Aust. J. Rural Health (2001) 9, 222– 228 Blackwell Science Asia 54 University Street, PO Box 378, Carlton South, Victoria 3053 Australia AJR The Australian Journal of Rural Health 1038-5282 © 2001 National Rural Health Alliance Inc. 9 2001 399 AUSTRALIAN JOURNAL OF RURAL HEALTH Planning community-Based Injury control: C. Loos et al. Original Article 000 000 Graphicraft Limited, Hong Kong PLANNING OF A COMMUNITY-BASED APPROACH TO INJURY CONTROL AND SAFETY PROMOTION IN A RURAL COMMUNITY Colleen Loos, 1 Brian Oldenburg 2 and Lily O’Hara 3 1 Department of Social and Preventive Medicine, University of Queensland, 2 School of Public Health, Queensland University of Technology and 3 University of the Sunshine Coast, Queensland, Australia ABSTRACT: This paper describes the planning of a community-based approach to injury control and safety pro- motion, the Kolan Injury Prevention Program. The process involved the establishment of a local steering committee, 11 months of injury surveillance, a critical review of the evidence base, community consultations and assessment of community resources. There were 412 recorded injury cases during the surveillance period, with higher rates among men, manual workers, those aged 15 – 34 years, sport / leisure activities and around the home and farm. Salient issues for residents included a lack of access to safety information and skills, particularly with regard to first aid and bush fire for isolated residents and rurally inexperienced new residents. While injury prevention was identified as an important issue for the community, the rapidly changing size and nature of the community and its infrastructure made this a particularly challenging issue. Challenges included limited availability of volunteers from key sectors, lack of formal data collection systems, difficulties in mobilising support for a broad issue like injury, limited communication networks and the negative impact of distance and role uncertainty on community ownership of the program. This case study illustrates the steps involved in an effective community-based needs assessment addressing injury prevention. Such an approach, if carried out systematically, will help ensure that the strategies and programs developed will be both appropriate and likely to obtain the support of the local community. KEY WORDS: community based injury prevention, community needs assessment, safety promotion. INTRODUCTION Injury is a major public health problem, being the fifth main cause of death in Australia, and accounting for over 7000 deaths annually. 1 The enormous individual, social and economic consequences of injury have made it a national priority issue. 2 In rural Australia, injury is responsible for higher rates of morbidity and mortality than is the case in metropolitan regions. 3,4 Rural people face an increased exposure to risk and a decreased access to appropriate emergency services and health facilities. 4 Comprehensive rural injury information is not routinely collected throughout Australia; however, available data for unintentional injury show a steady increase in death rates according to the degree of isolation of the population: from 33.5 deaths per 100 000 persons in capital cities to 86.2 per 100 000 for the most remote regions. 3 Injuries occurring in Queensland’s, Central West Region were almost twice as likely to result in death or hospital admission than injuries reported by participating hospitals in Brisbane. 5 Traditional approaches to injury prevention have tended to focus overly on behaviour change at the individual level. This ascribes the primary causes of injuries to the individual, with less consideration being given to the Correspondence: Professor Brian Oldenburg, School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld 4059, Australia. Email: b.oldenburg@qut.edu.au Accepted for publication March 2001.