Targeting Pediatric Injuries During COVID-19 via Mapping: A Preventive Community Intervention

Malvi Mehta, BS
Michelle Ruda, MD
Sandra McKay, MD
Zoabe Hafeez, MD

During the shelter-in-place period of the COVID-19 pandemic, there was a perceived increase in emergency department (ED) visits and hospitalizations among the pediatric population in Houston. Using local data comparing ED visits before and during the pandemic, the frequencies of 5 different injury mechanisms were geographically mapped around the Houston area. After localizing certain injury mechanisms to specific regions of Houston via zip codes, a community-based injury prevention program was implemented with the goal of preventing pediatric mortality at a regional level. In January 2022, we were awarded a grant by the Texas Pediatric Society (TPS) to fund 4 types of injury prevention materials for community distribution.

The main injury mechanisms from ED data included burns, falls, motor vehicle/pedestrian injuries, firearm related injuries, and child abuse/neglect. Injury mechanisms were identified and separated by ICD-10 codes. Pre-pandemic data was from the January to September 2019 timeframe, while the pandemic data was collected from the same time period in 2020. After mapping the frequencies of different types of pediatric injuries based on zip code data, the top 3-5 zip codes with the highest number of injuries were identified in each injury mechanism category. Using grant funding, injury prevention materials were ordered for 4 injury categories. Water thermometers were ordered for burn prevention, baby gates for fall prevention, car seats for motor vehicle accidents, and firearm safety locks for prevention of accidental firearm injuries. In the top 3-5 zip codes for each injury category, several pediatrician’s practices were contacted in efforts to send them the relevant injury prevention materials for community distribution. Participating physicians were sent a pre and post survey to assess comfort level in addressing injury prevention topics as well as track the number of patients given materials during well child visits.

This community intervention project is ongoing; however, at this time 2 pediatrician’s practices have begun to participate in burn prevention and fall prevention by accepting materials to distribute to patients. With grant funding we were able to order 20 water thermometers, 10 baby gates, 10 firearm safety locks, and 5 car seats. Currently, primary care physicians are still being sought out for participation in firearm and motor vehicle injury prevention in the targeted zip codes for those injury types. Pre and post survey results are still in the process of being collected as well.

The goal of this project is to geographically target different types of injuries based on local ED data and implement community-based injury prevention via pediatrician’s practices. With the help of a grant, vulnerable populations of patients were identified in particular zip codes to receive relevant injury prevention materials from their primary care physicians. Although limitations of this project have proved to include lack of response from PCP offices and limited follow up with surveys, this could be overcome by contacting more offices in the targeted zip codes.

1. Discuss the utility of mapping in injury prevention efforts.
2. Outline a plan for targeting vulnerable patient populations at a community level within the scope of a large city.
3. Demonstrate how to identify specific injury mechanisms and advocate for prevention at a local level.