Honoring 22 IPRC Annual Report A publication of the University of North Carolina Injury Prevention Research Center2010
Honoring 22 Years of Service
Carol W. Runyan, Ph.D., MPH, Director of UNC IPRC, 1989-2011
The mission of the University of North Carolina Injury Prevention Research Center is to build the field of injury prevention and con-trol
through a combination of interdisciplinary scholarly approaches to research, intervention, and evaluation as well as through
the training of the next generation of researchers and practitioners.
If you have an inquiry, please send to iprc@unc.edu. To subscribe to electronic publications, please sign up at www.iprc.unc.edu
About This Publication
Layout and Design
Betsy Vardell
RubyStudio
Assistant Director for
Planning and Communications
Elizabeth Dawes Knight, MSW
Director
Carol W. Runyan, PhD, MPH
Carol W. Runyan retired from UNC on 7-31-11. Steve Marshall became Interim Director on 8-1-11.
Fifth cover image clockwise from the top left, by Andrés Villaveces
Address
UNC Injury Prevention Research Center
Bank of America Plaza,
Suite 500
137 East Franklin Street, CB# 7505
University of North Carolina
Chapel Hill, NC 27599-7505
Web site
www.iprc.unc.edu.
Email
IPRC@unc.edu
Phone
919-966-2251
Photo by Richard Brame
Letter from Outgoing Director
Message from the Interim Director
The Center’s Goals
The Injury Problem
About the Center
Organizational Chart
Funding Sources
Core Faculty
Executive Summary
Education & Training
Occupational Injury
Sports & Recreational Injury
Other Unintentional Injury
Residential Injury
Violence
Evaluation & Dissemination
Technical Assistance
Center Services
Publications
References
Table of Contents
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2010 Annual Report
During 2010, the Center continued to provide leadership to the field of injury and violence prevention
through research, training, and advocacy for injury control. Dr. Smokowski won a major grant to create the
NC-ACE: North Carolina Academic Center for Excellence in Youth Violence Prevention to implement and
evaluate interventions for youth violence prevention. This project, along with the work on dating violence
of Dr. Foshee, on child maltreatment of Dr. Desmond Runyan and his team, on sports injury research of Drs.
Guskiewicz and Marshall, and on occupational research of Dr. Casteel and others, is providing evidence to
guide interventions to reduce some of the greatest injury problems in the US and abroad. We provide lead-ership
not only in North Carolina, but also globally through our many collaborations on program and policy
development, such as developing policies for child labor reform in the US, and fostering evidence-based
practice. For example, we are coordinating the evaluation of a large scale intervention focused on the Period
of PURPLE Crying®, an intervention designed to improve adult responses to crying infants and reduce child
maltreatment by shaking. Also, the Center continued to provide leadership over the past year in training
professionals. The PREVENT Program (Preventing Violence through Education, Networking and Technical
Assistance) has trained more than 900 professionals from 44 states in the fundamentals of public health and
primary prevention of violence. Our case studies of participating teams demonstrate that the program has
made a difference.
I am encouraged by our successes and the energy that our faculty, staff and students bring to the Center.
We remain challenged, however, by the lack of attention to injury and violence as critical public health
problems, and by the lack of recognition of the need for support for this field. As noted in a paper published
this year1, if we used the funding for the National Cancer Institute at NIH and calibrated based on number
of deaths or on the basis of lives lost before age 65, the annual funding for injury control research would be
$1.4 billion or $8 billion respectively – a far cry from the $145-150 million that the CDC currently receives. As
we move forward, we need to be sure that this pattern of inadequate support changes. So, in addition to our
other work, we need to remain advocates for the field in all sectors. Injury control requires attention in our
curricula, in our funding, and in the emphases that our organizations give to the problem and to the work
that we do. Though funding is tight, needs remain high. Injury is still the leading cause of death for much of
the lifespan, resulting in 5 million deaths worldwide each year, about a fifth of whom are children2. Injuries
are major causes of disability and health care costs. They are highly preventable. But, we need good science
to drive prevention.
In July 2011, after 32 years in Chapel Hill and serving as director of the IPRC since 1989, I will be leaving UNC
to join the faculty at the Colorado School of Public Health. I have been extremely proud to have this oppor-tunity
since Patricia Waller and I formed the center in 1987. I applaud all my colleagues who have contrib-uted
to our considerable success, but emphasize that we must never rest on our laurels. I hope to continue
many collaborations with colleagues connected to UNC IPRC as well as those throughout the US and around
the world as we pursue our shared mission to build the field. There is much more work to be done!
Sincerely,
Carol W. Runyan retired from UNC on 7-31-11. Steve Marshall became Interim Director on 8-1-11.
1Runyan CW, Hargarten S, Hemenway D, Peek-Asa, C, Cunningham R, Costich J, Gielen A. (2010). An Urgent Call to Action in
Support of Injury Control Research Centers. Amer. J. of Preventive Med. 39(1): 89-92.
2Peden M, et al. (Eds). (2008). World report on child injury prevention. Geneva, Switzerland. World Health Organization.
Letter from Outgoing Director 4
UNC Injury Prevention Research Center 2010 Annual Report
The Center’s work is guided by the following broad goals:
To advance the science of injury control by conducting in-novative
research focused on occupational injury, residen-tial
injury, sports and recreational injury, and violence; and
by facilitating research on a broad array of injury topics
To lead the development of new approaches to injury
control policy and program development, implementation,
and evaluation
To participate in providing national leadership in training
the next generation of researchers and practitioners, and in
providing continuing education for those already in
the field
To bridge research and practice through successful exchang-es
of knowledge from each domain and to advance our
understanding and practice of dissemination
To continue to cultivate a vigorous, interdisciplinary “com-munity
of scholars” who are affiliated with UNC IPRC and
who are actively engaged in cutting-edge injury research
and dissemination efforts
To evaluate and continually improve our organizational and
management structure to enhance program growth, quality,
and efficiency
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Photo by Jeff Simmons
Message from the Interim Director
It was with great sadness that I learned, early in 2011, that Carol and Des Runyan would be leaving UNC for the University
of Colorado in Denver. Carol has joined the Department of Epidemiology in the newly-founded Colorado School of Public
Health and is creating a new injury research initiative with Children’s Hospital Colorado. Des now directs the internationally-recognized
Kempe Center for the Prevention and Treatment of Child Abuse and Neglect.
To say that Carol has defined the success of the IPRC is an understatement. Her involvement with the IPRC spans nearly a
quarter century; she has served as Director for 22 of those years. Carol has taken the IPRC from humble beginnings through
to an internationally-recognized center conducting dozens of studies. She has trained literally hundreds of researchers and
practitioners, through classroom teaching, mentoring, and through the highly successful PREVENT violence prevention train-ing
program, which she developed.
Carol is one of the most respected researchers in injury prevention, and her name rightly belongs beside other giants in the
field such as William Haddon and Susan Baker. There are few other injury researchers whose impact on an injury control
research center, and on the entire field of injury prevention, has been so sustained and so transformative.
Carol will be sorely missed. However, she retains many linkages to the IPRC, including several training activities and ongoing
research projects. Carol will continue to be a nationally and internationally recognized leader in our field, and I have no doubt
that her counsel will continue to be sought by, and help guide, the leadership of the UNC IPRC for many years to come.
The Carol W. Runyan Chair in Injury Prevention has been established to recognize Carol’s many years of service to our univer-sity
and to injury prevention. This chair fulfills Carol’s dream of ensuring a lasting legacy for injury control scholarship at UNC.
I encourage you consider a donation to this fund as part of your annual giving. You are invited to visit http://www.iprc.unc.
edu to make a gift.
Join me in honoring the remarkable and unique legacy that is Carol’s 22 years of leadership as director of the University of
North Carolina Injury Prevention Research Center. Her contributions to the science of injury control stand as an impressive
example of what can be achieved when visionary ideas are combined with dedication and commitment.
2010 Annual Report
The significance of injury as a public health, social,
and economic problem in our state, region, nation,
and world is undeniable. Despite improvements over
the past several decades, injury mortality rates in the
U.S. remain high. Injuries—including both uninten-tional
(for example, poisoning, motor vehicle crashes,
falls, drowning) and intentional (e.g., violence such as
homicide, suicide, and child maltreatment)—are the
leading cause of death for persons between the ages
of 1 and 44, and are among the top ten causes of
death throughout the life span, accounting for more
than 179,000 deaths in the U.S. in 2006.1 Southern
states, including North Carolina, generally have higher
rates of injury mortality than the rest of the country; in
2005, North Carolinians experienced an injury mortali-ty
rate of 67.22 per 100,000, compared to a national
rate of 58.82 per 100,000.1
In addressing the need to reduce injury-related dis-ability
and death, the Institute of Medicine (IOM), in
its 1999 publication Reducing the Burden of Injury,2
described the need for high quality research on un-intentional
injury and violence. The report strongly
emphasized the need for developing and supporting
the infrastructure of the field, including attention to:
• Improving coordination and collaboration
among multiple types of agencies and
constituencies;
• Strengthening the capacity for research and
practice;
• Providing training and technical assistance to
support states and communities in developing
and implementing practical injury prevention
plans, building and sustaining an injury preven-tion
infrastructure, evaluating prevention
programs, and making the transition from
research to practice; and
• Integrating the field.2
The work of the UNC Injury Prevention Research
Center is designed to address each and every one of
these important approaches. Our activities include a
focus on research, program development and evalua-tion,
technical assistance, training, and the coordina-tion
and collaboration across multiple agencies and
disciplines.
The Injury Problem
Photo by Dan Sears
UNC Injury Prevention Research Center 2010 Annual Report
The University of North Carolina Injury Prevention Research Center (UNC IPRC), one of five original “Centers of
Excellence” for research in injury prevention, was created with funding from the Centers for Disease Control
and Prevention in 1987.
Research and Policy
Our work emphasizes research on injuries in four areas: those that occur in residential environments; those
that result from sports and recreational activities; those that occur in the context of work; and those that re-sult
from violent acts, including child maltreatment, youth violence, intimate partner violence, and suicide. In
addition to addressing injury and violence prevention issues through research, UNC IPRC directs substantial
attention to the planning, implementation and evaluation of both policies and interventions.
Collaboration
Collaboration is crucial as we partner with Safe States, the Society for the Advancement of Violence and Injury
Research (SAVIR), the Southeastern Regional Injury Control Network (SERICN), North Carolina’s state injury
unit, and multiple other state, regional, national and international partners. UNC IPRC also plays a major role
in contributing to the development of injury control infrastructure and surveillance activities, training, and
through the bridging of research and practice. On a national level, UNC IPRC provides leadership in enhanc-ing
the injury and violence prevention infrastructure by providing technical assistance to injury control prac-titioners
and students. The Center responds to technical assistance requests from agencies, organizations
and individuals throughout the U.S. and plays a particularly active role in collaborating with organizations in
North Carolina. Additionally, through continuing education activities, we have served thousands of profes-sionals
working in settings that include state and local health departments, hospitals, community organiza-tions,
and academic institutions.
Training and Education
We maintain a strong commitment to students at the undergraduate, graduate, and professional levels. The
Center employs undergraduate and graduate students and typically offers more than two dozen graduate re-search
assistantships annually. We also sponsor undergraduate internships in injury and violence prevention,
support a student grants program to encourage student-led injury research, and offer an annual prize that
awards graduate and professional students for excellence in research contributions. On the UNC campus,
UNC IPRC-affiliated faculty are active in teaching classes and engaging students in Center activities that fur-ther
develop the next generation of injury researchers and practitioners and expand the range of disciplines
involved in the field.
Sustainability
Our plan is to continue to employ an interdisciplinary approach to teaching both unintentional injury and
violence prevention and to advance the science and practice of injury and violence prevention intervention
and evaluation. Toward this end, the Center has developed and nurtured relationships with multiple academ-ic
institutions and with a diverse array of professionals, agencies and organizations in public health, clinical
medicine, criminal justice, psychology, social work, and the military, among others. We recognize the poten-tial
to make an even greater contribution to the field by creating partnerships with scholars and practitioners
who represent multiple disciplines.
Throughout our history, our efforts have created new knowledge and have led to the application of research
findings in the field. The work of the Center has had notable impact on the field and beyond, resulting in
changes in state policy that address, among others, safety in childcare, increased use of residential smoke de-tectors,
and control of the sale of pyrotechnics; implementation of science-based prevention programs at the
state, tribal, regional and national levels; enhancement of injury surveillance; and development of workforce
capacity.
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About the Center
About the Center
UNC Injury Prevention Research Center 8 2010 Annual Report
Vice Chancellor for Research and Economic Development
Barbara Entwisle, PhD
Director
Carol Runyan, PhD, MPH
External Advisors
Philip J. Cook, PhD
Lois A. Fingerhut, MPH
Russell Jones, PhD
James Merchant, MD, PhD
Patricia O’Campo, PhD
Donald F. Schwarz, MD, MPH, MBA
Shelli Stephens-Stidham, MPA
Senior Advisory Committee
Martha Cox, PhD (Chair)
Alice S. Ammerman, DrPh
Charles B. Cairns, MD
Mark W. Fraser, PhD
David L. Harkey, MS
Jacob A. Lohr, MD
Sandra L. Martin, PhD
Anthony J. Meyer, MD, PhD
Andrew F. Olshan, PhD
Michael R. Smith, JD
Barbara Entwisle, PhD, (ex-officio)
Core Faculty
Shrikant Bangdiwala, PhD
Susan Blalock, PhD
J. Michael Bowling, PhD
Carri Casteel, PhD, MPH
Kevin Guskiewicz, PhD, ATC
Deborah J. Jones, PhD
Stephen Marshall, PhD
Biostatistician Faculty
Shrikant Bangdiwala, PhD (Chief)
J. Michael Bowling, PhD
Stephen Marshall, PhD
Andrés Villaveces, MD, PhD
Manager BIOS Core Unit
Open
Assistant Director
for Planning &
Communications
Elizabeth D. Knight, MSW
Interim Assistant Director
for Administration
John W. Gallagher
Assistant Director for
Education & Outreach
Karen S. Moore, MPH
Assistant Director for
Evaluation and
Dissemination
Mariana Garrettson, MPH
Senior Research Scientist
Christopher Ringwalt, DrPH
Newsletter editor
Student Temp
Open
Accountant
Charlene Phillips
Accounting Tech
Amorelle Crossley
Business Officer
Martha Martin
Administrative
Support
Associate
Margie Foushee
Programmer &
Webmaster
Guifeng Jin, MS
CORE
OPERATIONS
PROJECTS
Faculty Investigators (~ 20)
Project Staff (perm) (~11)
Project Staff (temps) (~ 41)
Postdoctoral fellows (2)
Krista Perreira, PhD
David Richardson, PhD
Carol Runyan, MHP, PhD
Desmond Runyan, MD, DrPH
Paul Smokowski, MSW, PhD
Andrés Villaveces, MD, PhD
Adam Zolotor, MD, MPH
Organizational Chart 2010
Organizational Chart
*Carol W. Runyan retired from UNC on 7-31-11. Stephen Marshall became Interim Director on 8-1-11.
**Tonya Watkins became Assistant Director for Administration 7-1-2011.
*
**
UNC Injury Prevention Research Center 2010 Annual Report
UNC IPRC Senior Advisory Committee
Martha Cox, PhD (Chair)
Director, Center for Developmental Science and Professor of Psychology
Alice Ammerman, DrPH
Director, Center for Health Promotion and Disease Prevention and
Professor of Nutrition
Charles Cairns, MD
Professor and Chair of Emergency Medicine
Mark Fraser, PhD
John A. Tate Distinguished Professor for Children in Need and Associate
Dean for Research, School of Social Work
David Harkey, MS
Director, Highway Safety Research Center
Jacob Lohr, MD
Lohr Distinguished Professor of General Pediatrics and Chief of the Divi-sion
of General Pediatrics
Sandra Martin, PhD Associate Dean for Research, Gillings School of
Global Public Health, Professor of Maternal and Child Health
Anthony Meyer, MD, PhD
Professor and Chair of Surgery
Andrew Olshan, PhD
Professor and Chair of Epidemiology
Michael Smith, JD
Vice Chancellor for Engagement and Dean, School of Government and
Professor of Public Law and Government
Barbara Entwisle, PhD (Ex-officio)
Vice Chancellor for Research and Economic Development
UNC IPRC External Advisors
Philip Cook, PhD
Terry Sanford Professor of Public Policy Studies; Professor of Economics
and Sociology and Associate Director, Terry Sanford Institute of Public
Policy at Duke University
Lois Fingerhut, MPH
Private consultant (formerly Special Assistant for Injury Epidemiology ,
National Center for Health Statistics)
Russell T. Jones, PhD
Professor of Psychology, Virginia Polytechnic Institute and State
University
James Merchant, MD PhD
Professor, Department of Occupational and Environmental Health, Col-lege
of Public Health, The Univserity of Iowa
Patricia O’Campo, PhD
Professor and Director, Centre for Research on Inner City Health, Univer-sity
of Toronto
Shelli Stephens-Stidham, MPA
Director, Greater Dallas Injury Prevention Center
Donald Schwarz, MD, MPH, MBA
Deputy Mayor of Health and Opportunity and
Health Commissioner for the City of Philadelphia
9
Funding Sources 2010
Research Funding Sources FY 2010
Federal
Administration for Children,
Youth and Families
Fogarty International Center
Indian Health Services
Centers for Disease Control and
Prevention
Other Non-Profit
American Academy of Family
Physicians
Duke University
Ontario Neurotrauma
Foundation
Research Triangle Institute
States/Tribes
North Carolina Division of
Public Health
University of Iowa
Grand Total
$2,864,288
$500,000
$113,203
$225,840
$2,025,245
$214,402
$29,125
$104,700
$16,551
$64,026
$97,382
$74,660
$22,722
$3,176,072
7% 3%
90%
Federal $2.9M
Other Non-Profit $214K
States/Tribes $97K
10 2010 Annual Report Core Faculty
Carol W. Runyan, Ph.D., MPH*
Director, UNC Injury Prevention Research Center
Professor, Department of Health Behavior and Health Education;
and Adjunct Professor, Department of Epidemiology, UNC Gill-ings
School of Global Public Health
Professor, Department of Pediatrics, UNC School of Medicine
Shrikant I. Bangdiwala, Ph.D.
Chief, UNC IPRC Biostatistical Core Unit
Research Professor, Department of Biostatistics, UNC Gillings
School of Global Public Health
Susan J. Blalock, Ph.D., MPH
Associate Professor and Director of Graduate Studies, Division of
Pharmaceutical Outcomes and Policy, UNC School of Pharmacy
J. Michael Bowling, Ph.D.
Statistician and Research Associate Professor, Department of
Health Behavior and Health Education, and Adjunct Associate
Professor, Department of Biostatistics, UNC Gillings School of
Global Public Health
Carri Casteel, Ph.D., MPH
Research Associate Professor, Department of Epidemiology, UNC
Gillings School of Global Public Health
UNC Injury Prevention Research Center 11 2010 Annual Report
Kevin M. Guskiewicz, Ph.D., A.T.C.
Professor and Chair in the UNC Department of Exercise
and Sports Science, and Kenan Distinguished Professor.
Director of the Matthew Gfeller Sport-Related Traumatic
Brain Injury Research Center, UNC College of Arts &
Sciences
Deborah Jones, Ph.D.
Associate Professor, Department of Psychology, UNC
College of Arts & Sciences
Stephen W. Marshall, Ph.D.*
Professor, Department of Epidemiology, UNC Gillings
School of Global Public Health
* Carol W. Runyan retired from UNC on 7-31-11.
Stephen Marshall became Interim Director on 8-1-11.
Krista Perreira, Ph.D.
Associate Professor, Department of Public Policy; and
Adjunct Associate Professor, Department of Health
Behavior and Health Education, UNC Gillings School of
Global Public Health
Preston “Chip” Rich, M.D.
Trauma Medical Director, University of North Carolina
Health Care Systems
Division Chief, Trauma and Critical Care Services – UNC
Associate Professor, Departments of Surgery and Anes-thesiology,
UNC School of Medicine
David Richardson, Ph.D.
Associate Professor, Department of Epidemiology, UNC
Gillings School of Global Public Health
Desmond Runyan, M.D., DrPH
Professor, Department of Social Medicine; and Professor,
Department of Pediatrics, UNC School of Medicine
Clinical Professor, Department of Epidemiology, UNC
Gillings School of Global Public Health
National Program Director, Robert Wood Johnson Clini-cal
Scholars Program
Andrés Villaveces, M.D., Ph.D.
Research Assistant Professor, Department of Epidemiol-ogy,
UNC Gillings School of Global Public Health
Adam Zolotor, M.D., MPH
Assistant Professor, Department of Family Medicine;
and Adjunct Professor, Department of Pediatrics, UNC
School of Medicine Associate Medical Director, North
Carolina Child Medical Evaluation Program
Paul Smokowski, M.S.W., Ph.D.
Professor at the UNC School of Social Work
Core Faculty
2010 Annual Report Executive Summary 12
Through education, research, training and outreach efforts, UNC IPRC continues to have a sig-nificant
impact on injury control. This influence is largely the direct result of our efforts to bridge
practice and research, and has affected organizational and governmental policies, injury and
violence practice, and workforce infrastructure at the local, state, tribal, and national and global
levels. Selected highlights from the Center’s 2010 activities are below.
Global Impact on International Child Maltreatement Surveillance
UNC IPRC Core faculty Desmond Runyan and Adam Zolotor led a team of international researchers that developed the
International Society for the Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool that allows
lower- to middle income countries to collect data on violence against children to drive policy and monitor policy
effectiveness over time. Partners included Queensland University of Technology, the International Society for the
Prevention of Child Abuse and Neglect, and the United Nations Children’s Fund.
Local, State and National Impact on Sport-Related Traumatic Brain Injury
UNC is well recognized nationally and internationally as a research leader focusing on the prevention and manage-ment
of these often debilitating and potentially catastrophic brain injuries. The findings from research conducted
at UNC have contributed to changes in the prevention, assessment and response to traumatic brain injuries in both
youth and adult athletes in the US and Canada, and have prompted changes in the policies of professional organi-zations,
including the NFL. IPRC Core faculty member Kevin Guskiewicz directs the Matthew Gfeller Sport-Related
Traumatic Brain Injury Research Center, which was established in 2010, and serves on two subcommittees of the NFL’s
Head, Neck & Spine Medical Committee. Dr. Guskiewicz’s findings and advocacy have been well disseminated to the
general public through extensive media coverage, including a recent feature in the New York Times.
Youth Violence Prevention
North Carolina Academic Center for Excellence in Youth Violence Prevention: NC-ACE. The CDC’s National Center for
Injury Prevention and Control has made a large award to establish the nation’s first rural youth violence prevention
center in Robeson County, NC. The NC-ACE in Youth Violence Prevention is a collaboration between UNC IPRC, the
UNC School of Social Work, and community partners in Robeson County. The project is led by IPRC Core faculty Paul
Smokowski.
National Impact on Policy Advocacy for Injury Control
A paper by Center Director Carol Runyan and colleagues from seven other injury centers, published in the American
Journal of Preventive Medicine (July 2010), makes the case for increased funding for injury control and will be used to
support advocacy efforts to build the field.
State and National Impact on Youth Labor Saftey
At the request of the NC Child Fatality Task Force, IPRC Director Carol Runyan and Kimberly Rauscher provided in-formation
about the hazards associated with youth work as the General Assembly deliberated legislation that, once
passed, increased penalties for businesses that violate child labor laws. This work has also been used to inform federal
policy. For example, as stated in a letter from Arthur M. Kerschner, Jr., Acting Director, Office of Enforcement Policy and
Procedures, US Department of Labor “…We have relied heavily on the published findings of the (UNC Injury Prevention)
Research Center. These findings have helped us plot and prioritize both our enforcement and rulemaking strategies. They
provide us with important insights into ways of reducing occupational injuries to young workers that we may not have
previously considered.”
Local and State Level Impact on Child Maltreatement Prevention
The Center continues to play a key role in child maltreatment prevention in North Carolina, including working with the
NC Child Fatality Task Force, Prevent Child Abuse NC, the Department of Public Health and Safe Kids NC. A team led
by Desmond Runyan delivers the crying education and Shaken Baby Syndrome prevention intervention entitled The
Period of PURPLE Crying® to the parents of every child born in a hospital in North Carolina. Additionally, participants
in IPRC’s PREVENT training program are influencing state and local policy throughout the United States. For example,
a team from Ohio successfully advocated for legislation banning corporal punishment in schools.
UNC IPRC 2010
UNC Injury Prevention Research Center 13 2010 Annual Report
Executive Summary
Impact in North Carolina: Testimonials
“The University of North Carolina’s Injury Prevention Research Center (IPRC) is an invaluable partner to the growth and
development of the injury and violence community in North Carolina. The support of IPRC was a key factor in my decision
to apply and accept the position as Head of the Injury and Violence Prevention Branch with the North Carolina Division of
Public Health; I had worked with IPRC staff in the past and knew how valuable they are in fostering excellence in injury and
violence prevention. IPRC supports the injury community in North Carolina through work force development, research
projects, program evaluation, and on-going technical assistance. IPRC staff serve on our State Advisory Council, serve as
evaluators for state injury and violence prevention programs, and provide assistance to our staff. North Carolina is widely
recognized as a leader in injury and violence prevention in the country; the long standing support of IPRC is a key fac-tor
in North Carolina’s success.”
Alan Dellapenna, MPH, Head, Injury and Violence Prevention Branch, North Carolina Department of Public Health
“…We in North Carolina and across the region are extremely fortunate to have the expertise of the UNC Injury Prevention
Research Center. The staff are extremely responsive when we ask for your expertise and advice on health policy issues facing
the state. IPRC serves as a strong model for collaborative research, training and outreach --one that helps translate
research into realistic and actionable public health practices.”
Pam Silberman, JD, MPH, President and CEO, North Carolina Institute of Medicine
“…The information collected by the Center regarding the risks of injury and death to children has proven invaluable. The
Center provides a service to Safe Kids North Carolina that we have been unable to find anywhere else….the two reports
that IPRC developed for the state office have allowed coalitions across our state to tailor their programs based on the com-munity
needs...”
Kelly Ransdell, Director, Safe Kids North Carolina
Faculty Achievements and Honors
Dr. Kevin Guskiewicz was named Director of Carolina’s newly established Matthew Gfeller Sport-Related Traumatic
Brain Injury Research Center. Dr. Guskiewicz is a Kenan Distinguished Professor and Chair of the Department of Exer-cise
and Sport Science.
Dr. Carri Casteel received the Seminal Research Publication Award from the Society for the Advancement of Violence
and Injury Research for the following article: Casteel C., Peek-Asa C., Greenland S., Chu LD, and Kraus J.F. “Effectiveness
of a workplace violence intervention in small retail and service establishments.” Journal of Occupational and Environ-mental
Medicine 50(12) (2008):1365-1370.
Dr. Krista Perreira received the 2010 Phillip and Ruth Hettleman Prize for Artistic and Scholarly Achievement for her
scholarship on Latino populations and immigration.
Dr. Andrés Villaveces received the Publication of the Year Award of the American Society for Information Science &
Technology and Special Interest Group for International Information Issues for the article, “Information Visualization
Services in a Library? A Public Health Case Study,” and the entire issue of Bulletin of the American Society for Information
Science and Technology 35(5) (June/July 2009): 13-18
Dr. Adam Zolotor received the UNC School of Medicine’s James W. Woods Junior Faculty Award, which supports prom-ising
young members of the medical school’s clinical faculty early in their academic careers.
Dr. Shrikant Bangdiwala was designated ‘Professor Extraordinarious’ by the University of South Africa, Johannesburg,
March 2010
14 2010 Annual Report Education & Training
UNC IPRC offers both education in traditional classroom settings and continuing education oppor-tunities
for public health and social work practitioners, medical providers, and others to learn more
about injury and violence prevention. Through multiple training initiatives, UNC IPRC plays a cen-tral
role in bridging the gap between research and practice, and building the injury and violence
prevention infrastructure and workforce. Education and training efforts occur on the UNC campus
and reach undergraduate students through post graduate fellows, and students and professionals
statewide, nationally and internationally. In addition, the Center actively works to provide mentor-ship
to newer investigators.
IPRC Seminars, Lectures & Exchange
The UNC Seminar Series provides an opportunity for UNC faculty, staff, students and the community at large to learn
about the latest findings from injury research and practice on and beyond the UNC campus. The series covered a vari-ety
of topics in 2010, including: special health care needs among children reported for maltreatment; preventing falls
through enhanced pharmaceutical care; the Carolinas Poison Center’s role in injury prevention; using social marketing
to promote falls prevention among older adults; adolescent female sex workers—invisibility, violence and HIV; and is-sues
related to the terrorist threats.
The annual Patricia F. Waller Lecture brings to campus a leading scholar in the injury field to present on cutting edge
issues in the field. In 2010, the presentation, “Pediatric Injury Prevention: From the Trenches to the Ivory Tower and
Back Again,” was made by Andrea C. Gielen, ScD and Director, the Center for Injury and Research Policy at the Johns
Hopkins Bloomberg School of Public Health.
Small group meetings with seminar and lecture presenters are organized and held at IPRC, and provide the opportu-nity
to learn more about each others’ work in a less formal setting. This opportunity is considered a vital part of IPRC’s
engagement with community partners, as well as an opportunity for UNC students, staff and faculty to interact with
visiting scholars.
The monthly IPRC Exchange provides a forum in which students, faculty and staff present on-going injury-related
work, and receive feedback from colleagues.
The Center provides mentoring in multiple formats and for multiple audiences. For example, in grant writing work-shops
and other mentoring, senior IPRC faculty provide on-going mentoring to junior faculty and post-doctoral fel-lows
in the development of initial federal grant submissions. Student opportunities at IPRC in 2010 included hosting
undergraduate summer internships for students exploring careers in public health, internships and Capstone projects
for masters students in social work and public health, pre and post doctoral training, and employment as research as-sistants.
The IPRC faculty also provide vital mentoring and networking to graduates seeking employment in the field of
injury and violence prevention.
IPRC faculty and staff regularly provide consultation and training opportunities to local, state and national partners,
and are frequent invited speakers at academic institutions and at professional workshops and conferences; for instance,
our national training effort to build workforce capacity and national leadership in child maltreatment, The PREVENT
Child Maltreatment Institute, is described on p. 34. The Institute is easily adapted to other areas of injury and violence,
as it focuses on instilling core competencies in public health injury prevention that are applicable to injury prevention
in general. IPRC’s Assistant Director for Evaluation, Mariana Garrettson, and Center Director Carol Runyan chaired and
co-chaired the Training and Infrastructure Committee of SAVIR throughout 2010. Off-campus, IPRC faculty have
taught over 15 courses and workshops related to injury and violence prevention, and presented numerous invited
presentations nationally and internationally.
On campus, UNC IPRC faculty taught several courses in 2010, including “Injury and Violence as Public Health Prob-lems.”
This three-credit course is offered yearly by the UNC School of Public Health with support from UNC IPRC, and
was led by Center Director Carol Runyan and Dr. Jonathan Kotch. The course considers the causes and consequences of
traumatic injury within developmental, social, and economic contexts, and dilemmas in injury research and prevention.
Injuries associated with transportation, violence, the home, and occupational environments are included. Drs. Carol
Runyan and Andrés Villaveces taught a required on-going module for third year medical students in their surgery rota-tion
and Dr. Villaveces taught modules in five UNC courses, including four courses in the School of Public Health. Dr.
Runyan and IPRC Assistant Director for Education and Training Ms. Karen Moore also taught a campus-wide course on
injury and violence as public health problems which enrolled 22 students, 20 of whom were undergraduates.
UNC Injury Prevention Research Center 15 2010 Annual Report
Education & Training
Student Research Awards
Annually, IPRC funds student research grants. 2010
student research awards included the following.
Reliability of a mobile device compared to a standard
computer monitor for viewing x-rays for orthopae-dic
diagnosis and treatment planning, examined the
hypothesis that orthopaedic x-rays viewed on a mobile
device, such as a smartphone, can be used for initial di-agnosis
and treatment planning. Joshua Tennant, MPH,
MD (PI). Dr. Tennant is a resident in the Department of
Orthopaedics, UNC School of Medicine. His mentor for
the project was Douglas R. Dirschl, MD, Professor and
Chairman, UNC Orthpaedics.
Trajectories of Adolescent Dating Abuse Perpetration
and Victimization: The Impact of Pubertal Timing and
the Role of Peer Context, utilized data from a multi-wave
study of adolescents conducted between 2002
and 2005 in two rural counties in North Carolina to
investigate two aims. These included 1) examining the
association between the pubertal timing in both boys
and girls and the developmental trajectories of adoles-cent
dating abuse perpetration and victimization, and
2) testing the theoretically based processes through
which pubertal timing influences the development of
dating abuse. Ashley Brooks, MPH (PI). Ms. Brooks is a
doctoral student in The Gillings School of Global Public
Health, Department of Health Education and Behavior.
Her mentor for this project was Vangie A. Foshee, Ph.D.
Photo by Dan Sears
2010 Annual Report
Translation of a Robbery and Violence Prevention Program to
High Risk Businesses
Violence Against Home Health and Hospice Workers
Workplace Violence Prevention Programs in New Jersey Health
Care Facilities: A Pilot Study
Young Worker Fatalities and Violations of Labor and Safety
Regulations: Moving Toward a Solution
Criminal Background Checks at the Workplace
Improving the Experiences of Young Workers in North
America: An Interdisciplinary Educational Program
Occupational Health Literacy, Socioeconomic Status
& Work-related Injury to Teens
Occupational Injury
17
18
18
19
19
20
21
FEATURED PROJECT
Photo by Dan Sears
UNC Injury Prevention Research Center 2010 Annual Report
Occupational injuries were responsible for 4,551 deaths in the US
in 2009, 129 of which occurred in North Carolina. Over 3.2 million
nonfatal injuries are recorded annually, over a million of which
involved days away from work – an injury rate of 117 per 10,000
full-time workers. Transportation remains the largest source of
fatal injuries, though homicide is tied with transportation among
female workers.1 The fatal injury rate remains highest in the ag-ricultural
industry.2 Young workers are often inexperienced and
insufficiently trained, yet frequently work in hazard-rich environ-ments.
Approximately 360 workers under age 24 die from work-related
injuries, and 795,000 injuries in young workers require
medical attention every year.3
17
Occupational Injury
FEATURED PROJECT
Workers in the retail industry are at greatest risk for workplace homicide, and
over two-thirds of these homicides are committed during a robbery. Evidence-based
programs that include employee training, cash handling procedures,
safe management, interior and exterior lighting, visibility, access control, and
signage to indicate safety procedures have shown great success in reduc-ing
robbery and violent crime in retail settings. Despite strong evidence of
program success, research indicates that many small businesses have imple-mented
very few to none of the program recommendations, and that what
is implemented is often done so incorrectly. The project team is conducting
a translational study where an evidence-based robbery and violence preven-tion
program is disseminated to businesses through police departments. The
objectives of the study are to identify optimal, sustainable methods in which
law enforcement can: 1) recruit businesses to participate in an evidence-based
robbery and violence prevention program, and 2) achieve high levels of com-pliance
to program recommendations.
Project Period
2006 – 2013, Pilot Project: 2007 – 2011
Key Personnel
Carri Casteel, PhD, MPH (PI); Maryalice Nocera, MSN; Catherine Vladutiu, MPH;
Stephanie Finkbeiner; Carol Runyan, PhD, MPH; Corinne Peek-Asa, PhD; Harlan
Amandus, PhD; Daniel Hartley, EdD; Detective Martin Ennis; and Commander
Tom Chronister, CPP.
Other Organizations or Institutions Represented
University of Iowa; National Institute for Occupational Safety and Health;
Oxnard, California Police Department
Funding
National Institute for Occupational Safety and Health
Contact
Carri Casteel, PhD, MPH
ccasteel@email.unc.edu
Translation of a Robbery and Violence Prevention
Program to High Risk Businesses
UNC Injury Prevention Research Center 18 2010 Annual Report
Health care workers frequently face the threat of violence
at work, and this violence can lead to fear, stress, physical
injury, and even death. Home health and hospice care work-ers
experience violent hazards primarily associated with the
provision of medical care to patients who are aggressive,
disoriented, or under the influence of illegal substances, and
they provide this care in an uncontrolled setting. Threats
can come from crime-ridden neighborhoods, hazards within
the patient’s home, and from the patient and other house-hold
occupants. The goal of this project is to increase imple-mentation
of comprehensive security programs into home
health and hospice agencies to reduce violent events and
their consequences for home care providers. The objectives
of the project are to understand the interaction of organi-zational,
worker and job characteristics, and the external
environment that contribute to and protect home health
and hospice workers from violence, and to identify the most
effective strategies to intervene.
Project Period
2006 - 2010
Key Personnel
Carri Casteel, PhD, MPH (PI); Maryalice Nocera, MSN; Corinne
Peek-Asa, PhD; Robert Harrison, MD; Suzi Goldmacher, RN;
Robert Kosnik, MD
Other Organizations or Institutions Represented
University of Iowa; California Department of Health Services;
University of California San Francisco
Funding
National Institute of Occupational Safety and Health
Contact
Carri Casteel, PhD, MPH
ccasteel@email.unc.edu
Violence Against Home Health and
Hospice Workers
Healthcare workers are nearly five times more likely to be
victims of violence than workers in all industries combined.
While healthcare workers are not at particularly high risk
for job-related homicide, nearly 60% of all nonfatal assaults
occurring in private industry are experienced in healthcare.
Eight states have enacted laws to reduce violence against
healthcare workers by calling for workplace violence preven-tion
programs. However, little is understood about how
effective these laws are in reducing violence against work-ers.
The long-term goal of the project is to understand the
impact of state legislation on the comprehensiveness of
healthcare facilities’ workplace violence prevention pro-grams
and rates of employee workplace violence-related
injury. The objective of the study is two-fold: 1) to examine
healthcare facility compliance to the New Jersey Violence
Prevention in Health Care Facilities Act, and 2) to evaluate
the effectiveness of the Act in reducing assault injuries to
workers.
Project Period
2010 - 2011
Key Personnel
Carri Casteel, PhD, MPH; Marilyn Ridenour, MPH; Daniel Hart-ley,
EdD; James Blando, PhD
Other Organizations or Institutions Represented
National Institute for Occupational Safety and Health;
Old Dominion University
Funding
Subcontract from the National Institute for Occupational
Safety and Health
Contact
Carri Casteel, PhD, MPH
ccasteel@email.unc.edu
Workplace Violence Prevention
Programs in New Jersey Health Care
Facilities: A Pilot Study
Occupational Injury
UNC Injury Prevention Research Center 2010 Annual Report
Evidence shows that non-fatal injuries can occur when
youth are illegally employed, yet little research has looked
at the relationship between fatal young worker injuries
and labor and safety violations. 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 by capitalizing on the
excellent data available within the NC medical examiner sys-tem.
The second 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 cur-rent
challenges in enforcement and develop strategies to
overcome these challenges and improve the protection of
young workers by engaging with a range of local stakehold-ers
through focus groups, in-depth interviews, and a multi-organizational
capstone meeting. Data on the magnitude
and nature of young worker fatalities in NC between 1990
and 2008 have been published in the American Journal of
Industrial Medicine. Findings on child labor violations and
enforcement activities presented at the 2010 Annual Meet-ing
of the American Public Health Association are being
prepared for journal submission.
Project Period
2008 - 2012
Key Personnel
Kimberly J. Rauscher, MA, ScD (PI); Carol W. Runyan, PhD,
MPH; and Deborah Radish, MD
Other Organizations or Institutions Represented:
West Virginia University, North Carolina Office of the Chief
Medical Examiner
Funding
National Institute for Occupational Safety and Health
Contact
Kimberly J. Rauscher, MA, ScD
krauscher@hsc.wvu.edu
Young Worker Fatalities and Violations
of Labor and Safety Regulations:
Moving Toward a Solution
19
Occupational Injury
The purpose of this pilot study is to survey human resources
personnel from a wide range of industries in order to un-derstand
why employers run criminal background checks
and how best to design a future study that measures the ef-fectiveness
of criminal background checks at the workplace.
The survey was completed in September, and a manuscript
is now being prepared that focuses on the reasons employ-ers
run criminal background checks. The most frequent
reasons given for running criminal background checks were
to prevent liability and criminal misconduct. The manuscript
will review the literature on this topic to assess how strong
the evidence is that criminal background checks can prevent
these outcomes.
Project Period
2009 - 2011
Key Personnel
Matthew W. Pierce, JD, MPH (PI)
Funding
North Carolina Occupational Safety and Health Education
and Research Center through the National Institute for Occu-pational
Safety and Health (NIOSH)
Contact
Matthew Pierce, JD, MPH
mpierce@WCL.American.edu
Criminal Background Checks at the
Workplace
Occupational Injury
2010 Annual Report UNC Injury Prevention Research Center 20 Occupational Injury
Young workers in North America have much in common in
the way they experience the workplace for their benefit or
detriment. The purpose of this project is to carry out a series
of symposia designed to help a diverse group of scholars
and practitioners update and synthesize their understand-ing
of the benefits and risks of youth employment and to set
an agenda for future scientific and programmatic directions
throughout the U.S. and Canada. The program consists of a
series of four sessions with distinct themes to be held in the
U.S. and Canada over a three year period. These educational
sessions are bringing together scholars and practitioners
from a wide range of disciplines who are concerned with
youth employment and its effects. The project is working
to compile papers generated in the project into a special
issue of a journal, including recommendations for policy and
research.
Project Period
2006 - 2010
Key Personnel
Carol W. Runyan, PhD, MPH (PI); John H. Lewko, PhD;
Kimberly J. Rauscher, MA, ScD
Other Organizations or Institutions Represented
Laurentian University (Canada) ; Ontario Neurotrauma Foun-dation
(Canada); West Virginia University
Funding:
National Institute of Occupational Safety and Health; Ontario
Neurotrauma Foundation (Canada)
Contact:
Carol W. Runyan, PhD, MPH
carol.runyan@ucdenver.edu
Improving the Experiences of Young
Workers in North America: An
Interdisciplinary Educational Program
“Most teens work – and work has
many benefits. Yet the potential
hazards have not been adequately
examined. We are trying to under-stand
how to make work safer for
young people.” - Dr. Carol Runyan
UNC Injury Prevention Research Center 2010 Annual Report
This study examines the relationship between adolescent
health literacy as it applies to the workplace, i.e., “occupa-tional
health literacy,” (OHL) and work-related injury (WRI),
which affects approximately 200,000 U.S. adolescents
under 18 every year. This study will examine OHL as both
a determinant of WRI prevalence among adolescents and
as a mediating factor in the known association between
socioeconomic status (SES) and adolescent WRI. We will
take 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 OHL (e.g., access to health and safety informa-tion
and demonstrated health and safety knowledge and
skills). Findings will be useful in developing interventions
to enhance OHL among working youth, with specific efforts
targeted at improving literacy among disadvantaged youth,
to reduce their disproportionate injury burden. Findings on
the association between OHL and WRI have been submitted
for presentation at the 2011 Annual Meeting of the Ameri-can
Public Health Association, and findings on the relation-ship
between SES and WRI have been submitted to the 2011
NIOSH-sponsored conference “Eliminating Health and Safety
Disparities at Work.” Data analysis is ongoing and results are
being prepared for journal submission.
Project Period
2009 - 2011
Key Personnel
Kimberly J. Rauscher, MA, ScD (PI); Douglas J. Myers MA, ScD
(Co-PI); J. Michael Bowling, PhD; Carol W. Runyan, PhD, MPH
Other Organizations or Institutions Represented
West Virginia University; Duke University School of Medicine
Funding
National Institute for Occupational Safety and Health
Contact
Kimberly J. Rauscher, MA, ScD
krauscher@hsc.wvu.edu
Occupational Health Literacy,
Socioeconomic Status & Work-related
Injury to Teens
21
Occupational Injury
Photo by iStockPhoto
2010 Annual Report
FEATURED PROJECT
JUMP-ACL (Epidemiology of Jump-Landing Movements and ACL Injury)
Influence of Hamstring Muscle Stiffness on Knee Joint Stability
Center for the Study of Retired Athletes
Translating Lower Extremity Injury Prevention into Practice
Validity & Reliability of the NCAA Web-Based Injury Surveillance System
Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center
Sports & Recreational Injury
23
24
24
25
26
27
Photo by Robyn Gayle
UNC Injury Prevention Research Center 23 2010 Annual Report
Despite the benefits of participation in sports and other recreational
activities, athletes are at risk of sports-related injuries at the school
and professional level. Close to 1.5 million injuries occur in high-school
athletes every year at a rate of 2.4 per 1,000 athlete exposures.
For some sports, such as football, these rates can climb to 12 per
1,000 exposures during competitive play.1 A central focus of sports
injury research at UNC is traumatic brain injury. Close to 450,000
sports-related head injuries are seen in U.S emergency departments
every year. A fifth of these head injuries, and a third of all sports-related
injuries occur in cyclists. Football, however, accounts for
300,000 traumatic brain injuries, such as concussion, every year.2 Col-laboration
between UNC IPRC and the Matthew Gfeller Sport-Related
Traumatic Brain Injury Research Center, also at UNC, has focused on
this incredible epidemic.
FEATURED PROJECT
Sports & Recreational Injury
Anterior Cruciate Ligament (ACL) injuries are devastating knee injuries that typical-ly
occur in physically active populations. Women have a higher risk of ACL injury
than men, but the actual mechanism of this injury is unknown. This study focuses
on human movement as a risk factor for ACL injury and combines an epidemio-logic
prospective cohort design with a biomechanical motion analysis assessment.
The subjects in the cohort are female and male cadets and midshipmen at the U.S.
Naval Academy, the U.S. Air Force Academy, and the U.S. Military Academy at West
Point. Cohort enrollment has been completed, and a total of 5,868 subjects have
been enrolled in the cohort (39% are female) and undergone a baseline human
movement biomechanical assessment protocol involving a jump-landing task.
Data collection for ACL injuries is on-going, and to date the study has registered
over 100 injuries. Based on preliminary multivariate Poisson regression models,
the rate of ACL injury is higher in those subjects with increased hip adduction
angle at initial ground contact. Several ancillary projects in progress extend the
work to other lower extremity outcomes (stress fractures and anterior knee pain)
that are common in military populations.
Project Period
2005 - 2011
Key Personnel
Stephen W. Marshall, PhD (PI); Darin Padua, PhD, ATC; Anthony Beutler, MD; Sue
Wolf, MS; Dean Taylor, MD; William E. Garrett Jr., MD, PhD; Bing Yu, PhD; Kevin
Guskiewicz, PhD, ATC; Barry Boden, MD; Scott Pyne, MD; John Tokish, MD; Thomas
DeBerardino, MD
Other Organizations or Institutions Represented
Uniformed Services University of the Health Sciences; United States Naval Acad-emy;
The Orthopedics Center; United States Air Force Academy; United States
Military Academy at West Point
Funding
National Institute for Arthritis, Musculoskeletal, and Skin Disorders; The American
Orthopedic Society for Sports Medicine
Contact
Stephen W. Marshall, PhD
steve_marshall@unc.edu
JUMP-ACL (Epidemiology of Jump-Landing
Movements and ACL Injury)
2010 Annual Report UNC Injury Prevention Research Center 24 Sports & Recreational Injury
Anterior cruciate ligament (ACL) injury affects a substantial
number of individuals in the U.S. each year, and females
demonstrate a substantially greater injury rate than males.
Public health initiatives such as Healthy People 2010 pro-mote
healthy lifestyles through physical activity. However,
population increases in physical activity will likely result in
an increase in the rate of musculoskeletal injuries, including
those of the ACL. This investigation will evaluate the influ-ence
of hamstring stiffness on knee joint stability in 50 males
and 50 females. The aims of this project include the fol-lowing:
1) to evaluate the relationship between hamstring
stiffness and sagittal plane knee joint stability; 2) to evaluate
sex differences in sagittal plan knee joint stability; and 3) to
evaluate the contribution of hamstring muscle stiffness to
the sex difference in sagittal plane knee joint stability. Data
collection has been completed, as have analysis for Aim 1.
We have recently published a peer-reviewed paper (Clini-cal
Biomechanics 26(3): 278-283, 2011) that discusses the
finding that hamstring stiffness is an important contributor
to knee joint stability, and likely to anterior cruciate liga-ment
(ACL) injury risk. Furthermore, hamstring stiffness can
be modified via numerous mechanisms, thus these data
provide rationale for future interventions designed to en-hance
hamstring stiffness in an effort to increase knee joint
stability and reduce ACL injury risk. These findings are likely
to have substantial implications for the public health burden
associated with ACL injury, as well as future ACL injury
prevention efforts. The investigators have also developed a
biomechanical model for predicting strain of the ACL during
the selected tasks, and a manuscript describing the model is
currently in preparation.
Project Period
2009 - 2011
Key Personnel
J. Troy Blackburn, PhD, ATC (PI); Darin A. Padua, PhD, ATC;
Marc F. Norcross, MA, ATC
Funding
UNC-Chapel Hilll Award Program for Junior Faculty Develop-ment;
National Center for Injury Prevention and Control
Contact
J. Troy Blackburn, PhD, ATC
troyb@unc.edu
Influence of Hamstring Muscle Stiffness
on Knee Joint Stability
Hundreds of professional athletes retire every year, many
of whom were forced to abuse their bodies throughout a
career that likely caused them to play injured and crippled
on occasion. These very same “bodies,” which provided an
opportunity of a lifetime for some players, are now deterio-rating.
The Center for the Study of Retired Athletes, housed
in the Department of Exercise and Sport Science at UNC-Chapel
Hill, was developed in 2000. The primary goals of
the Center are to collect epidemiological data on retired
professional athletes, and to provide medical care for select
retirees in a research setting. The hope is that these research
findings will help improve the quality of life for many retired
athletes. This information will also be used to prepare active
athletes for a healthier retirement. Currently, the Center is
conducting two research studies. One explores the relation-ship
between recurrent concussion and hypopituitarism in
retired NFL players. The second is examining the effects of
Omega-3 fatty acid supplementation in 40 retired NFL play-ers
who suffer from memory dysfunction. Three publica-tions
from this work are currently under review or in prepa-ration.
UNC IPRC assists the Center for the Study of Retired
Athletes by providing biostatistical support and participat-ing
on the Center’s advisory board.
Project Period
2000 - Present
Key Personnel
Kevin Guskiewicz, PhD, ATC (PI); Stephen W. Marshall, PhD
Other Organizations or Institutions Represented
National Football League Players’ Association (Washington,
DC); John Wayne Cancer Institute at the St. John’s Health
Center (Santa Barbara, CA); Harbor-UCLA Medical Center
(Torrance, CA)
Funding
Office of the UNC Vice Chancellor for Research and Econom-ic
Development; Office of the Dean, UNC College of Arts and
Sciences; The National Football League Players’ Association
– Professional Athletes Foundation; Medtronic, Inc; Martek
Biosciences Corporation; National Operating Committee on
Standards for Athletic Equipment.
Contact
Amy Matthews, MSW
novello@email.unc.edu
Center for the Study of Retired Athletes
UNC Injury Prevention Research Center 25 2010 Annual Report
A critical barrier to progress in community sports injury pre-vention
programs is the lack of “buy-in” from the team coach.
Coaches hold the key to effectively reaching players during
practice times. Yet injury prevention programs are devel-oped
and implemented by researchers without considering
the coaches’ perceived barriers to injury prevention imple-mentation.
No study conclusively quantifies the effects of
coach supervision on injury markers and injury rates.
To address this critical translational gap, this project com-paratively
studies a proven Lower Extremity Injury Preven-tion
(LEIP) program using the three most common imple-mentation
models in community youth sports: program
supervision by an outside professional, supervision by a
trained coach, and supervision by a coach with access to
LEIP program materials only. Based on Fishbein’s reasoned
action approach model, the investigators have developed
a Coaches’ Behavioral Change Workshop. The workshop
will be given to “train coaches” to improve program compli-ance,
a key deficiency in previous coach-led programs. The
study team will assess the knowledge, attitudes, and beliefs
of youth soccer coaches before and after program imple-mentation.
The primary outcome measure of successful
implementation will be reductions in lower extremity injury
rates. Secondary outcome measures of interest are improve-ments
in balance (measured by Star Excursion Balance Test)
and movement patterns which predict injury (measured by
the Landing Error Scoring System and by three-dimensional
biomechanical analysis). The investigators hypothesize that
following the behavioral change workshop, teams super-vised
by trained coaches will exhibit protective biomechani-cal
changes and reductions in their injury rate similar to
teams supervised by trained professionals.
Project Period
2009 - 2011
Key Personnel
Darin A. Padua, PhD, ATC (PI); Stephen W. Marshall, PhD
Funding
UNC Injury Prevention Research Center Faculty Small Grant
Program
Contact
Darin Padua, PhD, ATC
dpadua@email.unc.edu
Translating Lower Extremity Injury
Prevention into Practice
Sports & Recreational Injury
By the Numbers: SPORTS INJURIES
AMERIcans who receive med ical attention 7million
for spo rts and recreat ional injuries in a year
Source:Conn, JM, Annest JL, Gilchrist J. Sports and recreation related inju-ries
in the US population, 1997-99. Injury Prevention 2003; 9 (117-123.)
americans who are trea ted in emerge ncy departmen ts 4.3million
for spo rts and recreat ional injuries in a year
Source: CDC 2000-2001 Morbidity and Mortality Report
Percen t of Spinal Cord Injuries 12% resul ting fro m Spor ts and Recreati onal Activities
SOURCE: http://www.cdc.gov/TraumaticBrainInjury/scifacts.html
2010 Annual Report UNC Injury Prevention Research Center 26 Sports & Recreational Injury
The National Collegiate Athletic Association (NCAA) Web-based
Injury Surveillance System (ISS) involves hundreds
of certified athletic trainers (ATC) in the USA entering injury
surveillance data into a web-based system. These data are
used by NCAA committees to make decisions relevant to
student-athlete welfare and are used by sports medicine
researchers around the world. The system is widely re-garded
as the premier sports injury surveillance system in
the world. However, the validity and reliability of these data
are currently unknown. This study quantitatively established
the reliability and validity of the system. Abstractors visited
a sample of 15 schools contributing data to the system and
abstracted data on sports-related injuries from sources other
than the ISS (hard copy files or other databases). Results
indicate that the ISS captures the vast majority of sports in-juries
(close to 90%) and reliability of most data fields is high
(over 90%). A paper reporting the results will be published
in the Journal of Athletic Training.
Project Period
2006 - 2010
Key Personnel
Stephen Marshall, PhD (PI); Kristen Kucera, PhD, ATC
Other Organizations or Institutions Represented
Duke University Medical Center
Funding
National Collegiate Athletic Association
Contact
Stephen W. Marshall, PhD
steve_marshall@unc.edu
Validity & Reliability of the NCAA Web-
Based Injury Surveillance System
Photo by Dan Sears
UNC Injury Prevention Research Center 27 2010 Annual Report
Sports & Recreational Injury
The mission of the “Matthew Gfeller Sport-Related Traumatic
Brain Injury Research Center” is to improve the prevention,
evaluation, management, and rehabilitation of sports-related
traumatic brain injuries through research, education,
and clinical practice. The Center is under the sponsorship of
the University of North Carolina at Chapel Hill’s Department
of Exercise and Sport Science, in collaboration with several
other units, including the UNC Injury Prevention Research
Center, UNC School of Medicine, UNC Gillings School of
Global Public Health, and UNC Division of Sports Medicine.
The Center’s research team also collaborates with concus-sion
experts world-wide to carry out its mission. Through
clinical and research initiatives, the Center’s faculty and staff
demonstrate a commitment to providing the highest level
of care for athletes of all ages suffering from sports-related
brain injuries, and to assist parents, coaches, and medical
professionals in managing these student-athletes.
The Center carries out its mission through a values-based
clinical and research agenda. The program guides clinicians
to better manage sports-related concussions and traumatic
brain injury and apply the values of:
Injury prevention
Injury surveillance
Education
Evaluation
Management
Rehabilitation
Collaboration
Integrity & Responsibility
The Matthew Gfeller Sport-Related Traumatic Brain Injury
Research Center is housed in a newly renovated 1,300 sq. ft.
space on the top floor of the Stallings-Evans Sports Medi-cine
Center in the heart of UNC-Chapel Hill’s campus. It is
a center of excellence for treating athletes suffering from
sport-related concussion. This dedicated clinical research
space offers state-of-the-art balance assessment, neuropsy-chological
assessment, and other neurological evaluations.
The close proximity to the main floor of the UNC Athletic
Training Room in Stallings-Evans is ideal for treating col-legiate
athletes, as well as recreational and high school
athletes from the surrounding communities. The Center also
serves as an evaluation and treatment facility for UNC’s well-known
Center for the Study of Retired Athletes, aimed at
investigating a spectrum of physical and mental challenges
facing former NFL players.
Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center
UNC is well recognized nationally and internationally as a
research leader focusing on the prevention and manage-ment
of these often debilitating and potentially catastrophic
brain injuries. Our work over the past 16 years has been
conducted out of the Sports Medicine Research Laboratory
and we have used this time to form a qualified and highly
respected interdisciplinary research team, consisting of
neuroscientists, physicians, certified athletic trainers, and
injury epidemiologists. The newly named Center allows for
Carolina to continue its tradition of excellence in an environ-ment
that promotes collaboration between clinicians and
researchers with a more clear vision and identity. Ultimately,
the major benefactors are the young athletes participating
in sports who are at risk for these injuries.
Key Personnel
Kevin Guskiewicz, PhD, ATC; Stephen W. Marshall, PhD;
Jason P. Mihalik, PhD, CAT(C), ATC; Frederick O. Mueller, PhD;
Johna K. Register-Mihalik, PhD, ATC
Other Organizations or Institutions Represented
UNC Sport Medicine Research Lab; Center for the Study of
Retired Athletes; Matthew Gfeller Foundation; UNC Neu-romuscular
Research Lab; National Center for Catastrophic
Injury Research
Contact
Kevin Guskiewicz, PhD, ATC
gus@email.unc.edu
2010 Annual Report
FEATURED PROJECT
The Effect of a Driver Training Course on the Incidence of
Moving Violations and Traffic Crashes after the Course
Pedestrian Injuries and the Built Environment in Colombia
Integrating Qualitative and Quantitative Methods in
Longitudinal Measurement and Analysis
Other Unintentional Injury
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Photo by Richard Brame
UNC Injury Prevention Research Center 29 2010 Annual Report
While the work of the UNC IPRC is largely characterized by a focus
on the four injury areas of violence, residential injury, sports and
recreational injury and occupational injury, we also are engaged
in cross-cutting research that extends beyond these four content
areas. Studies of the built environment, safe transportation, mo-tor
vehicle crashes and data management are yielding important
findings that help build the field while addressing major injury
problems of our time.
Other Unintentional Injury
FEATURED PROJECT
The purpose of this project was to evaluate the effect of a driver training course
implemented in Pitt County, North Carolina. The effect of this strategy on the
incidence of re-offending as expressed by new moving violations or crashes
over a period of two years after the intervention is also being evaluated.
Project Period
2009 - Present
Key Personnel
Herbert G. Garrison MD, MPH (PI); Andrés Villaveces MD, PhD; Jennifer P. King
MA; Jennifer L. Smith MSW; J. Michael Bowling PhD; Eric A. Rodgman MPH
Other Organizations or Institutions Represented
Department of Emergency Medicine, The Brody School of Medicine, East Caro-lina
University; Eastern Carolina Injury Prevention Program, University Health
Systems of Eastern Carolina; UNC Department of Health Behavior and Health
Education; UNC Highway Safety Research Center
Funding
National Center for Injury Prevention and Control
Contact
Andrés Villaveces, MD, PhD
avillav@email.unc.edu
The Effect of a Driver Training Course on the
Incidence of Moving Violations and Traffic Crashes
after the Course
UNC Injury Prevention Research Center 30 2010 Annual Report
Consideration of the built environment and its influence
on injury has become increasingly highlighted in injury
prevention work. The purpose of this project is to conduct
a pilot study of the built environment in a metropolitan
area of a middle-income country (Cali, Colombia), and to
study its influence on the incidence of pedestrian-related
deaths at an ecological level. This will be accomplished by
using aggregate measures of the built environment and city
infrastructure and evaluating their spatiotemporal associa-tion
with mortality data on overall injuries while focusing on
structural inequalities. Injury mortality data collection on
pedestrian fatal injuries was completed in 2010. Geographic
information about population data sources was completed
in 2008. Funding from the UNC Office of the Provost and the
University Research Council enabled acquisition of better
maps for spatial analyses.
Project Period
2007 - 2011
Key Personnel
Andrés Villaveces, MD, PhD (PI); Daniel Rodriguez, PhD;
Stephen Lippmann, MPH; Shrikant I Bangdiwala, PhD; Ste-phen
W. Marshall, PhD; Marc Serre, PhD.
Other Organizations or Institutions Represented
UNC Department of City and Regional Planning; Cisalva
Institute, University of El Valle, Cali, Colombia
Funding
National Institutes of Health, Fogarty International Center;
University Research Council; UNC Office of the Provost; Na-tional
Center for Injury Prevention and Control
Contact
Andrés Villaveces, MD, PhD
avillav@email.unc.edu
Pedestrian Injuries and the Built
Environment in Colombia
Other Unintentional Injury
The mission of the Family Life Project is to better understand
how child characteristics, family life, and community sup-port
interact and contribute to the growth and development
of young children. This sub-study of the Family Life Project
seeks to use innovative ways of combining quantitative and
qualitative methods to examine child injury. This sub-study
has resulted in one completed manuscript and another pub-lished
in Pediatrics in 2008.
Project Period
2006 - 2007
Key Personnel
Margaret Burchinal, PhD (PI); Debra Skinner, PhD;
Adam Zolotor, MD, MPH
Other Organizations or Institutions Represented
Pennsylvania State University
Funding
Maternal and Child Health Bureau
Contact
Adam Zolotor, MD, MPH
ajzolotor@email.unc.edu
Integrating Qualitative and Quantitative
Methods in Longitudinal Measurement
and Analysis
UNC Injury Prevention Research Center 31 2010 Annual Report
Other Unintentional Injury
Residential Injury Preventing Falls Through Enhanced
Pharmaceutical Care
This study evaluated the effectiveness of a community-based
falls prevention program delivered by community pharmacists. A
randomized controlled clinical trial design was used. The target
population was community-dwelling older adults (age 65+) at high
risk for future falls because 1) they had experienced a fall within
the past year, 2) they were currently using four or more prescrip-tion
medications, and 3) they were currently using at least one
CNS-active medication. Participants were recruited using prescrip-tion
profile records maintained by the pharmacies where they
obtain their medications. Individuals in the intervention group
received an in-depth consultation concerning their current medi-cations,
conducted by a community pharmacist. The consultation
was designed to elicit medication-related problems (e.g., ortho-static
hypotension, daytime sedation). Problems identified during
the consultation, and therapeutic recommendations designed to
address these problems, were communicated to the prescribing
physician as well as the patient’s primary physician. With physician
approval, appropriate modifications were made to the patient’s
medication regimen. Individuals assigned to the Control Group
received written information about falls prevention. All individuals
were followed for one year. Data concerning falls were collected
via Monthly Falls Calendars. Data concerning medication use were
collected quarterly via a combination of self-report and review
of participants’ pharmacy prescription profile records. One year
following study enrollment, more comprehensive follow-up data
were collected. To date, this project has succeeded in identifying
older adults at increased risk of falling via review of prescription
profile records. The findings demonstrate the feasibility of us-ing
community pharmacies to deliver a falls prevention program
targeting older adults who are taking medications that have been
associated with an increased risk of falling. Two peer reviewed
papers have been published using this data and a third has been
submitted.
Project Period
2004 – 2009
Key Personnel
Susan J. Blalock, MPH, PhD (PI); Mary Roth, MHS, PharmD; Stefanie
Ferreri, PharmD; Carri Casteel, PhD, MPH; Karen Demby, PhD; Cath-leen
Colón-Emeric, MD, EHSc; Joseph T. Hanlon, PhD; Carol Hogue,
PhD
Other Organizations or Institutions Represented
Duke University Medical Center; University of Minnesota; Univer-sity
of Pittsburgh
Funding
National Center for Injury Prevention and Control
Contact
Susan J. Blalock, MPH, PhD
s_blalock@unc.edu
Most unintentional injuries, such as burns,
drownings and falls, occur in a residential set-ting.
Older adults face a high risk of falls, the
leading cause of injury in adults over age 65.
New interventions to prevent falls can ad-dress
the disproportionate impact falls pose
to these older populations. 1 Drug poisoning
causes nearly 28,000 deaths annually in the
U.S. and has become the 2nd leading cause of
injury death in the U.S., second only to traffic
injuries, and the leading cause of injury death
for adults age 35-54.1 Prescription opioids
are the most common cause of unintentional
overdose, and account for more deaths than
heroin and cocaine combined. 2,3 Research at
UNC IPRC has focused on this dramatic and
recent epidemic.
31 2010 Annual Report
Photo by iStockPhoto
2010 Annual Report
CHILD MALTREATMENT
FEATURED PROJECT
Longitudinal Studies of Child Abuse and Neglect
The Period of PURPLE Crying®: Keeping Babies Safe in North Carolina
PREVENT Child Maltreatment (CMT) Institute
Project Smartphone
Formative Evaluation of The Circle of Parents® Program in North Carolina
Oral Trauma in Infant Victims of Abusive Head Trauma
International Society for the Prevention of Child Abuse and Neglect
Child Abuse Screening Tool
Global Symposium for Examining the Relationship between Online and
Offline Offenses and Preventing the Sexual Exploitation of Children
Violence Exposure Trajectories and LIGHTHOUSE
YOUTH VIOLENCE
North Carolina Academic Center for Excellence in Youth Violence
Prevention: NC-ACE
Do Criminal Background Checks Improve Safety on College Campuses?
INTIMATE PARTNER VIOLENCE
FEATURED PROJECT
Family-Based Dating Violence Prevention for Latino Teens
Evaluation of One Act: A UNC Campus Bystander Intervention Initiative
Understanding the Role of Substance Use in Intimate Partner Violence
Dating Abuse Prevention in Teens of Moms with Domestic Violence
Protection Orders
Evaluation of Implementation and Adoption of Close to Home
SUICIDE & HOMICIDE
FEATURED PROJECT
Evaluation of NC DHHS Statewide Suicide Prevention Initiative
Alcohol Sales Laws and Homicide Injuries in Cali, Colombia
North Carolina Violent Death Reporting System (NC-VDRS)
Violence
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Photo by iStockPhoto
UNC Injury Prevention Research Center 33 2010 Annual Report
FEATURED PROJECT
This multi-site longitudinal study of 1354 participants is designed to: 1) exam-ine
the impact of child abuse and neglect on young children at five sites (North
Carolina, San Diego, Seattle, Chicago, and Baltimore) over a twenty-year period;
2) examine the extent to which children are victimized throughout their life-times;
3) identify the factors that increase the likelihood a child will experience
chronic and severe abuse; 4) determine what life experiences exacerbate or
ameliorate the negative impact of maltreatment; and 5) determine factors that
might contribute to resilience in vulnerable children. The study sites follow a
common protocol for data collection that includes face-to-face interviews with
children and their primary caregivers at the time the children are 4, 6, 8, 12, 16,
and 18 years old. Additional data sources include teacher questionnaires and
CPS records.
In December 2010, the LONGSCAN Investigators received approval for addition-al
funding from the Doris Duke Charitable Foundation to support From Science
to Practice: LONGSCAN Findings that Can Change Child Welfare. This three-year
project, starting in 2011, will support continuing analysis of the LONGSCAN
data, as well as dissemination meetings and the writing of findings summaries
for child welfare practitioners and policy makers.
To date, LONGSCAN investigators and other researchers using LONGSCAN data
have published 130 peer-reviewed journal articles which have made significant
contributions to the child maltreatment literature in the areas of defining and
measuring maltreatment, ethical issues related to conducting child maltreat-ment
research, risk and protective factors, the role of fathers in the lives of mal-treated
children, the interface of child maltreatment with other interpersonal
violence exposure, suicidality, and the effects of early childhood maltreatment
on later physical health. Please visit http://www.iprc.unc.edu/longscan/ for
more information.
Project Period
2005 - 2011
Key Personnel
Desmond Runyan, MD, DrPH (PI); Mark Everson, PhD; Jonathan Kotch, MD,
MPH; Jon Hussey, PhD; Shrikant Bangdiwala, PhD; Terri Lewis, PhD; Richard
Thompson, PhD; Alan Litrownik, PhD; Rae Newton, PhD; Howard Dubowitz, MD;
Maureen Black, PhD; Diana English, PhD; Elizabeth Dawes Knight, MSW; Jamie
Smith, MA; Lynn Martin, MS
Other Organizations or Institutions Represented
Juvenile Protective Association of Chicago; San Diego State University; Uni-versity
of Washington; University of Maryland at Baltimore; Washington State
Department of Health and Social Services
Funding
Administration on Children, Youth and Families: Office of Child Abuse and Ne-glect;
Doris Duke Charitable Foundation
Contact
Lynn Martin, MS
lynn_martin@med.unc.edu
Longitudinal Studies of Child Abuse and Neglect
Violence
UNC Injury Prevention Research Center 34 2010 Annual Report
Abusive Head Trauma in infants, or Shaken Baby Syndrome,
is a leading cause of infant mortality in the U.S. Some work
has been done to develop educational interventions for new
parents to eliminate this threat to infant well-being. No rig-orous
evaluation of the effectiveness of these programs has
been undertaken, although some estimate that more than
58% of new parents in the U.S. received some form of this
educational intervention in 2007. In partnership with other
organizations, UNC IPRC is fielding a study of the effective-ness
of educating new parents about shaking and how to
respond to infant crying. Over 5 years, this effort is intended
to reach the parents of over 600,000 new babies. This proj-ect
also will develop and test a media campaign and provide
the materials to be distributed to these households.
Project Period
2007 - 2012
Key Personnel
Desmond Runyan, MD, DrPH (PI); Adam Zolotor, MD, MPH;
Maryalice Nocera, MSN; Robert Murphy, PhD; Marilyn Barr,
BA; Ronald Barr, MD, MPH; Frederick Rivara, MD, MPH;
Heather Keenan, MDCM, PhD.
Other Organizations or Institutions Represented
National Center on Shaken Baby Syndrome; Center for Child
and Family Health; North Carolina Partnership for Children;
North Carolina Division of Health; Prevent Child Abuse North
Carolina; Smart Start (North Carolina); University of Utah
Health Sciences Center; University of Washington; University
of British Columbia (Canada)
Funding
Centers for Disease Control and Prevention; The Duke En-dowment
(through the Center for Child and Family Health);
Doris Duke Charitable Foundation
Contact
Adam Zolotor, MD, MPH
ajzolo@med.unc.edu
Child Maltreatment
This project built on the UNC IPRC’s twenty year history of
leadership in conducting internationally recognized injury
and violence research and developing strategies that bridge
research to practice. PREVENT’s CMT Institute is a training
effort that aims to expand national capacity to address the
primary prevention of child maltreatment. The training uses
action learning techniques to enhance the ability of partici-pants
to conduct evidence-based child maltreatment inter-ventions,
assess their impacts, and continuously improve the
quality of their organizations’ approaches to primary preven-tion.
Project goals were to:1) build organizational, com-munity,
state and national capacity in primary prevention
of violence through effective training of child maltreatment
leaders, frontline professionals, and community partners; 2)
prevent injuries resulting from violence against children by
developing and implementing child maltreatment preven-tion
programs; and 3) facilitate collaboration of injury and
violence prevention practitioners across disciplines, settings
and types of populations served. In 2010 the team devel-oped
a short video and series of case studies to describe the
program and the work that participating teams have done
to apply the skills learned in the training, and select teams
received monthly telephone coaching. For success stories
from the PREVENT Institute, please visit
http://www.prevent.unc.edu/successstories/.
Project Period
2008 - 2010
Key Personnel
Carol Runyan, PhD, MPH (PI); Desmond Runyan, MD, PhD;
Andrés Villaveces, MD, PhD; Karen Strazza Moore, MPH;
J’Ingrid Mathis, MS; Elizabeth Dawes Knight, MSW; Mariana
Garrettson, MPH; David Hollar, PhD
Funding
Doris Duke Charitable Foundation
Contact
Carol W. Runyan, PhD, MPH
carol.runyan@ucdenver.edu
PREVENT Child Maltreatment (CMT)
Institute
Violence
The Period of PURPLE Crying®:
Keeping Babies Safe in North Carolina
UNC Injury Prevention Research Center 35 2010 Annual Report
Formative Evaluation of The Circle of
Parents® Program in North Carolina
Child abuse occurs at epidemic proportions in the US, and
the children of adolescent mothers are at the greatest risk.
A variety of evidence-based and best-practice interventions
to nurture safe and supportive families and prevent mal-treatment
have been developed. However, enrollment and
engagement in these interventions continues to be a chal-lenge,
and attrition rates are often high. Furthermore, pro-gram
effects are often small and hard to replicate, and many
programs are enormously expensive to implement. Mobile
technologies have been increasingly utilized in health pro-motion
programs and have been shown to be successful for
a variety of conditions. The application of mobile technolo-gies
to child maltreatment prevention has been limited.
Poor social support has been repeatedly shown to be a risk
factor for child maltreatment. This pilot study will utilize
Facebook groups and group cell texting to engage pregnant
and parenting adolescent mothers around the challenges
of pregnancy and parenting, and to promote social support
among group members. The primary outcome of interest
will be perceived social support, and secondary outcomes
will include knowledge of infant development, parenting
self-efficacy, parenting beliefs, and effective contraceptive
use. The pilot is also designed to build collaborative capac-ity
between UNC researchers, the Adolescent Pregnancy
Prevention Campaign of North Carolina, and local adoles-cent
parenting programs.
Project Period
2010 - 2011
Key Personnel
Adam Zolotor, MD, MPH (PI); Desmond Runyan, MD, DrPH;
Heidi Hennik Kaminski, PhD, Terri Lewis, PhD; Elizabeth
Dawes Knight, MSW
Other Organizations or Institutions Represented
Adolescent Pregnancy Prevention Campaign of North Caro-lina;
Adolescent Parenting Programs in Guilford, Orange, and
Durham, NC Counties
Funding
North Carolina Translational and Clinical Sciences Institute
Contact
Adam Zolotor, MD, MPH
ajzolo@med.unc.edu
Using Cell and Internet-Based
Technology to Promote Social Support
Among Pregnant and Parenting Teens:
PROJECT SMARTPHONE
Circle of Parents is a nationally utilized, well-respected par-ent
mutual support and empowerment intervention with
promising but limited scientific evidence of effectiveness.
This formative evaluation study, in partnership with Prevent
Child Abuse North Carolina (PCANC), seeks to meet four
primary aims in response to the need for further evaluation
of the Circle of Parents® programming in NC:
1) enhance understanding of current implementation
practices throughout the state;
2) assess the association between implementation prac-tices,
parent retention rates and parents’ self-reported
social support, use of positive or negative parenting
practices, and use of community resources;
3) develop recommendations as to how PCANC can
enhance and standardize process and outcome data
collection protocols;
4) develop strategies designed to overcome ethical and
methodological challenges related to implementing a
rigorous evaluation of Circle of Parents®, and build the
trusting relationships with Circle of Parents® programs
around the state that constitute a prerequisite to such
an evaluation.
Project Period
2010 - 2011
Key Personnel
Elizabeth Dawes Knight, MSW (PI); Erica Lane; Meghan Sha-nahan,
PhD; Molly Berkhoff, MD, MPH; Mariana Garretson,
MPH; Christopher Ringwalt, DrPH
Other Organizations or Institutions Represented
Prevent Child Abuse North Carolina; North Carolina’s Circle of
Parents® affiliate programs
Funding
UNC Injury Prevention Research Center Small Faculty Grant
Contact
Elizabeth Dawes Knight, MSW
LKNIGHT@MED.UNC.EDU
Violence
UNC Injury Prevention Research Center 2010 Annual Report
Oro-pharyngeal injuries are commonly described in child
victims of physical abuse. Several case series of abused chil-dren
examined by dentists have described the type of oral
injuries most commonly seen among both inpatient and
outpatient cases. Understanding the specificity and positive
predictive value of this and other oro-pharyngeal injuries is
critical for primary care physicians seeing children with this
seemingly trivial injury. This project leverages an existing
prospective study of children under two admitted to inten-sive
care units or with fatal head injuries in North Carolina
which is part of an evaluation of an abusive head trauma
prevention program. Each infant seven months and under
admitted to the UNC medical center’s intensive care unit
with abusive head trauma or non-intentional head trauma
or with a fatal head injury examined in our medical exam-iner’s
office will receive a comprehensive dental exam by a
pediatric dentist. This prospective cohort study of infants
with serious head injuries allows a nearly perfect compari-son
group to better understand the association between
oro-pharyngeal injuries and abuse. If this study supports
our hypothesis, it will provide critical information to family
physicians seeing babies with this seemingly mild injury.
Project Period
2009 - 2012
Key Personnel
Adam Zolotor, MD, MPH (PI); Desmond Runyan, MD, DrPH;
Rocio Quinonez, DMD, MPH; Michael Milano, DMD; Mary-
Alice Nocera, MSN, RN
Funding
American Academy of Family Physicians
Contact
Adam Zolotor, MD
ajzolo@med.unc.edu
Oral Trauma in Infant Victims of Abusive
Head Trauma
Violence
Photo by iStockPhoto
UNC Injury Prevention Research Center 37 2010 Annual Report
In April 2009, UNC IPRC, in collaboration with the U.S.
Department of Justice, hosted an international symposium
addressing the scope of child sexual abuse and exploitative
practices both online and offline, and identifying strategies
for protecting children in online and offline environments.
The symposium involved experts in the areas of criminal
justice, sexual behavior, and applied psychology from the
G8 countries (Canada, France, Germany, Italy, Japan, Rus-sia,
UK, US) and beyond. As a result of the symposium, a G8
ministerial declaration on child pornography was issued (see
http://www.iprc.unc.edu/report.shtml). The project team is
planning to publish the symposium findings.
Project Period
2008 - 2011
Key Personnel
Kurt M. Ribisl, PhD (PI); Ethel Quayle, PhD; Andrew Ooster-baan,
JD; Sharon Cooper, MD, FAAP; Anitha Ibrahim, JD;
J’Ingrid Mathis, MS; Sharon Berlin
Other Organizations or Institutions Represented
U.S. Department of Justice; University of Edinburgh (Scot-land)
Funding
U.S. Department of Justice
Contact
Kurt Ribisl, PhD
kurt_ribisl@unc.edu
Global Symposium for Examining the
Relationship between Online and Offline
Offenses and Preventing the Sexual
Exploitation of Children
International Society for the Prevention
of Child Abuse and Neglect Child Abuse
Screening Tool
An international team of researchers in child maltreatment
prevention, led by IPRC Core faculty Desmond Runyan and
Adam Zolotor, developed the ISPCAN Child Abuse Screening
Tool (ICAST), a child abuse screening tool that allows lower-to
middle income countries to collect data on violence
against children to drive policy and monitor policy effective-ness
over time.
Key Personnel
Desmond K. Runyan, MD, Dr PH; Adam Zolotor, MD, MPH
Other Organizations or Institutions Represented
The International Society for the Prevention of Child Abuse
and Neglect; United Nations Children’s Fund; Queensland
University of Technology.
Funding
International Society for the Prevention of Child Abuse and
Neglect (ISPCAN)
Contact
Adam Zolotor, MD, MPH
ajzolo@med.unc.edu
Violence
UNC Injury Prevention Research Center 38 2010 Annual Report
Violence Exposure Trajectories and HIV/AIDS Risk Behavior among Maltreated
Youth and “LIGHTHOUSE: Guiding Maltreated Youth and their Families through
the Transition to Adolescence”
Adolescent exposure to violence, either as a witness or
victim, is increasingly common or has been associated with
a wide range of negative outcomes for youth, including
increased likelihood of engaging in HIV/AIDS risk behaviors.
This study will utilize advances in quantitative methods in
combination with the methodological rigor of the Longitu-dinal
Studies of Child Abuse and Neglect (LONGSCAN). The
specific aims of this study are to: 1) examine the exposure
to sexual abuse, family violence, and community violence
among youth in LONGSCAN, the link between trajectories
of youth violence exposure and HIV/AIDS risk behaviors,
and contextual moderators of these behaviors; 2) use
findings from the LONGSCAN analyses along with family
and practitioner feedback to guide the development of a
family-based HIV/AIDS prevention program for youth with
violence exposure histories; 3) use study findings, and the
associated prevention manual to serve as the pilot data for
other research. Consistent with Aim 1, findings revealed that
sexual abuse trajectories across childhood were associated
with HIV/AIDS in adolescence and that the findings were
consistent with both boys and girls (Jones, Runyan, Lewis, Li-trownick,
Black, Wiley, English, Proctor, Jones, & Nagin, 2010);
however, findings suggested that the effects of sexual abuse
had to be interpreted in the context of other types of abuse
and violence exposure as well. Year 2 focus group findings
revealed the following: 1) both parents and youth recognize
the importance of communicating about the risks associ-ated
with the transition to adolescence; 2) however, families
of youth with sexual abuse histories do not seem to identify
sexual abuse as a vulnerability for increased risk behavior
during the adolescent transition; and 3) families are look-ing
for avenues to raise conversations about the adolescent
transition with youth, but often rely on youth or media (e.g.,
television shows) as prompts. Consistent with Year 3 aims,
the PI developed an innovative HIV/AIDS prevention pro-gram
for youth with sexual abuse histories and their families.
“LIGHTHOUSE: Guiding Maltreated Youth and their Families
Violence
through the Transition to Adolescence”, is a brief (7 session),
family-focused, strengths-based program designed to re-duce
the vulnerability for risky behavior among youth with
sexual abuse histories by providing youth and families who
have completed trauma-focused programs (e.g., Trauma-Fo-cused
Cognitive Behavioral Therapy; TF-CBT; Cohen, Manna-rino,
& Deblinger, 2006) with the support, skills, and oppor-tunities
to identify and build upon adolescent and family
strengths. Consistent with a call for children and families to
have a voice in programming (National Federation of Fami-lies
for Children’s Mental Health, 2008), LIGHTHOUSE was de-veloped
in collaboration with clinicians and researchers who
work with maltreated youth and their families, as well as a
focus group of both adults and children with maltreatment
histories and their non-perpetrating caregivers. Specifically,
LIGHTHOUSE aims to identify and reshape the cognitions
and attitudes stemming from sexual abuse that increase vul-nerability
for later risky behavior by identifying and building
upon child and family strengths and competencies.
Project Period
2007 - 2011
Key Personnel
Deborah Jones, PhD (PI); Desmond K. Runyan, MD, DrPH;
Seth Kalichman, PhD; Daniel Nagin, PhD
Other Organizations or Institutions Represented:
University of Connecticut; Carnegie Mellon University
Funding
Centers for Disease Control and Prevention (K award)
Contact
Deborah J. Jones, PhD
djjones@unc.edu
“Initial findings revealed that for
both girls and boys, sexual abuse
trajectories across childhood were
associated with risky behaviors in
adolescence” - Dr. Deborah Jones
UNC Injury Prevention Research Center 2010 Annual Report
The Violence Problem
A crucial mission of Public Health practi-tioners
and researchers around the world
is the abolition of health disparities, and
violent injury dramatically affects young
males, racial minorities and those who
are poor, mediating further disparities
between communities. 51,000 violent
deaths occur in the U.S. every year, with
over 18,000 homicides and 34,000 sui-cides.
Sexual violence is a key women’s
health issue, and the 3rd leading cause
of violent injury in women of all ages.1,2
In the U.S. alone, an estimated 772,000
cases of child maltreatment occur annu-ally,
with the highest incidence among ra-cial
minorities and infants. Maltreatment
was responsible for 1,740 deaths in 2008
alone.3 UNC IPRC is committed to innova-tion
in child maltreatment and intimate
partner violence prevention.
Youth Violence
Homicide is the 2nd leading cause of
death for 10 to 24 year-olds. In 2007,
5,764 young people were murdered, an
average of 16 a day. The homicide rate
for young African-American males is 17
times higher than the same rate in White
males, highlighting the disproportion-ate
impact of youth violence among
racial minorities.4 More than 656,000
young people require medical attention
for nonfatal injuries every year. A 2009
survey reported that 31.5% of grade 9-12
youths had been in a fight in the last year,
7.7% reported being threatened or in-jured
with a weapon on school property
at least once in the last year, and almost
20% reported being bullied on school
property in the last year.5,6
Photo by iStockPhoto
UNC Injury Prevention Research Center 40 2010 Annual Report
Youth Violence
The Campus Safety Project is a feasibility study aimed at un-derstanding
whether colleges can identify potentially dan-gerous
students by running criminal background checks on
applicants. It includes a pilot case-control study to generate
preliminary data on whether students who have criminal re-cords
before coming to college are more likely to engage in
misconduct during college than students who do not have
criminal records before coming to college, coupled with a
survey about student misconduct during and before college.
Finally, in order to understand how criminal background
checks fit into colleges’ overall safety strategies, researchers
will survey a national sample of college administrators about
criminal background checks and other safety interventions.
Project Period
2009 - 2011
Key Personnel
Carol W. Runyan, PhD, MPH (PI); Matthew W. Pierce, JD, MPH;
Shrikant Bangdiwala, PhD
Funding
Centers for Disease Control and Prevention
Contact:
Carol W. Runyan, PhD, MPH
carol.runyan@ucdenver.edu
Do Criminal Background Checks
Improve Safety on College Campuses?
A Feasibility Study
North Carolina Academic Center for
Excellence in Youth Violence Prevention:
NC-ACE
North Carolina Academic Center for Excellence in Youth Vio-lence
Prevention, known as the NC-ACE, is the nation’s first
rural Youth Violence Prevention Center and serves Robeson
County, one of the most ethnically diverse rural counties in
the United States, and a county severely affected by on-going
economic struggles precipitated in part by the loss
of thousands of manufacturing jobs. Led by UNC School of
Social Work Professor Paul Smokowski, PhD, the Center is a
collaborative partnership between the UNC School of Social
Work, the UNC Injury Prevention Research Center, and com-munity
partners in Robeson County, including the Robeson
County Health Department, the nonprofit Center for Com-munity
Action, and Public Schools of Robeson County. The
five-year project will include the establishment of the Center
to provide community support and solutions for prevent-ing
youth violence. Evaluation activities include tracking
community and school rates of violence in the County, and
following the health and development of 3,000 Robeson
County middle school students and a comparison group
of 2,000 students from a nearby county. Middle school
was chosen as the optimal age for intervention as it should
allow the team to reach and affect students before prob-lems
related to violence become entrenched. The Center
joins three existing Centers, which were established by the
Centers for Disease Control and Prevention’s National Center
for Injury Control and Prevention following the shootings at
Columbine High School. Please visit https://ncace.web.unc.
edu/ for more information.
Project Period
2010 - 2015
Key Personnel
Paul Smokowski, PhD (PI); Natasha K. Bowen, Ph.D.;
Shenyang Guo, PhD., Dean Duncan, PhD; Rev. Mac Legerton;
Martica Bacallao, PhD; Jim Barbee
Other Organizations or Institutions Represented
Robeson County Health Department; Public Schools of
Robeson County; Robeson County Juvenile Courts; Center
for Community Action; UNC Pembroke; UNC Greensboro
Funding
National Center for Injury Prevention and Control
Contact
Paul Smokowski, PhD
Smokowski@email.unc.edu
Jim Barbee, Center Coordinator
jbarbee1967@gmail.com
Violence
UNC Injury Prevention Research Center 2010 Annual Report
FEATURED PROJECT
41
Latino teens are at increased risk for dating abuse victimiza-tion
and perpetration, yet very few dating violence preven-tion
programs have been developed specifically for them
and their culture. This multi-phased project combines
translational research with developmental and interven-tion
research. For the translational phase we will adapt our
evaluated family-based dating abuse prevention program,
Families for Safe Dates, to be culturally appropriate for Latino
families (Aim 1). We will also culturally adapt data collec-tion
instruments that will be used in a randomized trial of
the program for Latino parents/caregivers and teens (Aim 2).
After completion of the program and data collection adapta-tion
phases, a randomized controlled trial will be conducted
with Latino families to assess the efficacy of the program on
proposed theoretically-based mediating variables related to
the primary prevention of dating abuse (Aim 3). Thus far, the
formative research for Aim 1 has included the conduct of 24
focus groups with Latino caregivers and teens. Findings from
this formative research were use to develop the program
called “NOVIOlencia: Preparing our teens for healthy and safe
dating” which includes 6 booklets of interactive activities for
Latino caregivers to do with their teens. Feedback on these
6 booklets will be obtained through additional up-coming
focus groups. For Aim 2, cognitive interviews about data
Family-Based Dating Violence Prevention for Latino Teens
Intimate Partner Violence
collection instruments have been conducted with 20
Latino caregivers and 18 Latino teens. Data collection
instruments are being revised based on this feedback
and more cognitive interviews will be conducted
on the revised instruments. Recruitment of Latino
families for the randomized trial (Aim 3) will begin July
2011.
Project Period
2009 - 2014
Key Personnel
Vangie Foshee, PhD (PI); Mimi Chapman, MSW, PhD;
Susan Ennett, MSPH, PhD; Luz McNaughton Reyes,
MPH, PhD; Paula Gildner, MPH
Funding
National Center for Injury Prevention and Control
Contact
Vangie Foshee, PhD
foshee@email.unc.edu
Violence
Photo by iStockPhoto
UNC Injury Prevention Research Center 42 2010 Annual Report
Intimate partner violence (IPV) during and after pregnancy
is associated with harmful maternal, fetal, and neonatal
outcomes and is a leading cause of pregnancy-related
death. This investigation aims to (1) consider the ecological
relationship between alcohol control policies and female ho-micide
victimization rates at the state level, as an indicator
of the prevalence of intimate partner violence; (2) examine
the differential roles of paternal and maternal substance use
in intimate partner violence in families with young children
(under the age of five); and (3) evaluate the relative impor-tance
of individual socio-demographic (e.g., race-ethnicity,
nativity, and education) and neighborhood contextual-level
factors (e.g. alcohol prices, taxation, and availability; and
social acceptability) in explaining the occurrence of inti-mate
partner violence during and after pregnancy and the
relationship between substance use and intimate partner
violence.
Project Period
2009 - 2011
Key Personnel
Krista Perreira, PhD (PI); Christine Durrance, PhD; Shelley
Golden, MPH
Funding
Centers for Disease Control and Prevention
Contact:
Krista Perreira, PhD
perreira@email.unc.edu
Understanding the Role of Substance Use
in Intimate Partner Violence
Sexual violence prevention efforts have long focused on
addressing potential perpetrators and victims and changing
their attitudes, beliefs and behaviors. Increasingly experts in
the field are promoting the idea of bystander intervention,
in which witnesses to an interaction that seems like it may
lead to an abusive interaction have the skills and confidence
to step in and act to change the eventual outcomes. The In-terpersonal
Violence Prevention Coordinator for UNC-Chapel
Hill and students across campus have reviewed many promi-nent
bystander intervention programs, and subsequently
developed a training curriculum that they believe will be the
most effective on this university campus. It is called One Act
because it encourages students to take at least one prosocial
action to change the norms on campus around parties, alco-hol
use, dating relationships, and sexual violence. They are
also developing a campus wide social marketing campaign
to support the messages from the training. This study is sup-porting
several phases of the program planning and evalu-ation
of this effort, including process evaluation, evaluation
of short term impacts on training participants, and assessing
campus-wide social norms change from the trainings and
the media campaign.
Project Period
2010 - Present
Key Personnel
Mariana Garrettson, MPH (PI); Erica Lane; Robert Pleasants,
PhD; Kelli Raker, MSW
Funding
UNC-Chapel Hill Student Campus Safety Committee & UNC
Injury Prevention Research Center
Contact:
Mariana Garrettson, MPH
marianag@email.unc.edu
Evaluation of One Act: A UNC Campus
Bystander Intervention Initiative
Violence
UNC Injury Prevention Research Center 2010 Annual Report
“Preventing this high-risk group of
teens from becoming involved in dat-ing
abuse is one important way of
breaking the cycle of family violence
that is linked to many of our social and
public health problems.” - Dr. Vangie Foshee
43
Dating Abuse Prevention in Teens of
Moms with Domestic Violence
Protection Orders
Approximately 15 million children are exposed to domes-tic
violence every year. Identifying effective programs
for preventing adolescent dating violence among these
high-risk adolescents is one way of breaking the cycle of
family violence. The aims of this research are to: 1) develop
an intervention to prevent dating abuse in 12 to 15 year old
teens exposed to domestic violence; and 2) conduct a small
randomized trial to pilot test the procedures that would
be used in a future, larger randomized trial to test program
efficacy. The formative research for Aim 1 is now completed,
and included the conduct of 12 focus groups and 107
interviews with mothers who had been victims of domestic
violence and their teens. The finalized program, based on
the findings from this formative research, is called Moms and
Teens for Safe Dates and includes 6 booklets of interactive
activities for formerly abused mothers to do with their teens.
The pilot randomized controlled trial for Aim 2 is also almost
completed. For this study, 51 additional mothers who had
been victims of domestic violence, but who no longer lived
with the abuser, and their teens completed baseline inter-views
assessing dating abuse outcomes and hypothesized
theoretically-based mediators and moderators of program
effects and were randomly allocated to one of three inter-vention
conditions. One-month follow-up data are currently
being collected from these mothers and teens. The findings
from this study informed the development of a random-ized
efficacy trial of Moms and Teens for Safe Dates that was
funded by the CDC on August 1, 2010.
Project Period
2008 - 2011
Key Personnel
Vangie Foshee, PhD (PI); J. Michael Bowling, PhD; Susan En-nett,
MSPH, PhD; Kathryn E. Moracco, PhD; Kimberly Dixon,
MSW
Funding
US Department of Justice
Contact
Vangie Foshee, PhD
foshee@email.unc.edu
Evaluation of Implementation and
Adoption of Close to Home, a
Community Mobilization Domestic
Violence Prevention Program
Founded in 2002 by a small group of community residents
in Dorchester, MA, Close to Home has pioneered the use of
community mobilization strategies to foster community-wide
responsibility to prevent domestic and sexual violence.
By combining expertise in domestic and sexual violence
with expertise in community organizing, Close to Home
draws attention to a public health problem that is often
considered a private matter rather than part of public life,
and it engages all community members in developing and
implementing solutions.
Funding from Jane’s Trust and the Massachusetts State
Legislature allowed for this innovative model to be imple-mented
in three pilot sites in MA. The goal of this study is to
assess facilitators and barriers that have lead to variation in
the extent of implementation of the model at the three sites.
In addition, this study is assessing fidelity of pilot agency
activities to the model. The results from this study will be
used to guide future implementation efforts of this model of
primary prevention of domestic violence.
Project Period
2010 - 2011
Key Personnel
Mariana Garrettson, MPH (PI)
Other Organizations or Institutions Represented
Close to Home
Funding
Robert Wood Johnson Foundation
Contact
Mariana Garrettson, MPH
marianag@email.unc.edu
Violence
UNC Injury Prevention Research Center 2010 Annual Report
FEATURED PROJECT
Project Period
2008 - 2011
Key Personnel
Carol W. Runyan, PhD, MPH (PI); Susan Ennett, MSPH, PhD;
Lawrence Scholl, MPH; J’Ingrid Mathis, MS; Karen Moore,
MPH; Lynn Martin, MS
Other Organizations or Institutions Represented
North Carolina Department of Health and Human Services,
Division of Public Health, Injury and Violence Prevention
branch.
Funding
Substance Abuse and Mental Health Services Agency
(SAMHSA) through the NC Department of Health and Hu-man
Services
Contact
Lynn Martin, MS
Lynn_martin@med.unc.edu
44
This project is evaluating aspects of the North Carolina Depart-ment
of Health and Human Services’ youth suicide prevention
program which is focused on increasing capacity in the state to
identify youth at risk for suicide and to link them with mental
health treatment through training and technical support of
school personnel. The effort includes three components: 1)
development of a communications campaign intended to
increase help seeking behavior and reduce suicidal behavior of
youth; 2) delivery of gatekeeper suicide prevention training to
select school personnel with the intent of increasing the skills
of adults who work with youth to recognize warning signs and
respond appropriately when youth are at risk of suicidal behav-ior;
and 3) implementation of a school-based student suicide
prevention curriculum to juvenile justice health education
teachers as well as to physical education and health education
teachers. UNC IPRC is evaluating the second program com-ponent—
gatekeeper suicide prevention training delivered to
select school personnel. The delivery of this gatekeeper train-ing
includes both a training for trainers (T4T) as well as training
sessions directed specifically to school personnel.
Evaluation of NCDHHS Statewide Suicide Prevention Initiative
Violence
Suicide & Homicide
Photo by iStockPhoto
UNC Injury Prevention Research Center 45 2010 Annual Report
The purpose of this project is to evaluate the effects of poli-cies
determining citywide bar closure times at three differ-ent
hours of the day (2:00AM, 3:00AM, and 4:00AM), and
their association with homicide and unintentional injuries
in Cali, Colombia, over a period of three years. Analyses of
these data were conducted using time-series analysis tech-niques
and regression models for count data. A manuscript
with results has been submitted.
Project Period
2009 - Present
Key Personnel
Alvaro Sánchez Ortíz MD, MPH (PI); Andrés Villaveces, MD,
PhD
Other Organizations or Institutions Represented
University of Pittsburgh
Funding
Fogarty International Center – (NIH); National Center for
Injury Prevention and Control
Contact
Andrés Villaveces, MD, PhD
avillav@email.unc.edu
Alcohol Sales Laws and Homicide
Injuries in Cali, Colombia
North Carolina Violent Death Reporting
System (NC-VDRS)
Steve Marshall acts as an advisor to the North Carolina
Violent Death Reporting System. Dr. Marshall has been
involved with the system since its inception in 2004. The
NC-VDRS is conducted by the Injury and Violence Preven-tion
Branch at the North Carolina Department of Health
and Human Services. NC-VDRS is a surveillance system for
suicide and homicide in NC. It is one of 17 states funded by
the CDC to collect VDRS data. For more information, visit:
http://www.injuryfreenc.ncdhhs.gov/DataSurveillance/Vio-lentDeathData.
htm
Key Personnel
Steve Marshall, PhD; Sandra Martin, PhD; Anna Waller, ScD.
NC-VDRS personnel : Scott Proescholdbell, MPH; Tammy
Norwood, Injury and Violence Prevention Branch, NC DHHS;
Tamera Coyne-Beasley, MD, MPH; Sandra Martin, PhD
Other Organizations or Institutions Represented
Injury and Violence Prevention Branch, North Carolina De-partment
of Health and Human Services
Contact
Scott Proescholdbell, Injury and Violence Prevention Branch,
NC DHHS, Phone: (919) 707-5425
Violence
46 2010 Annual Report
In February 2010, IPRC launched a new Core in Evaluation and Dissemination to build on
and expand IPRC’s long standing expertise in evaluation and dissemination research.
The mission of the evaluation and dissemination core is to develop and promote the use of evidence-based injury and
violence prevention strategies. We provide services to those doing injury and violence research aimed at identifying
best/promising practices and to those using scientific research and program evaluation to ensure they are implement-ing
the highest quality prevention programs possible. We aim to expand the range of evaluation research that is hap-pening
at the Center and increase the capacity of our injury partners to be able to evaluate their efforts. The evalua-tion
core is led by Mariana Garrettson, MPH. Dr. Christopher Ringwalt, DrPH is the senior evaluation research scientist
for the core. Dr. Ringwalt has 20 years of experience in the design, development, analysis, and reporting of epidemio-logical,
etiological, and evaluation studies relating to public health issues. His research interests have focused primarily
on the prevention of adolescent and adult risk behaviors, particularly alcohol, tobacco, and other drug use. Among nu-merous
other projects, Dr. Ringwalt has directed evaluations of the Drug Abuse Resistance Education (DARE) Program
for the National Institute on Drug Abuse and the National Institute of Justice, and has served as the Senior Evaluator for
the Southeast Center for the Application of Prevention Technology. He has been responsible for translational research,
and large randomized controlled trials of Projects SUCCESS and ALERT with support from the Office of Juvenile Justice
and Delinquency Prevention and also evaluated Project Success for the Chicago Public Schools. Also serving in the
evaluation and dissemination core are Meghan Shanahan, PhD, a postdoctoral associate and Lynn Martin, MS, a senior
project manager.
The Core launched outreach efforts to both injury researchers and practitioners to understand their resources and
needs around evaluation and dissemination of injury and violence initiatives. The Core has focused its initial efforts on
building the evaluation research portfolio in the area of unintentional prescription drug poisoning, the fastest growing
cause of injury fatality in the state and the country. We have developed relationships with the Controlled Substances
Reporting System, the Medicaid Controlled Substance Abuse Taskforce, Project Lazarus in Wilkes Co., and the Carolina
Poison Center, each of which has resulted in a proposal being developed and submitted. We have also developed a
relationship with the UNC Counseling and Wellness Services Office to design and implement an evaluation of the cam-pus
wide sexual violence bystander intervention program called One Act. Other evaluations are under development
in a variety of other areas, including work to assess the implementation of a new carbon monoxide detector policy
change, evaluate a newly re-organized program out of the CDC called Healthy Homes and Lead Poisoning Preven-tion
Program, and identify outcomes of a teen driver education supplement that has been implemented in Cleveland
County. Partnerships with NCDPH, PCANC, and the UNC Highway Safety Research Center and others are on-going.
The Core also provides technical assistance to evaluation projects. For example, a large NIH funded multi-site trial of
an intervention to reduce childhood obesity was funded at UNC’s Department of Pediatrics along with four other sites.
UNC’s site was randomized to be a control site, where instead of an obesity reduction intervention they decided to
use an injury prevention intervention. The researchers decided to take the control intervention seriously and treat it
as a reverse trial in which the injury intervention could use the obesity intervention as its control. The evaluation core
provided consultation and support to Eliana Perrin, MD in Pediatrics and her colleagues as they found themselves sud-denly
implementing an injury evaluation study for the first time.
The Core in Evaluation and Dissemination is also charged with training and capacity building around evaluation and
dissemination. We have held three workshops or seminars in 2010, and expect to expand that number in coming
years. We also plan to expand our efforts in dissemination research and practice.
Evaluation & Dissemination
UNC Injury Prevention Research Center 47 2010 Annual Report
Evaluation & Dissemination
The North Carolina Translational and Clinical Sciences (NC
TraCS) Institute at UNC-CH is one of 60 medical research
institutions working together as a national consortium to
improve the way biomedical research is conducted across
the country. The consortium, funded by NIH through the
NIH Clinical and Translational Science Awards (CTSA), shares
a common vision to reduce the time it takes for labora-tory
discoveries to become treatments for patients, and to
engage communities in clinical research efforts. It also is
fulfilling the critical need to train a new generation of clinical
researchers. To achieve these goals, TraCS offers a number
of programs and services to assist researchers through all
phases of the process of translating basic science discoveries
into meaningful health advances.
Key Personnel
Dr. Marschall S. Runge serves as PI of the NC TraCS Institute;
Christopher Ringwalt, DrPH, serves as PI of the external
evaluation of the Institute.
Funding
National Institutes of Health
Contact
Christopher Ringwalt, DrPH
ringwalt@pire.org
Evaluation of NC TraCS
The primary aim of this project is to develop methods and
feasible measures that can be used by the National Center
for Injury Prevention and Control (NCIPC) for accomplishing
two goals: 1) assessing the overall impact of the Injury Con-trol
Research Centers program and 2) monitoring the prog-ress
of individual Centers within the context of the overall
logic model established by NCIPC for Injury Control Research
Centers (ICRCs). In conducting this study, we used three pri-mary
sources of information. One, we obtained background
information about evaluation of research centers from
the literature and selected key informants of other federal
research center program. Two, we queried directors of injury
research centers on existing evaluation indicators used for
their centers and on their opinions about proposed future
evaluation indicators. Three, we queried selected staff at the
CDC, both inside the National Center for Injury Prevention
and Control as well as in selected other programs.
Project Period
2010 -2011
Key Personnel
Carol Runyan, PhD, MPH; Mariana Garrettson, MPH
Other Organizations of Institutions Represented
SAVIR (Society for Advancement of Violence and Injury
Research)
Funding
National Center for Injury Prevention and Control
Contact
Mariana Garrettson, MPH
marianag@email.unc.edu
Metrics: Proposed Indicators For Docu-menting
Impact Of The Injury Control
Research Center Program And Monitoring
The Progress Of Centers Individually And
Collectively
Extensive additional evaluation and dissemination work has been conducted at the Center throughout its twenty-plus years of
existence; on-going evaluation and dissemination projects not initiated by the Evaluation Core itself are described elsewhere
in this report. 2010 Evaluation and Dissemination Projects developed through the IPRC Evaluation Core include the following
(project descriptions are provided for projects not described elsewhere in this report):
Affiliate Safe Community Support Center (p.49)
Period of Purple Crying®: Keeping Babies Safe in North Carolina (p. 34)
Formative Evaluation of the NC Circle of Parents® Program (p. 35)
One Act (p. 42)
Close to Home (p. 43)
Evaluation of NCDHHS Statewide Suicide Prevention Initiative (p.44)
Evaluation of NC TraCS (p.47)
Metrics (p. 47)
48 2010 Annual Report Technical Assistance
Since 1990, UNC IPRC has jointly sponsored the Southeast-ern
Regional Injury Control Network (SERICN) with the Uni-versity
of Alabama at Birmingham Injury Control Research
Center (UAB ICRC). Along with two regional Injury Centers,
the Network includes the lead state public health agency
injury prevention program and selected traffic safety,
child-centered, and emergency medical services programs
in each of the eight states in the southeast region. These
include Alabama, Florida, Georgia, Kentucky, Mississippi,
North Carolina, South Carolina, and Tennessee. In 2010, the
group continued to host topic specific conference calls with
regional and national experts.
Project Period:
Ongoing
Key Personnel:
Karen Strazza Moore, MPH, Mariana Garrettson, MPH
Other Organizations or Institutions Represented:
Emory Center for Injury Control; University of Alabama,
Birmingham Injury Control Research Center; University of
Kentucky Injury Prevention and Research Center State injury
programs (Alabama, Florida, Georgia, Kentucky, Mississippi,
North Carolina, South Carolina, and Tennessee); Mississippi
Governor’s Highway Safety Program; Children’s Safety Net-work
; Georgia Safe Kids; Maternal and Child Health Bureau;
National Highway Traffic Safety Administration – Region IV;
State and Territorial Injury Prevention Directors Association
Funding:
National Center for Injury Prevention and Control
Contact:
Mariana Garrettson, MPH
marianag@email.unc.edu
Southeastern Regional Injury Control
Network (SERICN)
Photo by Dan Sears
UNC Injury Prevention Research Center 49 2010 Annual Report
UNC IPRC has been designated as the Affiliate Safe Com-munity
Support Center for the World Health Organization’s
(WHO) Safe Communities worldwide initiative. To that end,
the Center is working on establishing measures and strate-gies
to improve the capacity of designated “safe communi-ties”
to effectively evaluate the Safe Communities America
program in these local communities. The evaluation
measures will be based on the six indicators established by
the international WHO Safe Communities program, which
include: 1) an infrastructure based on partnership and
collaborations, governed by a cross-sectional group that
is responsible for safety promotion in their community; 2)
long-term, sustainable programs covering both genders,
and all ages, environments and situations; 3) programs that
target high-risk groups and environments, and programs
that promote safety for vulnerable groups; 4) documenta-tion
of the frequency and causes of injuries; 5) evaluation
of programs, processes, and the effects of change; and 6)
participation in national and international safe communi-ties
networks. To accomplish this goal, the IPRC team is:
1) conducting an extensive review of relevant empirical
literature on evaluation of Safe Communities internationally;
2) assessing current evaluation measures through review of
annual reports of Safe Communities; and 3) reviewing the
evaluation work of country affiliates such as the report card
developed by Safe Communities Canada.
Key Personnel
Shrikant Bangdiwala, PhD (PI); Andrés Villaveces, MD, PhD;
Karen Strazza Moore, MPH; Carol W. Runyan, PhD, MPH; Mari-ana
Garrettson, MPH
Funding
Pending
Contact
Mariana Garrettson, MPH
marianag@email.unc.edu
Affiliate Safe Community Support Center
Monitoring and technical assistance services are being
provided to 22 Tribes/Tribal organizations funded through
the Indian Health Service (IHS) Tribal Injury Prevention
Cooperative Agreements Program (TIPCAP). UNC is provid-ing
the following technical assistance services: 1) annually
developing and distributing three project newsletters; 2)
conducting conference calls with sites three times per year;
3) providing on-going training and technical assistance to
IHS and Tribal staff; 4) developing and conducting an annual
training workshop; 5) providing evaluation consultation and
technical assistance to IHS Headquarters, field, and Tribal
staff; and 6) conducting one site visit to 13 Part I Basic and 9
Part 1 Advanced TIPCAP sites.
Project Period
2009 - 2011
Key Personnel
Carolyn Crump, PhD (PI); Robert J. Letourneau, MPH
Funding
Indian Health Service Injury Prevention Program
Contact
Carolyn Crump, PhD
ccrump@email.unc.edu
Technical Assistance and Monitoring
Service to the Indian Health Service
Tribal Injury Prevention Cooperative
Agreements Program
Technical Assistance
50 2010 Annual Report
UNC IPRC strives to provide outstanding service to faculty members, students, and com-munity
partners working to further the field of injury prevention. Given that many of these
services are described elsewhere in this report, the following is intended as an overview of
services provided by UNC IPRC.
Center Services
Biostatistical Support & Consultation
Senior biostatisticians, IT