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Pedestrian injuries were also a big problem in Philadelphia, where Marla Vanore, RN, MHA, is codirector of the Coalition site at The Children’s Hospital of Philadelphia.

The hospital has worked with the Injury Free Coalition for Kids since 1999, and it mentors two other Philadelphia hospitals.

Although she has been involved in various injury prevention endeavors, Vanore likes the Injury Free Coalition for Kids because “it’s a marriage between prevention and research. We need research on prevention to show it actually does something.”

Every site is encouraged to do research to find an area of need and to try to track how numbers of injuries change after a project is implemented, although that’s no small task, she notes. While the group has been fitting and distributing bicycle helmets, for example, and teaching children the rules of the road, it’s hard to measure compliance after children go home, or count accidents that could have — but don’t — happen. “All of these things are a real challenge to measure,” Vanore says.

While some children come in with bicycle-related injuries, pedestrian accidents in western Philadelphia are more pressing. “We see too many, and the injuries are severe,” Vanore says.

Safety messengers

It took a while to assess the needs of the community, Vanore says, and the group is just getting off the ground, but it has already developed a video aimed at educating children and their parents. While many other such videos have been made, most are aimed at children in suburban areas. The west Philadelphia area is urban and largely populated by African Americans, so local schoolchildren were solicited to develop and play in the video, called The Adventures of Hattie Mae and Thelma. It uses language that these particular families understand, Vanore says. They are now working on lesson plans to accompany the video and are creating a video for older children.

Their first assessment of the project will be to survey those who watch the video, to see if the messages are well-received.

It takes a long time to get the message out, and researching whether the injury rate is reduced will likely take time, Vanore adds. Furthermore, the video
“is not a Band-Aid. We are trying to be involved in the community and almost change the culture.”

Like the coalition site in San Diego, the Philadelphia group worked on putting in a playground — one of the first on a school lot, Vanore says. That was a job she particularly enjoyed, although her work is administrative. “I was building the playground,”Vanore says. The benefits were immediate: Within hours of its being built, the playground was filled with children.

In Denver, Theresa Rapstine, RN, BSN, administrative director of injury prevention at the Kiwanis Pediatric Trauma Institute, says it received its first grant from the coalition last November. “We’re one of the first to work specifically with rural communities,” she says.

Her group targeted a county that has the highest injury and death rate of children who are unrestrained in car seats.

They collected data on the community, which is made up mainly of migrant seasonal farm workers. The majority of people living there are Hispanic, Rapstine says.

The group is hiring a bilingual community liaison to run educational meetings in the community. Jacko says many of the nurses involved see tragedy on a day-to-day basis, as she does, and “often they feel they need to do something about it.”

The rewards are self-evident. “I see it makes a difference in the lives of the kids,” says Cox, who has been working in pediatric trauma for 25 years. While it’s hard to get exact numbers on accidents that could have happened but don’t, “I’ve seen a dramatic difference in the number of head injuries.”

Vanore’s bottom line: “We feel like we’re making a difference.”

Nancy Deutsch, RN, is a freelance writer.