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Past PIPER Projects

Unintentional Injuy: Drugs & Alcohol
2010-2013 Aurora P.A.R.T.Y. (Prevent Alcohol and Risk Related Trauma in Youth) Program
The goal of the Aurora Prevent Alcohol and Risk Related Trauma in Youth (P.A.R.T.Y) program is to promote injury prevention through reality education about injury awareness and prevention by means of an interactive program that helps teenagers recognize risk and make informed choices about activities and behaviors. Participating youths experience a full-day session following the path of an automobile injury survivor from crash occurrence through transport, treatment, rehabilitation, and community re-integration, meeting the professionals who would care for them in a trauma situation, and learning about the impact such injuries could have on their futures (health, legal, and financial) and everyone around them. P.A.R.T.Y presentations held through 2013 on the University of Colorado campus and on the road have reached over 3,800 youth across Colorado.
PIPER Contact: Marian Betz, MD, MPH (Scientific Advisor/Consultant)
Funder: Colorado Department of Transportation
2010-2013 HIV Risk Behavior in Drug-Involved Former Inmates
The criminal justice population is large, growing, and has a high prevalence of HIV/AIDS and substance use disorders. After release from prison to the community, drug-involved former inmates have considerable opportunities to engage in high-risk behaviors that put themselves and community members at risk for HIV. Risk behavior in this context is likely influenced by pre-incarceration, incarceration, and re-entry factors, including community supervision status and gender. This study utilized a longitudinal cohort design in a random sample of 200 drug-involved former inmates to investigate HIV risk behaviors over time after release from prison, test whether drug-involved former inmates on community supervision have a lower prevalence of HIV risk behaviors than those released without supervision, test whether women have a higher prevalence of HIV risk behaviors than men, and determine whether HIV risk behaviors correlate with other health risk behaviors. This study also examined HIV as a risk factor for overdose and history of overdose among former prison inmates. Findings will lead to a better understanding of the patterns of HIV risk behavior among drug-involved former inmates to develop targeted, timely and appropriate interventions to reduce HIV transmission.
PIPER Contact: Ingrid Binswanger, MD, MPH, MS (PI)
Funder: National Institute on Drug Abuse
2011-2013 Drug-Related Risk for Death After Release from Prison
Prior research by Dr. Binswanger (PI) demonstrated that former inmates are at high risk for death, especially in the first two weeks after release from prison. Nearly one quarter of all deaths was due to drug overdose; many other causes of death were related to substance abuse. However, little is known about drug-related risk factors for death after release from prison. This study examined the drug-related risk and protective factors associated with death after release from prison over a ten year period, with an emphasis on substance dependence, narcotic prescriptions shortly before release, HIV status, and in-prison substance dependence treatment. The study aims included determining if substance dependence, prescribed narcotic use prior to release, and HIV are associated with an elevated risk of death after release from prison, and if substance dependence treatment in prison is protective, as well as the risk of death from all causes (including overdose) after release. The results will inform further research into substance dependence screening and treatment in correctional facilities and the development of a targeted intervention to reduce the risk of drug-related deaths after release from prison.
PIPER Contact: Ingrid Binswanger, MD, MPH, MS (PI)
Funder: National Institute on Drug Abuse
2013 Preventing Unintentional Ingestion of Marijuana by Children: A Health Impact Assessment of Packaging Regulations in Retail Marijuana Establishments in Colorado
To inform the state of Colorado's development of regulations for retail marijuana, PIPER faculty and the Children's Health Advocacy Institute at Children's Hospital Colorado collaborated on a Health Impact Assessment which examined the issue of unintentional ingestion of marijuana by children. The HIA made the following recommendations: 1) All retail marijuana and marijuana products should leave retail establishments in child-resistant packaging as defined by ASTM International and the Poison Prevention Packaging Act of 1970 (PPPA); 2) All child-resistant packaging should be opaque; 3) All child-resistant packaging should be re-closeable; and 4) Allowances should be made to re-use appropriate child-resistant packages. View the full report.
PIPER Contact: Greg Tung, PhD, MPH (PI)
Funder: Children's Hospital Colorado

Unintentional Injury: Motor Vehicle
2013 Senior Driver Cohort Study (Pilot Study)
The U.S. Census Bureau reports that 10,000 people will turn 65 every day from now until 2030. Understanding the safety and mobility needs of these newly-minted seniors is a pressing concern. This pilot study (completed) is part of a long-term project that will generate a wealth of data by tracking a large group of older drivers (roughly 3,000) for a period of 5-10 years, collecting information on the effects of aging on safe driving, specific risk factors, circumstances surrounding driving cessation, and mobility options for seniors who no longer drive. This large study will provide the scientific backing needed to implement effective policies and programs, will support fair treatment of older drivers, and the database it creates will serve as a unique resource for answering questions about senior safety and mobility.
PIPER Contacts: Carolyn DiGuiseppi, MD, MPH, PhD (Site Co-PI) and Marian Betz, MD, MPH (Site Co-PI)
Funder: AAA Foundation for Traffic Safety

Other Unintentional Injury
2007-2013 Marketing Fall Prevention Classes to Older Adults in Faith-Based Congregations: Cluster Randomized Controlled Trial
Injuries from falls are a leading cause of emergency visits, hospitalizations, and deaths in older US adults, resulting in total lifetime costs of more than $19 billion in 2000. Fall injuries reduce independence and mobility, and increase the risk of disability and institutionalization. There is good evidence that community-based group exercise classes focusing on strength and balance prevent older adult falls, but uptake is limited. This study will test a new approach to promote participation in group balance-retraining exercise classes, using social marketing to target older adults in faith-based congregations (FBCs). Following formative research consisting of focus groups and key informant interviews, a targeted social marketing program will be developed to motivate participation by increasing class attractiveness, usability, and uptake and reducing barriers or costs, and using incentives or other benefits to reinforce participation. Sixty-two diverse FBCs will be randomly allocated to intervention or control groups to test whether seniors from intervention FBCs are more likely to join balance-retraining classes. If the marketing program is effective, it may be widely implemented and/or inform the development of similar programs with other target audiences.
PIPER Contact: Carolyn DiGuiseppi, MD, MPH, PhD (PI)
Funder: Centers for Disease Control and Prevention, Colorado Injury Control Research Center
2008-2013 National Children’s Study - Douglas County, CO
The National Children's Study (NCS) is a prospective longitudinal cohort study of the individual and combined effects of environmental exposures and gene environmental interactions on child health and development in a representative sample of approximately 100,000 children born in the United States and followed from before birth until age
21. The study is the largest long-term study of children's health ever conducted in the United States. The primary aim of the NCS is to investigate the separate and combined effects of environmental exposures (chemical, biological, physical, psychosocial) as well as gene-environment interactions on pregnancy outcomes, child health and development, and precursors of adult disease. Injury risk is one of the factors being examined in the cohort.
PIPER Contact: Carolyn DiGuiseppi, MD, MPH, PhD (Co-I, Lead Evaluator)
Funder: National Institute of Child Health and Human Development

2012-2014 Harmonizing Child Unintentional Injury Research Through Shared Instrumentation
As the field of injury has grown, more investigators are examining patterns of child injury in different settings. In 2011, for example, there were more than 6000 papers listed in SafetyLit®.org with a focus on child and adolescent injury. Yet, no central compendium of data collection instruments accessible to the community of researchers exists, and there has never been a systematic method to compile, on an ongoing basis, measures used in injury research. To address this need, we created a searchable database of data collection instruments so that investigators can benefit from prior work and enhance the consistency across studies. This database has been made available to the community of scholars through Dr. David Lawrence of, Inc.
PIPER Contact: Carol Runyan, MPH, PhD (PI)
Funder: National Center for Injury Prevention and Control, through a contract with the Society for the Advancement of Violence and Injury Research

Suicide & Interpersonal Violence
2009-2013 Evaluating Population-Based Approaches to Suicide Prevention through Systematic Reviews
Suicide is the most common cause of violent death in the US, and the eleventh leading cause of all deaths. The identification of biological, psychological, and socio-environmental risk factors has prompted many disciplines to develop interventions to prevent suicide. This project comprehensively identified high-quality studies of suicide prevention programs and used the identified studies to conduct two systematic reviews of suicide prevention strategies to determine whether they are effective. This project will contribute to the available evidence base for policy makers, public health, and other professionals to use when making decisions about program implementation. The systematic reviews include a study of social connectedness interventions for preventing suicide in young and middle aged adults (analyses in progress) and a study of interventions for primary prevention of suicide in the post-secondary educational setting (found insufficient evidence to support widespread implementation of any studied programs or policies for primary suicide prevention in post-secondary educational settings). This was a joint project with CSPH and CSU.
PIPER Contact: Carolyn DiGuiseppi, MD, MPH, PhD (PI)
Funder: National Center for Injury Prevention and Control, Colorado Injury Control Research Center
2013-2014 Means Restriction Education for Adolescent Suicide Prevention: A Quality Improvement Pilot Project at Children’s Hospital Colorado
This project was designed to enhance the care of patients in the Psychiatric Emergency Service (PES) by implementing a structured protocol for addressing suicide prevention. Using an evidence-based approach, providers educated parents/guardians of children and adolescents seen in the PES about restricting access to medications and firearms and provided them with the means to better secure medications and firearms (e.g., lock boxes, trigger locks); this approach to suicide prevention is referred to as means restriction. All providers in the PES who handle discharge planning received standardized, on-line training developed in partnership with the Colorado Department of Public Health and Environment.
PIPER Contact: Carol Runyan, MPH, PhD (Co-I and lead evaluator)
Funders: The O’Shaunessy Foundation; Colorado Department of Public Health and Environment; Children’s Hospital Colorado

Other: Infrastructure Development/Training
2000-2013 Injury Prevention Activities at UCDHSC, Colorado Injury Control Research Center
The purpose of the Colorado Injury Control Research Center (CICRC) is to reduce the occurrence, severity, and adverse consequences of injuries through research, education, and service, primarily in Public Health Service Region VIII, which includes Colorado, Wyoming, Montana, South Dakota, Utah and North Dakota. Death rates from all injuries are higher than US rates in all the states except North Dakota; unintentional injury death rates are higher than US rates in all states except Utah; motor vehicle occupant death rates are higher than US rates in all states except Colorado and Utah; and suicide death rates are higher than US rates in all states in the region. In addressing these injury issues, emphasis is placed on reducing disparities in injury outcomes while working in community partnerships alongside underserved populations. The CICRC also values innovation in education, training, community programs, and research, as well as identification of evidence-based, efficient approaches to preventing injuries. This CICRC subcontract covers injury prevention activities at University of Colorado Denver Health Sciences Center.
PIPER Contact: Carolyn DiGuiseppi, MD, MPH, PhD (Deputy Director of Center)
Funder: Centers for Disease Control and Prevention, Colorado Injury Control Research Center

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