Concurrent Sessions 4
Thursday, November 3, 2022 | 1:30 – 3:00 PM
For a brief overview of the presentations occurring during Concurrent Sessions 4, please consult the tables below.
To view the full abstracts, please scroll down further or use the links in the tables below.
Topic: Pediatric Falls | Location: Coal Harbour Ballroom A
Moderator: Hélène Gagne
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Topic: Road Safety and Children | Location: Coal Harbour Ballroom B
Moderator: Jeanette Foreman
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Topic: Sport and Concussion | Location: Grouse Room
Moderator: Sarah Richmond
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Topic: Children and Youth | Location: Seymour Room
Moderator: Mariana Brussoni
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| Pediatric Falls | Road Safety and Children | Sport and Concussion | Children and Youth |
Abstract #2224: Childhood fall prevention indicators for public health practice in Ontario
Presenting Author: Alexia Medeiros1,2
Authors: Alexia Medeiros1,2, Alison Macpherson1, Ian Pike3,4, Sarah Richmond2
1York University
2Public Health Ontario
3BC Children’s Hospital Research Institute
4BC Injury Research and Prevention Unit;
Abstract:
Background: Falls represent the highest cost of any injury mechanism in Canada, with falls among children costing Canadians $996 million annually. Additionally, rates of fall-related injuries among children have not improved in recent years. Currently, only high-level burden indicators are systematically reported on in Ontario. As a result, we sought to develop a list of indicators that better inform the work of stakeholders to be used in a province-wide multi-sectoral approach to child fall prevention programming.
Methods: An environmental scan, including a peer-reviewed and grey literature search, was conducted to identify existing child fall prevention indicators in Canada and internationally. Stakeholders and experts then provided feedback on the identified indicators in several rounds, as well as were given the opportunity to recommend novel indicators that were not previously identified.
Results: A final list of indicators was refined based on stakeholder and expert feedback. Indicator specification tables were developed for each indicator to guide their use. One novel indicator, serious fall-related injuries, was selected by the stakeholder group for its importance in distinguishing the most severe fall-related injuries to be populated using data from Ontario and piloted among a set of public health units.
Conclusion: The environmental scan and iterative feedback process were successful in developing a set of indicators that will be used in a province-wide multi-sectoral approach to child fall prevention programming. The piloting phase will allow for further refinement of the indicators and their use in practice.
Abstract #2228: Using a pediatric serious injury indicator to identify high risk falls in Ontario
Presenting Author: Alison Macpherson
Authors: Mishel Mahboob1, Sarah A. Richmond2, Alexia Medeiros1, Alison Macpherson1
1York University
2Public Health Ontario
Abstract:
Introduction: Falling is a part of normal child development; however, some falls can result in severe injuries such as face and skull fractures, and injuries to the intra-abdominal and pelvic organs. It is important to identify the groups at highest risk and the mechanisms commonly associated with these injuries in order to guide prevention program planning. This study sought to analyze serious fall-related injuries in Ontario by age group, mechanism, and public health unit.
Methods: Fall-related hospitalizations among 0-19 year olds in Ontario were obtained from the Discharge Abstracts Database (DAD). A selection of codes from the International Classification of Diseases (ICD-10) were used to identify serious injuries. Serious fall-related injuries between 2010 and 2019 were analyzed by age and public health unit and then by age, sex and mechanism of injury. Rate ratios were used to compare the rate of serious to non-serious injuries in each public health unit.
Results: Between 2010 and 2019 26,345 fall-related injury hospitalizations and 3,652 serious fall-related hospitalizations among children ages 0-19 were observed in Ontario. The highest rate of serious injuries was observed among 15-19 year olds in one public health unit at 369.4 per 100,000 and the lowest at 61.9 per 100,000 in 5-9 year olds in another public health unit. The rate ratios comparing serious to non-serious injuries ranged by age and public health unit from 0.04 to 0.40. The mechanism of injury responsible for the highest rate of serious injuries was falls from skis, blades, skates and boards and was observed among males ages 15-19 (67.2 per 100,000).
Conclusion: Identifying the groups at highest risk of serious fall-related injuries, as well as the mechanisms commonly responsible for these injuries can inform public health program planning to prevent the most severe injuries.
Abstract #2231: Reframing childhood fall prevention for collective action in Canada
Presenting Author: Michelle Dueckman1
Authors: Michelle Dueckman1, Liane Fransblow2, Hélène Gagné1
1Parachute
2Montreal Children’s Hospital Trauma Centre;
Abstract:
Rationale: Falls are the number one cause of injury hospitalizations, emergency department visits and disabilities in children and children’s falls injuries cost $996 million a year in Canada. Most falls don’t result in serious injury, but nearly 4,500 children (0-14) were admitted to hospital because of a fall in 2018. Despite this, there is no defined collective understanding for how to approach childhood fall prevention in Canada. This is why a national committee has begun examining the issue and proposing a common approach based on evidence and stakeholder input.
Objectives: 1) Develop a common understanding of the Canadian context of childhood fall prevention. 2) Develop a common understanding of practitioner perspectives. 3) Design, validate and implement a childhood fall prevention approach informed by data, existing theories, and those who work with children.
Approach: The committee led scoping work including two environmental scans and two townhall meetings with key stakeholders in the field of childhood fall prevention. The townhalls sought to validate findings, gather input on a proposed framework for childhood fall prevention and identify priorities for collective action.
Findings: The scoping work identified key differences between falls in older adults and children, siloes within the sector, challenges balancing risk and play, certain at-risk populations, and practical challenges. Townhall participants identified the need to redefine childhood fall prevention in a broader context to resonate with parents, intermediaries and communities at large.
Practice Implications: The proposed approach reframes childhood falls, prevention strategies, and the need for collective action in a community well-being context. It targets a broader audience than those usually tasked with the responsibility and engages those in sectors with day-to-day interactions with children. Priorities for action and next steps for collective impact across Canada will be discussed.
Abstract #2258: Reaching for new heights: our collective role in children’s fall prevention
Presenting Author: Sandra Newton1
Authors: Sandra Newton1, Chantal Walsh1
1IWK Health – Child Safety Link
Abstract:
Falls, followed by transport incidents (e.g., motor vehicles, ATVs, bicycles and being a pedestrian) represent the highest costs of injury for children in Atlantic Canada. The cost of children’s falls alone is $52 million in Atlantic Canada. Child Safety Link is a Maritime-wide (Atlantic when appropriate) child and youth injury prevention program of IWK Health in Halifax, Nova Scotia. During the beginning of the pandemic, Child Safety Link conducted a series of engagement sessions with agencies who work with young families. The purpose was to understand the barriers and challenges to preventing unintentional injuries when supporting vulnerable families. Child Safety Link conducted six engagement sessions with more than 45 service providers. Overall, the findings from the engagement sessions can be categorized into three areas: Family and community impacts of injury; Barriers to injury prevention; and Recommendations for next steps. Barriers included challenges in building trust with families, ensuring access to resources and services, and the availability of culturally competent and relevant information. This session will Identify the top causes of unintentional injuries among children 0-14 years; Outline key barriers and challenges for those who work with young families to address injury prevention; and Identify Child Safety Link’s next steps based on the barriers and challenges identified including work to address fall prevention.
Abstract #2226: Preventing falls from windows in the children of British Columbia
Presenting Author: Meah Lamothe1
Authors: Meah Lamothe1, Ruth Mitchell2,3, Stephano Chang4, Ash Singhal2,3, Mandeep Tamber2,3
1Faculty of Medicine, University of British Columbia
2Faculty of Medicine and the Division of Neurosurgery, University of British Columbia
3British Columbia Children’s Hospital
4Division of Neurosurgery, Department of Surgery, University of British Columbia
Abstract:
Objective: Unintentional falls are the leading cause of non-fatal injuries in the pediatric population. Falls from windows commonly lead to serious injuries requiring costly, invasive interventions. We aim to describe the severe injuries sustained due to falls from windows in a province-wide pediatric population, to inform prevention initiatives.
Materials and methods: We searched the British Columbia Trauma Registry (BCTR) for patients treated at the provincial pediatric trauma service who had unintentional falls from January 1, 2007 to December 31, 2020. The trauma database, electronic and paper-based medical records were searched. Institutional ethics board approval was obtained.
Results: We found 2420 patients admitted in the defined period with falls, 1605 having fallen from less than one metre. We focused on falls between one and six metres resulting in admission to the Intensive Care Unit, and falls more than six metres, for 168 patients in total. Falls from windows accounted for just over a third of the falls in this period, more than any other mechanism. The mode of transportation to hospital, length of hospital stay, and length of ICU stay were similar in falls from windows, and other falls. However falls from windows resulted in significantly greater rates of trauma team activation, and patients were more likely to have sustained a head injury. Falls were most common in the summer months, with a peak in August.
Conclusions: A significant proportion of falls in our pediatric population are falls from windows. Further analyses are planned with regard to the age, number of operative interventions, permanent disability, and death in this cohort when compared with other pediatric falls patients. If such a high incidence of falls from windows occurs in our relatively temperate climate, a similar injury pattern might be found in warmer climates. Seasonal patterns of injury may help inform prevention efforts.
Abstract #2222: Social inequalities in child pedestrian motor vehicle collisions and the built environment
Presenting Author: Linda Rothman1,2
Authors: Linda Rothman1,2, Naomi Schwartz2, Marie-Soleil Cloutier3, Raktim Mitra2, Natasha Saunders4, Alison Macpherson5, Pamela Fuselli6, Andrew Howard4
1Ryerson University
2Toronto Metropolitan University
3Institut National de la Recherche Scientifique (INRS)
4Hospital for Sick Children
5York University
6Parachute
Abstract:
Background: In Canada, road injury is a leading cause of death among children and youth. Important inequalities in child pedestrian-motor vehicle collisions (CPMVC) are evident, with higher rates in low socioeconomic status neighbourhoods. The mechanism through which area-level social dimensions influence CPMVC is not well understood, nor is the role of the roadway-built environment.
Methods: This cross-sectional study examined the relationship between area-level social dimensions (material deprivation, recent immigrants, visible minorities) and CPMVC, controlling for built environment features (traffic interventions, roadway environments, and land-use features) in Toronto, Canada. Police-reported CPMVC (age 1-17), from 2010-2018 were mapped by census tract. Social indicators were derived from the Ontario Marginalization Index and the 2016 Canadian census. Built environment features were derived from the census and City of Toronto built environment data. Multivariable negative binomial regression models estimated associations between social dimensions and child PMVC per road kilometer.
Results: Between 2010-2018, 2,028 CPMVCs occurred. In adjusted models, all social dimensions were significantly associated with CPMVC, including material deprivation (Incidence Rate Ratio (IRR): 1.31, 95% Confidence Interval (CI): 1.22-1.40), recent immigrant (IRR: 1.58, 95% CI: 1.30-1.92, per 10% increase), and visible minority (IRR: 1.09, 95% CI: 1.05-1.12, per 10% increase). Built environment features, including certain land-use features (e.g., multi-dwelling density) were significantly associated with CPMVC, but did not attenuate associations with the exception of recent immigrant populations.
Conclusion: Inequalities in CPMVC exist across Toronto, particularly in areas with higher proportions of recent immigrants. Results suggest a need to target traffic safety interventions towards socially marginalized areas to provide safe walking environments for all children.
Abstract #2214: Child bicyclist injuries and the built environment: a case-crossover study
Presenting Author: Janet Aucoin1
Authors: Janet Aucoin1, Moreno Zanotto2, Tate HubkaRao1, Quynh Doan3, Suzanne Beno4, Antonia Stang1, Andrew Howard4, Gavin McCormack1, Alberto Nettel-Aguirre5, Meghan Winters2
Brent E. Hagel, University of Calgary
1University of Calgary
2Simon Fraser University
3University of British Columbia
4University of Toronto
5University of Wollongong Australia
Abstract:
Background: Bicycling provides health benefits but can also result in injuries. Built environment features can prevent bicycling injuries in adults; however, research on children is limited. Additional evidence about how the built environment influences child bicycling injury is needed.
Objective: To assess if built environment features are associated with child bicyclist injury risk in three Canadian regions using a case-crossover design.
Methods: Children (ages 5-17) injured while bicycling presenting to emergency departments in Vancouver, Calgary, or Toronto were recruited from May 2018 – October 2021. Children completed an interview on injury circumstances, location and bicycling route details. Environmental audits were conducted at the injury site and two control sites (one randomly selected; one matched to case intersection status) along the route. Characteristics of case and control sites will be compared in matched (within child) analyses and a mixed-effects logistic regression model will be used to formally assess associations.
Results: Preliminary unmatched results (n=347) suggest that compared with control sites, injury sites were: off road (41% vs 29%), areas with no path (11% vs 4%), had no bicycling signs/symbols (81% vs 72%), and frequently contained gravel (21% vs 7%). Next steps will use matched analyses including mixed-effects modelling to estimate associations between site features and child bicyclist injury.
Conclusion: Preliminary results suggest some built environment features may be associated with child bicyclist injuries. Additional analyses will be completed on route types, presence of infrastructure, and grade at injury and control sites. Study results will inform road safety changes and policies to increase child bicyclist safety.
Abstract #2215: Child bicyclists’ perceptions of safety: a qualitative analysis using Haddon’s Matrix
Presenting Author: Janet Aucoin1
Authors: Janet Aucoin1, Sarina Aryal1, Gavin McCormack1, Alberto Nettel-Aguirre2, Meghan Winters3, Brent E. Hagel1
1University of Calgary
2University of Wollongong Australia
3Simon Fraser University
Abstract:
Background: Bicycling can be a beneficial physical activity for children; however, child and parent perceptions of bicyclist safety may influence participation. The Haddon’s Matrix breaks down the factors (human, vehicle, environment) and phases (pre-injury, injury, post-injury) that relate to injury outcomes. It has been widely used in quantitative studies of road safety, but less in qualitative work. Applying Haddon’s Matrix to injured child bicyclist interview data may offer new insights.
Objective: To explore injured child bicyclists’ perceptions of safety using the Haddon’s Matrix.
Methods: Injured child bicyclists (aged 5-17) who presented to participating children’s hospitals in Vancouver, Calgary, or Toronto from May 2021 – October 2021 were recruited. Forty participants provided responses to open-ended questions on bicycling safety in an interview. A qualitative framework analysis was used to identify themes according to the factors and phases of the matrix.
Results: Of the factors children perceived as influencing safety, the majority were in the pre-injury phase, with fewer factors in the injury and post-injury phases. Within the pre-injury phase, over half of the factors mentioned related to the physical environment such as surface quality, gravel and bicycling infrastructure. Children consistently perceived interactions with motor vehicles and a lack of separation from them as reasons for feeling unsafe while bicycling.
Conclusion: Children can express factors that influence their perceptions of safety and that align with the Haddon’s Matrix. It is important to integrate children’s voices to better understand their perceptions of bicycling safety.
Abstract #2286: Building capacity: online child passenger safety training for social service organizations
Presenting Author: Holly Choi1, Katherine Hutka2
Authors: Holly Choi1, Katherine Hutka2, Jen Shapka1
1Child Passenger Safety Association of Canada
2Child Safety Link, IWK Health
Abstract:
Introduction: The Child Passenger Safety Association of Canada (CPSAC) is a non-profit organization, self-funded by members and powered by volunteers.
Approach: During the pandemic, the demand grew for an evidence-based, standardized child passenger safety basics program specifically for social service organizations.
Online, on-demand training has the potential to reach underserved populations; it can be accessible in terms of language, geography, and time commitment, and removes barriers in work schedules and time zones. An established in-person workshop from an injury-prevention program in Atlantic Canada was adapted with permission.
Evaluation: Pre- and post-training attitudes and confidence are measured, as is comprehension through mini-quizzes. A final assessment evaluates understanding, and a record of completion is provided.
Receiving hands-on support from someone with additional training after completion is encouraged but not required. Additional resources were developed to support in-person evaluation of knowledge and application of skills.
Findings: There is a strong demand for basic information designed for targeted audiences. This training aligns clearly with our organization’s mission to provide Canadians with the skills and knowledge to safely transport children, at a time when comprehensive in-person training had been limited due to the pandemic.
Participants report increased awareness of the importance of child passenger safety, confidence in their basic knowledge, and an understanding of how and where to get more help and information.
Conclusion: Delivering information in this way reaches far more people than in-person workshops or live webinars ever did, in a cost-effective, efficient, and accessible format with very few reported technological barriers.
Future plans include a French translation and the adaptation for other targeted audiences including retailers.
Abstract #2318: CATT for high performance athletes: reach and effectiveness
Presenting Author: Shelina Babul5,7
Authors: Amanda M. Black1-4, Aura Wetherell1, Kate Turcotte5, Taryn Taylor6, Samantha Bruin5, Karen Sadler5, Shazya Karmali5 , Shelina Babul5,7
1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Canada
2Alberta Children’s Hospital Research Institute, University of Calgary, Canada
3Hotchkiss Brain Institute, University of Calgary, Canada
4O’Brien Institute for Public Health, University of Calgary, Canada
5BC Injury Research and Prevention Unit, BC Children’s Hospital, Canada
6Carleton Sport Medicine Clinic, Carleton University, Canada
7Department of Pediatrics, University of British Columbia, Canada
Abstract:
Rationale: Tailored messaging can be effective at changing concussion management beliefs. In 2019, the BCIRPU partnered with U SPORTS (Canadian national university sports-governing body) to create a concussion education module with tailored messaging for high performance athletes (CATT-HPA).
Objective: To examine the reach and effectiveness of the CATT-HPA.
Methods: University administrators and clinicians at all U SPORTS institutions were provided a link to the CATT-HPA to share with their athletes, including a pre and post course assessment. The assessment examined determinants of appropriate concussion management informed by the Theoretical Domains Framework hypothesized to be affected by exposure to the tool (i.e., knowledge, skills, social roles/identity, beliefs about capabilities, beliefs about consequences, intentions to report, and emotions). Reach was assessed using analytics from completed course certificates. T-tests were used to examine mean score differences (MD) with 95% Confidence Intervals(95%CI) of each domain.
Results: 21 U SPORTS universities implemented the mandatory institution email certificate tracking system and there have been >10562 certificate completions from 47/56 (84%, median (range): 153 (1-898)) universities. A convenience sample of 257 student-athletes [99 males, 158 females; median age (range) 20 (17-33)] from 14 universities completed the pre-post course assessments. Exposure to the CATT-HPA resulted in significant immediate increases in mean knowledge scores [MD:0.88 (95%CI:0.58-1.17)], skills [MD:0.55 (95%CI:0.41-0.68)], beliefs about capabilities [MD:0.64 (95%CI:0.50-0.78)], indirect and direct self-reporting intentions [MD:0.26 (95%CI:0.18-0.35), MD:0.25 (95%CI:0.16-0.33)], and direct teammate reporting intentions [MD:0.24 (95%CI:0.14-0.35)].
Conclusions: CATT-HPA implementation in Canada has been very successful and exposure resulted in small but statistically significant positive changes in most behavioural determinants.
Abstract #2287: High rates of injury in high school male rugby union: Time to tackle concussion
Presenting Author: Isla Shill1,2
Authors: Stephen West1,3, Isla Shill1,2, Stacy Sick1,4, Kathryn Schneider1,2,4,5, Preston Wiley1,4,6, Brent Hagel1,3,5,7,8, Carolyn Emery1-3,5-8, Amanda Black1-3,5
1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary
2Hotchkiss Brain Institute, University of Calgary
3O’Brien Institute of Public Health, University of Calgary
4University of Calgary Sport Medicine Centre, Faculty of Kinesiology
5Alberta Children’s Hospital Research Institute, University of Calgary
6McCaig Institute for Bone and Joint Health, University of Calgary
7Department of Community Health Sciences, Cumming School of Medicine, University of Calgary
8Department of Pediatrics, Cumming School of Medicine, University of Calgary
Abstract:
Introduction: Rugby Union is a collision sport which is growing in Canada. Previously, the rates of injury have been shown to be high compared with other youth sports, however very little evidence pertaining to the sport in Canada has been described. Importantly, youth rugby players are exposed to the sport for the first time at a later age than those in other established rugby nations.
Objectives: To examine match injury and concussion rates, mechanisms, locations, and types of injury in Canadian high school male rugby
Methods: This was a two-season cohort study (n=429 male high school rugby players). Injury surveillance included baseline questionnaires, weekly exposure, and injury reports. Injuries included those requiring medical attention, resulted in time loss and/or inability to complete a session. Concussion was defined as per the 5th Consensus on Concussion in Sport and all players with a suspected concussion were referred to a study sport medicine physician.
Results: A total of 134 injuries were captured in 481 player-seasons, leading to an injury incidence rate (IR) of 57.9/1000 hours (95%CIs: 45.4-73.8). Median time-loss was six days (Range: 0-90). Injuries to the head were the most common (40%), followed by shoulder (12%) and ankle (10%). The concussion IR was 22.0/1000 hours (95%CIs: 15.9-30.4), the most common injury type (38%), followed by sprain (20%) and strain (15%). Player-to-player contact accounted for 86% of injuries. Sixty-five percent of injuries occurred in the tackle (ball carrier-35%, tackler 30%). The ruck was responsible for the second greatest proportion of injuries.
Conclusion: The rate of injury and concussion in Canadian youth high school boys’ rugby is high, with concussion and tackle-related injuries the most common. Given this, there is a critical need for implementation of prevention strategies in youth rugby, in particular targeting concussion and the tackle event (e.g., neuromuscular and tackle training).
Abstract #2265: Sex-based comparison of head impact biomechanics in university ice hockey
Presenting Author: David Luke1
Authors: David Luke1, Daniel Bondi2,; Adam Clansey2, Ahmad Rezaei2, Rebecca Kenny3, Lyndia Wu2
1Biomedical Engineering, University of British Columbia
2Mechanical Engineering, University of British Columbia
3Faculty of Medicine, University of British Columbia
Abstract:
Introduction: Instrumented mouthguards can be deployed in sports concussion research to capture head impact kinematics with higher accuracy over more commonly used wearable sensors. While ice hockey has high head impact exposures, there are limited studies of head impact biomechanics in the sport. Past hockey studies have focused on male athletes, despite evidence for females having worse outcomes from milder impacts than males.
Objective: To investigate sex-based head impact biomechanics differences in university ice hockey.
Methods: We recruited seven women’s and 26 men’s university ice hockey athletes to wear Prevent Biometrics mouthguard sensors during a competitive season. Only impacts over 5g that passed a teeth-coupling threshold and did not lead to a clinically-diagnosed concussion were included. Impact kinematics were transformed to head centre-of-gravity and low-pass filtered using a fourth order Butterworth filter at 200Hz.
Results: 254 and 334 head impacts were analyzed from the women’s and men’s team, respectively. Median (95th percentile) peak linear acceleration (PLA) and peak angular acceleration (PAA) for the women’s impacts were 9.5g (19.9g) and 1305rad/s2 (2613rad/s2), respectively. Median (95th percentile) PLA and PAA for the men’s impacts were 11.5g (26.4g) and 578rad/s2 (2,179rad/s2), respectively.
Conclusion: Women’s team athletes had higher median PAA and lower median PLA compared to men’s team athletes. This may suggest that females are exposed to higher angular head accelerations than men, which may be a greater risk factor for concussion than linear components. This could lead to developing sex-based injury prevention methods. Data collection and video verification of impacts is ongoing.
Abstract #2289: Comparing male and female injury and concussion rates in youth rugby union
Presenting Author: Isla Shill1,2
Authors: Isla Shill1,2, Stephen West1,3, Stacy Sick1,4, Kathryn Schneider1,2,4,5, Preston Wiley1,4,6, Brent Hagel1,3,5,7,8, Carolyn Emery1-3,5,6-8, Amanda Black1-3,5
1Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary
2Hotchkiss Brain Institute, University of Calgary
3O’Brien Institute of Public Health, University of Calgary
4University of Calgary Sport Medicine Centre, Faculty of Kinesiology
5Alberta Children’s Hospital Research Institute, University of Calgary
6McCaig Institute for Bone and Joint Health, University of Calgary
7Department of Community Health Sciences, Cumming School of Medicine, University of Calgary
8Department of Pediatrics, Cumming School of Medicine, University of Calgary
Abstract:
Introduction: Rugby Union is a fast-paced collision sport which is growing globally. The rates of injury are often described as high compared with other sports, however few studies have compared rates in males and female youths.
Objectives: To compare overall match and training injury rates and concussion specific rates in male and female high school rugby players.
Methods: This was a two-season cohort study (n=429 male, n=361 female). Injury surveillance included baseline questionnaires, weekly exposure, and injury reports. Injuries included those requiring medical attention, time loss and/or inability to complete a session. Concussion was defined as per the fifth Consensus on Concussion in Sport. Injury and concussion incidence rate ratios (IRRs) were calculated using univariate Poisson regression, offset by team exposure and clustered by team.
Results: Considering match injury, the female IR was 62% higher (IR=93.7/1000 match-hours; 95% CI: 78.6-111.7) than males (IR=57.9; 95% CI: 45.4-73.8)(IRR=1.62; 95% CI: 1.20-2.18). Concussion was the most common match injury for females (40%) and males (38%), with female match-concussion IR (37.5/1000 match-hours; 95% CI: 26.8-52.3) 70% higher than males (22.0/1000 match-hours; 95% CI: 15.9-30.4) (IRR=1.70; 95% CI: 1.08-2.69). The tackle was the event associated with the greatest proportion of match injuries (female: 70%, males: 65%). For training, the rate of injury was over two-fold higher in the female (IR=5.3/1000 match-hours; 95% CI: 4.0-6.9) than male cohort (IR=2.5; 95% CI: 1.7-3.5) (IRR=2.15; 95% CI: 1.40-3.32). The most common training injury type was sprains for females (29%) and both sprains and concussions for males (24% each).
Conclusion: Females exhibit a greater rate of injury in Canadian youth rugby players. The high rates of injury and concussion highlight the need for injury prevention strategies targeting both male and female players.
Abstract #2202: Rural fathers’ fears for children’s safety during outdoor play
Presenting Author: Michelle E. E. Bauer1
Authors: Michelle E. E. Bauer1, Christina Han1, Mariana Brussoni1
1University of British Columbia
Abstract:
Introduction: Over the past six decades, there have been increasing restrictions placed on thrilling and exciting play for children. These restrictions can mean there are fewer developmentally beneficial opportunities where children can learn threat navigation and safety strategies. Rural compared to urban environments can provide children with opportunities to engage in outdoor play in close physical proximity to natural spaces such as forests and lakes, and near animals and farm equipment. Despite the benefits for child development associated with these opportunities, rural compared to urban children can experience more hospitalizations and serious injury related to farm equipment and animal interactions. Exploring fathers’ fears for their children’s safety in the context of outdoor play can help researchers identify best strategies for mitigating their safety concerns and address potential safety threats in rural environments.
Objectives: We explored the perspectives of 32 rural fathers in Quebec (n = 16) and British Columbia (n = 16), Canada, on their fears for children’s outdoor play safety.
Methods: We employed tenets of narrative inquiry and conducted semi-structured interviews with the fathers. Our results were analyzed through reflexive thematic analysis.
Results: The results of our reflexive thematic analysis indicate the fathers feared their children’s play with rural equipment and machinery, and some were concerned by their children’s play near bodies of water or motor vehicles. Further, our results indicate that to keep their children safe, they practiced exchanging safety information, supervised children’s activities, and installed barriers to potential hazards.
Discussion: Our results can inform conversations on rural fathers’ fears for their children’s safety during outdoor play, and can contribute to supporting family and play scholars in identifying ways to mitigate these fears.
Abstract #2250: Investigating Parents’ Risk Propensity for Themselves, Their Child, and Child Injury Incidence
Presenting Author: Hebah Hussaina1-3
Authors: Mathilde Duflos1-4, Hebah Hussaina1-3, Lise Olsen5, Mariana Brussoni1-3,6,7
1Human Early Learning Partnership, University of British Columbia
2Department of Pediatrics, University of British Columbia
3British Columbia Children’s Hospital Research Institute
4Laboratoire PAVéA (EA 2114), University of Tours, France
5School of Nursing, University of British Columbia Okanagan
6School of Population and Public Health, University of British Columbia
7BC Injury Research and Prevention Unit
Abstract: Risky play supports children’s health and development. Parents’ fear of injury increases risk aversion, influencing children’s risky play opportunities. It is not clear how parents’ risk perceptions relate to pediatric injury.
We aimed to compare parents’ risk propensity for themselves and for their child, to determine sex-related differences in parents’ risk propensity for their child, and to examine the association between parents’ risk propensity for a child and a child’s injury history.
467 parents visiting BC Children’s Hospital with a 6-12-year-old child completed a questionnaire containing the Risk Propensity Scale and the Risk Propensity Scale for Children. They also reported on the number of medically attended injuries the child sustained in the previous year. Analyses consisted of non-parametric tests, univariate and logistic regressions.
A paired Wilcoxon signed-rank test showed that parents’ risk propensity for themselves (Md = 3.86) was significantly higher than for their child (Md = 3.00; Z = – 14.98, p < .001). Univariate linear regressions showed that fathers reported significantly more risk propensity for their child than mothers (Œ≤ = .29, 95% C.I. (.05, .53), p = .018), but parents did not differentiate between their sons and daughters. A binary logistic regression showed that parents’ risk propensity for their child was a significant predictor of likelihood of pediatric injury (Œ≤ = .24, SE = .09, Wald = 6.89, p = .009).
Parents were more comfortable in engaging in risks for themselves than for their child. While fathers were more comfortable with their child engaging in risks than mothers, child’s sex did not influence parents’ risk propensity for their child. Pediatric injury was related to parents’ risk propensity for their child, suggesting that parents’ perception of risk may be associated with their behaviors around child safety. Further research including prospective injury data and information on injury type and severity is needed.
Abstract #2255: ‘Cool 2 Be Safe Junior’: a playground safety intervention program
Presenting Author: Mike Corbett1
Authors: Amanda Cox, Barbara Morrongiello, Mike Corbett
1University of Guelph
Abstract:
Introduction: Unintentional injury is the leading cause of death and disability to children worldwide, and playgrounds pose a significant risk of injury (Morrongiello, Klemencic & Corbett, 2008). Those who are four to six years of age are particularly vulnerable given their transition towards increased autonomy and less direct supervision. Previous interventions have typically targeted environmental modifications or increased supervision to reduce playground injuries. The need for an intervention that aims to address playground behaviours is imperative as minimal research has focused on implementing behavioural interventions (Heck, Collins, & Peterson, 2001).
Methods: The current study sought to address these gaps in the literature by implementing a playground safety intervention program that aimed to increase five- and six-year-old children’s hazard awareness, knowledge of unsafe playground behaviours, and decrease their risk-taking behavioural intentions while on the playground. A total of 38 children completed the intervention program.
Findings: Comparing children’s scores at pre- and post-intervention, results revealed significant increases in children’s hazard awareness, knowledge of unsafe playground behaviours and significant decreases in children’s risk-taking behavioural intentions. Attention and memory scores showcased that the program content was effective in maintaining the attention of five- and six-year-olds.
Conclusions: Results of the current program indicate that the Cool 2 Be Safe Junior Program shows promise in addressing the issue of playground injuries in children.
Abstract #2201: VOICES Vancouver: promoting children’s voices in injury prevention, safety, and play research
Presenting Author: Michelle E. E. Bauer1
Authors: Michelle E. E. Bauer1, Ian Pike1
1University of British Columbia
Abstract:
Introduction: Over the past six decades, there have been an increasing number of restrictions placed on children’s independent navigations of neighborhood spaces and their outdoor thrilling and exciting play opportunities. This is problematic, as these types of opportunities can provide children with fun, desirable, and social activities, help to hone their threat navigation and safety adoption skills, and foster their confidence and independent learning in nature. Although children can provide unique insight into their safety and play needs and desires in neighborhood environments, their voices are often peripherally considered to those of adults in academic scholarship. It is thus important to include children’s voices in injury prevention scholarship to promote their right to have their perspectives heard.
Objectives: In this study, we explore children’s perspectives on neighborhood safety and play, as part of Clubhouse Kids’ day camp programming in Vancouver, Canada.
Methods: We use a child-centred community-based participatory research approach to injury prevention and employ a four-staged model that includes (a) injury information exchanges between children and the researcher, (b) an adapted version of participatory photo-mapping where they meet with a professional photo-journalist, (c) an excursion in their camp neighborhood to capture their perspectives through photography and a go-along interview, and (d) a reflection period to categorize and further discuss the photographs. This research is conducted with approximately 20 children over a two-week period.
Discussion: The results from this study can be used to expand methodological considerations for children’s inclusion in injury prevention research, and they can inform conversations on children’s civic agency, safety, threat navigations, and fear during their navigations of their outdoor worlds.
Abstract #2252: Development and Evaluation of a Grade 3 Water Smart School Program
Presenting Author: Kelly Carter1
Authors: Kelly Carter1, Kelsey Lalonde1, Dr. Kathy Belton2
1Lifesaving Society, Alberta and Northwest Territories Branch
2Injury Prevention Centre, University of Alberta
Abstract: In 2020, the Lifesaving Society Alberta and Northwest Territories Branch with funding from the Injury Prevention Centre developed and delivered a Grade 3 Water Smart program in schools to students across Alberta through in-person and virtual means. Materials developed included a student workbook, teacher delivery guide, certificate, and tattoos. Data was collected from students in the form of an assessment prior to taking the Water Smart training and students completed a second self-assessment post training. All Teachers were also required to complete a survey post training as part of the program evaluation. The results showed an increase in awareness for lifejacket safety, how to recognize and respond to individuals in trouble, and overall awareness for injury prevention around water. The data is based on 32 deliveries in various communities, with 255 students participating. These results are encouraging as many children do not have access to swimming lessons and this may be their only source for water safety information. This low barrier, easy to access water safety training program can be delivered directly in schools by teachers and allows children to receive basic training on how to be safe when in, on and around water throughout the seasons.