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Mon Dec 6 22:55:38 GMT 2010

TY. I'll read 

On Dec 6, 2010, at 5:51 PM, Bjorn, Pret wrote:

> Twelve friends.  I wish.
> 
> Turns out there is a surprising amount of scholarly literature out there.  I skimmed.
> 
> Here's a couple that evaluate the evaluation process.  Interesting reading.
> 
> Tay et al
> Resolving some methodological issues in road safety evaluations: the Victorian TAC Campaigns Revisited
> http://eprints.qut.edu.au/7110/1/7110.pdf
> 
> Elder, et al
> Effectiveness of mass media campaigns for reducing drinking and driving and alcohol-involved crashes.  A systematic review.
> Am J Prev Med 2004; 27(1); 57-65
> 
> We should bear in mind that violence prevention programs (as examined by Prothrow-Stith) suffer some selection bias related to the nature of the target audience.  No pun intended.
> 
> Pret
> 
> 
> -----Original Message-----
> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert Smith
> Sent: Monday, December 06, 2010 3:55 PM
> To: Trauma-List [TRAUMA.ORG]
> Subject: Re: A drunk driving video from Australia-- that MADE a difference
> 
> Pret,
> 
> So you and 12 of your friends share a common belief system. That's great. But as Dr. Frykberg used to say, "there's this little thing called science".
> 
> As far as I know, no media program or intervention like Scared Straight of D.A.R.E. has been shown to be effective when examined scientifically. Please let me know the references if I missed something, which I often do these days. If I remember correctly, some well intentioned programs implemented by really smart people like Dr.Prothrow - Stith, actually caused harm when evaluated.
> 
> Rob
> 
> 
> On Dec 6, 2010, at 3:27 PM, Bjorn, Pret wrote:
> 
>> Careful: I think you're making my case for me.
>> 
>> The effectiveness of these ideas (or lack thereof) is long established and largely uncontested.  But, as with gun control, their implementation runs smack into our cultural sensibilities.  See also SEATBELT LAWS.
>> 
>> We have the tools, we've proven their effectiveness, and we KNOW (at least in our case) why we have been traditionally reluctant to use them: because Americans place far more value on individual rights than societal responsibilities.  We know what's good for us; we just hold precious our ability to ignore it.  Bring all the data you want; the scientific method carries little water in the debate.  It's only a short jump from science to socialism, after all.
>> 
>> Lucky for us, where reason fails or fears to tread, God gave us MEDIA.  
>> 
>> The TAC videos are more than education; they're compelling and durable iconography.  They appeal not to our malleable ideology, but to our immutable FEARS.  And Americans are grand evidence that if you want to restructure a culture's values, then you need only methodically and relentlessly scare the shit out of it.
>> 
>> Viral video will only go so far.  But at least it goes somewhere, with somebody.  I've already heard from a dozen or more colleagues who've thank me for the YouTube link and planned to show it to their teenagers.  Doubt I'd get the same response by lamenting sixteen thousand US drunk driving deaths per year...
>> 
>> Pret
>> 
>> 
>> 
>> 
>> -----Original Message-----
>> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert Smith
>> Sent: Monday, December 06, 2010 10:38 AM
>> To: Trauma-List [TRAUMA.ORG]
>> Subject: Re: A drunk driving video from Australia-- that MADE a difference
>> 
>> Thank you Dr. Haddon, lol.
>> 
>> Sure we can. We could easily design cars that don't start if you're intoxicated, have random spot breathalyzer tests for all drivers and make our own videos. In order of efficacy as you rightly point out.
>> 
>> I would like to reduce the burden of injury in our country and I don't think it's stupid at all to try to scientifically evaluate which interventions are effective and which are not. Because they all have a cost in one way or another. Given the whole firearm debate it's obvious that our society won't accept some interventions that other societies will. But that, imho, doesn't mean we shouldn't keep exploring interventions and evaluating them for their efficacy rather than just implementing them to make us feel like we're doing some good.
>> 
>> Don't make me do the Dr. Frykberg thing Pret :)
>> 
>> 
>> On Dec 6, 2010, at 10:19 AM, Bjorn, Pret wrote:
>> 
>>> All I'm saying is that if you're looking for the one or two Big Ideas that flipped the injury prevention switch in Victoria, you won't find them -- or if you do, you won't be able to reproduce their effects in a dish.  
>>> 
>>> Steve's list of factors is comprehensive, but our inclination to dissect them from the whole is misguided, and debating the relative value of each in its isolation is just stupid.  Which is more important: your heart or your liver?
>>> 
>>> We've long understood that injury prevention across populations can be influenced -- in rapidly-diminishing order of effectiveness -- by engineering, enforcement, and education.  The limiting factor is the degree to which these strategies are linked to the engagement of the population; but in a free society we cannot design, compel, or teach engagement.  Culture to culture, then, we get the injuries we deserve.  And with that in mind, it's sadly instructive that the sociologists are dead last on Steve's list.  And they're observers.
>>> 
>>> If it's true that societies exchange culture chiefly through media, then I think viral video is as good as anyplace to begin internationalizing injury prevention.  But I'm not naïve enough to think that America will become a safer society by watching the TAC Victoria PSA's.  After all, "Jackass 3-D" will probably have a huge DVD release just in time for the holidays...
>>> 
>>> Just me, just now.
>>> 
>>> Pret
>>> 
>>> 
>>> 
>>> 
>>> -----Original Message-----
>>> From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert Smith
>>> Sent: Monday, December 06, 2010 8:25 AM
>>> To: Trauma-List [TRAUMA.ORG]
>>> Subject: Re: A drunk driving video from Australia-- that MADE a difference
>>> 
>>> Pret,
>>> 
>>> Sure, Go Oz! Great effort slashing the traffic mortality rates.
>>> 
>>> But if you don't know what was done to effect that, then the intervention certainly isn't portable. The message really is, if you want to live in an environment with safer driving, move to Australia. They did a whole bunch of different things and around that time their traffic mortality rates fell dramatically in a sustained trend. Saying they had a cultural change isn't too helpful if you want to use whatever they did or whatever happened in another setting. Maybe the only thing that mattered were the road blocks. Or what parents said at the kitchen table. Who knows?
>>> 
>>> The Grinch that Stole Christmas
>>> 
>>> 
>>> On Dec 6, 2010, at 8:05 AM, Bjorn, Pret wrote:
>>> 
>>>> Let me suggest that the collective myopia here may be diminishing a
>>>> truly impressive accomplishment.  
>>>> 
>>>> Looks to me as if Victoria is undergoing a CULTURAL change.  Such is, by
>>>> definition, multifactorial, multidimensional, and complex.  But the
>>>> underlying individual drivers are not nearly as important as their
>>>> synergy.  The media is of course conspicuous -- but as an expression of
>>>> cultural values, it always is.  
>>>> 
>>>> (Media and culture are symbiots.  As an American, I can attest that this
>>>> is not always a good thing; but in this case I say relax and enjoy the
>>>> ride.)
>>>> 
>>>> The beauty of it all is that these media, unlike most of the other
>>>> factors, are PORTABLE.  They offer inspiration from which other cultures
>>>> might begin to mature -- if they're paying any attention at all.
>>>> 
>>>> Go, Aussies.
>>>> 
>>>> Pret 
>>>> 
>>>> -----Original Message-----
>>>> From: trauma-list-bounces at trauma.org
>>>> [mailto:trauma-list-bounces at trauma.org] On Behalf Of Robert Smith
>>>> Sent: Sunday, December 05, 2010 7:49 PM
>>>> To: Trauma-List [TRAUMA.ORG]
>>>> Subject: Re: A drunk driving video from Australia-- that MADE a
>>>> difference
>>>> 
>>>> Steve,
>>>> 
>>>> That's very well put. The same thing happens/happened with violence
>>>> prevention interventions. Except there have been fewer successes. It is
>>>> possible to study the effects of a particular intervention, but you have
>>>> to plan how you're going to do that beforehand and no one is usually
>>>> motivated or interested in doing that. That resulted in a lot of "feel
>>>> good" interventions in violence prevention that didn't do anything or
>>>> were in fact harmful even though it seemed on the surface that they
>>>> should be good things. At least here, for whatever reason, there was a
>>>> positive change. Of course it would be tremendously important to know
>>>> the reason for it.
>>>> 
>>>> Rob
>>>> 
>>>> On Dec 5, 2010, at 7:38 PM, Steve Walker wrote:
>>>> 
>>>>> The problem is that everyone takes credit for a reduction in the road
>>>> toll.
>>>>> 
>>>>> The Police point to a drop and say that it reflects increased
>>>>> law-enforcement efforts.
>>>>> The legislators take credit and say it reflects tougher legislation.
>>>>> The engineers argue that it reflects improved car safety measures, and
>>>>> improved road design.
>>>>> Economists point out the correlation between tougher economic times
>>>> and a
>>>>> reduction in risk taking behavior.
>>>>> Trauma services feel it is due to improved trauma care.
>>>>> Educators and the media claim that they are getting the message
>>>> through to a
>>>>> new generation of drivers.
>>>>> Sociologists argue that accepted norms are changing and behavior that
>>>> was
>>>>> once condoned is less acceptable today.
>>>>> 
>>>>> The reality is that everyone will argue that they have made a
>>>> difference in
>>>>> order to secure their share of scarce government funds.
>>>>> 
>>>>> There is probably some truth to all of these, and it is impossible to
>>>>> determine the relative contribution of each factor.
>>>>> 
>>>>> In the end it doesn't really matter - a continued multifaceted
>>>> approach is
>>>>> likely to produce the best results.
>>>>> 
>>>>> Having lived and worked in Melbourne, I believe that the TAC campaign
>>>>> certainly made a difference. But it was only one of the things that
>>>> made a
>>>>> difference.
>>>>> 
>>>>> Steve
>>> 
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