planning process. This stage involves the collection, analysis and interpretation of information in order to: understand the context, define the priority injury issue(s) and describe the extent to which the selected injury is a problem.
The second stage is determinants and involves assessing the determinants of injury. Determinants are factors that both raise and lower the risk of that injury occurring. Those factors that have a positive influence are known as “protective factors” and those that have a negative influence are known as “risk factors”. The determinants might be factors that occur at the individual level, community level or the broader environment; and in many instances are a combination of factors at all three levels.
The third stage is interventions and involves assessing what can be done about the issue. An intervention is a combination of activities designed to change behavioural, environmental and/or social determinants to improve the health status of individuals or populations.
The fourth stage is implementation. Information collected in the planning stages (surveillance, determinants and interventions) are now brought together to implement an evidence-informed intervention. There may be many individuals and organisations involved in implementing an intervention, as an injury risk often needs to be addressed by multi-component interventions.
The fifth stage is evaluation and involves assessing and making judgements about whether the intervention implemented in stage four made an impact on preventing injuries in the community.
To supplement these stages you also need to think about sustainability early in the planning and implementation process. Sustainability refers to the “existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based policies and activities.”2 Sustainability is important when it comes to public health intervention given the ever-increasing demands for resources, services need to ensure that they maintain the capacity and resources to deliver public health interventions and that the interventions have a long lasting impact.2 More information about sustainability is contained in the implementation section.
This is not necessarily a linear process and many of the skills used in one stage are valuable in others. This is particularly true of the evaluation stage; as it can be good to think about how you are going to evaluate an intervention whilst still in the planning stages.
1Injury prevention in Australia. (2015). Department of Health, Australia. Retrieved from http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-injury-index.htm
2 Schell et al. Public health program capacity for sustainability: a new framework. Implementation Science, 2013, 8:15