Browsing by Author "Pike, Ian"
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Item Open Access Built environment change for injury prevention: insights from public health professionals across public health units in Ontario, Canada(2025-01-03) McCullogh, Emily; Macpherson, Alison; Harrington, Daniel W.; Pike, Ian; Hagel, Brent; Buchan, Claire; Fuselli, Pamela; Richmond, Sarah A.Abstract Background Road-related injuries and deaths are among the most significant and avoidable public health problems in Canada. Modifications to the built environment (BE) can reduce injury rates for vulnerable road users (VRUs) and other priority populations who experience disproportionate risk. This paper highlights public health professionals’ experiences working in injury prevention across Ontario public health units (PHUs) navigating barriers and facilitators to BE change. Their perspectives offer valuable insights that can support future BE change work in the Ontario public health context, thus illustrating the importance of including practitioners’ voices in injury prevention research. Methods Qualitative data were collected for a larger pan-Canadian study examining barriers and facilitators to BE change from the perspectives of injury prevention and transport professionals working across a variety of sectors, including public health, using key informant interviews (KI) and virtual focus groups (VFGs). Participants (n = 9) from four PHUs are included in this present study: Peel Region; York Region; Peterborough; and Ottawa. Thematic analysis was used to organize and code the data in relation to the guiding principles of the Ontario Public Health Standards (OPHS), situating our results within the broader context of public health and road-related injury prevention in Ontario. Results Major barriers included motor vehicle prioritization and decision-making structures. Facilitators included partnerships and collaboration, champions and advocates, and access to data. Lastly, participants highlighted the important role of public health in BE change discussions and decision-making for road-related injury prevention. Conclusion Public health professionals’ insights about barriers and facilitators show that some of their work aligns with the existing OPHS. Needs of local populations are clearly identified, while local data illustrating the impact of public health interventions are lacking. There are limits to PHU’s capacities, as well as the capacities of communities, which can be strengthened through the work of champions and advocates. Partnerships, collaboration, and engagement are also significant facilitators to BE change, aligning with the OPHS, but PHUs need to be involved more in BE change processes in order to prioritize the safety needs of VRUs in local communities.Item Open Access Injury and concussion in youth female rugby: Evaluating and informing injury and concussion prevention strategies(2024-06-17) Shill, Isla Jordan; Emery, Carolyn A; Hagel, Brent E; Palmer, Debbie; Pike, Ian; Stokes, Keith AInjury and concussion rates in Canadian female high school rugby are the highest reported in youth rugby. The tackle accounts for the largest proportion of injuries. All injury prevention strategy evaluations are in male populations with none in youth females. This is insufficient to improve female player welfare. Therefore, the objectives of this dissertation were to (1) summarise the rugby injury epidemiology literature within youth female rugby, (2) discuss strengths and limitations of the literature using video analysis for rugby injury epidemiology, (3) evaluate the association between tackle-related characteristics and concussion in female rugby (high school, varsity), and (4) evaluate the effectiveness of a rugby-specific neuromuscular training (NMT) warm-up on injury and concussion in high school female rugby. The association between tackle-related characteristics and suspected concussion was examined using a case-control video analysis study. Within female varsity rugby, ball-carrier concussion was associated with head contact intensity of 2/4 and 3-4/4, illegal and tap tackle, and down head position. Tackler concussion was associated with 3 tacklers in the event, tap tackle, head contact intensity of 3-4/4, and away head position. Within a female high school population, ball-carrier concussion was associated with illegal and trip/collision tackle, increased tackle height compared with knee to upper leg, deceleration and no change of speed, and any head contact. Tackler concussion was associated with 2-3 tacklers in the event, tap or trip/collision tackle, sternum to armpit tackle height, down head position, and any head contact. The effectiveness of a rugby-specific NMT warm-up in high school female rugby players was evaluated using a multi-year quasi-experimental study. There was no difference in injury and concussion rates between control and intervention cohorts, as well as no differences based on adherence to the NMT warm-up. All match and training injury burden were estimated to be lower in those that used a NMT warm-up compared with those that did not. These studies provide a summary of injury prevention evaluations in female rugby. To inform appropriate recommendations for female player safety, a multifaceted approach to injury prevention should be considered. A combination of a NMT warm-up and a tackle injury prevention intervention, such as a tackle training program or tackle law change (e.g., lower legal tackle height), should be considered.Item Open Access Is Blood Alcohol Level a Good Predictor for Injury Severity Outcomes in Motor Vehicle Crash Victims?(Hindawi Publishing Corporation, 2011-05-25) Mann, Bikaramjit; Desapriya, Ediriweera; Fujiwara, Takeo; Pike, IanItem Open Access Is Blood Alcohol Level a Good Predictor for Injury Severity Outcomes in Motor Vehicle Crash Victims?(2011-09-14) Mann, Bikaramjit; Desapriya, Ediriweera; Fujiwara, Takeo; Pike, IanExperimental studies in animals suggest that alcohol may influence pathophysiologic response to injury mechanisms. However, biological evidence for the alcohol-injury severity relationship provides conflicting results. The purpose of our retrospective cross-sectional study in 2,323 people was to assess whether blood alcohol level (BAC) adversely influences injury severity in victims of motor vehicle collisions (MVCs). We found no difference in mortality OR 1.09 (0.73–1.62), or length of hospital stay, and a trend for lower ISS score was found in the high-alcohol group (). Furthermore, the high-alcohol group demonstrated a lower adjusted rate of severe head injury OR 0.65 (0.48–0.87), chest injury OR 0.58 (0.42–0.80), and serious extremity injury OR 0.10 (0.01–0.76). The findings of our study do not demonstrate a dose-response relationship between alcohol consumption and injury severity in MVCs. This study implies that higher BAC may lead to less severe injuries, without impacting mortality or length of hospital stay, however, further research is required to elucidate the nature of this relationship.Item Open Access Reducing Injuries in Soccer (Football): an Umbrella Review of Best Evidence Across the Epidemiological Framework for Prevention(2020-09-21) Owoeye, Oluwatoyosi B A; VanderWey, Mitchell J; Pike, IanAbstract Soccer is the most popular sport in the world. Expectedly, the incidence of soccer-related injuries is high and these injuries exert a significant burden on individuals and families, including health and financial burdens, and on the socioeconomic and healthcare systems. Using established injury prevention frameworks, we present a concise synthesis of the most recent scientific evidence regarding injury rates, characteristics, mechanisms, risk and protective factors, interventions for prevention, and implementation of interventions in soccer. In this umbrella review, we elucidate the most recent available evidence gleaned primarily from systematic reviews and meta-analyses. Further, we express the exigent need to move current soccer injury prevention research evidence into action for improved player outcomes and widespread impact through increased attention to dissemination and implementation research. Additionally, we highlight the importance of an enabling context and effective implementation strategies for the successful integration of evidence-based injury prevention programs into real-world soccer settings. This narrative umbrella review provides guidance to inform future research, practice, and policy towards reducing injuries among soccer players.Item Open Access Road safety, health equity, and the built environment: perspectives of transport and injury prevention professionals in five Canadian municipalities(2023-06-22) McCullogh, Emily; Macpherson, Alison; Hagel, Brent; Giles, Audrey; Fuselli, Pamela; Pike, Ian; Torres, Juan; Richmond, Sarah A.Abstract Background Concerns regarding health equity (HE) and the built environment (BE) are well established in the Canadian urban context. Transport and injury prevention professionals across sectors, such as transportation and public health, are involved in designing and implementing BE interventions that enhance the safety of vulnerable road users (VRUs). Results from a larger study examining barriers and facilitators to BE change are used to illustrate how transport and injury prevention professionals perceive HE concerns in their work in five Canadian municipalities. Broadening our understanding of how HE influences the professional BE change context is crucial when advocating for modifications that enhance the safety of equity-deserving VRUs and groups who experience marginalization. Methods Interview and focus group data were gathered from transport and injury prevention professionals working in policy/decision-making, transport, police services, public health, non-profit organizations, schools/school boards, community associations, and private sectors across five Canadian urban municipalities: Vancouver, Calgary, Peel Region, Toronto, and Montréal. Data were analyzed using thematic analysis (TA) to illustrate how equity considerations were perceived and applied in participants’ BE change work. Results The results of this study illustrate transport and injury prevention professionals’ awareness of the varying needs of VRUs, as well as the inadequacies of current BEs in the Canadian urban context and consultation processes utilized to guide change. Participants emphasized the importance of equitable community consultation strategies, as well as specific BE changes that would support the health and safety of VRUs. Overall, the results highlight how HE concerns inform transport and injury prevention professionals’ BE change work in the Canadian urban context. Conclusion For professionals working in urban Canadian transport and injury prevention sectors HE concerns influenced their perspectives of the BE and BE change. These results illustrate a growing need for HE to guide BE change work and consultation processes. Further, these results contribute to ongoing efforts in the Canadian urban context to ensure that HE is at the forefront of BE policy change and decision-making, while promoting existing strategies to ensure that the BE, and related decision-making processes, are accessible and informed by a HE lens.Item Open Access Social determinants of health and disparities in pediatric trauma care: protocol for a systematic review and meta-analysis(2024-03-22) Gnanvi, Janyce E.; Yanchar, Natalie; Freire, Gabrielle; Beaulieu, Emilie; Tardif, Pier-Alexandre; Bérubé, Mélanie; Macpherson, Alison; Pike, Ian; Zemek, Roger; Gagnon, Isabelle J.; Carsen, Sasha; Gabbe, Belinda; Gnanou, Soualio; Duval, Cécile; Moore, LynneAbstract Background Social determinants of health (SDH), including “the conditions in which individuals are born, grow, work, live and age” affect child health and well-being. Several studies have synthesized evidence about the influence of SDH on childhood injury risks and outcomes. However, there is no systematic evidence about the impact of SDH on accessing care and quality of care once a child has suffered an injury. We aim to evaluate the extent to which access to care and quality of care after injury are affected by children and adolescents’ SDH. Methods Using Cochrane methodology, we will conduct a systematic review including observational and experimental studies evaluating the association between social/material elements contributing to health disparities, using the PROGRESS-Plus framework: place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital and care received by children and adolescents (≤ 19 years of age) after injury. We will consult published literature using PubMed, EMBASE, CINAHL, PsycINFO, Web of Science, and Academic Search Premier and grey literature using Google Scholar from their inception to a maximum of 6 months prior to submission for publication. Two reviewers will independently perform study selection, data extraction, and risk of bias assessment for included studies. The risk of bias will be assessed using the ROBINS-E and ROB-2 tools respectively for observational and experimental study designs. We will analyze data to perform narrative syntheses, and if enough studies are identified, we will conduct a meta-analysis using random effects models. Discussion This systematic review will provide a synthesis of evidence on the association between SDH and pediatric trauma care (access to care and quality of care) that clinicians and policymakers can use to better tailor care systems and promote equitable access and quality of care for all children. We will share our findings through clinical rounds, conferences, and publication in a peer-reviewed journal. Systematic review registration PROSPERO CRD42023408467Item Open Access The built environment and active transportation safety in children and youth: a study protocol(2019-06-11) Hagel, Brent E; Macpherson, Alison; Howard, Andrew; Fuselli, Pamela; Cloutier, Marie-Soleil; Winters, Meghan; Richmond, Sarah A; Rothman, Linda; Belton, Kathy; Buliung, Ron; Emery, Carolyn A; Faulkner, Guy; Kennedy, Jacqueline; Ma, Tracey; Macarthur, Colin; McCormack, Gavin R.; Morrow, Greg; Nettel-Aguirre, Alberto; Owens, Liz; Pike, Ian; Russell, Kelly; Torres, Juan; Voaklander, Donald; Embree, Tania; Hubka, TateAbstract Background Active transportation, such as walking and biking, is a healthy way for children to explore their environment and develop independence. However, children can be injured while walking and biking. Many cities make changes to the built environment (e.g., traffic calming features, separated bike lanes) to keep people safe. There is some research on how effective these changes are in preventing adult pedestrians and bicyclists from getting hurt, but very little research has been done to show how safe various environments are for children and youth. Our research program will study how features of the built environment affect whether children travel (e.g., to school) using active modes, and whether certain features increase or decrease their likelihood of injury. Methods First, we will use a cross-sectional study design to estimate associations between objectively measured built environment and objectively measured active transportation to school among child elementary students. We will examine the associations between objectively measured built environment and child and youth pedestrian-motor vehicle collisions (MVCs) and bicyclist-MVCs. We will also use these data to determine the space-time distribution of pedestrian-MVCs and bicyclist-MVCs. Second, we will use a case-crossover design to compare the built environment characteristics of the site where child and youth bicyclists sustain emergency department reported injuries and two randomly selected sites (control sites) along the bicyclist’s route before the injury occurred. Third, to identify implementation strategies for built environment change at the municipal level to encourage active transportation we will conduct: 1) an environmental scan, 2) key informant interviews, 3) focus groups, and 4) a national survey to identify facilitators and barriers for implementing built environment change in municipalities. Finally, we will develop a built environment implementation toolkit to promote active transportation and prevent child pedestrian and bicyclist injuries. Discussion This program of research will identify the built environment associated with active transportation safety and form an evidence base from which municipalities can draw information to support change. Our team’s national scope will be invaluable in providing information regarding the variability in built environment characteristics and is vital to producing evidence-based recommendations that will increase safe active transportation.