Description of ldkoking.dat (free format) Abstract from "The Lidkšping Accident Prevention Programme -- a community approach to preventing childhood injuries in Sweden" by Svanstršm L, Ekman R, Schelp L, and Lindstršm A. Injury Prevention 1995 1: 169-172. Objectives -- In Sweden about 100 children 0-14 years die from accidental injuries every year, roughly 40 girls and 60 boys. To reduce this burden the Safe Community concept was developed in Falkšping, Sweden in 1975. Several years later a second programme was initiated in Lidkšping. The objectives of this paper are to describe the programme in Lidkšping and to relate it to changes in injury occurrence. Setting -- The Lidkšping Accident Prevention Programme (LAPP) was compared with four bordering municipalities and to the whole of Skaraborg County. Methods -- The programme included five elements: surveillance, provision of in formation, training, supervision, and environmental improvements. Process evaluation was based mainly on notes and reports made by the health planners, combined with newspaper clippings and interviews with key people. Outcome evaluation was based on information from the hospital discharge registry. Results -- In Lidkšping there was an on average annual decrease in injuries leading to hospital admissions from 1983 to l991 of 2.4% for boys and 2.1% for girls compared with a smaller decline in one comparison area and an increase in the other. ConclusionŃBecause the yearly injury numbers are small there is a great variation from year to year. However, comparisons over the nine year study period with the four border communities and the whole of Skaraborg county strengthen the impression that the programme had a positive effect. The findings support the proposition that the decrease in the incidence of childhood injuries after 1984 could be attributed to the intervention of the LAPP. Nevertheless, several difficulties in drawing firm conclusions from community based studies are acknowledged and discussed. Table 2: Incidence of hospitalized injuries (rates/1000 under 14 years) in Lidkšping (intervention area) and comparison areas by year and gender (Pop. =area population) INTERVENTION AREA COMPARISON AREA 4 BORDER MUNICIPALITIES Girls Boys Girls Boys Year # Pop. Rate # Pop. Rate # Pop. Rate # Pop. Rate 1983 34 3247 10.5 59 3356 17.6 34 4118 8.3 52 4318 12.0 1984 48 3200 15.0 44 3271 13.5 28 4046 6.9 58 4203 13.8 1985 32 3140 10.2 41 3265 12.6 34 4059 8.4 47 4175 11.3 1986 26 3092 8.4 55 3252 16.9 27 4018 6.7 57 4146 13.7 1987 38 3056 12.4 39 3208 12.2 38 4018 9.5 66 4162 15.9 1988 22 3016 7.3 43 3204 13.4 17 4049 4.2 52 4163 12.5 1989 40 3006 13.3 62 3232 19.2 44 4113 10.7 59 4163 14.1 1990 28 3072 9.1 34 3287 10.3 46 4179 11.0 59 4304 13.7 1991 30 3160 9.5 37 3378 11.0 30 4235 7.1 53 4355 12.2 Mean 10.6 14.1 8.1 13.2 95% CI 8.7 to 12.5 11.5 to 16.7 6.4 to 9.8 12.1 to 14.3 beta Đ0.3 Đ0.4 0.2 0.1 %change per year Đ2.1 Đ2.4 2.2 0.6 COMPARISON AREA SKARABORG COUNTY Girls Boys Year # Pop. Rate # Pop. Rate 1983 228 26202 8.7 349 27464 12.7 1984 227 25818 8.8 356 26998 13.2 1985 214 25519 8.4 347 26690 13.0 1986 1220 25296 8.7 363 26470 13.7 1987 1239 25151 9.5 374 26325 14.2 1988 1196 25079 7.8 327 26391 12.4 1989 1221 25153 8.8 330 26602 12.4 1990 237 25506 9.3 346 27047 12.8 1991 205 25977 7.9 314 27552 11.4 Mean 8.7 12.9 95% CI 8.3 to 9.1 12.3 to 13.5 beta Đ0.1 Đ0.2 %change per year Đ0.3 Đ1.0 Data on rates and population sizes taken directly from Table 2 of article; # of injuries reconstructed as nearesr integer to population x rate ----------------------------------------------------------- Data in ldkoping.dat set out in form suitable for use in statistical packages.. year rate population Number of of gender* area** injuries 1983 10.5 3247 34 0 1 1983 17.6 3356 59 1 1 .. 1991 11.0 3378 37 1 1 1983 8.3 4118 34 0 0 .. 1991 12.2 4355 53 1 0 1991 11.4 27552 314 1 2 * gender: 0 = females 1 = males ** area 0 = 4 border municipalities 1 = intervention area 2 = Skaraborg County ====================== Introduction and Methods from paper by Svanstršm et al.: I N T R O D U C T I O N During the 1950s as many as 400 children were fatally injured annually in Sweden. This number has since fallen to include about 100 children 0-14 years who die from accidental injuries every year--roughly 40 girls and 60 boys.1 For every child killed there are about 100 children whose injuries are serious enough for them to receive inpatient hospital care. Among the fatalities in the preschool age group home and leisure injuries dominate, while most teenagers are killed in traffic. In the middle of the 1970's the Safe Community concept was developed in Sweden and was first put into practice in Falkšping in 1975.2 Subsequently, in 1984, a similar programme was initiated in Lidkšping, Sweden. As with most other safe community programmes both began by establishing a local injury surveillance system. The purpose of this surveillance was to give information that would both help shape the intervention and assist in its evaluation. The objectives of this paper are to describe the Lidkšping Accident Programme (LAPP); its possible effect on injury incidence; and to discuss how the processes might serve to reduce injuries over time. The Lidkšping Accident Prevention Programme In the early seventies, a community health unit was established to plan and coordinate health and safety promotion for Skaraborg County, including the Falkšping and Lidkšping municipalities. A fall of 34% in the incidence of injuries among preschool children was attributed to the Falkšping Accident Prevention Programme3-- from 48.6/1000 in 1978 to 32.2 in 1981/2. This inspired the local health authority in Lidkšping to start a similar safe community programme: LAPP.4 To raise the initiative's profile and to draw as much as possible on local knowledge and experience, an extensive intersectoral network was created. The interventions agreed on including five elements: surveillance of injuries, provision of information, training, supervision, and environmental measures. The intervention started in 1984 and dealt with injuries affecting children and the elderly. This paper only addresses the former--injuries involving those under age 14 years. M E T H O D S STUDY AREAS Skaraborg County, the home of Lidkšping, is located between Gottenburg and Stockholm in southern Sweden. It is mainly an agricultural and manufacturing county with 40% arable land compared with 8% for Sweden as a whole. In 1991 the population was 278,162. For this study comparisons are made between the intervention area, the municipality of Lidkšping (population 35,949), four bordering municipalities (population 42,078), and the whole of Skaraborg County. The 'border' municipalities use the same hospital as Lidkšping but received no intervention. PROCESS EVALUATION The LAPP evaluation involved studies of both process and outcome. The process evaluation was based mainly on reports made by the health planners, combined with newspaper clippings and interviews with key informants. OUTCOME EVALUATION The outcome evaluation was based on data from Skaraborg County Hospital discharge register. Cases are patients discharged from hospitals with an injury diagnosis coded E807-929 according to the International Classification of Diseases (ICD-9). These patients are then identified by place of residence regardless of the location of the hospital in which they were treated. STATISTICAL METHODS Difference in annual injury rates and their 95% confidence intervals between the comparison areas of Lidkšping, the four border municipalities combined, and Skaraborg County were calculated. Linear regression was then used to estimate the annual change in incidence. ============= Exercise for Course 678 I Restrict your comparison to Girls in the intervention area versus Girls in the "4 Border municipalities" comparison area. a verify the beta estimates (Đ0.3 and 0.2). Do so (i) using the variable Year 'as is' as the x variable and (ii) using the variable YearĐ1987 as the x variable. b Obtain the SE of each beta estimate, and calculate a t-statistic to test equality of slopes. c Fit two regression equations to the 18 observations (i) to represent two parallel lines and (ii) to represent two non-parallel lines and report your conclusions. II Repeat steps a-c for Boys in the intervention versus "4 Border municipalities" comparison area.