Preventing child unintentional injury deaths: prioritizing the response to the New Zealand Child and Adolescent Injury Report Card.

OBJECTIVE: To develop recommendations for child unintentional injury prevention by comparing New Zealand's child unintentional injury mortality and injury prevention policies with those of European countries. METHODS: Unintentional child injury death rates based on external cause of injury were calculated and ranked. NZ's score for each of the 12 domains (based on external causes of injury) from the New Zealand Child and Adolescent Report Card was compared to European scoring. Policy priorities are identified by domains where mortality makes up a high proportion of overall child unintentional injury mortality (high burden of injury) and where report card score for that domain is low in comparison to other countries (under-utilisation of effective interventions). RESULTS: Death as a motor vehicle occupant accounts for 49% of all child unintentional injury deaths, followed by pedestrian (10%) and drowning deaths (8%). The overall score for the 12 policy domains of the NZ Report Card ranks NZ as 15(th) among the 25 European countries. There are important policy and legislative actions which NZ has not implemented. CONCLUSIONS: A number of evidence-based injury prevention policy and legislative actions are available that could target areas of greatest childhood injury mortality in NZ. IMPLICATIONS: A set of injury prevention policy and legislation priorities are presented which, if implemented, would result in a significant reduction in the injury mortality and morbidity rates of NZ children.

Child and adolescent injury report card: New Zealand 2009.

AIM: Injury is the leading cause of death of children and adolescents. Among the Organisation for Economic Co-operation and Development nations, New Zealand has the highest rate of child and adolescent injury death. This study aimed to evaluate the status of New Zealand's child and adolescent unintentional injury prevention. METHODS: The methodology of the European Child Safety Alliance Child Safety Report Card (completed for 24 countries in Europe, generating a standardised assessment of child and adolescent injury prevention) was applied to New Zealand's injury prevention position. New Zealand's position with regard to 102 questions (spanning 12 injury topics) was investigated. This information was systematically presented to a panel of child and adolescent injury experts, and agreed scores for each item were derived. RESULTS: New Zealand's overall score was 33/60. Deficiencies were identified across many injury prevention topics including passenger and driver safety, pedestrian safety, water safety, falls, poisoning, burns/scalds and choking/strangulation. New Zealand lacks a robust home visiting programme and injury prevention strategies with specific child and adolescent targets. CONCLUSIONS: New Zealand has not implemented a number of evidence-based injury prevention policies. The information from this study should be interpreted in conjunction with the epidemiology of child and adolescent injury in New Zealand. The Child Safety Report Card provides a useful methodology to guide a country's child and adolescent injury prevention policy direction.

A randomized controlled trial of a brief emergency department intimate partner violence screening intervention.

STUDY OBJECTIVE: We evaluate the efficacy of emergency department (ED) brief intimate partner violence screening intervention in reducing short-term revictimization. METHODS: A randomized controlled trial with blinded 3-month follow-up was conducted in an urban New Zealand ED. Participants included 399 nonacute, English-speaking women aged 16 years and older, 199 randomly assigned to the treatment group and 200 to the control group. Participants in both groups received usual emergency health care. Women assigned to the treatment group received a standardized 3-item intimate partner violence screen, statements about the unacceptability of violence, risk assessment, and referral by a health professional research assistant. The main outcome measure was self-reported intimate partner violence exposure. Secondary outcomes included self-care strategies (use of safety behaviors and community resources). RESULTS: Forty-four of 344 (12.8%) women reported intimate partner violence during the 3-month follow-up period: 24 of 177 (13.6.%) among women in the usual care group and 20 of 167 (12.0%) among women in the treatment group. The adjusted odds ratio, controlling for design effects and covariates, was 0.86 (95% confidence interval 0.39 to 1.92). CONCLUSION: This brief intimate partner violence screening intervention did not significantly reduce short-term violence exposure. Continuing work is needed to maximize intervention effectiveness and monitor medium- and long-term outcomes.