Resources: Implementation of prevention strategies

Getting started

The Injury Prevention Program Planning Guide from the Center for Injury Prevention Policy & Practice San Diego State University, is an excellent resources and a careful exploration of this pdf file linked above will prove an excellent preparation for the development of your own planned intervention.

“This Guide is designed to provide a systematic approach to planning and implementing childhood injury prevention programs that are both priority- and value-driven. Five phases are described to help move the practitioner though this process”. This approach is also suitable for programmes other than for childhood injury.

Phase I: Conducting a Needs Assessment - A needs assessment can be done on a small or large scale using a systematic set of procedures for setting priorities and making decisions about a program. A needs assessment will include a review of demographic data, and often some new information, gained through surveys of the population or other relevant sources.

Phase II: Determining Intervention Strategies- It is always necessary to determine: 1) the injury problem that 1) is significant and solvable with your limited resources and 2) has interventions that are proven to be appropriate for your chosen population.

Phase III: Developing the Action Plan- The Action Plan maps out how you are going to do what you want to do. It is based upon your choice of target injury, target population and intervention strategies. An Action Plan is designed to reach program goals and objectives. It specifies the implementation of key activities and guides the use of resources within a specified timeframe.

Phase IV: Implementing the Plan- This phase involves the commitment community agencies and implementation of program activities.

Phase V: Evaluating Progress and Success- The ongoing monitoring of program progress and assessment of the results of the program activities and objectives."

More on implementation

There is a science to the way of implementing a strategy, as a couple of papers below demonstrate:

Implementation epidemiology: The study of the frequency, distribution and determinants of effective prevention practice (The pdf file is here)

"There is a growing literature demonstrating the limited extent to which quality evidence has led to injury prevention policy action. The innovation challenge now recognised throughout the world is not ‘what works’, but how to ‘make it work’ at the population level. The purpose of this paper is to introduce the concept of ‘implementation epidemiology’ as a methodology that enables the roles of injury prevention research and practice to be quantified within a single analytic process; and thus a methodology for facilitating the translation of injury research evidence to evidenced-based prevention practice. The contribution of ‘implementation epidemiology’ beyond the more traditionally defined scope of the discipline is to extend the definition of epidemiology from ‘the study of the distribution and determinants of health conditions’ to include the empirical measurement and quantification of determinants of implementation effectiveness. In order to consider injury research and practice within one methodological dimension, implementation epidemiology requires first a shift in the public health approach to injury prevention from the traditional proximal risk factor paradigm to a more ecological understanding of injury causation, and then a further shift in the notion of causation to incorporate within the eco-epidemiological models, not just the multilevel risk factors for injury, but also the determinants of widespread uptake of known countermeasures."

Evidence into practice: combining the art and science of injury prevention  (pdf file also here)

"There is good evidence of strategies to reduce injuries but less is known about the art of translating those strategies to implementation in real-world settings. England’s Health Development Agency developed a structured process applicable to many public health fields, which integrates practitioner knowledge into the evidence base and reflects local contexts. The multistep process includes convening structured field meetings with local practitioners and policy makers, which focus on a mapping exercise of strategies, policies, targets, and funding streams related to childhood injury prevention, and barriers and facilitators relating to implementation of specific interventions….This methodology represents an efficient way of gaining insight necessary for successful implementation of evidence based programs. It may be particularly useful in lower and middle income countries, serving to translate evidence into the local contexts and circumstances within which practitioners operate."

Although evaluation might fit better into the previous Topic, it is worth considering how you will evaluate a programme as you develop it.

The development of an evaluation framework for injury surveillance systems

is a good example of some of the issues to take into account when evaluating a programme. The paper is rather detailed, but this is what they did:

"The development of an Evaluation Framework for Injury Surveillance Systems (EFISS) involved a four stage process. First, a literature review was conducted to identify an initial set of characteristics that were recognised as important and/or had been recommended to be assessed in an evaluation of a surveillance system. Second, this set of characteristics was assessed using SMART criteria. Third, those surviving were presented to an expert panel using a two round modified-Delphi study to gain an alternative perspective on characteristic definitions, practicality of assessment, and characteristic importance. Finally, a rating system was created for the EFISS characteristics. The resulting EFISS consisted of 18 characteristics that assess three areas of an injury surveillance system – five characteristics assess data quality, nine characteristics assess the system's operation, and four characteristics assess the practical capability of an injury surveillance system. A rating system assesses the performance of each characteristic."