The Impact of a Statewide Coalition to Decrease Pediatric All-Terrain Vehicle Injuries.

Children lack the cognitive judgment and motor skills to safely operate all-terrain vehicles (ATVs) in all situations. The Trauma Team clinicians at Nemours Children's Health System/Alfred I. duPont Hospital for Children (N/AIDHC) were concerned about the severity of injuries sustained by children when they were either the driver or a passenger on an ATV. Although this subset of children within the trauma registry did not account for a high volume of trauma patients, these children sustained a higher proportion of severe injuries. In 2012, the Trauma Team at N/AIDHC partnered with Nemours Health & Prevention Services to form a broad-based statewide coalition in order to impact this alarming trend and to improve safety for those who ride ATVs. The coalition worked together to reach consensus and to successfully advocate for the passage of legislation requiring helmets and limiting passengers for recreational ATV riders under the age of 18. This legislation was signed into law in July 2015. Working with both ATV dealers and a national industry association, the coalition also has been successful in bringing to the State of Delaware, an ATV safety training course for riders in 2016. An evaluation of the impact of this new legislation using state trauma data will begin in 2017.

A comprehensive scoring system to measure healthy community design in land use plans and regulations.

Comprehensive land use plans and their corresponding regulations play a role in determining the nature of the built environment and community design, which are factors that influence population health and health disparities. To determine the level in which a plan addresses healthy living and active design, there is a need for a systematic, reliable and valid method of analyzing and scoring health-related content in plans and regulations. This paper describes the development and validation of a scoring tool designed to measure the strength and comprehensiveness of health-related content found in land use plans and the corresponding regulations. The measures are scored based on the presence of a specific item and the specificity and action-orientation of language. To establish reliability and validity, 42 land use plans and regulations from across the United States were scored January-April 2016. Results of the psychometric analysis indicate the scorecard is a reliable scoring tool for land use plans and regulations related to healthy living and active design. Intraclass correlation coefficients (ICC) scores showed strong inter-rater reliability for total strength and comprehensiveness. ICC scores for total implementation scores showed acceptable consistency among scorers. Cronbach's alpha values for all focus areas were acceptable. Strong content validity was measured through a committee vetting process. The development of this tool has far-reaching implications, bringing standardization of measurement to the field of land use plan assessment, and paving the way for systematic inclusion of health-related design principles, policies, and requirements in land use plans and their corresponding regulations.