Slicing Through the Layers of Pediatric Unintentional Injury With the Swiss Cheese Model: A Topical Review.

Pediatric unintentional injury significantly burdens children, families, and society. Behavioral researchers have examined the problem for decades, identifying many risk factors and greatly enhancing knowledge of the injury antecedent process. Approaches using theories and models to guide inquiry into etiology and prevention are still needed. We offer an approach borrowed from the field of human factors to enhance understanding and prevention. We focus our exploration on an error modeling and accident investigation tool called the Swiss Cheese Model. We first introduce the basic elements of the model. Next, we apply error modeling concepts to example scenarios drawn from real unintentional incidents and discuss the implications for understanding etiology and prevention. Finally, potential future directions are discussed to illustrate paths for the advancement of injury etiology and prevention.

Predicting behavioral intentions for unsafe off-highway vehicle use.

INTRODUCTION: Hundreds of adults are killed or injured each year while operating off-highway vehicles. Four common risk-taking behaviors were identified on off-highway vehicles in the literature and examined intention to engage in such behaviors within the context of the Theory of Planned Behavior. METHOD: One hundred and sixty-one adults completed measures of experience on off-highway vehicles and injury exposure followed by a self-report created according to the predictive structure of the Theory of Planned Behavior. Behavioral intentions to engage in the four common injury risk behaviors on off-highway vehicles were predicted. RESULTS: Similar to research on other risk behaviors, perceived behavioral control and attitudes emerged as consistently significant predictors. Subjective norms, the number of vehicles operated, and injury exposure showed varying relationships to the four injury risk behaviors. Results are discussed in the context of similar studies, intrapersonal predictors of injury risk behaviors, and with regard to implications for injury prevention efforts.

BASE: Pragmatic Injury Prevention for Practitioners.

Unintentional injury remains a leading health problem in developed nations, making injury prevention imperative. Practitioners are primary stakeholders in the injury prevention process but rarely can devote significant time to complicated prevention efforts. Furthermore, theory-based approaches to support injury prevention are less common than atheoretical approaches. We propose a simple method for injury prevention grounded in concepts found in antecedent models. Barriers, attitudes, social context, and environmental factors (or BASE) are suggested as a simple injury prevention model practitioners can follow when working with patients. We present each component of BASE and offer examples of how the approach can be applied to risk factors associated with several types of injury risk behavior.

A Risk Appraisal Framework for Injury Etiology.

Unintentional injury is a significant worldwide health concern. Researchers have called on several occasions for conceptual frameworks to guide work on unintentional injury. Using conceptual approaches to organize our inquiry is one way to advance our knowledge of injury etiology. To this end, we suggest a risk appraisal framework for examining enactment or avoidance of injury risk behaviors. Our framework comprises broad antecedents, focusing on the evaluative stage preceding behaviors. Four categories influencing efficacy related to injury risk behavior are included: environmental context, experience, social context, and strategy. In this article, we explain the categories and concepts in our framework, discuss each in terms of etiology, briefly discuss interrelations between the categories, and suggest future paths using the framework.

Assessing pedestrian safety across modalities via a simulated vehicle time-to-arrival task.

Pedestrians must use a variety of visual and auditory cues when determining safe crossing opportunities. Although vision has received a bulk of the attention in research on pedestrian safety, the examination of both vision and audition are important to consider. Environmental, intrapersonal, and cognitive qualities of a pedestrian context may limit the use of one or both perceptual modalities. Across two experiments, we examined the impact of perceptual constraints on pedestrian safety by measuring the accuracy of vehicle time-to-arrival estimates in a virtual environment when vehicles were only visible, only audible, or both visible and audible. In both experiments, participants estimated the time-to-arrival of vehicles moving at one of two speeds (8-kph, 40-kph). In the second experiment, we introduced ambient traffic noises to examine the impact of environmentally relevant traffic noises on pedestrian perception. Results suggest seeing a vehicle is more advantageous than hearing a vehicle when interacting with traffic, especially in the presence of ambient sound. Both experiments resulted in more accurate time-to-arrival estimates in the visual and mixed conditions than in the auditory-only condition. Implications for pedestrian safety and future research are discussed.