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Completed Projects

Concurrent Drug, Alcohol, and Decedent Characteristics in Deaths Due to Opioids (Funded by the CDC/National Center for Injury Prevention and Control for 2012-2014)
Co-PI’s:  Marie A. Abate, BS, PharmD; Marcella H. Sorg, PhD, RN, D-ABFA.  Co-Investigators: James C. Kraner, PhD; James A. Kaplan, MD; Matthew J. Gurka, PhD
Drug-related poisoning deaths, especially those resulting from misuse and abuse of prescription drugs, are a growing U.S. health problem. An emerging CDC injury control focus area is the prevention of unintentional drug overdoses and poisonings, which now constitute the second most common cause of unintentional injury deaths. Prescription opioids are frequently found to cause or contribute to overdose deaths. Since West Virginia (WV) has had the highest unintentional drug death rate in the nation, a forensics drug database (FDD) was developed to electronically capture the relevant data from all WV drug-related deaths. Rural areas have been found to have greater prescription drug overdose death rates than urban locations. However, the relatively small number of decedents in a rural area could make it difficult to identify possible interactions with specific drug combinations or those decedent characteristics or co-morbidities that might contribute to death and be preventable. Thus, this project will create an expanded FDD research database by incorporating the drug poisoning death data from rural states with similar demographics, i.e., the northern New England states of Maine, Vermont, and New Hampshire, while continuing to update the WV death data. This project will identify potential relationships and interactions among specific opioids and other drugs or alcohol in opioid-related deaths in the four rural states. This enhanced scientific base will be used to explore the patterns of drugs found in opioid-related deaths and possible interactions among specific drug and alcohol combinations, in the presence and absence of certain decedent characteristics and pre-existing co-morbidities. Epidemiological study of the opioid deaths will determine overall and state-specific mortality rates for key drugs identified, drug combinations, and changes over time; the presence of any geographical death clustering within states; and the drug and alcohol combinations and co-morbidity patterns present. Our findings will identify areas for further research and help guide public policy development and clinician decisions to minimize opioid-related deaths.

Acceptability to Key Constituencies and Feasibility of an Opioid Overdose Prevention Program (OOPP) with Takehome Naloxone in Rural West Virginia (Funded by the West Virginia Clinical and Translational Science Institute, 2012-2014)

PI: Kelly Gurka, PhD; Co-Investigators: Jeffrey Coben, MD; Matthew J. Gurka, PhD, Herbert Linn, MS
Unintentional drug overdose – particularly involving prescription opioid analgesics – is a leading cause of death among West Virginians, yet no intervention of which we are aware has been designed specifically for and implemented in our State to reverse opioid overdoses. The proposed research aims to augment existing partnerships between members of the substance abuse prevention and treatment community in southern West Virginia and the Injury Control Research Center at West Virginia University. Together, we will assess the acceptability and feasibility of adapting and implementing an opioid overdose prevention program (OOPP) with take‐home naloxone in West Virginia. Based on interventions that have been effectively implemented in urban settings among heroin users, we will target West Virginians in three southern counties who misuse and abuse opioids and are at high‐risk for overdose, prescribers in these same counties who would prescribe the naloxone, and pharmacists who would dispense naloxone in an OOPP.
Our long‐term research goal is to develop, evaluate, and disseminate effective OOPPs throughout Appalachia. Our objective in this pilot study is to assess the acceptability of an OOPP with take‐home naloxone among communities in southern WV. This pilot project will work with community members at high risk for opioid overdose, community members who could prescribe naloxone, and community members who could dispense naloxone kits to determine what components of an OOPP are feasible to translate to southern WV. The rationale for the study is that by assessing the acceptability to key constituencies of such a program, barriers can be identified and avoided, and the intervention can be tailored to the specific community in which the program will be piloted.


An analysis of postural instability in women with urinary incontinence
PI: Jean McCrory, PhD; Co-PI: Krystal Thomas, DPT, MPh; Co-I: Corrie Mancinelli, PhD, PT
Project Period: 04/13 – 09/14
Pelvic floor dysfunction (PFD) affects more than 25% of American women. Urinary incontinence (UI) is a primary symptom of PFD.  Women with UI fall at a greater rate than women without UI. However, the co-incidence of PFD and postural instability in older women is not known. Women with UI have greater risk of falling than women without UI. This may be due in part to weakness or dysfunction of the pelvic floor musculature. Furthermore, it is not known if physical therapy (PT) targeting the pelvic floor musculature can affect postural control. The purpose of this study was to examine static and perturbed postural stability in women with UI compared to unaffected women, as well as to determine the effect of physical therapy on postural control in women with UI. Seven women with UI and seven controls participated. Women with UI were tested before and after a physical therapy intervention for pelvic floor muscle training, which concluded when symptoms of incontinence were resolved. Controls were tested twice, with at least eight weeks between testing sessions. Static and dynamic postural control were assessed with a Neurocom SMART BalanceMaster. A series of MANOVAs (α=0.05) examined the differences between groups and between testing sessions.
In the static trials, women with UI demonstrated less COP displacement (p=0.021) and velocity (p=0.021), and greater standard deviation of the vertical force (p=0.001). In the perturbation trials, the women with UI had less initial sway (p=0.002) and total sway (p=0.001) than controls.  No variable was significantly different between UI pre and UI post for any of the tests. The physical therapy intervention for UI did not seem to improve postural control. Women with UI may have adapted compensation mechanisms, such as enhanced muscular contractions and/or co-contractions to assist in maintaining balance.

Coping with Chronic Illness: Prospective Study of Suicidal Ideation
PI: Amy Fiske, PhD
Project Period: 4/13-9/14

There are compelling reasons to believe that risk for suicide may be influenced by developmental factors in late life. Growing old entails increased threats to independence, as physical illness and associated functional limitations can rob the older adult of control over important aspects of daily life. Most individuals adapt by altering their strategies for exerting control, but those who do not adapt may be at risk for depression and suicidal thinking. The objective of this application is to gather pilot data in preparation for a R01 proposal to prospectively examine the effects of control strategy use on depressive symptoms, hopelessness and suicidal ideation among older adults with recent onset of a physical illness that limits capacity for control. The sample for the pilot study will consist of 40 older adults with recent onset of functional limitations. The project will gather pilot data to test the reasonableness of the hypotheses and establish the feasibility of the study methods.  Recruitment is ongoing.


Development and Evaluation of an Intervention for Intimate Partner Violence in the Context of Nurse Home Visits (Funded by the CDC/National Center for Injury Prevention and Control for 2007-2012: currently under a no-cost extension)

Co-PI's: Harriet MacMillan, MD; Matthew J. Gurka, MD; David Olds, PhD

The overall goal of this project is to develop and evaluate an intervention to improve quality of life and reduce intimate partner violence (IPV) among low-income women during pregnancy and in the first two years postpartum.  This five-year project is still underway, but considerable progress has been achieved.  The intervention has been developed, pilot tested, and found to be acceptable to both nurses and clients in the NFP.  The evaluation is ongoing.  Originally proposed as a 10-site cluster randomized controlled trial, we have been able to expand the trial to include 15 sites within the Nurse Family Partnership program.

Factors Affecting Teachers Adoption of Youth at Work Talking Safety Curriculum (Funded by the CDC/National Institute for Occupational Safety and Health for 2011-2013)

PI: Kimberly Rauscher, ScD

This diffusion research study is an investigation of the barriers and facilitators faced by high school teachers in adopting and sustaining a youth-oriented occupational safety and health (OSH) curriculum. Over 200,000 teens are injured on the job annually, and one dies every five days from a work injury. Having safety training can help prevent these injuries, yet studies consistently show that many teens do not receive such training from their employers. NIOSH scholars have called for increased efforts at integrating OSH information into high school curricula, suggesting it is an effective way to transfer knowledge and raise OSH awareness among youth. A review of the OSH dissemination/translation literature provides little or no evidence on how best to do this. The proposed study aims to fill this gap. The NIOSH sponsored curriculum, Youth @ Work: Talking Safety (Talking Safety), is the most current and thorough program available in the United States to provide youth with the fundamental skills and knowledge they need to help keep themselves safe at work. While efforts to incorporate OSH topics into high school curricula are ongoing, there are no published data available on the success or sustainability of these efforts. With the ever increasing and often conflicting demands placed on teachers, the viability of their implementing an OSH curriculum in their classrooms, in a sustainable way and with fidelity, remains a question. Through telephone interviews with a sample of 338 high school teachers trained in the Talking Safety curriculum, we will achieve the following specific aims: 1) determine whether teachers trained in Talking Safety have adopted the curriculum (i.e., have ever used it in their classrooms) and if so, describe their level of sustainability (i.e. continued use) and fidelity to the curriculum activities and materials; 2) describe the barriers faced by teachers in adopting the curriculum, sustaining its use, and doing so with fidelity, and their suggested strategies for overcoming these barriers; and 3) identify the individual-, classroom-, and institutional-level factors associated with teachers’ initial adoption, sustained adoption, and fidelity to the curriculum activities and materials.

Burden of Injury in West Virginia (Funded by the West Virginia Bureau for Public Health for 2011-2012)

PI: Jeffrey Coben, MD

The West Virginia Bureau of Public Health has contracted the West Virginia University Injury Control Research Center to create a report that documents the “Burden of Injury in West Virginia.” Proceeding in four phases, this report will describe the morbidity, mortality, and financial costs associated with intentional and unintentional injuries to the residents of West Virginia. Phase I involves the identification and assessment of available data sources to be used in preparing the report. The objectives in Phase I are to: 1) identify relevant data sources, assess their usefulness, and determine their availability for analysis; and 2) summarize identified data sources and collaborate with the Bureau in deciding which data sources will be used to gather the information necessary to complete the report. In Phase II, the ICRC will specify both the design and content of the report. In Phase III, the ICRC and subcontractors will conduct data analysis and interpretation, construct tables and graphs, as well as design the layout of and assemble the report. Finally, in Phase IV the ICRC will disseminate the report (in both hard copy and electronic form) using a distribution list developed in collaboration with the Bureau.  

Occupational Health Literacy, Socioeconomic Status & Work-related Injury to Teens (Funded by the CDC/National Institute for Occupational Safety and Health for 2009-2012)

PI: Kimberly Rauscher, ScD

This study examines the relationship between health literacy as it applies to the workplace, i.e., “occupational health literacy,” and work-related injury (WRI), which affects nearly 230,000 U.S. adolescents under 18 every year. Since general health literacy is known to be associated with a variety of health outcomes and with socioeconomic status (SES), occupational health literacy is likely to be related to occupational health outcomes and to SES as well, yet no previous studies have explored this hypothesis.  In this study, occupational health literacy is examined as both a determinant of WRI prevalence and as a mediating factor in the known association between SES and adolescent WRI.  Specific aims are to determine: 1) if low occupational health literacy is associated with higher WRI prevalence among youth; 2) if youth of lower SES have lower occupational health literacy; and 3) if low occupational health literacy among low SES youth mediates the association between low SES and elevated WRI prevalence.  We will achieve these aims by taking advantage of a unique dataset containing information on 2,315 adolescent workers of varying levels of SES in five cities across the US. These data include WRI prevalence, several measures of SES and an array of variables used to measure occupational health literacy (e.g., access to health and safety information and demonstrated health and safety knowledge and skills).

Young Worker Fatalities and Violations of Labor and Safety Regulations:  Moving Toward a Solution (Funded by the CDC/National Institute for Occupational Safety and Health for 2008-2012)

PI: Kimberly Rauscher, ScD

Evidence shows that nonfatal injuries can occur when youth are illegally employed, yet little research has looked at the relationship between fatal injuries among young workers and violations of labor and safety regulations. Understanding this problem and generating strategies for improvements are the goals of this study. To achieve them, the study uses a mixed-methods approach which involves taking the findings into the field and engaging with stakeholders (i.e., enforcement officials) to affect change at the local level. The first aim of the study is to understand the extent to which violations of child labor laws and/or health and safety standards are related to adolescent occupational fatalities. The second aim is to explore how the current enforcement environment might have an impact on this relationship by examining the extent and nature of investigations carried out by federal and NC regulatory agencies on identified young worker fatalities. The last aim is to identify current challenges in enforcement and develop strategies to overcome these challenges and improve the protection of young workers by engaging with a range of local stakeholders through focus groups, in-depth interviews, and a multi-organizational capstone meeting.


Does Graduated Drivers Licensing Produce Safer Teen Drivers? (Funded by the CDC/National Center for Injury Prevention and Control for 2010-2012: currently under a no-cost extension)

PI:  Motao Zhu, PhD

This comprehensive evaluation of Graduated Drivers Licensing (GDL) at the national level is expected to provide the strong scientific evidence needed to assess whether GDL does, in fact, produce safer drivers, and the extent to which GDL affects transport choices.  Given that GDL influences nearly all adolescents and their families nationwide, the results of this study will be an important factor in informing policy decisions regarding whether GDL should be continued in its current form or substantially modified for safer driving as opposed to limiting driving. The objective of this research is to examine the impact of GDL on multiple outcome variables, including driving behaviors, alternative transportation, crash rate (per mile driven) and non-driver injuries (per person-year) among teenagers aged 15-17 years, and crash rate among 18 year olds.  Using data from the National Household Travel Survey, which provides estimates on driving and transportation behaviors, as well as the Fatality Analysis Reporting System and Police Accident Reports, which identify fatal and injury crashes, we will: 1) identify changes in driving behaviors and crash rate among 15-17 year olds due to GDL implementation; 2) identify how GDL affects the use of alternative means of transportation (public transport, walking, bicycling, being driven by others) by teenagers aged 15-17 years, as well as how GDL affects deaths and injuries among 15-17 year olds who are vehicle passengers, pedestrians, and bicyclists; and 3) assess changes in driving behaviors and crash rate among 18 year olds due to GDL implementation.

Screening, Motivational Assessment, Referral & Treatment in Emergency Departments (Funded by the NIH/National Institute on Drug Abuse, Clinical Trials Network for 2010-2012)

PI's: Owen Lander, MD and Stephen Davis, MS, MPA

This study contrasts substance use and substance-related outcomes among patients exhibiting problematic drug use during an emergency department (ED) visit who are randomly assigned to one of three treatment conditions:  1) minimal screening only (MSO); 2) screening, assessment, and referral to treatment (if indicated) (SAR); and 3) screening, assessment, and referral plus a brief intervention (BI) with two phone follow-up booster sessions (BI-B). Individuals presenting in the ED displaying problematic drug use on screening are randomized in 1:1:1 ratio to MSO vs. SAR vs. BI-B. Randomization occurs after screening, and those randomized to MSO do not receive further assessment until follow up.  The other two groups receive baseline assessment, and assignment to SAR vs. BI-B is not revealed until after the baseline assessment is complete. Those in the SAR group then receive referral if indicated, and those assigned to the BI-B group receive a brief intervention consisting of motivational enhancement therapy (MET) adapted for use in the ED, followed by referral if indicated.  The BI-B group also receives two booster telephone calls, ideally within one week of the ED visit. Face-to-face follow up assessments of all three groups are conducted at 3 months, 6 months, and 12 months post-enrollment.  A total of 1,285 patients with probable drug abuse or dependence (approximately 429 per group) seeking medical treatment in the ED, recruited from 6 EDs, will be enrolled.

Investigating the Longitudinal Consequences of Adverse Medical Events Among Older Adults (Funded by the NIH/National Institute on Aging for 2010-2012)

PI:  Mary Carter, PhD

A paucity of information exists about the scope and impact of adverse medical events, especially among older adults.  Moreover, because previous research has focused primarily on acute care settings, little is known about the pattern of adverse medical events across healthcare settings.  In response, the overall goals of this project are to: 1) conduct a nationally representative, longitudinal investigation of the incidence of adverse medical events among older adults; and 2) examine the subsequent patterns of health, healthcare service use, and costs over several years duration. Our specific aims are to: 1) examine the incidence and patterns of adverse medical events among older adults across settings and over time; 2) examine the consequences of adverse medical events on subsequent healthcare service use over time; 3) explore transitions in health and functioning levels over time; and 4) estimate the direct and indirect healthcare costs associated with adverse medical events over several years of study.  We are drawing upon multiple years of the Medicare Current Beneficiary Survey, a nationally representative, longitudinal panel of Medicare beneficiaries, to build an analytical data file, capable of tracking adverse medical events across medical settings and over time, for five separate cohorts of Medicare beneficiaries.

Rural-Urban Differences in Injury Hospitalizations (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Jeffrey Coben, MD

The objective of this project was to determine the incidence, causes, and costs of hospitalized injuries among rural residents in the United States and compare these with urban populations utilizing data from the Healthcare Cost and Utilization Project.  The findings from these analyses have demonstrated the substantial burden imposed by injury and the significantly increased risk for those residing in rural locations.  Overall, injury hospitalization rates increased with increasing rurality.  While hospitalization rates for assaults were highest in large urban counties, the rates for unintentional injuries from motor vehicle traffic, falls, and poisonings were higher in rural populations.  Rates for self-inflicted injuries from poisonings cuttings and firearms were also higher in rural counties, and, on a per-capita basis, hospital charges were highest for rural populations.

The Black-White Suicide Paradox: A Multilevel Multiple Cause-of Death Evaluation. (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Ian Rockett, PhD

This cross-sectional study utilized data from the Web-based Injury Statistics Query and Reporting System, and corresponding multiple-cause-of-death data from the National Center for Health Statistics public-use files.  The original study population was expanded to encompass Hispanics.  Results supported the likelihood that the suicide rate gap between blacks and Hispanics on the one hand, and whites on the other, was at least a partial artifact of serious disparities in suicide certification.  A second important finding was that the type of injury mechanism differentially predicted potential suicide misclassification.

Understanding the Long-Term Consequences of Injury among Older Adults. (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Mary Carter, PhD

This study utilized data from the Medicare Current Beneficiary Survey to examine the long-term risks of injury on Medicare beneficiaries’ healthcare cost and use patterns, risk of institutionalization and death, and disability-levels over time.   This study represents one of the most comprehensive, longitudinal studies of injury among older adults conducted to date.  Overall, findings from this project suggest that the consequences of sentinel injury among older adults is substantial, with results confirming that the effects of injury continue to influence Medicare cost and use patterns, risk of institutionalization and death, and disability levels for periods of time that extend long after the injury episode has “resolved” and over periods of time much longer than previously measured.

How often do Catastrophic Injury Victims Become Medicaid Recipients? (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: Ted Miller, PhD

The goal of this project was to describe the incidence of catastrophic injuries and the potentially long-term financial and disability burdens imposed on the government through increased Medicaid recipients.  Using 2003 data from the Center for Medicare and Medicaid Services, we determined that around 7,000 people aged 21-64 were added to the Medicaid rolls in 2003 due to catastrophic injury in the 14 states included in our study. An estimated 6,312 conversions to Medicaid occurred around the time of admission to an acute care hospital. Overall, we found a conversion rate of 2.55% for injury hospital admissions.

Adaptive Measures of Family Violence. (Funded by the CDC/National Center for Injury Prevention and Control, 2007-2011)

PI: William Gardner, PhD

The goal of the project was to improve the detection of violence towards children.  Based on data from the National Study of Child and Adolescent Well-being, two established child violence exposure instruments were converted into computerized adaptive surveys that will facilitate a child’s self-report of violence more efficiently and accurately.  These new adaptive scale instruments will be significantly more efficient and accurate than the instruments they replace and avoid exposing subjects to highly sensitive and potentially damaging notions.  Future plans include research and clinical applications to administer and test these new instruments in a variety of settings.

Epidemiological Analysis of Prescription Drug Misuse in West Virginia(Performed under contract from Marshall University; Funded by the West Virginia Division of Criminal Justice Services for 2009-2011)

PI: Jeffrey Coben, MD

This project is one component of a larger initiative designed to better understand the epidemiology of prescription drug misuse in West Virginia. The Governor, by authority of Executive Order #04-08, has designated West Virginia's Partnership to Promote Community Well-Being (Partnership) as the Commission with oversight of the State's Purdue Pharmacy Asset Forfeiture Funds. The Controlled Substance Advisory Board Workgroup of the Partnership has identified several potential data sources that it believes can add to the understanding of prescription drug misuse in West Virginia. Through a subcontract, the Prinicipal Investigator has been tasked with examining a specific database, West Virginia's Controlled Substance Monitoring Program (CSMP). A secondary analysis of the CSMP dataset is being conducted. Five years of data (2005-2009) are being obtained and analyzed. For each controlled substance prescription included in the dataset, the following variables are included: 1) the name, pharmacy prescription number and Drug Enforcement Administration (DEA) controlled substance registration number of the dispensing pharmacy; 2) the name, address and birth date of the person for whom the prescription is written; 3) the name and DEA controlled substances registration number of the practitioner writing the prescription; 4) the name and national drug code number of the Schedule II, III and IV controlled substance dispensed; 5) the quantity of the Schedule II, III and IV controlled substance dispensed; and 6) the date the prescription was filled.

Teen Dating Violence Prevention Initiative (Performed under a contract from the Pennsylvania Department of Health; funding from CDC/National Center for Injury Prevention and Control for 2010-2011)

PI: Jeffrey Coben, MD

The purpose of the Teen Dating Violence Prevention initiative is to strengthen the ability of the Pennsylvania Department of Health’s Violence and Injury Prevention Program by addressing teen dating violence as a public health issue. The Department selected Philadelphia as the site for this study based on its status as a high-risk urban area, along with the city’s capacity among existing teen dating violence prevention partners. This project, supported via a cooperative agreement with NCIPC, established a Teen Dating Violence Prevention Team (TDVPT), which brought together stakeholders to develop a plan for coordinating and expanding teen dating violence prevention efforts in the city. TDVPT activities included: 1) conducting an environmental and policy scan to better understand local leadership and support for teen dating violence prevention and current teen dating violence activities underway for Philadelphia; 2) conducting an assessment of evaluation capacity to identify gaps and needs for Philadelphia in prevention activities, surveillance, and policy initiatives; and 3) partnering with state and local leaders to promote and advance recommendations. 


Development and Evaluation of Targeted ATV Safety Educational Strategies for Rural Children (Performed under contract from Arkansas Children's Hospital Research Institute; Funded by the Maternal and Child Health Bureau’s Emergency Medical Services for Children Program for 2007-2010)

PI's: James Helmkamp, PhD (2007-2009); Maria Brann, PhD (2010)

Educational campaigns to increase use of bicycle helmets, seatbelts, and car seats have shown positive results in improving safe practices and decreasing injury number and severity.  We hypothesized that a carefully developed, targeted injury prevention educational program to encourage safe all-terrain vehicle (ATV) riding practices could yield similar results.  The purpose of this project was to develop and evaluate targeted educational materials for use in community-based ATV injury prevention through the use of targeted focus groups and the implementation of ATV safety materials in hunters’ education courses and public movie theaters.  The specific aims included: 1) conducting focus groups to determine general knowledge and perceptions about ATV safety as well as specific beliefs and practices with regard to ATV use in children; 2) evaluating the use of an ATV safety video in a hunter’s education course; and 3) evaluating the use of a movie theater to disseminate an injury prevention Public Service Announcement.

Identifying Rural Communities at Risk of Suicide (Funded by the American Foundation for Suicide Prevention for 2007-2009)

PI: Robert Bossarte, PhD

This study investigated community-level risk and protective factors for suicide in West Virginia in order to identify characteristics of rural communities that have comparatively high and low suicide rates. Informed by social capital theory, the study emphasized the role of social living environments in influencing suicide rates in communities, using area of residence as the unit of analysis. Data for all 55 counties in West Virginia on known and hypothesized risk and protective factors for suicide, including summary measures of social capital, as well as data on all suicide deaths, were obtained from the U.S. Census Bureau, U.S. Department of Agriculture, the National Healthcare Utilization Project, Religious Congregations and Membership study, Uniform Crime Reports, WV Department of Health and Human Resources, WV Department of Education, and Northeast Regional Center for Rural Development at Penn State University. The goals for this study were to: 1) compare risk for suicide among rural areas using analytic techniques including Poisson regression, cluster analysis, and principal components analysis; 2) provide information on differences in the association between suicide and county characteristics in rural areas; 3) construct a typology of risk for use in prevention activities and future analyses; and 4) compare the associations between social capital among adolescents/young adults and older adult populations.

All-terrain Vehicle (ATV) Safety and Injury Surveillance in West Virginia (Funded by the West Virginia Bureau for Public Health for 2007-2009)

PI: James Helmkamp, PhD

The goals of this project were to continue statewide efforts to improve all-terrain vehicle (ATV) safety and help decrease the incidence of injuries and their resulting costs.  Specific objectives were to: 1) Establish and maintain a database that would allow a comprehensive examination of the demographic characteristics of persons involved in ATV crashes and the social and environmental circumstances that may influence these crashes; 2) liaise with key advocates who are stakeholders in improving ATV safety in West Virginia and engage them during the annual legislative process; 3) work with the Office of Emergency Medical Services to facilitate the use of the Trauma and Emergency Medical Information System to provide timely and accurate injury-related data to improve the state’s capacity to identify high-risk groups and situations, develop viable prevention programs, and inform policymakers; 4) assist in interpreting ATV-related data from the Office of the Chief Medical Examiner and in the preparation of peer-review manuscripts; and 5) develop, in collaboration with the WV Office of Emergency Medical Services and the Joint Community Trauma Program at the Ohio Valley Medical Center and Wheeling Hospital, training materials to assist EMS squads and trauma centers across the state to more effectively respond to ATV crashes and aid in helmet removal onsite.

Death and Injury from ATV and Bicycle Crashes: A 5-year Comparison of National Prevalence and Cost Estimates among Children and Adults (Funded by the Arabella Legacy Fund for 2007-2008)

PI:  James Helmkamp, PhD

The goals of this project were to examine the increasing trends associated with all-terrain vehicle (ATV)-related injuries, and compare these trends with similar data on bicycle-related injuries.  For the 5-year period 2000-2004, and for two age groups (children ≤15 years and adults ≥16 years) the following analyses were conducted: 1) for fatal injuries we identified the number of ATV-related fatalities, by year, and the estimated overall economic costs (i.e., quality of life, work-loss, and medical) resulting from these deaths; 2) similarly, we identified the number of bicycle-related fatalities, by year, and the estimated overall economic costs (i.e., quality of life, work-loss, and medical) resulting from these deaths; and 3) for nonfatal injuries we identified, by year and rate, the estimated prevalence and total hospital charges of ATV-related injury hospitalizations. The prevalence and hospital charges were subset by gender, primary payer (i.e., government, private/HMO, self-pay, and other), and principal diagnoses. Similar data were identified for bicycle-related injury hospitalizations.

Completed ICRC-supported Pilot Projects

Longitudinal Investigation of Adolescent Life Satisfaction and Violent and Aggressive Behavior (PI= Keith Zullig, PhD)

Unintentional Injuries Among Grandparents and Grandchildren (PI =Julie Hicks Patrick, PhD)

Descriptive Analysis of Injury-related Healthcare Resources and Services Utilization Among Recipients in the West Virginia Medicaid Program (PI = Michael Smith, PhD)

Variations in Outcomes Following Hip Fracture Injury: Understanding the Effect of Hospital and Patient Volume Levels (PI = Mary Carter, PhD).

Human Head Response to Impact Loads and Post-traumatic Response (PI = Victor Mucino, PhD).

Exercise Interventions and Injuries: A Meta-analysis of Randomized Controlled Trials (PI = George Kelley, DA).

Suicide in the Context of Multiple Causes of Death (PI = Ian Rockett, PhD).

Internet Telemedicine Follow-up in Orthopaedic Trauma Patients (PI = Dina Jones, PhD).

Measurement of ATV Safety Behavior in Rural Communities (PI = Mary Aitken, MD, MPH).