A CONTROLLED EVALUATION OF A COMMUNITY INJURY PREVENTION PROJECT IN 2GREEK ISLANDS

Background. During the 20-month period September 1993 to April 1995, a health education injury prevention programme focusing on home injurie s among the young (less than or equal to 18 years old) and elderly (gr eater than or equal to 65 years old) on the Greek island of Naxos was undertaken; its effectiveness was evaluated by comparing the subsequen t injury experience in sentinel population groups in Naxos as well as in Spetses, another island of similar sociodemographic profile, where no such intervention programme had been formally implemented. Methods. On the island of Naxos an injury prevention campaign was initially un dertaken involving virtually all opinion leaders and implemented throu gh lectures, workshops and publicity in the local media. The main inte rvention focused on 172 households on the island of Naxos and was done by trained local collaborators who visited each household weekly to p rovide injury prevention advice and assess home safety. Similar visits were done by untrained collaborators in 177 households on the island of Spetses in order to assure collaboration of household members in th e comparative evaluation stage of the programme. The process evaluatio n was based on ascertained changes of safety features and attitudes in the participating households, whereas the outcome evaluation was base d on the incidence of injuries among members of the participating hous eholds in the two islands over a period of 8.5 months (255 days). Resu lts. On the intervention island of Naxos there were statistically sign ificant improvements with respect to 11 of the 28 examined variables, whereas on the island of Spetses, such improvement was only noted for one variable. The age-adjusted incidence rate ratio of injuries overal l among the target groups, contrasting the intervention and the contro l households was 0.85 with 90% confidence interval (CI) :0.69-1.05. Wi th respect to home accidents the corresponding ratio was 0.79 with 90% CI :0.60-1.04. Conclusions. An intensive and focused injury preventio n intervention had only modest success when injuries themselves were t he outcome variable.