***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective —To evaluate the  Latrobe Valley Better Health Injury Prevention Program  , a regional community based intervention in south east Victoria , Australia . Method —The evaluation design was quasiexperimental including pre-intervention and post-intervention observations in a predominately town dwelling population of approximately 76 000 . There was no comparison community . Process measures included key informant interviews . Impact evaluation utilised self reported changes in injury risk and protective factors , gathered by a r and om household telephone survey . Outcome evaluation was based on five years of emergency department injury surveillance data for the Latrobe Valley . Results —The program built strategic partnerships , increasing the emphasis on local safety . Activities were implemented in the targeted areas of home , sport , and playground injuries . Some 47 000 educational contacts were made with the community and at least 6000 re source items distributed . There were significant increases in home safety knowledge . Some changes in the areas of playground and sport safety were achieved after partnership development with relevant agencies . Poisson regression models showed significant decreases in the presentation rate for all home injury and for the more severe home injuries . Conclusion —This study clearly demonstrates the difficulty of conducting robust evaluation in the absence of readily available and reliable data and adequate budgets . The  Latrobe Valley Better Health Program activities contributed to structural , environmental , and organisational changes that have the potential to reduce injury . The extent of this contribution beyond that made by the statewide injury prevention strategy is not able to be determined In a quasi-experimental study , hospital-treated traffic accident injuries were recorded prospect ively for 7 1/2 years in the two Norwegian cities , Harstad and Trondheim . In Harstad the recorded data were used actively in analysis , planning , and implementation of a community-based injury prevention program . Trondheim was the nonequivalent control city . The intervention was divided into three periods , each of 30 months duration . Preventive efforts were implemented to some extent in period 1 , increasingly in period 2 and period 3 . Traffic safety was promoted in an extensive community program based on the Ottawa charter for health promotion . A 26.6 % overall reduction of traffic injury rates was found in Harstad from period 1 to period 3 ( p < 0.01 ) , whereas a corresponding significant increase was found in the comparison city . Analysis of data from other sources were not conclusive in supporting the Trondheim data as showing the national trend . Alternative explanations for the injury rate reduction in Harstad were assessed by means of other available relevant data . The exact mechanisms that brought about the reduction of injury rates were hard to eluci date because so many intervention elements were implemented at the same time . It is concluded that at least some of the reduction was due to behavioural and structural changes brought about by health promotion . Important factors for the effect of and participation in the prevention program were local relevance and continuous feedback of accident injury data OBJECTIVE --To describe the epidemiology of sports injuries occurring in a community during 8 years and to evaluate the outcome of an intervention implemented against injuries occurring in downhill skiing . METHODS --Hospital treated sports injuries occurring in Harstad , Norway ( population 22 600 ) were recorded prospect ively during an 8 year period . A prevention programme targeting downhill skiing injuries was evaluated . RESULTS --2234 sports injuries accounted for 17.2 % of recorded unintentional injuries . Two out of three injuries occurred in team sports . Soccer accounted for 44.8 % of all sports injuries . Downhill skiing injuries had higher mean score on the abbreviated injury scale than all other sports analysed combined ( P < 0.01 ) . Postintervention injury rates for downhill skiing were reduced by 15 % when adjusting for exposure ( P = 0.24 ) . Further observations are needed for assessing the effectiveness of the downhill skiing safety programme . CONCLUSIONS --Strategies for future sports injury prevention include community involvement , particularly sports organisations . Local data analysis seems to justify some priorities , for example , promotion of helmet use in downhill skiing for young adolescents and prevention of lower limb fractures in male soccer players 15 + years old . Prospect i ve hospital recording of injuries provides a tool for the design and outcome evaluation of sports injury intervention research OBJECTIVE To test the feasibility of a hospital-based injury recording for accident analysis and outcome evaluation of bicyclist and pedestrian injury prevention . DESIGN Prospect i ve injury recording lasting 7 1/2 years , using a quasi-experimental design . SETTING The population of Harstad ( 22,000 ) . INTERVENTION Injury data were evaluated in an injury prevention group and used in planning a community-based intervention . Promotion of bicyclist helmet use and pedestrian safe behaviour was implemented by activating public and voluntary organizations and media . A traffic safety pamphlet containing local traffic injury data was distributed . Changes were made in the physical traffic environment . MAIN OUTCOME MEASURES Injury rates for bicyclists and pedestrians . RESULTS In 275 bicyclists  upper extremity and head injuries were predominant 70 % were below 16 years . In 137 pedestrians  lower extremity injury was most frequent and children below 10 years had the highest injury rates . Significant injury rate reductions were observed after intervention for child bicyclists and pedestrians . CONCLUSION A hospital-based injury recording is feasible for bicyclists and pedestrian accident analysis , planning injury prevention , and outcome evaluation of the programme . This study indicates that a significant injury rate reduction in children may have been the result of the intervention The objective in this study was to calculate costs and benefits caused by a  safe community injury prevention programme in Motala , Sweden . The study design was a quasi-experimental evaluation involving an intervention population and a non-r and om control population .  All injuries were recorded before and after an intervention programme . The presented calculations show that costs of injuries in a societal perspective decreased from 116 million Swedish Crowns ( SEK ) to 96 million SEK , while the cost for the intervention was estimated at approximately 10 million SEK . Thus , the safe community injury prevention programme  in Motala should be judged as cost-effective BACKGROUND Although social ine quality in health has been an argument for community-based injury prevention programmes , intervention outcomes with regard to differences in social st and ing have not been analysed . The objective of this study was to investigate rates of injuries treated in health-care among members of households at different levels of labour market integration before and after the implementation of a WHO Safe Community programme .  METHODS A quasi-experimental design was used with pre- and post-implementation data collection covering the total population s < 65 years of age during one year in the programme implementation municipality ( population 41 000 ) and in a control municipality ( population 26 000 ) .  Changes in injury rates were studied using prospect i ve registration of all acute care episodes with regard to social st and ing in both areas during the study periods . RESULTS Male members of households categorized as not vocationally active displayed the highest pre-intervention injury rates . Also after the intervention , males in households classified as not vocationally active displayed notably elevated injury rates in both the control and study areas . Households in the study area in which the significant member was employed showed a post-intervention decrease in injury rate among both men ( P < 0.001 ) and women ( P < 0.01 ) . No statistically significant change was observed in households in which the significant member was self-employed or not vocationally active . In the control area , only an aggregate-level decrease ( P < 0.05 ) among members of households in which the significant member was employed was observed . CONCLUSIONS The study displayed areas for improvement in the civic network-based WHO Safe Community model . Even though members of non-vocationally active households , in particular men , were at higher pre-intervention injury risk , they were not affected by the interventions . This fact has to be addressed when planning future community-based injury prevention programmes STUDY OBJECTIVE : To describe a community based programme to prevent fractures result ing from falls and evaluate the outcome in terms of changes in fracture rates and short term hospital care costs . DESIGN : Prospect i ve intervention study . SETTING : The Norwegian municipalities of Harstad ( intervention ) and Trondheim ( reference ) from 1 July 1985 to 30 June 1993 . PARTICIPANTS : The person-years of the study were estimated from yearly census data on people aged 65 years and over . There were 22970 person years in Harstad and 158911 in Trondheim . MEASUREMENTS AND MAIN RESULTS : The variables were selected and coded according to the Nordic system and the data were collected as part of a national injury surveillance system . The first three years of the study provided baseline data , while the last five years involved community based interventions -eg , the removal of environmental hazards in homes and promotion of the use of safe footwear outdoors in winter . Rates of fracture from falls did not decline in nursing homes but decreased 26.3 % in private homes ( p < 0.01 ) . In 65 - 79 year olds , there was a 48.7 % reduction in fall-fracture rates for men in traffic areas in winter ( p < 0.05 ) . The data from the reference city , Trondheim , suggested a significant rise in fractures caused by falls . There was a 16.7 % reduction in hospital admission rates of fall-fracture patients from private homes , indicating a substantial saving in short term hospital costs . The observed fall-fracture rate reductions in private homes and traffic areas suggest that major parts of the interventions were effective . CONCLUSION : Fall-fracture prophylaxis in the aged is possible in a community based setting that utilises high quality , local injury data STUDY OBJECTIVE To do a complete survey of hospital-treated fractures in the aged ( 65 + years old ) and to report the characteristics and distribution of all fractures occurring within this defined population . DESIGN Prospect i ve injury recording study . SETTING The Norwegian municipality of Harstad ( population 23,000 ) during eight years from 1 July 1985 . PARTICIPANTS The person years of the study estimated from yearly census data , were 22,970 . MEASUREMENTS AND MAIN RESULTS The variables were selected and coded according to the Nordic system and the data were collected as part of a national injury surveillance system . Of 753 recorded fractures , nine out of ten were caused by falls . 50.6 % of fractures occurred in private homes , 24.4 % in traffic areas ( traffic accidents excluded ) , 13.3 % in nursing homes . Adjusting for exposure , fracture rates ( per 1000 person years ) were 70.0 in nursing homes , 17.7 in private homes , and 8.5 in traffic areas in winter ( traffic accidents excluded ) . The fracture risk in traffic areas increased fivefold in months with snow . CONCLUSION Nine out of ten fractures in the aged were caused by falls . Although the fracture risk for the elderly living in a nursing home was four times as high as those living in private homes , the volume of fractures occurring in private homes and traffic areas make them a prime target for interventions . Continuous prospect i ve hospital recording of fractures in a community of aged is feasible and provides a tool for targeting interventions and evaluating the outcome of a community fall-fracture prevention programme Objective —To evaluate a community based programme for evidence based prevention of injuries during physical exercise . Design —Quasi-experimental evaluation using an intervention population and a non-r and om control population . Participants — Study municipality ( population 41 000 ) and control municipality ( population 26 000 ) in Sweden . Main outcome measures —Morbidity rate for sports related injuries treated in the health care system ; severity classification according to the abbreviated injury scale ( AIS ) . Results —The total morbidity rate for sports related injuries in the study area decreased by 14 % from 21 to 18 injuries per 1000 population years ( odds ratio 0.87 ; 95 % confidence interval ( CI ) 0.79 to 0.96 ) . No tendency towards a decrease was observed in people over 40 . The rate of moderately severe injury ( AIS 2 ) decreased to almost half ( odds ratio 0.58 ; 95 % CI 0.50 to 0.68 ) , whereas the rate of minor injuries ( AIS 1 ) increased ( odds ratio 1.22 ; 95 % CI 1.06 to 1.40 ) . The risk of severe injuries ( AIS 3–6 ) remained constant . The rate of total sports injury in the control area did not change ( odds ratio 0.93 ; 95 % CI 0.81 to 1.07 ) , and the trends in the study and control areas were not statistically significantly different . Conclusion —An evidence based prevention programme based on local safety rules and educational programmes can reduce the burden of injuries related to physical exercise in a community . Future studies need to look at adjusting the programme to benefit all age groups Preventing children 's thermal injuries requires changes to both the home environment and the behaviour of family members . Two pilot studies were undertaken of a school-based programme that taught children aged 7 - 11 years about burns and scalds hazards , and encouraged changes to the home environment and family practice s through a take-home exercise . Both studies took place at ethnically diverse schools from low/middle-income areas of Waitakere City , New Zeal and . Study 1 involved 55 children who received the programme , and Study 2 involved 64 children who received the programme and 71 children from a control school . The children 's ability to identify the burns and scalds hazards illustrated in a series of pictures was measured before and after the programme . Children who received the programme showed considerable improvement in hazard identification at the post-test , while children at the control school showed minimal improvement . The take-home exercise  was completed by 85 % of the children and their families in Study 1 , and 61 % of the participants from the intervention school in Study 2 . In both studies families reported positive safety changes as a result of the programme . The programme appeared equally effective with all the ethnic groups involved . Future development of the programme is discussed 
    Output:
    
Although positive results were reported for some communities , there was no consistent relationship between being a WHO design ated Safe Community and subsequent changes in observed injury rates .
While the frequency of injury in some study communities did reduce following their design ation as a WHO Safe Community , there remains insufficient evidence from which to draw definitive conclusions regarding the effectiveness of the model .