Community-based participatory program development for controlling road traffic injuries in the city of Boroujerd, Iran.

摘要

Background: Road Traffic Injuries (RTIs) are a major public health problem, especially in developing countries. Iran has the highest mortality rates from RTIs in the world.;Community-based participatory program development is a promising approach in the developed world for reducing the burden of RTIs, but there are a few studies using this method in the developing countries.;Objectives: The purpose of this study is to develop a community-based participatory program for reducing RTIs in the city of Boroujerd, Iran. The research questions are: 1) What is the magnitude of the problem of RTIs in the city of Boroujerd and comparison city of Doroud? 2) What is the community's perception about the etiology of RTIs? 3) What solutions does the community propose for reducing the burden of RTIs? and 4) How can the impact of those solutions be measured?;Methods: This study consists of 1) a retrospective chart review (325 patient and 194 death files); 2) measurement of the public health burden of RTIs by computing DALYs using the Global Burden of Disease study methodology; 3) in-depth semi-structured interviews with different stakeholders (39 interviews); and 4) collection of qualitative data by conducting the Participatory techniques (36 participants). A qualitative approach using a grounded theory method was employed to analyze the interviews. A framework for a quasi-experimental design to evaluate the implementation phase was developed.;Results: In one year (March 21, 2008--March 20, 2009), the people of Boroujerd lost 3,092 years of healthy life due to RTIs; this is equal to 932 years lost per 100,000 population and the death rate was 41/100,000. The environmental and social factors were the core variables contributing to the magnitude of the RTI problem. To address this problem, four programs including 1) the motorcycle safety initiative; 2) the social marketing program targeting youth; 3) a program to address post-crash events; and 4) an advocacy program to develop recommendations to the national policy makers were developed by the people of Boroujerd.;Conclusion: Community-based participatory program development was used to identify feasible solutions to reduce the burden of road traffic injuries in the city of Boroujerd, Iran.