Transcript Public Health and Department of Transportation Partnerships Nicole Richmond, MPH Motor Vehicle Epidemiologist AASHTO Standing Committee on Highway Traffic Safety April 14, 2015

Public Health and Department of
Transportation Partnerships
Nicole Richmond, MPH
Motor Vehicle Epidemiologist
AASHTO Standing Committee on Highway Traffic Safety
April 14, 2015
Public Health Role
What does Public Health have to Offer?
• Data
• Epidemiology/Statistics
• Relationships with Injury Prevention Stakeholders
• Coalition Building Expertise
• Program Planning, Design, and Implementation Experience
• Knowledge of Evidence-Based Practices
• Strategic Planning Skills
• Policy Partnerships
• Evaluation Expertise
10 Essential Services
The Public Health Approach
Socio-Ecological Model
(Core Competency #3g)
State Public Health Injury
Prevention Programs
• Develop and oversee the state injury prevention strategic
plan
• Conduct surveillance of injury data, including motor
vehicle
• Convene injury prevention stakeholders and collaborate
to improve injury outcomes
• Educate partners regarding evidence-based practices,
using data, and program evaluation, action plans, logic
models, intervention program quality improvement
• Promote injury prevention policies
The E’s of Injury Prevention
Enforcement
Education
Environment
Economics
Motor Vehicle Best Practices
Source: CDC Public Health Grant Rounds Presentation: “Getting to Zero Traffic-related Deaths 9/17/2009.
http://www.cdc.gov/about/grand-rounds/archives/2009/download/GR-091709.pdf
Motor Vehicle Safety Strategies
Source: CDC Public Health Grant Rounds Presentation: “Getting to Zero Traffic-related Deaths 9/17/09.
http://www.cdc.gov/about/grand-rounds/archives/2009/download/GR-091709.pdf
Colorado Department of Public
Health Motor Vehicle Efforts
• Funding sources:
• Centers for Disease Control and Prevention: Core Violence and
Injury Prevention Grant
• Health and Human Services Administration: Maternal and Child
Health Block Grant
• Main goals - Educate decision-makers about evidence-based motor
vehicle policies:
1) Child passenger safety
2) Graduated driver licensing laws
3) Seat belt policies
• Motor Vehicle Safety is one of Colorado’s 10 Winnable Battles
Public Health Data Related
to Motor Vehicle Crashes
• Death Certificates
• Hospital Discharge
• Colorado Trauma Registry
• Behavioral Risk Factor Surveillance System
• Youth Risk Behavior Survey
• Child Health Survey
• Child Fatality Prevention System
• Compiled from Information reported on the Certificate of
Death
• Colorado Resident - even if the death occurred outside of
Colorado
• Cause of Death
• Injury-Unintentional
• Transport injuries – all
• Motor Vehicle Injuries – does not specify the type of
motor vehicle
Motor vehicle deaths of
Colorado teens aged 15-19
Source: Vital Statistics, Colorado Department of Public Health and Environment
Hospital Discharge
• Includes data from all non-federal acute care hospitals
in Colorado
• Information available on patient demographics,
mechanism of injury, and injury diagnosis
• Mechanism and diagnosis information coded following
ICD-9-CM
• Delineates occupant versus motorcycle motor vehicle
• Delineates driver and passenger
• Limitation: no data on restraint use
Colorado Trauma Program
• Charged with improving the state’s trauma system
• Assure people who are seriously injured in Colorado receive rapid
and appropriate care
• Emergency Medical and Trauma Services data program uses data
to assess the Emergency Medical Services (EMS) and Trauma
system in Colorado
• Data from 30 Level I-III trauma centers in Colorado
• Dataset is based on the National Trauma Data Standard
• Information on seatbelt, car seat, and booster seat use
• Information on injury severity
Colorado Behavioral Risk Factor Surveillance
System (BRFSS)
• Ongoing statewide telephone survey - monitors
prevalence of health behaviors and preventive health
practices associated with leading causes of disease,
disability, and premature death.
• Two years of data are combined to produce more stable
estimates.
• Complex survey design provides population-based
estimates using multi-stage probability weights with
post-stratification to reflect age and sex distribution of
selected area.
Colorado BRFSS –
Motor Vehicle Question
• Asked to individuals aged 18 and older
“How often do you use seat belts when you drive or
ride in a car?”
• Skip pattern ensures exclusion of those who never drive
or ride in a car
• Limitation: Young Teen drivers not evaluated for
frequency of seat belt use
Child Health Survey
Extension of BRFSS - Parents asked about randomly
selected child (ages 1 - 14 years)
Two questions on occupant safety:
1) “During the past 30 days, how often did the (focus
child) use a child safety seat, booster seat, or seat
belt when riding in a car, van, sports utility vehicle,
or truck?”
2) “What is the primary mode of restraint used by the
(focus child) when riding in a car, van, sports utility
vehicle?”, or truck?
http://www.chd.dphe.state.co.us/cohid/Default.aspx
Child Fatality Prevention System
• Colorado Child Death Occurrences
(Ages 0-17)
• Data Sources:
• Traffic Accident Reports
• Law enforcement Reports
• Death Certificates
• Hospital Records
• Child Protective Services
• EMS Trip Reports
• Uses national standardized reporting
tool
• Currently has data from 2004-2013
CDPHE & CDOT - Data Collaboration
• Since 2011, CDOT funds 1.0 FTE at the Colorado
Department of Public Health (CDPHE) to serve as the
state’s motor vehicle epidemiologist
• CDPHE produces the annual Colorado Department of
Transportation Problem Identification Report
• CDPHE provides technical assistance to state agencies
and CDOT grantees about motor vehicle data
• Participate on state-level motor vehicle coalitions to
improve data systems and data partnerships
Coalition Building
CDOT/CDPHE Mission Alignment
• Increase coordination, collaboration, and
mission alignment among state-level
motor vehicle partners in Colorado
related to evidence-based practices that
reduce motor vehicle occupant injuries
Injury Community Planning Group (ICPG)
Mission: to promote healthy and safe behaviors to reduce injury in
Colorado through collaboration with community partners.
• Partners: CDPHE, CDOT, State Emergency Medical and Trauma
Advisory Council (SEMTAC), Regional Emergency and Trauma
Advisory Councils (RETACs), Hospitals, EMS Providers, Local
Health Departments, Safe Kids.
• The Colorado Highway Safety Manager is currently the committee
chair.
• Motor vehicle safety is a standing agenda item.
• Project example: In order to increase rural seat belt use, CDOT
funded the 11 RETACS to start seat belt projects.
Colorado Teen Driving Alliance Goals
• Maintain an interagency statewide alliance to improve motor
vehicle safety
• Increase enforcement/compliance of current Graduated Driver
Licensing (GDL) law
• Strengthen Colorado’s GDL law by increasing the minimum driving
age and expanding the restricted driving hours for teens
• Increase seatbelt use across Colorado by advocating for a primary
seatbelt law for all ages
• Provide technical assistance and consultation to Statewide and
Local community organizations either interested in or currently
addressing teen motor vehicle safety
Law and Enforcement Efforts
Roll call video
GDL pocket card
Evaluation survey
GDL Pocket Card
Promote Evidence-Based
Practices
Colorado Strategic Highway Safety Plan
Collaboration
• CDPHE Collaboration:
• Member of Strategic Highway Safety
Plan (SHSP) Executive Committee
• SHSP Steering Committee
• Chaired the Young Driver Priority area
• CDPHE motor vehicle epidemiologist
consulted with CDOT to recommend target
goals
• Aligned several priority area strategies with
the Colorado Violence and Injury Prevention
Strategic Plan
Supporting Motor Vehicle Best
Practices — Health Department
• Motor vehicle safety is one of the 10 Winnable Battles
of the CDC and CDPHE
• The Child Fatality Review Legislative Report
recommends strengthening GDL and passing primary
seat belt
• Colorado Injury Prevention Strategic Plan 2011-2015
recommends strengthening GDL and passing Primary
Seat Belt Laws
• Teen motor vehicle safety is a 2011-2015 Colorado
Maternal and Child Health priority
Sample Action Plan for Local Grantees
Resources for Local Partners
Enhancing CDOT Grant-making Efforts
• CDPHE Grant Objective (CDC Funding): Increase the
number of teen motor vehicle safety programs funded
by state agencies that are aligned with the state Motor
Vehicle Action Plan from 55.3 percent alignment with
the plan in 2012 to 90 percent alignment by July, 31
2016.
• Assisted CDOT to revise their local request for
application to better support applications related to
evidence-based practices
• Annually provide technical review of grant applications
• Annually provide technical assistance to CDOT’s local
community grantees.
Grant Writing Tips
Evaluation
Evaluation Efforts
• Data reports to measure long-term outcomes
• Evaluation of education efforts:
•
Random digit dial survey to assess parental knowledge
of the GDL law
•
Law enforcement survey to assess enforcement of the
GDL law
•
Evaluation of GDL online parent course
• Technical assistance to local programs
•
Evaluation Trainings
Writing Objectives - MadLibs
• Formula to follow:
“(Increase/Decrease/Maintain) the (count/rate/percent) of
(subpopulation) (measure) in (geographical region) from (baseline
count/rate/percent) to (goal count/rate/percent) by (date
objective is to be achieved).”
Example:
Increase the percent of teen drivers wearing seat belts in Grand
Junction from 79% to 83% by June 1, 2016.
(SMART Objective TA Summary from Core Violence and Injury Prevention Program)
Process Evaluation Matrix
Element
Original Grant
Evaluation Measure
ACTIVITY
Implement the 6week DRIVE SMART
High School
Challenge
-# of schools recruited
-# of schools
successfully completed
-# and type of peer-led
activities
-# of students that
participated in creating
the campaign
-# of observational
surveys
Evaluation
Implementation
-Log # of schools
recruited
-Log # of successful
schools
-Log the type of
activities each school
implemented
Outcome Evaluation Matrix
Element
Original Grant
Evaluation
Measure
Evaluation
Implementation
GOAL
Reduce the # of
drivers age 20 or
younger involved in
fatal crashes
# of drivers age
20 or younger
involved in fatal
crashes
Annually, use the CDOT
problem identification
report to determine # of
Motor Vehicle fatalities
among drivers age 20 or
younger
OBJECTIVE
Decrease % drivers
age 20 or younger
that text and drive
% of drivers age
20 and younger
observed texting
and driving on
school grounds
Conduct observational
distracted driving
surveys before, during,
and after the 6-week
campaign
Policy
Policy Role of State Health
Departments
• Assess/analyze policies
• Convene interested groups to develop a plan for
establishing policy strategies
• Using data and science to educate decision-makers about
the components and potential effects of policies
• Increasing public awareness of existing policies or laws
• Evaluating the impact of policies
Example: 2010 Booster Seat Bill
• Injury Prevention Policy Subgroup helped get agreement
among stakeholder practices versus simplicity
• Injury Prevention Policy Subgroup meetings
• Reviewed versions of the bill
• Analyzed language
• Thought about consequences
• Developed Fact sheets — all stakeholders using same
information
Motor Vehicle Policy Legislative Tracker
Message Framing
• In August 2013, CDPHE hosted a Message Framing
Workshop for motor vehicle partners, including
CDOT, to strengthen how we communicate about
best practice policies
• Created seat belt talking points that are used by all
motor vehicle partners
• Created GDL talking points that are used by all
motor vehicle partners
New Messaging:
Colorado is falling behind
Colorado has a great quality of life. Safe roads are important to everyone so that we can all
enjoy the great things Colorado has to offer. Colorado has fallen behind other states'
innovations in keeping roads safe becoming one of only 17 states that have not passed a
primary seat belt law. In a CDC analysis of state motor vehicle laws, Colorado scored in the
lowest tier possible for GDL and seat belt laws. Simplified seat belt laws, like primary seat
belt legislation, encourage more people to buckle up, keeping our communities safe, healthy,
and free to enjoy all that Colorado has to offer.
Winning this Battle to Save Lives on Colorado Roads
Motor vehicle safety was selected as a priority for the Injury Prevention Winnable Battle in
Colorado because hundreds of Coloradans are killed each year in preventable motor vehicle
crashes.
Healthiest State in the Nation?
Many agencies have prioritized policies and programs that will make Colorado the healthiest
state in the nation, yet Colorado has fallen behind other states in implementing the single
most effective way to save lives and reduce injuries in crashes on Colorado roadways:
increased seat belt use.
Trainings and Conferences
Co-hosting Motor Vehicle Conferences
• 2009 Motor Vehicle Conference
• 2010 and 2011 Rural Motor Vehicle Safety Conference
• 2012 Motor Vehicle Winnable Battle Academy
• 2015 Improving Colorado’s Road Health Summit (July)
Conclusion
Opportunities for Collaboration
• Coalitions/Committees
• Joint data reports
• Pooled funding for media or other activities
• Combined trainings and conferences
• Common messages
• Grant review teams
• Joint policy efforts
Benefits of Collaboration
• Lasting partnerships
• Mobilization around legislative issues
• Useful materials
• Maximize funding and resources
• Statewide coordination
• Maintained energy
Nicole Richmond
Motor Vehicle Epidemiologist
[email protected]
303-692-2045