The Community Against Preventable Injuries

aka ‘Preventable’

Presentation to the BC Public Health Association Summer School

July 25, 2012

Dr. Ian Pike, Director, BCIRPU Dept. of Pediatrics, UBC

Co-Executive Director, Preventable

Who We Are

• Announced as “SafeBC” in May 2006 by the Minister of Labour and Citizen’s Services

• Provincial commitment to safety and injury prevention “in every aspect of life in BC”

• Make British Columbia “the safest province in Canada”

• Recognition of the magnitude of the issue

• Initiative has evolved - registered non-for-profit governed by a Board of Directors

The Magnitude of the Issue

In British Columbia

• Each year, 400,000 are seriously injured and 1,200 die

• Leading cause of death for ages 1 – 44

• More children die from preventable injuries than all other causes combined

• Total annual cost = $4.5 – 5.0B

• 3rd largest cost contributor to the BC health care system

A Provincial Opportunity

Social Marketing Approach

• Understand current attitudes, perceptions and consumer “realities”

• Engage British Columbians “on their own terms”

• Invite them to join the movement

• Raise awareness and begin the “attitudinal shift”

• Transform societal attitudes and behaviours

A Provincial Opportunity

5

Preventable’s Market Niche

• A holistic social marketing approach to preventable injuries

• Establish an overall injury prevention brand

• Speak to the attitude that connects preventable injuries at home, at work, at play and on the road (Connecting the Dots)

• Build a “community” of divergent interests, coming together for a single issue, under a single banner, using a single approach (critical mass)

• Use partnerships to leverage campaign to further specific health, safety and wellbeing objectives (expand reach)

How Preventable Works

• Evidence-informed Injury Prevention Pillars:

• Regulation & Enforcement of Legislation

• Engineering & Environmental Design

• Education & Social Marketing (Preventable)

• Partnering to combine the pillars into effective campaigns and strategies

• Leverage the partner activities and establish program synergies

Social Marketing Continuum

7

Low awareness/

Unengaged

Aware

No mass

engagement

Consciousness

Societal pressure

Behaviour

Modification

Mass

Engagement

Drinking/Driving

Anti-smoking

Helmets

Seat Belts

Recycling

Obesity

Climate Change

Aggressive

Driving

Cell Phone

while Driving

Homelessness

Injury Prevention

30 years 1-3 years 3-5 years 5-10 years

Preventable Partners

• Partnerships are critical to the Preventable strategy

• To date, over 80 organizations have joined, including some of the largest and most prominent organization’s in BC

The Campaign

Campaign Objectives

• Create awareness of magnitude and breadth of preventable injuries

• Start a “discussion” with British Columbians

• Create a province-wide injury prevention “brand”

• Let British Columbians draw their own conclusions

• Opportunity to connect back to partner brands

• Create opportunity to join the movement and become an agent for change

• Target age group: 25 – 55 year olds

Campaign Development & Delivery

• 2-year iterative process – understand consumer realities and the communication opportunities

• Focus group testing of creative, vetting and approval by partner senior marketing teams

• Not-for-Profit structure and focused mission – important for delivery

• Key to Delivery is Partnership • Tapping into partner customer communication channels

and touch points • Meaningful co-branding to extend market penetration • Leverage partner expertise and resources

• Campaign components: mass media, ambient, community outreach, Internet (www.preventable.ca), Partnership Programs

Television and Mass Media

Ambient Messaging and Guerilla Activity

Partnerships

Partnership Staff Engagement Programs

Distracted Driver and Road Safety Initiatives

Television and Mass Media

Guerilla activities

Pavement Patty, West Vancouver, September 2010

Guerilla activities

Digital Speedboard, Cities of Burnaby and Surrey, September 2011

Ambient messaging

Parking garage ambient, Vancouver

Parking elevator ambient, Vancouver

Partnerships, Co-branding and Staff Engagement

Transit Shelter Signage, Vancouver & Victoria

Locker Room Signage, Vancouver & BC Parks

BCAA HQ Parking Lot

Campaign Effectiveness

Results: Campaign Effectiveness Model

Reaction

Campaign Effectiveness Recall of

preventable.ca advertising campaign

Shifts in key awareness,

attitude and self-report behaviour metrics over time

Source: data collected on a four week roll-on basis via on-line surveys conducted by IPSOS

ASI.

Campaign Summary

• Campaign launched in June 2009

• Reached over 2M BC customers (≈ 50% of the BC population), every week between June and December 2009, through TV, radio, print and on-line media

• Over 100M media impressions generated

• About 50,000 customers visited preventable.ca in the first year following the launch

Campaign Effectiveness Results

• Campaign recall increased by 45% (from Jun. 09 baseline to Dec. 09)

• Ads were considered informative, relevant, credible and generated self-reflection

• TV advertising was the key driver of recall

• No advertising fatigue during the campaign period

• Positive shifts (5-10%) observed in attitudes towards injury prevention

Results: Attitudes – Inevitability of Injury

37%

78%

56%

43%

37%

76%

56%

45%

29%

73%

54%

41%

31%

72%

62%

41%

30%

75%

58%

41%

31%

75%

61%

45%

29%

74%

61%

44%

It is inevitable that people get

injured

Injuries only happen to other

people

The majority of injuries are

preventable

Preventing injuries is a daily

consideration for me

May-09 Sep-09 Feb-10 Aug-10 Nov-10 Feb-11 Sep-11

Results: Self Reported Precautionary Actions

59%

55%57%

41%

62%

58%

65%

60%

65%

52%

63%64%

62%

57%

65%

49%

72%

58%

65%

61%62%

49%

77%

65%

62%60%

58%

50%

76%

63%61%

60%

65%

51%

73%

60%61% 61%

60%

50%

73%

63%

Around Pools / Lakes

/ Water

Around the use of

ladders

In doing your work Jaywalking to cross a

street

Multitasking while

driving

Driving when

fatigued

May-09 Sep-09 Feb-10 Aug-10 Nov-10 Feb-11 Sep-11

Results: Number and Rate, Unintentional Injury Deaths by Year and Age Group, BC, 2005-2010

0

100

200

300

400

500

600

700

800

2005 2006 2007 2008 2009 2010

Year

Nu

mb

er

of

De

ath

s

0

10

20

30

40

50

60

70

Rat

e p

er

10

0,0

00

Po

pu

lati

on

0-24 Deaths 25-54 Deaths 55+ Deaths

0-24 Rates* 25-54 Rates* 55+ Rates * significant trend p value <0.05

Pre-Preventable Pre-Campaign Campaign

606

360

Results: Number and Rate, Unintentional Injury Deaths by Year and Age Group, BC, 2005-2010

0

100

200

300

400

500

600

700

800

2005 2006 2007 2008 2009* 2010*

Year

Nu

mb

er

of

De

ath

s

0

10

20

30

40

50

60

70

Rat

e p

er

10

0,0

00

Po

pu

lati

on

0-24 Deaths 25-54 Deaths 55+ Deaths

0-24 Rates* 25-54 Rates* 55+ Rates

• For years 2005-2008 there were no significant trends in injury death data • From 2009 onward a statistically significant decrease was observed for age groups

25-54 and 0-24 years

* significant trend p value <0.05

Pre-Preventable Pre-Campaign Campaign

542 573 512 489

360

606

Results: Number and Rates, Unintentional Injury Deaths by Year and Cause, Ages 25-54 Years, BC, 2005-2010

0

50

100

150

200

250

300

2005 2006 2007 2008 2009 2010

Year

Nu

mb

er o

f D

eath

s

0

2

4

6

8

10

12

14

16

Rat

e p

er 1

00

,00

0 P

op

ula

tio

n

Fall Deaths

Drowning Deaths

Unintentional Poisoning Deaths

MV Occupant Deaths

Pedestrian Deaths

Fall Rates

Drowning Rates

Unintentional Poisoning Rates

MV Occupant Rates

Pedestrian Rates

2005-2006 2007-2008 2009-2010 Fall Drowning sig. increase sig. increase sig. decrease Poisoning sig. decrease MVC sig. decrease sig. decrease Pedestrian sig. decrease sig. increase

Results: Number and Rate of Unintentional Head Injury Deaths by Year and Age Group, BC, 2005-2010

0

50

100

150

200

250

2005 2006 2007 2008 2009 2010

Year

Nu

mb

er

of

De

ath

s

0

2

4

6

8

10

12

14

16

18

Rat

e p

er

10

0,0

00

Po

pu

lati

on

0-24 Deaths

25-54 Deaths

55+ Deaths

0-24 Rates

25-54 Rates

55+ Rates

2005-2006 2007-2008 2009-2010 0 – 24 yr sig. increase 25 - 55 yr sig. decrease sig. decrease 55+ yr sig. decrease

Results: Summary - Unintentional Injury Deaths Ages 25-54 Years, BC, 2005-2010

• Since 2005, there has been an overall significant reduction of 153 fewer injury deaths among 25-55 year-olds in BC - a significant reduction was only observed during the Campaign period (2009-2010), during which 81 fewer injury deaths occurred among 25-55 year-olds in BC

• When reviewed by cause of injury, significant reductions in injury deaths among 25-55 year-olds in BC were observed in:

• MVC (76 fewer deaths; 2007-2008 and 2009-2010 - Campaign period)

• Drowning ( 7 fewer deaths; 2009-2010 - Campaign period)

• Poisoning (30 fewer deaths; 2007-2008)

• Pedestrian (10 fewer deaths 2005-2006)

• Since 2005, there has been an overall significant reduction of 63 fewer injury deaths among 0-24 year-olds in BC - a significant reduction was only observed during the Campaign period (2009-2010), during which 15 fewer injury deaths occurred among 0-24 year-olds in BC

• This age group represents the children of our target population, and has been the secondary target of campaign messaging

Results: Number and Rate, Unintentional Injury Hospitalizations by Year and Age Group, BC, 2005/06 - 2010/11

0

5000

10000

15000

20000

25000

2005 2006 2007 2008 2009 2010

Year

Nu

mb

er

of

Ho

spit

aliz

atio

ns

0

200

400

600

800

1000

1200

1400

1600

1800

Rat

e p

er

10

0,0

00

Po

pu

lati

on

0-24 Hospitalizations 25-54 Hospitalizations 55+ Hospitalizations

0-24 Rates* 25-54 Rates 55+ Rates * significant trend p value <0.05

11740 11995

Pre-Preventable Pre-Campaign Campaign

Results: Rate per 100,000 Population, Hospitalizations by Year & Cause, Ages 25-54 Years, BC, 2005/06 - 2010/11

0

50

100

150

200

250

2005 2006 2007 2008 2009 2010

Year

Rat

e p

er

10

0,0

00

Po

pu

lati

on

Fall Unintentional Poisoning

MV Occupant* Pedestrian * significant trend p value <0.05

1177

890

Pre-Preventable Pre-Campaign Campaign

Results: Summary - Unintentional Injury Hospitalizations Ages 25-54 Years, BC, 2005-2010

• Since 2005/06, the number and rate of injury hospitalizations among 25-55 year-olds in BC has remained static at approximately 12,000 per year

• When reviewed by cause of injury, since 2005/06 there has been a significant reduction of 287 fewer MVC injury hospitalizations among 25-55 year-olds in BC

Preventable Campaign Summary

Low awareness/

Unengaged

Aware

No mass

engagement

Consciousness

Societal pressure

Behaviour

Modification

Mass

Engagement

Drinking/Driving

Anti-smoking

Helmets

Seat Belts

Recycling

Obesity

Climate Change

Aggressive

Driving

Cell Phone

while Driving

Homelessness

Injury Prevention

30 years 1-3 years 3-5 years 5-10 years

After the first phase of the Preventable campaign, results indicate: • A positive shift in attitudes and behaviours with regard to preventable injuries • Positive support for the Preventable brand • The campaign is successfully moving British Columbians from low awareness and unengaged

towards increased awareness and engagement • Significant reduction in injury deaths among 25-55 year-olds and 0-24 year-olds during the

campaign period in BC • No change in injury hospitalizations, with the exception of a significant reduction in MVC injury

hospitalizations among 25-55 year-olds in BC since 2005/06

Thank You

Questions?