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Awareness of Vision Zero among United States' road safety professionals.

ABSTRACT: BACKGROUND:Vision Zero is a strategy to eliminate all fatalities and serious injuries from road traffic crashes, while increasing safe and equitable mobility for all. In 2015, the United States' Department of Transportation announced the official target of the federal government transportation safety policy was zero deaths. In 2017, we assessed the dissemination of Vision Zero in the United States. METHODS:We conducted a web-based survey in 2017 among road safety professionals. Email invitations were sent using relevant membership directories and conference lists. RESULTS:We surveyed 192 road safety professionals, including planning/engineering (57.8%), public health (16.7%), and law enforcement/emergency medical services (EMS) (8.9%). Awareness of Vision Zero was higher among planning/engineering fields (97.3%) compared to law enforcement/EMS (76.5%) and public health (75.0%). Awareness was similar by number of years working in the field. Awareness was higher in the South (95.9%) and Northeast (95.0%) regions, followed by the West (90.8%) and Midwest (85.2%) Census regions. Among those that heard of Vision Zero (n?=?174), 41.8% worked at a municipality with a Vision Zero campaign, while 41.2% did not. Among those working at a municipality with a Vision Zero campaign (n?=?71), about half participated in the campaign (54.9%) while the other half did not (45.1%). CONCLUSIONS:With widespread dissemination of the Vision Zero strategy to road safety professionals, next steps include evaluating how Vision Zero is being adopted, implemented, and maintained in communities, as well as the awareness and acceptability by community members, and to identify the most promising policies and practices.

SUBMITTER: Evenson KR

PROVIDER: S-EPMC5938221 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Awareness of Vision Zero among United States' road safety professionals.

Evenson Kelly R KR LaJeunesse Seth S Heiny Stephen S

Injury epidemiology 20180508 1

<h4>Background</h4>Vision Zero is a strategy to eliminate all fatalities and serious injuries from road traffic crashes, while increasing safe and equitable mobility for all. In 2015, the United States' Department of Transportation announced the official target of the federal government transportation safety policy was zero deaths. In 2017, we assessed the dissemination of Vision Zero in the United States.<h4>Methods</h4>We conducted a web-based survey in 2017 among road safety professionals. Em ...[more]

PMID: 29736881

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Project description:Objective: Each year, more than 30,000 deaths occur on U.S. roads. Recognizing the magnitude and persistence of this public health problem, a number of U.S. cities have adopted a relatively new approach to prevention, termed Vision Zero (VZ). VZ has been adopted by more than 30 U.S. cities and calls for creating a transportation system that ensures that no road traffic crash results in death or serious injury. A core component of VZ is strong multidisciplinary and multisector stakeholder engagement, and cities adopting VZ often establish a VZ coalition to foster stakeholder collaboration. However, there is little information on the structure, development, and functioning of coalitions working to achieve VZ and on tools available to study and evaluate such coalition functioning. We sought to describe the characteristics of prominent U.S. VZ city coalitions and context surrounding VZ uptake and advancement in these cities. Moreover, we demonstrate use of network analysis as one tool for exploring the structure of interorganizational relationships in coalitions. Methods: We conducted case studies of 4 prominent U.S. VZ city coalitions in 2017-2018. We summarized coalition members' characteristics and responses to questions about their cities' VZ adoption, planning, and implementation. We asked each coalition member to provide information on their contact frequency, perceived productivity, and resource sharing with every other coalition member in their city and used network analysis techniques in 2 cities to understand the structures and relationships in coalitions. Results: Findings indicated that government agencies generally constituted the majority of coalition members and often played central roles in terms of coalition network contact, productivity, and resource flow. Other emerging similarities regarding coalition establishment and VZ implementation included the need for political support, the importance of formal plan development, and increased collaboration and cooperation among partners. Conclusions: Organizational network analyses, enriched with coalition member interviews, can elucidate key aspects of coalition creation, attributes, and relationship structure. The case studies of leading VZ coalition networks presented here highlight the use of these tools. Ultimately, understanding associations between VZ network structures and attributes and road safety outcomes could help inform effective coalition adoption, implementation, and maintenance to optimize safety outcomes.

Project description:ObjectiveTo synthesise and appraise the design and impact of peer-reviewed evaluations of Indigenous cultural safety training programmes and workshops for healthcare workers in Australia, Canada, New Zealand and/or the United States.DesignSystematic review.Data sourcesOvid Medline, Embase, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Bibliography of Indigenous Peoples in North America, Applied Social Sciences Index & Abstracts, ERIC (Education Resources Information Center), International Bibliography of the Social Sciences, ProQuest Dissertations & Theses Global, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index from 1 January 2006 to 12 May 2022.Eligibility criteriaStudies that evaluated the outcomes of educational interventions for selecting studies: designed to improve cultural safety, cultural competency and/or cultural awareness for non-Indigenous adult healthcare professionals in Canada, Australia, New Zealand or the United States.Data extraction and synthesisOur team of Indigenous and allied scientists tailored existing data extraction and quality appraisal tools with input from Indigenous health service partners. We synthesised the results using an iterative narrative approach.Results2442 unique titles and abstracts met screening criteria. 13 full texts met full inclusion and quality appraisal criteria. Study designs, intervention characteristics and outcome measures were heterogeneous. Nine studies used mixed methods, two used qualitative methods and two used quantitative methods. Training participants included nurses, family practice residents, specialised practitioners and providers serving specific subpopulations. Theoretical frameworks and pedagogical approaches varied across programmes, which contained overlapping course content. Study outcomes were primarily learner oriented and focused on self-reported changes in knowledge, awareness, beliefs, attitudes and/or the confidence and skills to provide care for Indigenous peoples. The involvement of local Indigenous communities in the development, implementation and evaluation of the interventions was limited.ConclusionThere is limited evidence regarding the effectiveness of specific content and approaches to cultural safety training on improving non-Indigenous health professionals' knowledge of and skills to deliver quality, non-discriminatory care to Indigenous patients. Future research is needed that advances the methodological rigour of training evaluations, is focused on observed clinical outcomes, and is better aligned to local, regional,and/or national Indigenous priorities and needs.

Project description:The prescription of opioid analgesics by dental professionals is widespread in the United States. Policy makers, government agencies, and professional organizations consider this phenomenon a growing public health concern. This study examined trends in the prescription of opioid analgesics for adults by dental professionals and associated factors in the United States. Data from the Medical Expenditure Panel Survey (1996-2013) were analyzed. Descriptive statistics were calculated separately for each year. Logistic regression analyses were conducted to estimate the overall trend during the period with and without adjusting for dental procedures and personal characteristics. Survey weights were incorporated to handle the sampling design. The prescription of opioid analgesics following dental care increased over time. After adjusting for sociodemographic factors, source of payment, and type of dental procedure, the odds ratio (OR) of prescribing opioid analgesics following a dental visit per each decade difference was 1.28 (95% confidence interval [CI], 1.19-1.38). Surgical, root canal, and implant procedures had the highest rates of opioid prescriptions and the greatest increases in rates over the study period. After adjusting for personal characteristics and type of dental procedure, the OR of receiving a prescription for opioids comparing blacks, Asians, and Hispanics to whites was 1.29 (95% CI, 1.17-1.41), 0.57 (95% CI, 0.47-0.70), and 0.84 (95% CI, 0.75-0.95), respectively. Opioid analgesic prescriptions following dental visits increased over time after adjusting for personal characteristics and type of dental procedure. The odds of receiving a prescription for opioids were higher for certain racial/ethnic minority groups. Knowledge Transfer Statement: This study highlights dental professionals prescribing practices of opioid analgesics by following dental treatments in the United States. With this knowledge, appropriate guidelines, protocols, and policies can be developed and implemented to address any inappropriate prescribing practices of opioid analgesics. In addition, this information could lead to an improvement in the prescribing practices of dental professionals and to evidence-based therapeutic decision making.

Project description:INTRODUCTION:National competent authorities (NCAs) use Direct Healthcare Professional Communications (DHPCs) to communicate new drug safety issues to healthcare professionals (HCPs). More knowledge is needed about the effectiveness of DHPCs and the extent to which they raise awareness of new safety issues among HCPs. OBJECTIVE:The objective was to assess and compare general practitioners' (GPs'), cardiologists', and pharmacists' familiarity with DHPCs as communication tools, their awareness of specific drug safety issues, and the sources through which they had become aware of the specific issues. METHODS:GPs, cardiologists, and pharmacists from nine European countries (Croatia, Denmark, Ireland, Italy, the Netherlands, Norway, Spain, Sweden, and the UK) completed a web-based survey. The survey was conducted in the context of the Strengthening Collaboration for Operating Pharmacovigilance in Europe (SCOPE) Joint Action. Respondents were asked about their familiarity with DHPCs in general and their awareness of safety issues that had recently been communicated and involved the following drugs: combined hormonal contraceptives, diclofenac, valproate, and ivabradine. Those HCPs who were aware of the specific safety issues were subsequently asked to indicate the source through which they had become aware of them. Differences between professions in familiarity with DHPCs and awareness were tested using a Pearson ?2 test per country and post hoc Pearson ?2 tests in the case of statistically significant differences. RESULTS:Of the 3288 included respondents, 54% were GPs, 40% were pharmacists, and 7% were cardiologists. The number of respondents ranged from 67 in Denmark to 916 in Spain. Most respondents (92%) were familiar with DHPCs, with one significant difference between the professions: pharmacists were more familiar than GPs in Italy (99 vs 90%, P = 0.004). GPs' awareness ranged from 96% for the diclofenac issue to 70% for the ivabradine issue. A similar pattern was shown for pharmacists (91% aware of the diclofenac issue to 66% of the ivabradine issue). Cardiologists' awareness ranged from 91% for the ivabradine issue to 34% for the valproate issue. Overall, DHPCs were a common source through which GPs (range: 45% of those aware of the contraceptives issue to 60% of those aware of the valproate issue), cardiologists (range: 33% for the contraceptives issue to 61% for the valproate issue), and pharmacists (range: 41% for the contraceptives issue to 51% for the ivabradine issue) had become aware of the specific safety issues, followed by information on websites or in newsletters. CONCLUSIONS:GPs, cardiologists, and pharmacists were to a similar extent (highly) familiar with DHPCs, but they differed in awareness levels of specific safety issues. Cardiologists were less aware of safety issues associated with non-cardiology drugs even if these had cardiovascular safety concerns. This implies that additional strategies may be needed to reach specialists when communicating safety issues regarding drugs outside their therapeutic area but with risks related to their field of specialisation. DHPCs were an important source for the different professions to become aware of specific safety issues, but other sources were also often used. NCAs should consider the use of a range of sources when communicating important safety issues to HCPs.

Project description:ObjectiveSeveral activities were planned for the Decade of Action (DOA) for Road Safety 2011-2020, covering key policies and interventions on road safety. Knowledge of the activities implemented by key actors is currently lacking in the literature. This study answers the question: what activities were implemented during the DOA by the United Nations Road Safety Collaboration (UNRSC) members?DesignThe study used content analysis techniques to extract and analyse information from five United Nations Secretary General's reports, which summarise the activities reported by UNRSC members.SettingThe primary setting for this study are 116 countries in which activities supporting the DOA were conducted.Outcome measuresFrequency of themes and subthemes that emerged from reported activities are identified and cross-tabulated by year of report, country level of income, geographical region and organisation type.ResultsOver the entire DOA, establishment of institutions and lead agencies as well as the development of national strategies featured prominently under the theme of management. This theme was steadily reported across regions, country income level and organisation type. Workshops, training and major events regarding road safety increased in frequency of reporting throughout the decade as did developing and promoting the basic road and vehicle systems supportive of road safety. It is further noted that other key activities like infrastructure and behaviour change that are required for a balanced approach to road safety policy were also attended to by various organisations. Activities related to road safety enforcement and post-crash response as well as activities in low-income countries appeared to be less reported.ConclusionThe wide range of activities reported by UNRSC members over the entire DOA need to be sustained and evaluated in years to come if they are to have a significant impact on reducing road traffic deaths and injuries at national and international levels.

Project description:ImportanceMost patients with low vision are elderly and have functional limitations from other health problems that could add to the functional limitations caused by their visual impairments.ObjectiveTo identify factors that contribute to visual ability measures in patients who present for outpatient low vision rehabilitation (LVR) services.Design, setting, and participantsAs part of a prospective, observational study of new patients seeking outpatient LVR, 779 patients from 28 clinical centers in the United States were enrolled in the Low Vision Rehabilitation Outcomes Study (LVROS) from April 25, 2008, through May 2, 2011. The Activity Inventory (AI), an adaptive visual function questionnaire, was administered to measure overall visual ability and visual ability in 4 functional domains (reading, mobility, visual motor function, and visual information processing) at baseline before LVR. The Geriatric Depression Scale, Telephone Interview for Cognitive Status, and Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning questionnaires were also administered to measure patients' psychological, cognitive, and physical health states, respectively.Main outcomes and measuresPredictors of visual ability and functional domains as measured by the AI.ResultsAmong the 779 patients in the LVROS sample, the mean age was 76.4 years, 33% were male, and the median logMAR visual acuity score was 0.60 (0.40-0.90 interquartile range). Correlations were observed between logMAR visual acuity and baseline visual ability overall (r = -0.42) and for all functional domains. Visual acuity was the strongest predictor of visual ability (P < .001) and reading ability (P < .001) and had a significant independent effect on the other functional domains. Physical ability was independently associated with (P < .001) overall visual ability as well as mobility and visual motor function. Depression had a consistent independent effect (P < .001) on overall visual ability and on all functional domains, whereas cognition had an effect on only reading and mobility (P < .001).Conclusions and relevanceVisual ability is a multidimensional construct, with visual acuity, depression, physical ability, and cognition explaining more than one-third of the variance in visual ability as measured by the AI. The significant contributions of the nonvisual factors to visual ability measures and the rehabilitation potential (ie, ceiling) effects they may impose on LVR are important considerations when measuring baseline visual ability and ultimately LVR outcomes in ongoing clinical research.

Dataset Information

Awareness of Vision Zero among United States' road safety professionals.

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Awareness of Vision Zero among United States' road safety professionals.

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