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Evaluation of an Adolescent Hospital-Based Injury Prevention Program

Stewart, Tanya Charyk MSc; Polgar, Denise EMCA; Girotti, Murray J. MD, FRCSC, FACS; Vingilis, Evelyn PhD; Caro, Daniel MSc; Corbett, Bradley A. PhD; Parry, Neil MD, FRCSC, FACS

Journal of Trauma-Injury Infection & Critical Care: May 2009 - Volume 66 - Issue 5 - pp 1451-1460
doi: 10.1097/TA.0b013e31819dc467
Original Articles

Background: IMPACT (Impaired Minds Produce Actions Causing Trauma) is an adolescent, hospital-based program aimed to prevent injuries and their consequences caused by alcohol or drug impairment and other high-risk behaviors. The overall objective of this evaluation was to determine the effect of the program on students’ knowledge and behavior regarding drinking and driving, over time.

Methods: A randomized control trial between students randomly selected to attend IMPACT and those not selected served as a control group. Students completed a questionnaire before the program and at three posttime periods (1 week, 1 month, and 6 months). Panel data models were used to analyze the effects of the experiment on students’ knowledge of alcohol and crash issues and negative driving behaviors (no seat belt, driving while using a cell phone, involved in conversation, eating, annoyed with other drivers, and drowsy). Descriptive statistics and logistic regression models were used to analyze the effect of IMPACT on students’ influence on friends and family about road safety.

Results: This study consisted of 269 students (129 IMPACT; 140 control) with an overall response rate of 84% (range, 99% presurvey to 71% at 6 months). The IMPACT group had a 57%, 38%, and 43% increase in the number of correct answers on alcohol and crash issues during the three time periods, respectively (p < 0.05). Students in the IMPACT group would try to influence friends and family to improve their road safety twice as often as 1-week postprogram (odds ratio 1.94, confidence interval 1.07, 3.53). The models did not suggest that the program had an effect on negative driving behaviors. Men and students who drove more frequently had worse driving behavior.

Conclusions: Our evaluation demonstrates that the IMPACT program had a statistically significant, positive effect on students’ knowledge of alcohol and crash issues that was sustained over time. IMPACT had an initial effect on students’ behaviors in terms of peer influence toward improving road safety (i.e., buckling up, not drinking, and driving) 1 week after the program, but this effect diminished after 1 month. Other negative driving behaviors had low prevalence at baseline and were not further influenced by the program.

From the Trauma Program (T.C.S., D.P., M.J.G., N.P.), London Health Sciences Centre, London, Canada; Department of Surgery (T.C.S., M.J.G., N.P.), Schulich School of Medicine, University of Western Ontario, London, Ontario; Population & Community Health Unit (E.V.), University of Western Ontario, London, Ontario; Department of Epidemiology & Biostatistics (E.V.), University of Western Ontario, London, Ontario; Humboldt University (D.C.), Berlin, Germany; Department of Sociology (B.A.C.), University of Western Ontario, London, Ontario; Division of Critical Care (N.P.), Schulich School of Medicine, University of London, Ontario.

Submitted for publication December 9, 2006.

Accepted for publication January 23, 2009.

Supported by the Internal Research Fund at the London Health Sciences Centre (Grant # IRF-026-99).

Presented at the 20th Annual Meeting of the Eastern Association for the Surgery of Trauma, January 16–20, 2007, Fort Meyers, Florida.

Address for reprints: T. Charyk Stewart, MSc, London Health Sciences Centre, Room E1-129, 800 Commissionners Road East, P.O. Box 5010, London, Ontario, N6A 5W9; email:

© 2009 Lippincott Williams & Wilkins, Inc.