Concurrent Sessions 2

Wednesday, November 2, 2022 | 1:30 – 3:00 PM

For a brief overview of the presentations occurring during Concurrent Sessions 2, please consult the tables below.
To view the full abstracts, please scroll down further or use the links in the tables below.

Overview

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Topic: Falls and Older Adults | Location: Coal Harbour Ballroom A

Moderator: Cathy Arnold
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Topic: Road Safety | Location: Coal Harbour Ballroom B

Moderator: Tobin Copley
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Topic: Sport Injury | Location: Grouse Room

Moderator: Brent Hagel
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Topic: Children and Youth Inflicted/Intentional Injury | Location: Seymour Room

Moderator: Alison Macpherson
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List of abstracts

Topic: Falls and Older Adults | Location: Coal Harbour Ballroom A

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Abstract #2267: Keeping Well – a resource to reach older Albertans

Presenting Author: Kathy Belton¹

Authors: Nan Shybunka¹, Melanie Morgan-Redshaw¹, Kathy Belton¹

¹Injury Prevention Centre, School of Public Health, University of Alberta

Abstract:

Introduction: Falls are the leading cause of injury among adults 65+. A fall can result in injury but also a loss of independence and unwanted lifestyle changes. Due to the pandemic, older Albertans living in the community have spent many months isolated in their own homes, with reduced access to exercise, socialization, and interaction with peers. This has had a significant impact on older Albertans’ mental and physical health, putting them at higher risk of falling.

Objectives: To develop a resource for older adults to address falls and overall declining health and encourage them to be active, build strength, challenge their balance while they age in place, at home.

Methods: We adapted a UK resource to the Alberta context. The resource contains a myriad of information for seniors from exercise to tips on fall prevention, healthy eating, medication use, vision care, mental health and avoiding fraud and scams. The free resource can be downloaded and printed booklets can be ordered at findingbalancealberta.ca.

ResultsL In 2021, 15,000 copies of Keeping Well were distributed through seniors’ recreation centres, service organizations, and independent living residences. An evaluation occurred in December 2021 and found:

• 84% of older adults responded they use the booklet regularly or occasionally
• 88% of older adults responded they have started or continued to use the exercises.
• 67% of practitioners think the booklet has influenced seniors to take actions to prevent falls

Older adults also commented:

• It has inspired and encouraged me to keep looking after myself so my children don’t worry about me and keep me independent.
• Use the exercise in the morning & night and stretch before and after bed.

Conclusion: Older Albertans appreciate and use print resources.  The booklet has been revised using feedback received from older adults. The second edition is available; we are gathering feedback through paper and QR code links to online surveys.

Abstract #2225: Older adult fall prevention: prioritizing indicators for public health practice

Presenting Author: Sarah A. Richmond¹

Authors: Alexia Medeiros^1-2, Alison Macpherson², Ian Pike³

¹Public Health Ontario

²York University

³University of British Columbia

Abstract:

Introduction: In Canada, falls represent the leading cause of injury deaths. In 2018, falls exacted a higher total cost than any other cause at $10.3 billion. To address this high burden, several sectors across the spectrum of prevention develop and evaluate programs to prevent falls. It is reported from stakeholders within these sectors; however, a need for older adult fall prevention indicators that better inform their work and reflect a system-level approach to reporting.

Objective: The objective of this work was to develop a prioritized list of indicators and create resources to use the indicators in practice.

Methods: An environmental scan, including a Modified Delphi process and pairwise comparison exercise was conducted to prioritize a set of indicators that would prompt decision-making at a system-level. This included a scientific and grey literature search, and consultation with stakeholders and experts. Data collection also included indicators currently in use as well as novel indicators recommended for use in both fall prevention program development and evaluation.

Results: Consensus was achieved on a list of 8 indicators, prioritized to prompt decision-making for older adult fall prevention; however clear differences in setting priorities for fall prevention indicators across sectors was noted. The rate of emergency department visits ranked the highest and the proportion of falls by place of occurrence ranked the lowest. Critical to the prioritization process was refinement of the list of potential indicators from our stakeholders and experts.

Conclusion: The environmental scan and Modified Delphi process was successful in establishing a set of indicators that can be used systematically by practitioners for older adult fall prevention programming and evaluation. Use of these indicators can reduce the duplication of reporting efforts across sectors and increase opportunities to compare data across settings.

Abstract #2242: Finding Balance: adapted resources for First Nations Elders in Alberta

Presenting Author: Bev Littlechilds¹, Jodi Sperber¹

Authors: Bev Littlechilds¹, Jodi Sperber¹, Kathy Belton²

¹Kee Tas Kee Now Tribal Council

²University of Alberta

Abstract:

Context: In 2019 the Kee Tas Kee Now Tribal Council (KTC) received funding to hire an injury prevention coordinator to adapt, deliver, and evaluate injury prevention programs for Alberta First Nation communities. The Coordinator had previous knowledge about the Finding Balance Program and Campaign and felt the materials could be adapted to be culturally relevant for First Nations people.

Process: Finding Balance was developed by the Injury Prevention Centre (IPC) in Alberta, Canada and first delivered in 2008 to educate and raise awareness among Seniors about the importance of falls prevention. The adaptation of the extensive suite of Finding Balance resources to reach First Nations people in Alberta required ongoing dialogue, flexibility of timelines, and commitment to creating appropriate resources to this underserved population. Resources can be used by caregivers and professionals to support Elders across Alberta. By engaging Elders, the resources and guides highlight the strength, independence, and unique needs of communities in each Treaty area.

Outcomes:

• Fall prevention activities link to Sustainable Development Goals (SDGs) such as poverty, reducing inequalities, good health, and well being.
• Expanding the reach of the program to an underserved population.
• Advancing knowledge at the local level for front line health care providers, caregivers, and individuals on and off reserve.
• Knowledge sharing at the local level with KTC that was shared with provincial partners.

Learning Outcomes:

Attendees will:

• gain an understanding of Indigenous demographics in Alberta;
• gain an understanding of the IPC Finding Balance program and the process to adapt existing materials to First Nations people in Alberta; and
• learn about the process for dissemination of resources and engagement processes with individual communities.

Abstract #2274: Designing Carefit for Indigenous communities: the importance of partnership

Presenting Author: Ann Pederson¹, Debbie Cheong², Charise Conkin³

Authors: Ann Pederson¹, Avneet Hayer¹, Debbie Cheong², Jade Wierks⁴, Lana Sullivan¹, Charise Conkin³

¹ BC Women’s Hospital and Health Centre

² CareFit Master Trainer

³ Stó:lō Nation

⁴ Fraser Health Authority

Workshop Objectives:

1. Understand ‘Carefit’, a physical activity program for older adults focussed on fall prevention, and mobility.
2. Describe a case example of re-designing Carefit materials and training to a culturally appropriate program to deliver to Indigenous communities.
3. Demonstrate the importance of partnered engagement to promote meaningful achievement of objectives.

Workshop Description: As we age, the incidence of falls increases. Many older adults become less mobile, tire easily, and experience a variety of conditions such as aching joints, all of which produce barriers to physical activity participation and make activities of daily living challenging. ‘Carefit’ is a physical activity program for older adults focused on fall prevention and mobility. Trained facilitators deliver this program in a variety of settings. The Carefit program was developed by adapting the Osteofit exercise program for more frail participants. Neither Carefit nor Osteofit were developed with the engagement of Indigenous leaders or community members, raising the question of the extent to which the programs are culturally safe and acceptable to Indigenous participants. This interactive workshop will introduce participants to the modified Carefit program created for use in the Stó:lō Nation of the Eastern Fraser Valley of British Columbia. Workshop participants will be guided through the collaborative approach taken to re-design the Carefit program training materials, visuals, and exercises to be culturally safe for members of this Indigenous community. Particular attention will be paid to establishing a partnership among physical activity leaders and Indigenous health authority and community staff and how Indigenous Elders and program participants were engaged throughout the project. Workshop participants will have a first-hand experience of the Carefit training, learn the results of a pilot training held in September 2022, and discuss the principles of decolonizing physical activity in the context of aging and fall prevention. Workshop participants will understand the basics of Carefit, be able to describe our case study method of partnership and engagement to re-design the Carefit program to be culturally safe, and be able to demonstrate the principles of establishing culturally appropriate and sustainable programming through partnerships with Indigenous communities.

Topic: Road Safety | Location: Coal Harbour Ballroom B

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Abstract #2212: Traffic-calming measures and road traffic collisions and injuries: A spatiotemporal analysis

Presenting Author: Brice Batomen¹

Authors: Brice Batomen¹, Marie-Soleil Cloutier², Mabel Carabali³, Brent Hagel^4,5, Andrew Howard⁶, Linda Rothman⁷, Samuel Perreault⁸, Patrick Brown⁸, Erica Di Ruggiero¹, Susan Bondy¹

¹Dalla Lana Scholl of Public Health, University of Toronto

²Centre Urbanisation Culture Société, INRS

³Ecole de Santé Publique Université de Montréal

⁴Departments of Paediatrics and Community Health Sciences, Cumming School of Medicine, University of Calgary

⁵Alberta Children’s Hospital Research Institute and O’Brien Institute for Public Health, University of Calgary

⁶The Hospital for Sick Children

⁷Toronto Metropolitan University

⁸Department of Statistical Sciences, University of Toronto

Abstract:

Introduction: Traffic-calming measures (TCMs) are physical modifications to the road network aimed at making the roads safer. Although studies have reported reductions in road crashes and injuries tied to the presence of TCMs, they have been criticized for their pre-post designs, which cannot generally account for i) the secular trend in the number of collisions, ii) regression to the mean, and iii) collision migration and dispersion.

Objectives: This study aims to complement our knowledge of TCMs effectiveness by assessing their impact using a longitudinal design.

Methods : The implementation of eight TCMs including curb extensions and speed humps was evaluated at the intersections and census tract levels in Montreal, Canada from 2012 to 2019. The main outcome was fatal or serious collisions among all road users. Secular trend in outcomes was considered by adjusting for year’s fixed effects. Conditional Poisson regression with Bayesian inference and time-varying random effects were used to account for the spatiotemporal variation in collisions. TCMs were generally implemented on local roads, although most collisions occurred on arterial roads.

Findings: Overall, there was weak evidence that TCMs influenced the study outcomes. However, subgroup analyses of intersections on local roads suggested a 69% reduction in collision rates due to TCMs (median IRR: 0.31; 95% Credible Intervals: 0.12 – 0.86).

Conclusion: To improve road safety, effective counterparts of TCMs on arterial roads must be identified and implemented. Further work addressing the potential confounding and mediating role of traffic volume are needed.

Abstract #2321: Exploring social-spatial inequities in road traffic crashes in BC

Presenting Author: Michael Branion-Calles¹

Authors: Michael Branion-Calles¹, Shannon Erdelyi¹, Herbert Chan¹, Jeff Brubacher¹

¹The University of British Columbia

Abstract: Our analyses sought to compare neighbourhood level indicators of socioeconomic status (SES) to rates of road traffic crashes and injury in the province of BC. We used SES indicators from the 2016 Canadian Census and road traffic crash and injury data from the Insurance Corporation of British Columbia (ICBC) from 2015-2019, aggregated to the Dissemination Area (DA) census boundaries. We calculated crude incidence of all crash victims and injury crashes, adjusting for DA road length, by quintiles of socioeconomic indicators including material deprivation indices, social deprivation indices, % recent immigrants, average income, % low-income, among others. We then conducted a geographically weighted regression of the relationship between each SES indicator and road traffic crashes to better understand regional variation in the magnitude and directionality of the relationship. Our results show that a strong socioeconomic gradient in road traffic injury exists at a provincial level with disadvantaged neighbourhoods having a higher incidence of collisions across all modes. For example, DAs with the highest proportion of people with low incomes (5th quintile) had incidence rates 3.1 times higher than DAs with the lowest proportions (1st quintile). The strength and directionality of this relationship, however, varies substantially within different areas of the province.

Abstract #2213: The effect of telematics feedback on driving behaviour and road safety outcomes of new drivers

Presenting Author: Michele Martin¹

Authors: Michele Martin¹, Mark Milner¹

¹ICBC (Insurance Corporation of British Columbia)

Abstract:

Introduction: New drivers are at increased risk of being involved in a crash and are disproportionately represented in the injury and crash statistics. As such, it is important to identify new approaches that can further reduce risk. A promising intervention is in-vehicle telematics with driving feedback.

To examine the potential use of telematics, ICBC, a public insurer, undertook a pilot with new drivers. The objective was to assess if telematics with driving feedback and incentives leads to improved driving behaviour and crash reduction.

Method: A post test-only control group design was used. Drivers with less than 4 years of unsupervised driving experience were recruited and randomly assigned to either a driving feedback plus incentives group or a control group. The pilot ran for 21 months. Comparisons were made across select driving behaviour events as well as crash frequencies.  A negative binomial regression was used to analyse driving events while a Poisson regression was used to analyze crash frequencies. To capture how drivers experience telematics, a survey and in depth interview was conducted.

Results: A total of 2,147 drivers were recruited. Telematics use had a positive influence on driving behaviour with improvements observed across most behaviour event types. These differences were statistically significant, p <0.05. Although differences up to 13% were observed in crash frequencies, this was not statistically significant, p > 0.05.

Drivers using telematics reported being more self-aware, including better reflection and adjustment of their driving behaviour. They also shared norms and attitudes about speeding in BC, and the impact it had on their driving.

Conclusion: Telematics use with driving feedback and incentives has a positive influence on driving behaviour. It shows promise as part of a larger road safety approach aimed at improving road safety for new drivers.

Abstract #2261: Syncope and the risk of subsequent motor vehicle crash

Presenting Author: John A Staples¹

Authors: John A Staples¹, Shannon Erdelyi¹, Ketki Merchant¹, Candace Yip¹, Mayesha Khan¹, Donald A Redelmeier², Herbert Chan¹, Jeffrey R Brubacher¹

¹University of British Columbia

²University of Toronto

Abstract:

Background: Syncope recurrence while driving might result in a traffic collision, yet medical driving restrictions impose occupational and social burdens on affected patients. Few empirical data inform current driving restrictions after syncope.

Methods: We performed a population-based retrospective observational study of crash risk after first-episode syncope. Patients visiting any of six urban emergency departments (ED) with a discharge diagnosis of ‘syncope and collapse’ were age- and sex-matched to 4 control patients visiting the same ED in the same month. We linked chart abstraction data, administrative health records and detailed crash data, then compared crash-free survival among individuals with syncope to that among controls.

Results: In the year following index ED visit, 846 first crashes occurred among 9,223 syncope patients and 3,457 first crashes occurred among 34,366 controls, indicating no significant difference in subsequent crash risk among syncope patients and controls (9.2% vs 10.1%; adjusted hazard ratio [aHR], 0.93; 95%CI, 0.87-1.01; p=0.073). Subsequent crash risk among syncope patients was not significantly increased in the first 30 days after index visit (aHR, 1.07; 95%CI, 0.84-1.36; p=0.56) or among subgroups at higher risk of syncope recurrence (i.e. age >65 years, index syncope deemed likely to be cardiogenic, San Francisco Syncope Rule score ‚â•1, or index ED visit ending in hospitalization). 

Conclusions: The risk of subsequent traffic crash among patients visiting the ED with first-episode syncope is no different than the risk among typical ED patients. Expansion of driving restrictions after syncope is not justified.

Abstract #2219: For young drivers, by young drivers: improving road safety for Canadian youth

Presenting Author: Umayangga Yogalingam¹

Authors: Umayangga Yogalingam¹

¹Parachute

Abstract:

Introduction: Young drivers are a priority population for road safety interventions. Crashes are the third-leading cause of death for young people in Canada and kill young people at a higher rate than any other age group under 75 (Parachute, 2021; Stats Can, 2020). Reaching young drivers for awareness and education presents unique challenges and opportunities compared to other demographic groups. The For Young Drivers, By Young Drivers project partnered with young Canadians to create innovative approaches to reach and meaningfully engage young road users and ultimately, create safer roads.

Objectives: This project aims to address the issue of road injuries and deaths among youth by partnering with 15- to 24-year old Canadians to:

• Understand facilitators, barriers and attitudes to safe driving behaviours in young people.
• Identify technology- and communications-based opportunities to increase youth awareness of road safety issues.
• Build a framework and tools to guide engagement of young people in road safety initiatives.

Approach: Informed by research and other youth outreach efforts, around 300 youth across Canada were engaged via focus groups, peer-to-peer interviews, and a survey to understand how they think and feel about safe driving behaviours, how they behave on the road, who and what influences their behaviours, and where they go for trusted information. Subject matter experts in road safety and youth engagement were also interviewed. Activities were co-led by the Canadian Youth Road Safety Council, consisting of 20 youth aged 15 to 24 across Canada. The purpose of the council is to integrate youth voices and expertise into this project and Parachute’s youth-focused road safety programs.

Results: Key learnings were compiled to co-develop a framework and accompanying assets to guide engagement of young drivers and their passengers during Parachute’s youth-focused road safety initiatives. The key learnings and framework will be presented at this conference.

Topic: Sport Injury | Location: Grouse Room

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Abstract #2307: Injury Rates of Three Popular Female Sports Across Three Canada Winter Games

Presenting Author: Caroline Hicks-Casey¹

Authors: Caroline E. Hicks-Casey¹, Taffin S. Evans², Brian D. Roy², Amanda M. Black²

¹Department of Kinesiology, Faculty of Applied Health Sciences, Brock University

²Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary

Abstract:

Rationale: Over 2000 athletes participate in the Canada Games each year, yet to date, there are no published studies that examine injury risk. Furthermore, there are few studies examining Canadian female youth athletes.

Objectives: To examine sport-related injury rates for females competing in sports with the most female participants during the 2011, 2015 and 2019 Winter Games (artistic swimming, ringette, and ice hockey).

Methods: This is a retrospective cohort study using data extracted from registration information and incident reports by Canada Games’ medical staff. The medical reports were coded based on the Orchard Sports Injury and Illness Classification System and the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport. Registered female athletes participating in artistic swimming, ringette, or ice hockey, were included in this analysis. Injury incidence proportions (IP) per 100 registered athletes with 95% confidence intervals (CI) were calculated for athletes by sport, based on index or subsequent injuries directly or non-directly related to sport.

Results: In total, 283 female athletes participated in artistic swimming [mean (SD) age=16.6(1.53)], 473 participated in ringette [mean (SD) age=18.5(1.09)] and 703 participated in hockey [mean (SD) age=16.8(1.10)] across three Winter Games. The IP was highest in women’s ringette [IP: 26.0 injuries (95% CI: 21.61-31.03) per 100 athletes], followed by hockey [IP:21.76 injuries (95% CI: 18.45-25.5) per 100 athletes] and finally lowest in artistic swimming [IP:11.31 injuries (95% CI: 7.73-15.96) per 100 athletes].

Conclusion: Approximately 1 in 4 ringette, 1 in 5 hockey, and 1 in 9 artistic swimming female athletes sustained at least one injury requiring medical attention during the Canada Winter Games, suggesting a need for future examination of injury prevention strategies in female and youth sport.

Abstract #2256: Adolescents’ perspectives on skateboarding and injury risk: the benefits outweigh the risks

Presenting Author: Mike Corbett¹

Authors: Mackenzie Seasons, Barbara Morrongiello,  Mike Corbett¹

¹University of Guelph

Abstract: Skateboarding is an increasingly popular sport among youth, despite the fact that children and adolescents are the age groups most frequently injured when skateboarding. A greater understanding of the psycho-social factors that motivate participation in skateboarding, including why youth return to the sport after serious injury, is needed to inform injury prevention efforts. Addressing this gap, twenty-six Canadian adolescent skateboarders 14 – 17 years of age (20 males and six females) who had previously sustained medically-attended injuries participated in individual interviews to explore their perspectives on skateboarding and injury risk. Thematic analyses revealed that participants perceived many unique benefits from skateboarding, including: interpersonal benefits; mental and physical health benefits; pleasure; personal growth; and identity development. Participants uniformly identified that a major drawback was risk of injury, with trickle down effects of injury including a loss of social contacts (e.g., missing friends), challenges to individual identity from not participating, and injury specific negative outcomes (e.g., pain, physical limitations). When exploring reasons participants returned to the sport and to the trick or activity that precipitated their injury, the primary theme identified was that the benefits of skateboarding, particularly psycho-social ones, significantly outweighed the costs associated with potential re-injury. Results paint a nuanced picture of psycho-social factors that impact youths’ skateboarding and decisions to return to the sport after injury. Implications for injury prevention are discussed.

Abstract #2263: Identifying environmental and personal risk factors for skatepark falls among youth

Presenting Author: Mike Corbett¹

Authors: Maria Amir, Belle Dodd, Barbara Morrongiello, Kelly Russell, Mike Corbett¹

¹University of Guelph

Abstract: Skateboarding is a common leisure activity and form of active transportation for Canadian youth (Aymar, 2017), yet injuries due to falls are on the rise as more cities construct skateparks to encourage physical activity (Dumas & Laforest, 2009). Past studies suggest that fractures and musculoskeletal injuries are the most frequently observed injuries in skateboarders, most often affecting the lower and upper extremities and resulting from falls. This study aimed to identify the skatepark features and tricks that pose an increased risk of fall injuries in teenage skateboarders. Unobtrusive observations of over 500 youth were recorded at a local skatepark. Videos were coded to identify the features used on the skatepark (e.g., stairs), the tricks attempted (e.g., olie), and the fall severity rating for the trick attempted which ranged from 1 (successful completion) to 6 (fall onto entire body); reliability estimates were completed during the coding session and exceeded 90% agreement. The results revealed differential risk for falls across different feature areas on skateparks. Additionally, certain tricks posed a higher fall risk in comparison to others. Suggestions for changes to skatepark design and youth behavior will be discussed as approaches to injury prevention among skateboarders.

Abstract #2204: Blessures subies lors des activités de compétitions de motocross au Québec

Presenting Author: Sophie-Anne Lemay¹

Authors: Sophie-Anne Lemay¹, Pierre Maurice¹, Mathieu Gagné¹, Thierry Arseneau¹, Claude Goulet²

¹Institut national de santé publique du Québec

²Université Laval

Abstract:

Introduction: Les habiletés psychomotrices des jeunes de moins de 16 ans n’étant pas développées complètement, on peut se demander s’il est avisé de leur permettre de participer à des compétitions de motocross.

Objectifs: Documenter le risque de blessures subies lors de compétitions de motocross selon l’âge des participants; comparer ce risque à celui encouru lors d’une activité de compétition couramment pratiquée par les jeunes de moins de 16 ans (ski alpin).

Méthodologie: Les risques ont été calculés à partir des taux d’incidence (TI) soit le rapport entre le nombre d’évacuations en ambulance lors des compétitions et a) le nombre de départs effectués par l’ensemble des participants (participations-départs) ou b) le temps de compétition de l’ensemble des participants (participations-minutes). Les TI calculés pour les compétitions de motocross ont été comparés aux TI pour le slalom et le slalom géant en ski alpin.

Résultats: Les TI des évacuations par ambulance lors de compétitions de motocross sont de 3,06 par 1000 participations-départs et de 0,25 par 1000 participations-minutes. Ces TI sont semblables pour les moins de 16 ans et les 16 ans et plus. Lorsqu’on les compare au slalom et slalom géant, ils sont supérieurs sur la base des participations-départs tant pour les moins de 16 ans (RTI 18,01; IC 95% : 6,87 à 47,19) que pour les 16 ans et plus (RTI 5,67; IC95% : 2,60 à 12,37). En participations-minutes, les différences ne sont pas statistiquement significatives.

Conclusion: Pour chaque départ, le risque d’autre évacué en ambulance est considérablement plus élevé lors d’une compétition de motocross que lors d’une compétition de ski alpin. Même si on n’observe pas cet excès de risque en utilisant le temps de compétition, nous considérons que cet excès de risque est bien présent puisque la durée d’une compétition est inhérente aux caractéristiques du sport. Ces résultats permettent d’appuyer l’importance de la réglementation de sécurité.

Abstract #2277: Decision making in mountain biking: role of riding ability and fear of falling

Presenting Author: Emily P. Chilton¹

Authors: Emily P. Chilton¹, Stephen N. Robinovitch¹

¹Simon Fraser University

Abstract:

Introduction: Falls and injuries are common in mountain biking (MTB), and safe participation in MTB relies on near-constant decision-making in selecting paths that can be safely negotiated (Becker et al., BJSM, 2013). Few studies have examined the factors that influence path selection.

Objective: We conducted experiments with wooden ramps (common features in MTB) of different heights and widths to determine how riders select paths based on their fear of falling and riding ability.

Methods. Experiments with 12 participants (age range: 19–69) were conducted at an outdoor space of the SFU Burnaby campus, using a 7.6m long ramp that could be adjusted (via a scissor jack) to heights above the ground between 32.5–96.5cm, and widths of 15.2, 30.5, and 45.7cm. Participants visualized nine randomly-presented combinations of ramp width and height, and described their willingness to ride each ramp. Riding ability was measured in maintaining a straight-line path on level ground. Fear of falling was assessed with a questionnaire. We used multiple logistic regression to examine how willingness to ride associated with riding ability, fear of falling, ramp height, and ramp width.

Results. A 1-point increase in riding ability was associated with a 10-fold increase in willingness to ride ramps (OR=9.7; 95%CI=1.5-62.7; p=0.008). When compared to those who feared falling, riders who expressed no fear of falling were 30-fold more likely to attempt a ramp (30.0; 2.5-352.6; p=0.001). Willingness to attempt a ramp increased 25% for each additional cm of width (p<0.0001) and decreased 12% for each additional cm of height (p<0.0001).

Conclusions. Rider decision-making in MTB depends on characteristics of the path (ramp width and height) and the rider (fear of falling and riding ability).

Topic: Children and Youth Intentional/Inflicted Injury | Location: Seymour Room

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Abstract #2248: It’s time to be BRAVE: addressing community violence together

Presenting Author: Brandy Tanenbaum¹

Authors: Brandy Tanenbaum¹, Corey Freedman¹, Avery Nathens¹

¹Sunnybrook Health Sciences Centre

Abstract:

Introduction: Violence is a global health issue that disproportionately affects young, racialized males. The number of violent injuries treated in the Sunnybrook Health Sciences Centre has doubled over the past five years accounting for almost 20% of trauma activations. In response, the Centre for Injury Prevention developed a hospital-based violence intervention program (HVIP) called Breaking the Cycle of Violence with Empathy (BRAVE) to address this issue.

Objectives: BRAVE aims to promote positive alternatives to violence in order to reduce retaliation/criminal involvement/re-injury among youth.

Approach: BRAVE uses a trauma-informed approach to violence prevention recognizing the modifiable risk factors including SDOH and systemic racism. A culturally-competent case manager provides social service support including: facilitation of referrals to community services, linking patients/families to mental health supports and supporting medical follow-up for physical injury care.

Findings: 52 patients were enrolled in the first year. These patients and their families were supported by the case manager including more than 640 patient interactions, 251 in-person home visits, 298 risk-factors identified, and 143 service referrals. A mixed-method evaluation of the first year demonstrated a 35% reduction in risk factors for violence following participation in the program. Patient/family/staff interviews reveal a unique therapeutic relationship providing youth injured by violence with support not available elsewhere in the healthcare or other community systems. Conclusion: System limitations for supporting violently injured patients disproportionately impacts systemically disadvantaged individuals. Programs like BRAVE fill system gaps and advocate for expanded services to address the underlying factors supporting violence. Hospitals are an ideal setting for secondary violence prevention and should be resourced to provide such services in collaboration with public health efforts.

Abstract #2304: Hospitalization trends for intentional self-harm among children and youth in British Columbia

Presenting Author: Mojgan Karbakhsh¹

Authors: Mojgan Karbakhsh¹, Neil Arason^2,3, Jeanette Foreman^2,4, Naiomi Lu^1,2, Fahra Rajabali¹, Alex Zheng¹, Megan Oakey^1,2, Ian Pike^1,5

¹BC Injury Research and Prevention Unit

²BC Centre for Disease Control

³Island Health

⁴Northern Health

⁵Department of Pediatrics, The University of British Columbia

Abstract:

Introduction: Intentional self-harm among children and youth is an important injury prevention priority in British Columbia (BC), Canada.

Objective: We examined hospitalization trends for intentional self-harm including suicide attempts and non-suicidal self-injury – among children and youth (10-24 years) from 2003 to 2019, by sex, age group, external cause, and Health Authority (HA).

Methods: Aggregated and de-identified injury data were retrieved from the BCIRPU injury Data Online Tool (iDOT), populated from the Discharge Abstract Database (DAD). Variables included year; sex; age-group (10-14, 15-19, 20-24 year-old); external cause of injury; and HA (Fraser (FR), Vancouver Island (VI), Interior (IN), Vancouver Coastal (VC), Northern (NO)). Linear regression was implemented to analyze trends in annual rates (per 100,000) using IBM SPSS version 26.

Results: The hospitalization rate across the study period was 110.46 (166.74 among females and 57.61 among males), with the highest rate among 15-19 year-olds (165.94). The rate was 2.8 times greater in the HA with the highest rate (187.52 in NO) compared to the HA with the lowest rate (67.29 in VC). An increasing trend in rates was observed, with significant differences across HAs (P<0.001). Increasing trends were also present among females; 10-15 and 15-19 year-olds; in VI and IN, but not among males, 20-24 year-olds or other HAs. Self-poisoning was the most common external cause (87.9%) overall, and in all HAs, with the rate increasing from 110.56 to 129.09 within the study period (P=0.013).

Conclusion: The high and increasing trend, especially among 15-19 year-old females is alarming and calls for targeted preventive interventions. Further studies would be informative to examine trends by intent, to delineate the burden of attempted suicide vs. non-suicidal intentional injuries among children and youth.

Abstract #2288: Suicide among children and youth in British Columbia: patterns and trends

Presenting Author: Jeanette Foreman^1,2

Authors: Jeanette Foreman^1,2, Mojgan Karbakhsh³, Neil Arason^1,4, Naiomi Lu^1,3, Fahra Rajabali³, Alex Zheng³, Megan Oakey^1,3, Ian Pike^3,5

¹BC Centre for Disease Control

²Northern Health

³BC Injury Research and Prevention Unit, BC Children’s Hospital

⁴Island Health

⁵Department of Pediatrics, The University of British Columbia

Abstract:

Introduction: Suicide is a leading cause of injury-related death among children and youth in British Columbia (B.C.), Canada. Identifying the circumstances around suicide, and understanding trends are essential for developing preventive initiatives. Although the drivers of suicide span individuals, families, peer groups, schools, communities and sociopolitical levels, this study mainly focuses on means as an important element of any comprehensive suicide prevention effort.

Objectives: We aimed to determine suicide trends and patterns among 10-24 year-olds in B.C., between 2004 and 2020, by sex, age group and Health Authority (HA).

 Methods: Using death data from B.C. Vital Statistics, variables including year; sex; age group; mechanisms; and HA (Fraser (FH), Island (IH), Interior (IHA), Vancouver Coastal (VCH) and Northern (NH)) were explored. Trends in rates were examined using linear regression.

Results: Of 979 suicide deaths, 72.8% were male and 59.2% were 20-24 years old. The suicide death rate was 6.91 per 100,000 (3.86 among female and 9.73 among males). The rates were highest among 20-24 year olds (11), followed by 15-19 (7.6) and 10-14 (0.95). Rates ranged from 4.60 in FH, 5.39 in VCH, 9.09 in IHA, 9.62 in IH, to 11.6 in NH. The overall rate and per age group and mechanism did not show significant trends. For FH, an increasing trend was observed (P=0.024, B=0.12). The most common suicide mechanisms were suffocation (55.9%), firearm (13.0%), poisoning (11.1%) and fall (10.3%).

Conclusion: As rates were consistently higher among males, and young adults (20-24 years) represented more than half of decedents, prevention should be especially prioritized for this group. HA differences need to be explored further. The high proportion of suicide by suffocation poses potential limitations on the extent to which suicide may be reduced through means restriction.  These data will help determine multi-level approaches needed for the prevention of youth suicide in B.C.

Abstract #2314: Does the PURPLE Program have an impact on infant physical abuse rates in BC?

Presenting Author: Karen Sadler^1,2

Authors: Fahra Rajabali², Karen Sadler^1,2, Ian Pike^2,3

¹Prevent Shaken Baby Syndrome BC

²BC Injury Research and Prevention Unit

³Department of Pediatrics, University of British Columbia

Abstract:

The study was undertaken to determine if physical abuse rates of children <24-months-old have also decreased in British Columbia (B.C.) due to the implementation of a 3-dose universal parenting education program for the prevention of shaken baby syndrome, the Period of PURPLE Crying Program® (PURPLE) in 2007. The validity of the PURPLE program in reducing Traumatic Head Injury – Child Maltreatment/Shaken Baby Syndrome (THI-CM/SBS) in B.C. has been determined in previous research, “Eight-year outcome of implementation of abusive head trauma prevention” that concluded that the intervention was associated with a 35% reduction in THI-CM/SBS admissions that was significant for <24-month-olds. This study follows similar research methodology to determine if a similar reduction can be seen in physical abuse cases for <24-months-old.

Methods: Hospitalizations for the admissions to British Columbia Children’s Hospital (BCCH) among children ages less than 24 months occurring between calendar years 2001 to 2019 were obtained from the Discharge Abstract Database (DAD), Ministry of Health. Population data were obtained from B.C. Stats. A retroactive review of all Child Protection Service (CPS) case charts (1999-2019) was undertaken by the PURPLE team where THI-CM/SBS admissions were tracked.

Results: Our study found an association between PURPLE implementation province-wide in B.C. with a decrease in physical abuse hospitalizations to BCCH. This reduction occurred despite low pre-implementation rates and contrasted positively with reports of increasing rates or no changes following prevention implementations.

Conclusion: Undertaking a review of impact on infant physical abuse in relation to pre and post-implementation of a universal THI-CM/SBS education program is important for decision-makers who typically make strategic investments in injury prevention and policymakers considering parental education programs as a component of physical abuse prevention.

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