Building Bridges in the Regions

From Summer 1996
Volume III, Number 2

The 10 regional offices of the National Highway Traffic Safety Administration (NHTSA) are using a series of cooperative agreements to foster collaboration between highway safety and public health professionals. Each region's approach is based on existing levels of collaboration, available resources, and other local conditions. The projects are being conducted by public health agencies, hospitals, injury control research centers, and other organizations in conjunction with regional office staff.

Assessing Existing Levels of Collaboration

A number of the regions began their projects with an assessment of the current level of collaboration. Regions V and IX surveyed local health departments to identify the extent of their involvement in traffic safety and to determine what types of agencies and organizations health departments have worked with in the past or would like to work with in the future. The results speak well for the future of collaboration. Both regions found high levels of public health involvement in traffic safety activities and a significant interest in collaborating with traffic safety professionals. Region IX's assessment was implemented by the Contra Costa County Department of Health Services Prevention Program, which discovered that almost three-quarters of the health departments responding to the survey are involved in traffic safety programs. Half have dedicated funding for traffic safety. In Region V, the Michigan Council on Injury Control found that 37 percent of respondents are involved in traffic safety activities and 22 percent receive funding for traffic safety. Both regions found the most common activities to be child passenger protection, safety belt, and bicycle helmet programs (in that order).

Respondents in Region V expressed a strong interest in working together. The Region V office is working with Christ Hospital and the Loyola University Medical Center to identify nursing and medical organizations that are good candidates for traffic safety and injury prevention projects and to develop strategies to institutionalize traffic safety programs within these groups. An initial project in Illinois will provide a basis for similar efforts in other states in the region.

Region IX is also using the results of its assessment to facilitate collaborative activities, especially those supporting NHTSA's Safe Communities initiative (which was the focus of an article in the spring issue of Building Bridges). Region IX will:

establish a traffic injury control contact in each county health agency and publish a newsletter to keep these agencies abreast of resources and other programs
encourage the creation of Safe Communities programs and provide technical assistance for these programs
encourage the governor's highway safety representative and state health department injury control offices to inform local health departments about funding opportunities
create opportunities for and facilitate meetings between public health and traffic safety agencies

The Region I and II offices are conducting independent mail surveys of public health, traffic safety, medical, and other organizations to assess levels of collaboration in their regions. In Region I, the results of the survey will guide the work of a new technical assistance project for state highway safety and public health agencies. This fall, a team from Education Development Center, Inc. (EDC) and the Harvard Injury Control Center (HICC) will visit each New England state highway safety and public health office to discuss the results of the survey and determine what follow-up is needed. EDC and HICC will work with staff in each state to develop a technical assistance plan, spelling out the resources or training they need to increase partnerships among highway safety, medical, and public health professionals and to implement Safe Communities programs in their state.

Region II's survey focuses on traffic safety activities in New York and New Jersey. In New York State, this effort was facilitated by the existence of a legislatively mandated system of county Traffic Safety Boards; these boards were able to provide the names of local organizations that should be included in the survey. Preliminary results reveal that between 120 and 150 agencies and organizations in New York State alone are engaged in traffic safety programs. However, few actively collaborate. According to Jerry Palisi, the NHTSA regional program manager, "The opportunity is there, but the marriage between traffic safety and public health has not been accomplished yet."

Recognizing the growing importance of the private sector for traffic safety and injury control, Region VII's assessment included the top 10 businesses in each state, as well as all the region's medical societies (including state chapters of national medical and nursing associations) and state and local highway safety, public health, and law enforcement agencies. Preliminary results show that there is a high level of interest and involvement in the prevention of motor vehicle injuries, but few joint projects. Bob Muelleman, an emergency physician who directed the assessment, predicts that it will be invaluable to Safe Communities programs: "We believe that the interest in traffic safety shown in our data will reinforce the confidence of Safe Communities projects to approach these groups."

Other Approaches to Assessment

Region VIII began with a pilot project examining opportunities for and barriers to collaboration in Colorado. A multidisciplinary advisory committee, convened and facilitated by the University of Colorado Health Services Center, identified 65 individuals from public health, medicine, law enforcement, emergency medical services (EMS), fire departments, and traffic safety to respond to a survey exploring their experiences with collaborative projects. One-on-one interviews were conducted with more than half the respondents to provide a more in-depth understanding than is possible from a mail survey alone. The pilot produced a comprehensive report detailing the state of traffic safety programs in Colorado and outlining an ambitious three-year plan to expand collaboration based on the needs and opportunities identified in the research. The Colorado project has been replicated in the other states in the region. A report on South Dakota is also available, and reports for other states are being finalized.

Region IV is using its cooperative agreement to expand on the work of an earlier project. In 1995, the Region IV office convened focus groups of trauma physicians and nurses, EMS providers, rehabilitation professionals, hospital administrators, and representatives from health maintenance organizations (HMOs) and insurance companies to explore their knowledge about traffic injuries and their interest in working together to prevent such injuries. Participants' knowledge about and interest in traffic injury prevention were generally high. However, many reported that they were never asked to collaborate on injury prevention projects.

Dr. Philip Graitcer and Marlena Wald of the Emory University Injury Control Center conducted a follow-up survey of the 60 original focus group participants. The survey explored respondents' views of their role in injury prevention, how they currently educate their patients about health issues, and their recommendations for including injury prevention content in patient education materials. Recommendations included materials on air bags and child safety seats. Hospital administrators expressed a concern that their employee wellness education programs fail to emphasize traffic injury prevention, and they were very interested in materials that could be integrated into these programs. Graitcer and Wald developed a Regional Directory of Injury Professionals to help states identify key health and medical groups that are potential partners for traffic safety and Safe Communities programs.

The Region IV team is also developing two regional newsletters. Building Advocacy for Safe Communities provides legislative updates and advocacy tips that promote the support of highway safety policies such as zero tolerance and primary seat belt laws. Traffic Injury Prevention (TIP) Bulletin focuses on creating awareness of "hot issues" in traffic safety, such as the potential for injury resulting from the interaction of air bags and child safety seats. In addition, Dr. Graitcer contacted the region's four Injury Prevention Research Centers to discuss organizing a Safe Communities consortium and providing technical assistance to Region IV Safe Communities programs.

The Region III office convened a conference at which highway safety and public health professionals explored common interests and ways of sharing resources and developing joint initiatives. (See "Moving Forward in Region III," page 4.) Region VI is using a series of site visits and meetings to encourage agencies and organizations in the Southwest to work together. (See "Working Together in Region VI," page 5.)

Collaborating with Tribal Governments

Region X is focusing its efforts on building partnerships to promote seat belt use among Native Americans. The region has joined forces with the Harborview Injury Prevention Research Center, the Northwest Portland Area Indian Health Board (NPAIHB), and the Indian Health Service to educate tribal leaders in occupant protection issues and to foster joint efforts.

On March 18, 1996, representatives from highway safety, tribal government, law enforcement, medicine, and public health gathered to plan a pilot project that will educate tribal leaders and community members on the importance of tribal statutes mandating seat belt use. (Many reservations are exempt from state and county seat belt and child restraint laws.) According to Rosemary Nye, Region X program manager, the tribal councils represented at this meeting reached a significant consensus that occupant protection should be a public health priority for Native Americans. She reported, "Participants talked about the economic and emotional costs of motor vehicle crashes, as well as the ways such crashes are a potential threat to tribal history and heritage." The group also discussed cultural practices that influence seat belt use, along with past barriers to passing mandatory seat belt legislation at the tribal level. NPAIHB is now seeking additional funding to develop an occupant protection program that will use strategies similar to those used in its highly successful smoking prevention program.

To assist the implementation of occupant protection programs, the collaborators are conducting an assessment of seat belt use on tribal lands in Washington, Oregon, and Idaho. In addition, they are developing an estimate of economic costs associated with motor vehicle crash injuries and fatalities among Native Americans in the Pacific Northwest. (For a more detailed discussion of traffic safety programs and Native American communities, see the spring/summer 1994 issue of Building Bridges.)

Further information on these initiatives can be obtained from the NHTSA regional offices, which are listed on page 6. The reports cited in this article are Assessment of Highway Safety Activities in State and Local Public Health Agencies (Region IX), An Assessment of Traffic Safety Activities in Local Public Health Departments in Region V, Collaboration Between Traffic Safety and Public Health Agencies in Colorado (Region VIII), and Collaboration Between Traffic Safety and Public Health Agencies in South Dakota (Region VIII).

Building Bridges Home Page

http://www.edc.org/HHD/csn/buildbridges/bb3.2/bbregn.html
Revised: October 25, 1996

Š1997 Education Development Center, Inc.