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Abstract
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Aims: The Fort McMurray Demonstration Project in Social Marketing blended occupational safety and injury prevention in community-based, participatory health promotion project. Setting: A small, industrial city in northern Alberta, which experienced an economic downturn during the study period which resulted in demographic changes. Participants: The project relied heavily on community-based partners and participants. Saturation penetration of safety messages was achieved for the resident population. Measurements: Results from a telephone survey of 120 residents conducted in 1995 were compared with results from a survey conducted in 1992 using the same questionnaire.
FINDINGS: There was little change in most self-reported safety-related behaviours and a reported decline in compliance with eye and ear protection. However, subjects in the 1995 survey round were a survivor population because they had stayed through the downturn and were older, less well educated, and earned less than the sample in 1992.
CONCLUSIONS: Injury rates changed dramatically during the study period in both the intervention and reference communities but self-reported safety- related behaviours in the monitoring survey did not change with the decline in injuries, as would be expected. Respondent bias is the most likely explanation for the absence of demonstrable change. Taking into account that the findings are confounded by a demographic transition in the community, there is still no evidence that the intervention changed safety-related behaviour in the community in the face of an already strong downward trend in injury frequency in the province as a whole. We conclude that future community-level interventions require a different model. The Fort McMurray Demonstration Project in Social Marketing was a comprehensive community-based program aimed at achieving reductions in the frequency of injuries through lasting changes in the safety-related health behaviours of residents (Guidotti, Ford, and Wheeler, 2000). Its design was based on injury prevention programs initiated in Scandinavia the decade before (Lindqvist, 2004, Lindqvist, Timpka, and Schelp, 1996; Nilsen, Ekman, Ekman, Ryen, and Lindqvist, 2007). The principal innovation in Fort McMurray was the blending of community and workplace interventions to achieve cross-over effects from safe behaviour at home and at work. Although injury rates in Fort McMurray fell precipitously during the period, they did so in the comparison community as well (Guidotti, Deb, Bertera, and Watson, 2009). The demonstration program therefore showed no addedvalue, although it was implemented under seemingly ideal conditions. Our experience therefore raises questions about the robustness of the model in practice and suggests that a new model is needed. Little is known about what makes such community-level interventions effective (Thompson and Kinne, 1990; Glanz, 2002; Nilsen, 2004). In this report we examine self-reported safety-related behaviour and find a paradox in that there was little change over the course of the study among respondents despite the dramatic reduction in injury rates. Our experience suggests that demographic change may affect the ability to detect behavioural change in a survivor population.
Language: en |