Using a novel data linkage approach to investigate potential reductions in motor vehicle crash severity - An evaluation of strategic highway safety plan emphasis areas.

INTRODUCTION: With the significant number of motor-vehicle fatalities occurring on the nation's roadways in recent years, there exists a need to integrate a more complete range of data sources, available at a regional or statewide level, to effectively evaluate existing safety concerns and quantify their impacts. Crash data alone does not provide ample crash-associated citation, injury, and roadway characteristics; therefore, a more cohesive dataset is required to accurately and completely analyze the true impacts of motor-vehicle crashes. Previously developed strategies linked crash data with citation and roadway inventory data to enhance the identification and optimization of highway safety strategies. METHOD: The main objective of this research focused on developing a new deterministic linkage between crash and Emergency Medical Services (EMS) data, by utilizing the Massachusetts Crash Data System (CDS) and the Massachusetts Ambulance Trip Record Information System (MATRIS). RESULTS: After several iterations of match criterion, the validated linkage successfully matched 58.3% of MATRIS records (containing an Injury Cause of Motor Vehicle Crash) to a CDS person record (55011 linked pairs, between 2014 and 2016). The data linkage provided significant insight into injury trends in several highway safety emphasis areas such as roadway departure, speeding-related, and distraction-affected crashes. The findings from this research are twofold: (1) an established process for linking previously separate data sets, and (2) a mechanism for analysis that provides decision-makers and safety professionals with a better measure of crash outcomes.

Developing Core Capabilities for Local Health Departments to Engage in Land Use and Transportation Decision Making for Active Transportation.

OBJECTIVE: To develop a core set of capabilities and tasks for local health departments (LHDs) to engage in land use and transportation policy processes that promote active transportation. DESIGN: We conducted a 3-phase modified Delphi study from 2015 to 2017. SETTING: We recruited a multidisciplinary national expert panel for key informant interviews by telephone and completion of a 2-step online validation process. PARTICIPANTS: The panel consisted of 58 individuals with expertise in local transportation and policy processes, as well as experience in cross-sector collaboration with public health. Participants represented the disciplines of land use planning, transportation/public works, public health, municipal administration, and active transportation advocacy at the state and local levels. MAIN OUTCOME MEASURES: Key informant interviews elicited initial capabilities and tasks. An online survey solicited rankings of impact and feasibility for capabilities and ratings of importance for associated tasks. Feasibility rankings were used to categorize capabilities according to required resources. Results were presented via second online survey for final input. RESULTS: Ten capabilities were categorized according to required resources. Fewest resources were as follows: (1) collaborate with public officials; (2) serve on land use or transportation board; and (3) review plans, policies, and projects. Moderate resources were as follows: (4) outreach to the community; (5) educate policy makers; (6) participate in plan and policy development; and (7) participate in project development and design review. Most resources were as follows: (8) participate in data and assessment activities; (9) fund dedicated staffing; and (10) provide funding support. CONCLUSIONS: These actionable capabilities can guide planning efforts for LHDs of all resource levels.

Qualitative Exploration of Cross-Sector Perspectives on the Contributions of Local Health Departments in Land-Use and Transportation Policy.

INTRODUCTION: Transportation and land-use policies can affect the physical activity of populations. Local health departments (LHDs) are encouraged to participate in built-environment policy processes, which are outside their traditional expertise. Cross-sector collaborations are needed, yet stakeholders' perceptions of LHD involvement are not well understood. The objective of this study was to describe the perceived value of LHD participation in transportation and land-use decision making and potential contributions to these processes among stakeholders. METHODS: We analyzed qualitative data from 49 semistructured interviews in 2015. Participants were professionals in 13 US states and 4 disciplines: land-use planning (n = 13), transportation/public works (n = 11), public health (n = 19), and other (municipal administration and bike and pedestrian advocacy [n = 6]). Two analysts conducted directed content analysis. RESULTS: All respondents reported that LHDs offer valuable contributions to transportation and land-use policy processes. They identified 7 contributions (interrater agreement 91%): 1) physical activity and health perspective (n = 44), 2) data analysis and assessment (n = 41), 3) partnerships in the community and across sectors (n = 35), 4) public education (n = 27), 5) knowledge of the public health evidence base and best practices (n = 23), 6) resource support (eg, grant writing, technical assistance) (n = 20), and 7) health equity (n = 8). CONCLUSION: LHDs can leverage their strengths to foster cross-sector collaborations that promote physical activity opportunities in communities. Our results will inform development of sustainable capacity-building models for LHD involvement in built-environment decision making.