hide abstract details

Jamie Holland, MD
Andrew Hashikawa, MD
Ashley Tracy, CHES
Wendi Wendt, MD

Unintentional injuries are the leading cause of death in children, with a disproportionate impact on populations experiencing health disparities. The Pop-Up Safety Town (PST) initiative, conceived by a group of pediatric emergency medicine physicians in Michigan, reimagines pediatric injury prevention education using a mobile, community driven approach to address the current barriers and limitations of traditional pediatric injury prevention education. We detail how we adapted and implemented PST in a second location to provide injury prevention education to young children living in underserved communities.

Two academic physicians from a tertiary children’s hospital adapted and expanded PST with contributions from the local Safe Kids coalition. We partnered with a local community center and school district primarily serving Hispanic (95%) and low income (75%) families. During Fall 2023, we scheduled four half-day PST sessions for all K4 and K5 students. PST curriculum spanned eight domains that were identified as areas of high need by school staff, including 1) animal safety, 2) bike safety, 3) burn safety, 4) car seat safety, 5) dental safety, 6) fire safety, 7) pedestrian safety, and 8) water safety and were developed by PST program leaders using evidence-based recommendations from the American Academy of Pediatrics. A North American foundation provided a one-time grant for financial support.

Over the four half-day PST sessions, we provided essential injury prevention education to over 400 students on the topics stated above. All children rotated through 15-minute stations for each topic. Volunteers, recruited from our hospital/medical school, local Safe Kids coalition, and local fire and police, engaged and educated each child at each topic station. Every child was fitted individually with an adjustable bike helmet to take with them for use at home. A drawstring backpack filled with injury prevention resources in both English and Spanish was provided to each child to share with their caregivers. Information on upcoming Safe Kids events and car seat checks was also provided to families.

Our PST events demonstrate the potential for a scalable, budget-friendly injury prevention model adapted to the unique needs of at-risk children living in underserved communities. Having demonstrated the program’s success in a second location, efforts are underway to secure sustained funding for its continuation for the following school year.

1. Unintentional injury is a leading cause of death in children, and there are substantial disparities.
2. Pop-Up Safety Town (PST) is a pediatric injury prevention program developed to address the limitations of a “traditional” Safety Town and include children and families who otherwise are unlikely to have access to injury prevention education and/or resources.
3. PST has now been shown to be adaptable and reproducible in different settings.

hide abstract details

Melissa H. Kwan, MD, FAAP
Sarah Beth Abbott, BS, EMT-LP
Victoria Pennington, LMSW, CCLS, CPST
Rodrigo Ordonez Palacios
Sandra McKay, MD FAAP

Back to school time is a great time to engage with families as this is a time for establishing new routines. Families are considering how they are going to be transporting kids to school, and it is a chance to emphasize ways to minimize the risks. We partnered with a local school district that serves over 44,000 students in a suburb of a large metropolitan area with a back-to-school celebration that has approximately 4000 attendees from the surrounding area to bring transportation education, bike helmets, injury prevention, first aid, and CPR education to our community.

Planning started 6 months prior to the event by determining the priorities and scope for this event. Through a partnership with our local community hospital’s marketing team and our IFCK chapter, we were able to purchase bicycle helmets through the state medical association community outreach program which provides a discounted and matching program for helmets that are purchased through them. We were also able to obtain safety lights, stickers, and hand-outs on how to fit a bicycle helmet and their importance. Volunteers from our community hospital and medical school fit these helmets properly.

We provided information about vehicle safety and child passenger safety with an emphasis on child safety seats for the elementary aged child. Paper collateral was provided by our state transportation department. We used a large stuffed animal giraffe that measures just under 4’9” so participants to measure themselves and gauge if they were tall enough to be out of a booster seat. Additional information was provided regarding teen driving and pedestrian safety.

We also had information for families regarding water safety and provided participants with Water Watcher cards and other water safety information. We also sponsored a booth where attendees had a chance to learn hands only CPR and how to use EpiPens. Pocket first-aid kits were distributed.

To bring participants to our tables, we had a volunteer dressed as the hospital mascot. Their presence allowed families to feel comfortable approaching the booth and provided a memorable photo opportunity for attendees to take with them.

With 25 volunteers: ~ 450 bicycle helmets fitted and distributed ~ 200 Water Watcher cards ~ 150 participants learned hands only CPR and use an EpiPen. Even more participants learned about child passenger safety for older children and pedestrian safety.

Leveraging established events can be an effective way to provide safety information to our community. Opportunities for improvement include moving the CPR station indoors to increase participation. This event was in August with temperatures in the upper 90s which is a major deterrent. Most of the traffic was families with elementary/early middle school aged children. If we plan to do more older adolescent education, we need to make it clearer or locate to an area of the event targeted to teens.

1. Describe how to develop and fund a successful educational program within a larger community event.
2. Examine funding sources and partnerships to help make an event successful.
3. Identify how a program like this can be replicated and evaluated in other arenas.

hide abstract details

Kristyn Jeffries, MD, MPH
Maneesha Agarwal, MD, FAAP
Tracy Mehan, MA
Gary Smith, MD, DrPH

Injuries remain the leading cause of death for children in the United States, yet medical trainees inconsistently receive education about pediatric injury prevention. Likewise, though the Accreditation Council for Graduate Medical Education (ACGME) requires pediatric residency programs to provide education about advocacy, trainees often have limited experiences with implementing these skills, potentially hindering their engagement with advocacy in the future. The Trainees for Child Injury Prevention (T4CIP) Program was created to help bridge these gaps by providing facilitated support in trainee-initiated outreach activities to promote local and national engagement in injury prevention.

T4CIP is sponsored by the Center for Injury Research and Policy in Columbus, Ohio, and the American Academy of Pediatrics Section on Pediatric Trainees and Council on Injury, Violence, and Poison Prevention. A national cohort of trainees that includes medical students, residents and fellows are recruited to participate in a year-long program. During monthly virtual sessions, national experts share education on injury prevention and advocacy and teach participants how to deliver anticipatory guidance for families, address health inequities, leverage both traditional media and social media for advocacy, build community coalitions, and engage with policymakers. T4CIP participants then apply their newly acquired skills during two Days of Action each year highlighting different pediatric injury mechanisms. Upon completion of the T4CIP program, participants can remain involved with the T4CIP alumni committee to support new trainees and work on longer-term advocacy projects.

Since 2021, four cohorts consisting of 280 trainees (123 medical students, 116 residents and 41 fellows from 117 institutions across 39 states) have participated in T4CIP. Day of Action topics have included: high-powered magnet ingestions, pediatric firearm injuries, helmet use, safe sleep, drowning prevention, safe storage of cannabis edibles, and child passenger safety. Over these 7 Days of Action, the trainees have collectively shared close to 6,000 social media messages with over 20 million impressions. Participants have also published letters to the editor; appeared on television news programs; presented at hospital Grand Rounds; hosted trainee lectures; distributed and developed educational materials for community events; and drafted policy recommendations. Participants report increased knowledge with pediatric injury prevention and comfort with application of advocacy skills, with many trainees remaining engaged as program alumni.

This national training program successfully enriches the advocacy skills of pediatric trainees while meeting a critical gap in pediatric injury prevention education. Similar program models can be developed to promote injury prevention advocacy with different disciplines.

1. Identify the gaps in medical trainee education about pediatric injury prevention and advocacy
2. Understand the impact of national Day of Action campaigns led by program participants
3. Discuss how similar programs could be implemented in other disciplines at a local or national level

hide abstract details

Andrew Hashikawa, MD
Sarah Stoddard, PhD, RN, CNP, FSAHM
Jill Solomon, MPH, CHES
Taylor Hautala, MPH
Nichole Burnside, MBA

Pediatric injury prevention training remains underrepresented in medical and public health curricula despite pediatric injuries being the number one cause of morbidity and mortality worldwide. Additionally, the CDC's National Action Plan has underscored the critical need to broaden the scope of pediatric injury prevention education. Recognizing the challenges faced by time-constrained online learners, there is a pressing need to offer injury prevention educational programming that is free, focused, and flexible to a wider audience.

In response to this educational gap, we launched a novel and comprehensive massive open online course (MOOC) titled "Injury Prevention for Children & Teens" in 2018. Hosted on the EdX platform, the free course featured seven modules encompassing critical areas such as firearm safety, sports injury prevention, adolescent substance use, transportation safety, burn prevention, advocacy, adverse childhood experiences (ACEs), dating violence, and drowning prevention and includes over sixty videos with curated readings and corresponding quizzes. The course was constructed so that the learner could advance through topics nonlinearly, and could choose to complete all modules, or choose only specific modules and topics. Learners completing each module could request free Category 1 CME, MOC Part II (for pediatricians), and CHES credits (public health). The full course was also integrated as an online elective at our medical school, with opportunities for student feedback. Data evaluation occurred through EdX analytics and post-module surveys.

Since its release, our global course has been taken by over 9,300 students from over 148 countries and the medical school elective by local 576 medical students. About 66% of all learners who filled out the evaluation reported that they were either somewhat or extremely likely to change their practice after taking this course. Among medical students specifically, almost all (99%) rated the course quality as “high”, with over 57% stating that they plan to make changes to their medical practices after taking the course. Furthermore, 89% reported a changed perception of pediatric injury prevention after course completion. Feedback highlighted the engaging content and user-friendly structure, with some feedback suggesting increased cultural context, succinct key takeaways, and increased regular content updates.

Our MOOC, "Injury Prevention for Children & Teens," successfully addresses the need for an accessible and flexible approach to online pediatric injury prevention education that is available for a broad audience of learners. Future development, informed by participant feedback, will aim to enhance the course with updated content and insights from new national experts in the coming year.

Describe the need for pediatric injury prevention training.
List criteria for an accessible injury prevention course.
Explain necessary components of pediatric injury prevention trainings.

hide abstract details

Olivia Frank, MPH
Emma Cornell, MPH
Chethan Sathya, MD, MSc, FRCSC, FACS

Hospital-based violence intervention programs (HVIPs) are an evidence-based strategy to address the impacts of community violence and reduce incidence of reinjury and hospital readmission. However, there are limited examples of HVIPs designed to meet the unique needs of violently injured pediatric patients and their families. The integration of HVIPs into pediatric care settings could help identify high risk patients and use incidents of violent injury as “teachable moments” to promote behavior change. We piloted an HVIP within the emergency department (ED) of a level 1 pediatric trauma center, with the goals of (1) describing the pediatric patient population affected by violent injuries at our site, and (2) assessing the feasibility of providing HVIP services (safety planning, resource referral, and trauma-informed care) to these patients.

In August 2023, we piloted an HVIP program in the ED of the largest level 1 pediatric trauma center in New York state, servicing both New York City and surrounding counties. Patients were eligible if they were <18 years of age at time of admission and had sustained a gunshot wound, a stab wound, and/or injuries from a violent altercation. Patients with injuries as a result of self-harm were not eligible. Program managers used the automated trauma activation system and input from clinical staff to identify eligible patients in the ED; hospital responders then met patients and families at bedside to offer crisis support and explain the HVIP. Enrollment occurred at any point in care, including post-discharge, and required verbal consent from both the patient and a guardian. Once enrolled, responders used motivational interviewing techniques to conduct a needs assessment, followed by safety planning and referrals to health system or community-based support services as appropriate. Data analyzed were extracted from electronic medical records and case management notes; standard descriptive analyses were conducted using SPSS.

Between August 1, 2023, and May 30, 2024, the HVIP engaged with 35 patients between 4-17 years old, who sustained violent injury from a firearm (40%), a stabbing (37.1%), or a violent altercation (22.9%). The majority of patients were male (88.6%), self-identified as Black/African American (65.7%) or multi-racial (14.3%) and were 15-17 years old (68.7%). Among patients who requested referrals (45.7%), 100% were successfully linked to appropriate health system and/or community-based services. Support relating to safe housing, educational assistance, and community violence intervention were the most common requests. Among patients not linked to resources, 22.9% did not request any referrals and 14.3% were lost to follow up (LTF) after discharge.

Pediatric HVIPs are a feasible intervention that pediatric trauma centers can implement to help identify and connect violently injured patients and their families to wrap-around support services. It also highlights the importance of sustainable partnerships with local community organizations in facilitating successful transitions post-discharge. Future goals include long-term patient follow-up and a formal process evaluation of the program’s implementation.

1. Attendees will be able to describe the patient population enrolled in a pediatric HVIP pilot program, including demographic makeup and injury mechanisms.
2. Attendees will be able to identify facilitators and barriers to the implementation of an HVIP in a pediatric emergency care setting.
3. Attendees will be able to apply the results and lessons learned to inform the implementation of a similar program at their institution.

hide abstract details

Wendy Stephan, PhD MPH CHES

Around the country, the nation's 55 poison control centers take calls to the 24-hour 1-800-222-1222 Poison Help line, providing free, confidential triage services to poisoned patients and/or their caregivers. But poison centers also offer educational services to help prevent poisonings. While children under 5 now account for only 0.02% of fatal poisonings in the U.S., we see increasing fatalities in teens and tweens, including from self-harm. Thankfully, the techniques used to prevent these poisonings are similar to those we've always taught new parents: identify the hazardous products, reduce access, and respond fast. As the second most populous state in the nation, Florida is a microcosm of national poison trends, and Florida's Poison Control Centers are working to meet these needs head on.

Florida's three poison centers leverage partnerships, traditional and social media, and remote/face to face events to reach 18 million residents with information about poison safety and the Poison Help line. Each poison center has educators on staff, in addition to the doctors, nurses and pharmacists treating poisonings on the hotline, 24/7. Poison center educators present data on current poisoning trends, effective prevention techniques and create materials and messaging for injury prevention partners of all stripes. Utilizing traditional partners in child safety, but also new partners in drug abuse prevention and harm reduction, poison center educators, guided by incidence data, now highlight medicine and drug overdose as the major poison threat to children and youth today. Eschewing an exclusive focus on small children, poison center educators work with families, schools and communities to protect tweens and tweens -- with a goal of creating safer adults.

In 2023, Florida Poison Control Centers and their trained partners delivered 5,597 educational programs to over a million participants. The Centers also delieverd over100,000 educational materials including magnets, stickers, posters and brochures promoting popison safety and poison centers' services. Florida's Poison Centers also managed 54,000 exposure calls about children 19 and under, providing immediate assessment and treatment guidance. Despite these diligent activities, fatal poisonings in youth continue to increase, with 94 fatal poisonings in children aged 19 and under logged by the Florida Department of Health in 2022, with almost all of them involving drugs (93/94) and the bulk (79%) occurring in teens.

Despite increases in prevention activities and expanded work with partners, more Florida youth are dying from poisoning. While the need remains to urge families with young children to lock up household cleaners and chemicals, poison safety activities must expand to address the presence of drugs in homes and the risks associated with new products on markets legal and illegal. Florida's Poison Control Centers welcome the assistance of injury prevention partners like the Injury Free Coalition for Kids and looks forward to tackling the modern problem of poisoning in our youth.

1. Most fatal poisonings in children today involve drug use in teens.
2. Traditional poison prevention techniques can be expanded to protect youth.
3. Poison control centers are important partners in preventing poisonings in all youth, not only toddlers.