American Journal of Lifestyle Medicine current issue

Injury Prevention and Lifestyle Medicine

Ikeda, R. M. — Mon, 11 Jan 2010 14:38:05 PST

Injury Prevention: A Medical and Public Health Imperative

Rippe, J. M. — Mon, 11 Jan 2010 14:38:05 PST

Injuries: An Underrecognized Lifestyle Problem

Sleet, D. A., Ballesteros, M. F., Baldwin, G. T. — Mon, 11 Jan 2010 14:38:05 PST

This article introduces the field of injury prevention and control and its relationship to lifestyle medicine. A review of injury epidemiology, definitions, intervention approaches, and the importance of injury as a public health problem are discussed. Injuries are a large, predictable, and preventable national and international problem affecting individuals, families, and communities. Behavioral, environmental, and technological solutions are necessary to reduce or eliminate injuries. Reductions in injuries and their costs to patients and their families are possible but will need support, collaboration, and partnering from policy makers, clinicians, and health care practitioners. Lifestyle medicine and primary care family practitioners are important allies in encouraging lifestyle choices that reduce injuries and in advocating for medical and public health policies related to injury prevention. Injuries should be added to the broad range of conditions resulting from lifestyle choices, and primary caregivers and other gatekeepers in health care can help reduce injuries from all causes.

Older Adult Fall Prevention: Perceptions, Beliefs, and Behaviors

Stevens, J. A., Noonan, R. K., Rubenstein, L. Z. — Mon, 11 Jan 2010 14:38:05 PST

Falls in adults aged 65 years and older are an important health issue associated with excess mortality, functional limitations, loss of independence, and reduced quality of life. Physicians can reduce the likelihood of falls in their older patients by incorporating prevention strategies into their clinical practice. Research has identified effective interventions, notably clinical assessment and risk factor reduction and exercise programs with balance training, that require older adults to adopt new behaviors. However, some older adults believe falls are an inevitable consequence of aging, while others do not see themselves as personally vulnerable. Factors that facilitate adopting fall interventions include social support, low-intensity exercise, and the perception that the programs are relevant. Barriers include fatalism, denial of risk, poor self-efficacy, and no previous history of exercise. To encourage their patients’ participation, physicians need to present fall interventions as lifestyle enhancing and as a way to remain independent. Messages should focus on positive health and social benefits such as improving balance and maintaining independence, rather than emphasizing negative information about falls and fall injuries. Along with the support of family and friends, a personal invitation from a health care provider will encourage older adults to take part in fall prevention programs.

Vitamin D and Injury Prevention

Johnson, M. A., Kimlin, M. G., Porter, K. N. — Mon, 11 Jan 2010 14:38:05 PST

Vitamin D, along with calcium, may help decrease the risk of falls and fractures in older adults. Sunlight and other sources of ultraviolet radiation are not recommended because they increase the risk of skin cancers and sun-induced eye disorders. Rather, vitamin D and calcium needs should be met through foods and dietary supplements. As a preventive measure to reduce the risk of falls and fractures, it is recommended that older adults meet the 2005 Dietary Guidelines and consume 1000 IU of vitamin D, preferably as vitamin D₃.

Preventing Unintentional Injury: A Review of Behavior Change Theories for Primary Care

Sleet, D. A., Carlson Gielen, A., Diekman, S., Ikeda, R. — Mon, 11 Jan 2010 14:38:05 PST

Many injuries are preventable, and most have a behavioral component on their causal pathway. However, far more effective use of theory-based approaches to behavioral risk management is needed, which remains a challenge for practitioners. This review discusses theories and applications of behavioral change principles for use in primary care and community health settings. Injury-related behaviors cannot be separated from the environments in which they take place. Preventing unintentional injuries requires an understanding of patient knowledge, attitudes, and behaviors, as well as community norms, that lead to injuries. In addition to the role clinicians have in counseling for lifestyle change to prevent injuries, reducing exposure of patients to hazardous products and environments, and fostering social and organizational change to improve public policy, legislation, and enforcement to prevent injuries are equally important. Challenges lie ahead in testing the applicability of these theories in primary care settings and in predicting and understanding injury-related behaviors of patients. Training more medical practitioners in the epidemiology of injury and the science of injury control is an urgent priority. Success will partly depend on how behavioral theories can be integrated into practice and adapted through clinical experience to benefit patients.

Opioid Drug Overdoses: A Prescription for Harm and Potential for Prevention

Dasgupta, N., Sanford, C., Albert, S., Wells Brason, F. — Mon, 11 Jan 2010 14:38:05 PST

This article reviews the burden of accidental poisonings from opioid overdoses in the United States, describes several current federal- and state-level prevention strategies, and illustrates several approaches taken to prevent deaths from opioid overdoses and reduce emergency department visits for chronic pain. One approach, Project Lazarus in North Carolina, is a community-based, secondary prevention program that trains medical care providers to coprescribe naloxone with opioids and provide education to patients who are at risk of opioid overdoses and to their families and peers.

Patient Counseling for Unintentional Injury Prevention

Ballesteros, M. F., Gielen, A. C. — Mon, 11 Jan 2010 14:38:05 PST

Injury prevention counseling (IPC) by health care providers is one strategy to reduce injury risk by encouraging people to modify their environment or their personal behaviors to protect themselves or their loved ones. National surveys indicate that few patients are receiving IPC. The evidence of IPC being effective at increasing safety practices is inconsistent. This may be explained partially because counseling recommendations for some injury issues may involve more effort, cost, or inconvenience by the patient. IPC that is based on behavior change theories is more likely to be effective. Physicians and other health care providers can play a critical role in efforts to prevent injuries, but barriers for delivering IPC need to be overcome.

Injury Prevention in Sports

Schiff, M. A., Caine, D. J., O'Halloran, R. — Mon, 11 Jan 2010 14:38:05 PST

Sports injuries can occur and may cause significant discomfort and disability. They may also be associated with considerable medical expenses. The objective of this article was to evaluate the current evidence-based effectiveness of sports injury prevention strategies. The authors assessed both intrinsic and extrinsic injury prevention strategies. However, determination of the relative contribution of each component was not determined in the multifaceted intervention studies. Among the interventions that used multiple components, including various combinations of warm-up, strengthening, stretching, and plyometric and balance exercises, the authors could not identify which of the components was effective. Among the extrinsic strategies, including mouthguards, face shields, helmets, bracing, insoles and orthotics, breakaway bases, and sport-specific rules, the authors found that ankle bracing, helmets, face shields, and mouthguards were effective. Studies of breakaway bases and sport-specific rules had methodological flaws that made interpretation difficult. Much future research is needed to identify modifiable risk factors that will lead to the development of new interventions. In addition, studies of new interventions should adhere to rigorous methodology to assess their effectiveness.

Child Injury: The Role of Supervision in Prevention

Morrongiello, B. A., Schell, S. L. — Mon, 11 Jan 2010 14:38:05 PST

As the leading cause of death and major contributor to hospitalization for children, unintentional injury is a significant health problem in the United States. How supervision influences children’s risk of injury has been of interest for some time, and much progress has been made recently to address definitional and measurement issues pertaining to supervision. Increasing evidence supports the notion of a general relationship between increased supervision and decreased injury risk, but also reveals that child behavioral attributes and environmental characteristics can interact with level of supervision to affect injury risk, making it challenging to develop guidelines regarding what constitutes "adequate" supervision. Further research is needed to explore if and how children’s risk of injury varies with different supervisors (eg, mothers vs fathers vs older siblings) and how these relations change as a function of children’s developmental level. Recent research has identified messaging approaches that are effective to invoke a commitment to more closely supervising young children at home. Examining how these messages affect actual supervisory practices is an essential next step in this research and can support the development of evidence-based programs to improve supervision and reduce children’s risk of injuries.

Home Injuries: Potential for Prevention

Mack, K. A., DeSafey Liller, K. — Mon, 11 Jan 2010 14:38:05 PST

There are approximately 18 000 injury-related deaths at home each year. Some of the leading causes of home injury deaths are falls, fire/ burns, poisonings, choking/suffocations, and drownings. Many more home injuries are treated at emergency departments, in doctors’ offices, or with self-care at home. Children and older adults are especially at risk for home injuries, and environmental factors can contribute to population disparities in home injuries. The causes and circumstances of home injuries are complex and multifaceted. This article provides an overview of the epidemiology and burden of home injuries and reviews the evidence for prevention by life stage. Reducing the risk of injuries at home is challenging, but fortunately there many ways that practitioners can help promote safer behaviors and help change home environments for patients and their families.

Preventing Traffic Injuries: Strategies That Work

Dellinger, A. M., Sleet, D. A. — Mon, 11 Jan 2010 14:38:05 PST

Motor vehicle crashes result in more than 40 000 deaths and 4.3 million nonfatal injuries annually. Many known effective strategies to address these preventable deaths and injuries are closely related to lifestyle factors. Clinicians can play a large part in supporting effective interventions in their practice, for example, by counseling patients about seat belt use. Clinicians can also have an impact in their community by supporting positive public policy change.

Human Factors in Injury Control

Porter, B. E., Bliss, J. P., Sleet, D. A. — Mon, 11 Jan 2010 14:38:05 PST

A person’s interaction with the environment represents a system for research and focus. Human factors is a discipline dedicated to studying this system. The authors provide a summary of how the field human factors informs and enhances injury control programs. They introduce perception, cognition, and environmental design components that should be considered; review automation and workload issues; and discuss best practice recommendations for increasing safe product use as well. Finally, the authors offer lessons learned from human factors approaches to safety at large and suggest future areas of study. Specifically, they note that investigating behavioral adaptation is important to extend intervention effects. They also note that human factors approaches have been used extensively in occupational and transportation areas but can be applied to other areas of injury control that are worth exploring.

Handbook of Injury and Violence Prevention Edited by Lynda S. Doll, Sandra E. Bonzo, James A. Mercy, and David A. Sleet * New York: Springer Science+Business Media, LLC * 2007 * $109.00 * ISBN-13: 978-0387-25924-6

Nasrullah, M. — Mon, 11 Jan 2010 14:38:05 PST

Empowering Parents to Prevent Unintentional Childhood Injuries

Huitric, M. A., Borse, N. N., Sleet, D. A. — Mon, 11 Jan 2010 14:38:05 PST

On average, 33 children die each day in the United States— about 12 000 children a year— because of unintentional childhood injuries. Another 9 million children are treated in emergency departments for unintentional injuries each year. To address this issue, the Centers for Disease Control and Prevention’s National Center for Injury Prevention and Control has launched a new initiative focused on parents: Protect the Ones You Love: Child Injuries Are Preventable. As trusted sources of health information, physicians and health care providers can use the initiative and the related ancillary materials to inform parents and caregivers about lifestyle changes that reduce the risk and potential harmful outcomes of an injury to a child or other family member.

2010 Injury-Related Conferences

Mon, 11 Jan 2010 14:38:05 PST

2010 Conferences

Mon, 11 Jan 2010 14:38:05 PST