Search

Background One of the most fundamental and formative aspects of childhood is play- which in Canada, frequently takes place on playgrounds. Previous research has shown that upgrading playground structures to comply with the Canadian Standards Association (CSA) standards, mitigates the effect of socioeconomic-status (SES) on playground injuries. Ontario government regulations require playgrounds to meet CSA standards if children in daycare use them. Objective The objective of this study was to examine the relationship between children’s falls from playground equipment and SES following compliance with CSA standards, and to examine injury trends from 2008–2015 in Ontario. Methods Population-based data from the Institute for Clinical Evaluative Sciences was used, and includes all Emergency-Department (ED) visits and hospitalizations with the ICD-10 code W09 representing falls from playground equipment. The denominator for this study was the number of children in Ontario (1–19 years) and rate per 1 00 000 was calculated from 2008–2015. SES was based on income-quintile of the child’s neighbourhood. Results There were 7,505 ED visits in 2008 vs 10 426 in 2015 (39% increase) and injury-rates demonstrated that children that live in the poorest (Quintile-1) neighbourhoods had lower playground injury rates than those in Quintile-5 (rates of 256.26, 334.3 respectively). Both income-quintiles (1 and 5) had a 45% increase over the study period and the five-to-nine age group was seen to be at highest risk of injury (average rate 551.6). Conclusion The results suggest that playground injury rates in Ontario, where most playgrounds meet the CSA standards, increase by SES status, with the wealthiest children at highest risk of injury. Differences recorded in this study may reflect differences in exposure to playgrounds (i.e., wealthier children may have more exposure to playgrounds). However, the changes to the SES/playground injury association suggests that policy changes to the built environment can modify vulnerable children’s incidence of injury.

Background Sport-specific neuromuscular training (NMT) warm-up programs have been shown to be effective in reducing injuries in youth sport but the effectiveness in school physical education (PE) is unknown. Objective To evaluate the effectiveness of iSPRINT, a NMT warm-up program implemented in junior high school (ages 11–15) PE classes in reducing sport and recreational (S and R) injury risk. Methods This is a cluster-randomized controlled trial. Participants were 1067 grade 7–9 students (53.7% female, 46.3% male) from 12 Calgary, Canada schools. iSPRINT is a 15 min NMT warm-up including aerobic, agility, strength, and balance exercises. Teachers in intervention schools (n=6) implemented the iSPRINT 12 week warm-up program in PE classes, while control schools (n=6) implemented a standard-of-practice warm-up. All teachers participated in a training workshop; only intervention school teachers participated in practical NMT components, receiving NMT video. An athletic therapist blinded to study group allocation, visited schools on a weekly basis to assess S and R injuries over 12 weeks. Injuries were those that resulted in the inability to complete a session, time loss and/or medical attention. Incidence rate ratios (IRR) were estimated based on multivariable Poisson regression analyses (adjusting for sex, clustering by class, offset by S and R participation hours). Findings The S and R injury incidence rates (IR) for all injury for the intervention and control groups respectively were1.5 and 1.8 injuries/1000 participation hours (IRR=0.73, 95% CI 0.46 to 1.16), for medical attention injuries were 0.7 and 1.3 (IRR=0.59, 95% CI 0.42 to 0.82), and 0.9 and 1.3 for lower extremity injuries (IRR=0.81, 95% CI 0.56 to 1.19). The injury incidence rate was significantly higher in females compared to males (IRR=1.59, 95% CI 1.12 to 2.22). Conclusion The iSPRINT NMT warm-up was effective in preventing medically treated S and R injuries in junior high school students. Further analysis will consider program adherence. Policy implications This research will inform safety policy considerations in junior high school PE programs.

Background Sport and recreation-related injuries have a significant cost in terms of the impact on the health care system. As prevention researchers and practitioners, we have a responsibility to provide guidance toward prevention to those who participate in sport, and those that coach, treat, and parent children that participate in sport. There are effective interventions to reduce injury in many sport and recreational activities; however, the accessibility of this information, as well as the guidance required to implement it, is often not available and accessible to the public. Objective The objective of this project was to complete a large-scale systematic review and synthesis of the literature across 51 sport and recreational activities. The evidence was used to inform the development of an end-user driven, digital platform that provides injury prevention information and resources. Methods An evidence synthesis framework was used to guide a review of reviews of 51 sport and recreational activities by 18 injury prevention trainees from across Canada. Data collection included evidence on the incidence, risk factors, interventions and implementation and evaluation of interventions to reduce the risk of injury in sport. Evidence was critically appraised, extracted, synthesized and translated into clear messaging for use in an online tool. Findings The ‘Active and Safe’ platform provides web-based sport injury and prevention information. Navigation through the tool brings the user to a sport specific content page subdivided into 4 sections: 1) sport injury overview, 2) incidence, 3) risk factors, and 4) prevention. Users are given evidence-informed, actionable prevention messaging from a personalized sporting context. Conclusion and policy implications This user friendly, web and mobile accessible tool can increase the reach, awareness and implementation of prevention programming in sport and recreational activity.

Background Public Health Ontario (PHO) is a provincial agency in Canada with a mandate to provide scientific and technical guidance to the field of public health practice. Clients include the provincial government and 36 public health units (PHUs) providing service to 14.2 million residents across over 9 00 000 square kilometres. Injury represents the leading cause of death and disability in 0–44 year olds in Canada, and PHO aims to support evidence-based injury prevention practice. Objective To complete a situational assessment of injury prevention practice across the provincial public health system to identify capacity building priorities for injury prevention knowledge and practices on a population level. The results of this study will inform a work plan in supporting effective public health practice across the system. Methods Data collection included a review of existing provincial standards and guidelines, surveillance data, evidence briefs and other knowledge exchange outputs, as well as information gathering through key informant interviews and site visits. Key informants included a cross-section of injury prevention practitioners, researchers and government staff (n=20), and site visits to 5 PHUs reflecting different population size and geographic characteristics. Site visits included interviews with front-line injury prevention practitioners, program managers, and the medical officer of health. A SWOT analysis (strengths, weaknesses, opportunities, and threats) will be used to synthesize and present the results of the situational assessment. Findings The situational assessment revealed many opportunities for collaboration and support for the PHUs. Common challenges for successful injury prevention practice included data access, evidence synthesis, and capacity to implement evidence-based practice. Conclusion and policy implications This project has significant implications for the practice of injury prevention in the province of Ontario, Canada. The results of this work will inform a work plan at PHO for injury prevention support, collaboration, and capacity building with the 36 PHUs across the province.