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Prevention of road traffic injuries among Aboriginal Australians

Prevention of road traffic injuries among Aboriginal Australians. An evidence-based action plan for the Royal Australasian College of Surgeons Tavender EJ, Ivers RQ, Gruen R. Background.

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Prevention of road traffic injuries among Aboriginal Australians

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  1. Prevention of road traffic injuries among Aboriginal Australians An evidence-based action plan for the Royal Australasian College of Surgeons Tavender EJ, Ivers RQ, Gruen R

  2. Background • Monash University in partnership with the Royal Australasian College of Surgeons Foundation for Surgery have developed evidence-based action plans (EBAPs) within four surgical areas to improve the delivery of surgical services to indigenous communities. • These include road injury prevention, transplantation, ophthalmology and ENT

  3. Background • Evidence-based action plans are action-oriented overviews aimed to help solve real problems. • Generated by engagement of stakeholders and reviews of existing research evidence.

  4. Methods • Aim: to review the evidence for road traffic injury prevention in Indigenous and non-Indigenous Australians • Searched Australian Indigenous HealthInfoNet, MEDLINE, The Cochrane Library, ANZ Clinical Trials Register and Google • Date of last search November 2009 • Reference lists screened and experts contacted for additional studies • Highest evidence level reported

  5. Search results • Global evidence (non-Indigenous Australians) • 8 Cochrane systematic reviews • 12 non-Cochrane systematic reviews • Evidence (Indigenous Australians) • 25 programs identified • 10 programs were evaluated and provided data

  6. Factors contributing to high injury rates in Aboriginal people • HUMAN FACTORS • lack of restraint use, overcrowding, unlicensed driving, speed, alcohol/drug use • VEHICLE FACTORS • Old, less well maintained vehicles • Less access to public transport • ENVIRONMENTAL FACTORS • Rural/remote locations • CULTURAL FACTORS

  7. Safe System Framework(Australian Transport Council)

  8. Results: global evidence

  9. Application of evidence • Evidence of effectiveness in mainstream high income settings • Relevance to Aboriginal communities? • Need to understand context and application

  10. Results: Evaluated programs releveant to

  11. What approaches work?* • Initiatives that will lead to state-wide policy reform on injury prevention issues prominent for Indigenous communities • prevention of overcrowding of motor vehicles • increases in alcohol tax reductions or measures to ensure they are not reduced • multi-faceted strategies to address alcohol-related injuries at the State and/or community level *Ivers, Senserrick. Boufous, Martiniuk, Clapham 2010

  12. What else do we know works? • Sustainable initiatives • Initiatives that include community engagement and consultation in development and implementations • Initiatives that have or can achieve a high level of acceptability and support for harm reduction strategies within the intervention population Ivers, Senserrick et al, 2010

  13. What else is important? • Initiatives based on community-owned models • Initiatives to ensure on-going injury information systems • Programs that include community control, respect, acceptability and ownership • Programs that include strong partnerships, especially with government • Multi-faceted interventions Ivers, Senserrick et al, 2010

  14. What next? • Continue to support and expand programs that have been shown to be effective in Aboriginal communities • State-wide alcohol programs • Driver licensing programs • Fund projects in areas poorly covered by current programs • Programs in urban areas • Programs addressing restraint use, pedestrian safety, vehicle maintenance

  15. What next? • Development of targeted social marketing and enforcement programs addressing the key issues for Aboriginal people (restraints, alcohol, vehicle access and overcrowding) • Development of novel community led approaches to education and enforcement in these areas • Research into the provision of appropriate alternative transport options for Indigenous people

  16. Important points to consider • Initiatives based on community-owned models for injury prevention • Initiatives to ensure on-going injury information systems • Programs that include community control, respect, acceptability and ownership • Programs that include strong partnerships, especially with government • Multi-faceted interventions Ivers, Senserrick et al, 2010

  17. What next • Urgent need to address the social and economic disadvantage and to improve the social, emotional and cultural well-being of Aboriginal people • The complexity of these issues should not deter efforts in addressing other risk factors for road injury in Aboriginal people

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