Chapter 8.

Bringing it all Together

By Carol Runyan, MPH, Ph.D.

The chapters you have read have covered a lot of ground. This chapter will recap some of the major points. (Slide 1) (Slide 2)

You've read that although injuries affect thousands of Americans each year, they ARE preventable-they are not accidents. Therefore, the things you've learned from VINCENTweb are important for getting started and taking ACTION.

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The problem is very large and funding to do injury prevention is not nearly as great as it needs to be. Compared to resources for research and programs to address other health problems, the funds for injury are extremely limited. But, while we all work to improve the availability of resources, we CAN do a great deal. For example, you've read in VINCENTweb Apendix C about one local health director who was able to do a lot for injury prevention work with virtually NO resources, but through strong commitment and a lot of energy and enthusiasm. There are many more examples. You can do that too.

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As you get started, you will probably find resources in places that you didn't even know about and find partners whose expertise, ideas and funds can be pooled with yours to help get the program off the ground.

You've read about approaches for doing injury prevention at the community level, taking a public health approach. As you begin this process, we encourage you to think about approaches that have the greatest chance of success. This may mean that you will sometimes need to try things you're not used to doing. Sometimes this will require getting involved in local politics or working with groups unfamiliar to you. Find partners to work with and learn how to put different talents together. Start small and build on your successes - but be innovative.

Remember too that public health problems result from many types of factors and require many different solutions. Rarely is one solution, by itself, sufficient.

Also, you've read about the fact that you need to develop partnerships with others and combine skills. Don't assume that you have all the answers about problem, even if you are very familiar with them. Look for new expertise and fresh ideas and realize that injury control takes many different types of expertise. Rarely does the same person know how to collect and analyze injury information, develop a program, develop a media campaign, conduct an evaluation and understand the political process. You may need to look for someone to complement your skills - or you may want to find the Injury Control Research Center in your area or your state health department injury specialist to help you. Quite a few resources exist and it is foolish to overlook them - some you've read about today and some are listed on the VINCENTweb Resource Page.

Several chapters have reminded you that the change process can take a very long time. Unlike emergency care or fire protection, where decisions produce very immediate results, the kinds of broader community changes required for injury prevention often take months or years. Remember that it wasn't that many years ago that cars didn't even have seat belts and there were no child restraint laws - now they exist in all 50 states. It wasn't long ago auto manufacturers were opposed to airbags. Now, safety is used as a marketing strategy for cars. Even more recently, the public discussion of domestic violence and child abuse has increased dramatically to the point that new attention is being given to these problems.

Things do change, but change takes time and some measure of patience. Patience is both a virtue and a curse. You should be patient about how long things take so you aren't unrealistic about your goals and don't become overly frustrated. But be impatient about the need to change and to keep agitating to make things happen more quickly than they will.

VINCENTweb has stressed the importance of tackling the problem in a systematic way. This will greatly increase your chances of success and help you use your limited resources wisely. But, you will undoubtedly experience some failures. This is important. If you aren't failing some of the time, you aren't trying hard enough. Just be sure to learn from your mistakes - and don't make the same ones over again!

In addition to using the information about injury prevention that you've learned today, a large part of what we want you to go away with is a commitment to do something about this problem. To get started, to keep trying and not to give up!

Think about what specific actions you are going to take first in getting started or moving ahead in injury prevention. Write your ideas and actions down and give it to your coworkers or stick it on your bulletin board as a way of formalizing that commitment.

Next: Appendix B. Developing Effective Coalitions: An Eight Step Guide

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