Injury Control Research Centers (ICRCs) FY 2014 Background Document Injury Control Research Centers Save Lives The Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control (CDC Injury Center) funds Injury Control Research Centers (ICRCs) at universities and medical centers throughout the United States to study ways to prevent injuries and disabilities. ICRCs are on the front line for conducting cutting-edge injury and violence prevention and control research, and supporting the translation of evidence-based programs and policies into community and state-based prevention efforts. Most events resulting in injury and/or death from injury could be prevented if evidence-based public health strategies, practices, and policies were used in every state in throughout the nation. Public Health Problem Unintentional injuries and violence are the leading cause of death for the first four decades of life, regardless of gender, race, or socioeconomic status. In fact: Every three minutes, a person dies from a preventable injury – this is more than 500 people each day and 180,000 each year in the United States In 2010, over 31 million nonfatal injuries occurred in the United States Injuries and violence cost the United States $406 billion annually; over $80 billion in medical costs, and the remainder in lost productivity. Strategies that Work Since 1987, CDC has funded Injury Control Research Centers (ICRCs) throughout the United States to study ways to prevent injuries and disabilities. An ICRC is not just a collection of research projects; it is a multidisciplinary organization addressing training and research in a crosscutting and integrated manner to impact the field of injury and violence prevention. ICRCs are uniquely positioned to develop, implement, and test programs and interventions designed to modify behavior, disseminate and translate research findings to communities, and inform practice. ICRCs work with state health departments and other partners to support the identification and dissemination of evidence-based strategies to reduce injury-related morbidity and mortality to advance science. Specific research topic areas include CDC Injury Center’s focus areas, which include: the prevention of motor vehicle-related injuries, violence against children and youth, prescription painkiller overdoses and traumatic brain injuries, as well other high burden injury and violence problems. These centers are recognized as national leaders in the field of injury and violence prevention, where the activities also focus on translational research, helping to translate scientific discoveries into practice for the prevention and control of fatal and nonfatal injuries, violence, and related disabilities. Research and Evaluation ICRCs’ research is used in clinical, academic, and community settings to develop tools and resources, training curricula, and public health interventions. 1 Education and Training ICRCs advance the injury and/or violence prevention field through training and education. Training programs include formal lectures and classes for students, research opportunities, stipends and seed grants, and mentoring. This helps ensure there is an adequate supply of qualified professional injury and/or violence prevention practitioners and researchers and helps train the next generation of leaders in the injury and/or violence prevention field. ICRCs train and educate students, university faculty and staff, and injury practitioners (e.g., health department staff, first responders, and other medical professionals). ICRCs develop, implement, and evaluate training and education materials and programs. In addition, ICRC education and training programs are multidisciplinary in nature and integrate professionals from a wide variety of injury and/or violence prevention disciplines. Partnerships ICRCs maximize the CDC’s ability to conduct multidisciplinary research and build the injury field through collaborations with other federal agencies, state and local agencies, universities and medical centers, CDC-funded programs, community-based groups and international partners and organizations. Unique Role of the CDC Injury Center funded ICRCs The overall mission of the ICRC program is to reduce the morbidity and mortality from unintentional and intentional injuries through the creation, dissemination, and translation of scientific discoveries, development of innovative training and education programs, and promotion of best practices and evidence-based interventions. ICRCs are unique in that no other federal entity supports injury and violence focused research centers linked with state health departments and other sectors to advance science and affect policy and programs. ICRCs in Action The research conducted by ICRCs is essential to identify and address critical gaps in the knowledge public health practitioners need to develop and disseminate effective injury and violence prevention programs. ICRCs include holistic approaches linking prevention, intervention, translation, outreach, education, and evaluation. CDC’s Injury Center currently supports 11 ICRCs in universities and medical centers to translate science into action by filling critical gaps in knowledge related to injury and violence risks and how they can be prevented. Columbia University Emory University Johns Hopkins School of Public Health Washington University University of Iowa University of Michigan Mount Sinai School of Medicine The Research Institute at Nationwide Children's Hospital University of North Carolina at Chapel Hill University of Rochester Medical Center West Virginia University Through previous competitive grant announcements, the CDC Injury Center has previously funded ICRCs at the following universities and medical centers: University of Alabama at Birmingham University of California, Los Angeles 2 Colorado State University Harvard University Medical College of Wisconsin San Francisco Injury Center University of Pittsburgh University of Washington, Harborview Medical Center ICRC Successes For more than 20 years, ICRCs have made progress in the prevention of injury and violence at the state and national level, including those related to child safety restraints, smoke alarms, seat belt use, alcohol screening and brief interventions, sports injuries, falls, motorcycle and bicycle helmet use, and violence prevention. Additionally, ICRCs have provided training of injury researchers, bringing new professionals and resources into the field, thus advancing our knowledge and abilities to impact policies and practice. ICRCs’ ability to develop strong partnerships is a key component in being effective change-makers at the private, local, state, tribal, and national levels. The translational research all CDC-funded ICRCs conduct illustrates performing high quality research and translating it into meaningful prevention strategies will reduce injuries and improve the lives of Americans. The following examples highlight the effectiveness and variety of currently and previously funded ICRC’s injury prevention and control interventions: JOHNS HOPKINS CENTER FOR INJURY RESEARCH AND POLICY Researchers at the Johns Hopkins Center for Injury Research and Policy found fire and life safety programs in Delaware offered a strategic, comprehensive and coordinated approach to fire prevention. The study, published in the November 2011 issue of the Journal of Public Health Management and Practice, offers recommendations to states and localities across the country looking to improve their fire and life safety activities. Using a case study method, the researchers collected data from in-person key informant interviews, direct observation of fire prevention events, and relevant documents such as programmatic materials. It was found partnerships with schools, the media and local businesses were integral to expanding the reach of fire safety and prevention programs throughout the state. Examples of fire prevention efforts include smoke alarm distribution initiatives and programs aiming to address recidivism among fire-setting youth. In 2006, Johns Hopkins Center for Injury Research and Policy conducted a nationwide review of Graduated Driver Licensing (GDL). The results of this study demonstrated the most restrictive GDL programs were associated with a 38 percent reduction of fatal crashes and a 40 percent reduction of injury crashes among 16 year olds. These results have been successfully used by scientists and advocates in several states to educate lawmakers about the importance of strengthening state GDL systems. UNIVERISTY OF IOWA INJURY PREVENTION RESEARCH CENTER The University of Iowa Injury Prevention Research Center (UI IPRC) is currently developing a smart phone application to help law enforcement and first responders to collect photos of the crashed vehicle, and then automatically send the photos to hospital emergency personnel. Alerting hospital staff early about a crash has several advantages: it can improve triage and transportation of the victims, assist the trauma center staff in better predicting injuries and treatment options, and even coordinate giving aid remotely. Additionally, the UI IPRC has over a decade of experience working with the Iowa Department of Health (IDPH) to develop and implement the statewide trauma system. Current collaborations include support to the IDPH Bureau of Emergency Medical Services in the evaluation of the Iowa Trauma 3 System. Using Trauma Registry data, the UI IPRC and IDPH recently published a report highlighting the huge public health burden caused by falls among Iowans. HARBORVIEW INJURY PREVENTION RESEARCH CENTER The Harborview Injury Prevention Research Center in Seattle, Washington, developed a database more than 20 years ago to track students by position, interest, grant funding and location, both nationally and internationally. It was found this ICRC had trained over 300 researchers who, after graduating, had generated over $114 million in funding between 1995 and 2008. UNIVERSITY OF NORTH CAROLINA INJURY PREVENTION RESEARCH CENTER In June 2011, the North Carolina governor signed into law the Geller-Waller Concussion Act, a bill designed to prevent head injuries in high school athletes. Research conducted at the University of North Carolina Injury Prevention Research Center on concussions and head injuries was presented to the North Carolina legislature and was a factor in the passage of this bill. NATIONWIDE CHILDREN’s HOPSITAL INJURY CONTROL RESEARCH CENTER In 2007, the ICRC at Nationwide Children’s Hospital in Columbus, Ohio, used an internet-based high school sports-related injury surveillance system, High School RIO™ (Reporting Injuries Online), to track injuries in nine high school sports in 100 United States high schools. As the only source of national data on high school sports-related concussion, concussion symptomology, and return to play decisions, the High School RIO™ data was utilized in discussions across the country related to state return to play laws for high school athletes following concussions. Another example of how these data have been used: the National Federation of State High School Associations (NFHS) football rules committee was considering moving the high school football kickoff point (40 yard line) to more closely align with the NCAA (35 yard line) and NFL (30 year line) kickoff points. The committee voted down the idea citing what they considered to be the likelihood of an unacceptable increase in injury risk to the players, a decision, which was in part driven by the High School RIO data. Future Goals The CDC Injury Center’s current and proposed research projects address the following injury topic areas: bullying, child maltreatment, traumatic brain injury, intimate partner violence, falls prevention, prescription drug overdose, youth violence, childhood Injuries, and effective smoke alarms for children and older adults, sports and recreational injuries, suicide prevention, sexual violence, and motor vehicle injuries (pedestrian injuries, teen drivers, and older adult drivers). Future goals for the ICRC program include: Research and Evaluation Increase the focus on translational research, policy research and evaluation while identifying and filling gaps in foundational knowledge needed to move science to practice. Further establish and expand the network of ICRCs to create synergies among CDC funded ICRCs, as well as other funded violence and injury research centers. Support each existing ICRC to carry out research necessary to effectively reduce the burden of injury, continue training activities, and build national infrastructure in injury prevention and control. Expand translational research capacity at existing ICRC’s and support workforce training to inform the implementation and evaluation of programs and policies designed to reduce injuries and violence and their associated costs. 4 Education and Training Enhance collaboration with state and local health departments, practitioners, community organizations, and other CDC-funded centers. Create a multidisciplinary focus on injury and violence prevention education bringing students and professionals from multiple disciplines both within and external to public to be educated and trained in the injury and violence prevention field. Improve access to high quality injury and violence prevention education and training opportunities across the nation. Partnerships Provide funding and dissertation research grants for graduate students in ICRCs. Enhance collaboration with state and local health departments, practitioners, community organizations, other CDC-funded centers, other violence and injury prevention research centers not funded by CDC. Strengthen existing partnerships and programs in the community to help move policy initiatives forward at local, state and national levels. 5