Applying best practices in behavioural interventions to injury prevention

The Editor’s Choice in the April 2010 issue of IP is “A practical approach for applying best practices in behavioural interventions to injury prevention,” a special feature authored by Flaura Winston and Lela Jacobsohn, from the Center for Injury Research and Prevention in Philadelphia, USA.

In this paper, the authors outline a practical approach for using behavioural theories to develop and implement prevention programs. Their approach borrows from existing theories in health promotion and disease and injury prevention and involves 2 sets of 3 steps.  The first 3 steps articulate a theoretically-grounded, actionable plan. The second 3 steps utilize the plan to guide intervention development, testing and refinement. The key emphasis of this approach is starting with a clearly defined, broad and measurable vision for the outcome rather than some preconceived idea about what the necessary interventions will be (based on assumptions, familiarity or resources available).

I think this deliberate approach has the potential to stop us from making some of the more common mistakes we see in ineffective prevention campaigns. These include rushing too quickly to a specific intervention that does not target key constructs required to promote or facilitate behavior change (no more brochures, please!), and failing to evaluate the programs we implement to see how well they do (or do not) work in diverse real-world settings.

While many talented people have brought behavioral theories to bear on injury problems in the past, this paper offers a welcome tutorial and structured approach for those in the trenches who know we could all be doing a better job of applying those behavioral principles in our daily practice.

The importance of doing this the right way was underscored by Dr. Winston in a recent conversation:

In this environment of limited resources, we need to make sure that prevention dollars are spent wisely.  We need to systematically apply evidence and theory to ensure the highest likelihood for success and then test and refine, particularly before large scale dissemination. Then, we will then have the greatest chance that interventions will be shown to effect positive change when implemented. I believe that the 6-step approach can provide a framework for guiding efficient prevention planning and execution.

Remember that the Editor’s Choice in each issue is freely accessible from the time of publication.