Evaluating programs to prevent unintentional trauma in Canada: challenges and directions.

BACKGROUND: Trauma remains the number one cause of death for people under the age of 44 years and consumes a disproportionate amount of resources. This review describes the spectrum of prevention strategies in Canada, current behavior-oriented trauma prevention initiatives, and evaluations of their effectiveness.
METHODS: A literature search of English language citations in MEDLINE was carried out by using the word "prevention" in conjunction with any of the words "injury," "accident," "trauma," "fall," "collision," and "traffic." Relevant material from bibliographies was also obtained. A comprehensive compilation of local and national prevention programs in Canada was reviewed. Only programs with reported evaluation data were included.
CONCLUSION: Enforcing trauma prevention measures through legislation seems to be the most effective strategy. Educational models have not been adequately evaluated because of methodologic and economic constraints. New prevention initiatives must be supported with more resources and evaluation strategies. Involvement of health care professionals in prevention is encouraged.