First published on April 6, 2015 in observance of the COPH’s 30^th anniversary celebration.

Dr. Karen Liller has been a child and adolescent injury prevention researcher for a quarter of a century.  A professor in the USF College of Public Health’s Department of Community and Family Health and a member of the Florida Injury Prevention Advisory Group, she worked with a Tampa General program called More Health in the mid-1990s to help evaluate its health education programs.  One of those programs promoted bicycle helmets for children.

Dr. Karen Liller

“I evaluated their program, and I started observational studies of children’s bicycle helmet use in Hillsborough County,” Liller said.  “I was monitoring this because, as part of the Injury Group, I knew this bill had been denied two times before.  We were all part of the advocacy efforts with Tallahassee between the state of Florida program, More Health and the college to get this passed.”

A natural proponent of requiring kids to wear helmets when they rode their bikes, Liller had her interest piqued.  From casual observation alone, she surmised that few were.  Determined to put scientifically collected numbers to the problem, she and a cadre of her graduate students set about the task of collecting data.

From low expectations to high hopes, then action

“I was focused on unintentional injuries in children,” she said.  “Nationally, this was a huge issue.  I had some colleagues at Harborview Injury Prevention Program in the state of  Washington, and they were some of the early leaders nationally in helmet use.  So I naturally got very, very interested and started looking, started conducting observational studies, because I didn’t know:  What is the helmet use rate? “I developed and performed community observations,” she said.  “I would hire my grad assistants, and they would stand on corners doing observational surveys of kids in helmets.  We mapped out the whole county, and I had them on streets everywhere.  We had a whole protocol of where we wanted to be, because we wanted to capture observational surveys in many different places – in community sites, in schools, not near schools, etc., so we had a good idea of what was going on in Hillsborough County.”

As low as Liller’s expectations were, reality turned out to be even worse.

“I can tell you, it was pitifully low,” she said.  “For children under 16, it was about three percent.”

Liller set out on a concentrated campaign to get a helmet law passed.  It already had languished and died in two previous legislative sessions, and she was determined to make the third try count.

“I did many radio spots and TV spots and Good Morning Whomever promoting bicycle helmets as the law was working its way through the legislature,” she recalled.

“I wanted to get ahold of it,” she said, “because I knew this was a national issue, and I knew states were starting to pass laws.  Florida is a tough state to get a law passed for children’s injury prevention.  In fact, we just got the booster seat law done.  We were one of the last states to do that.  I knew it was going to be a battle.  So, I knew I’d better get started early.” Liller learned through focus groups that legislators weren’t the only people she needed to convince.  Some parents didn’t want a law telling them to put helmets on their kids’ heads.  After all, bicycle shops already were selling more helmets.  McDonald’s was giving out helmet discount coupons and safe rider certificates.  Why should there be a legal mandate?

“My answer to them was, ‘Do you have a driver’s license?  Yes?  Well, the government told you to do that.’

“It always surprised me when parents would argue with me on this issue.  The famous one for me was, ‘I rode a bike all the time when I was a kid, and I never got a head injury.’  I’d say, ‘When was that?  Where was that?’  And it would be some idyllic little community in some other state, and I’d say, ‘Try riding a bike in Tampa now, and get back to me on that.  The world has changed.  The roads have changed.  The danger level has changed.”

Clearly, the law’s chief proponent had taken on a daunting task, but being part of the state’s first college of public health had its rewards.  Dr. Charles Mahan, state health director under Gov. Lawton Chiles, was a valuable ally.  COPH was still the only school of public health in Florida, and COPH professors were trekking all the way to Tallahassee to teach weekly classes at the state health department office.  Through the department’s close working relationship with COPH, Mahan already had known Liller and had been supportive of her efforts.

Dr. Charles Mahan

“We knew that Karen was really focused on getting a child helmet law through, and certainly, we were very much in favor of that,” said Mahan, who was COPH dean by the time the measure was in its third incarnation.  Mahan had known Chiles since well before the latter began his two terms as governor.

When Mahan was a medical student at the University of Florida, Chiles became interested in his work on infant mortality.  Personal and professional bonds soon followed.

“When he was a senator, I would go around the country and hold hearings with him,” Mahan recalled.  “He would do all the talking, but I would help him figure out what to say, depending on what the issue was.”

Mahan knew the governor well enough to know he was predisposed to children’s health issues.

“Any issue related to children was something that Gov. and Mrs. Chiles were supportive of,” Mahan said.  “Anything that needed his support on children’s issues for safety or survival or whatever, he would tell the staff – me and everyone else – to make sure that it got supported.” With the encouragement of a popular governor, the proposal was gaining momentum.  The awareness raised by the news of the pending legislation helped engender educational outreaches that helped the ball roll faster.

“Betty Castor, who became president of USF, was head of education at the time,” Mahan said, “and the school systems jumped right in with educational efforts.”

Those collective efforts eventually generated the irresistible momentum that carried the measure over the finish line.

“With Charlie’s support and the governor’s, on the third attempt, it was successful,” Liller said.  “And I testified and did a variety of things locally, as well, for the bill.  A colleague of mine also did a cost-effectiveness study, and he also testified with that in Tallahassee.  I think it was a combination of all of these things.  We kept sending the legislators our research findings, and with all the backing, eventually, in 1996, the bill passed.”

A victory not etched in stone

“Bike helmets are an investment we should make to ensure our children’s health and safety,” Chiles declared as he signed the bill onto law.

The measure became effective on Jan. 1, 1997, and for the next 12 months, it was easy for anyone to live with.  A violator would receive a warning and a bicycle safety brochure.  As of Jan. 1, 1998, however, that brochure was delivered with a $17 citation.  It was a light fine as fines go, and even it could be circumvented.

“After the first year, you could get a fine if the child was riding, was under the age of 16 and didn’t have a helmet on,” Liller said, “but you could get around that if you could show evidence of a bicycle helmet.”

That, of course, was only when the law was enforced, which, according to Liller, wasn’t – and still isn’t – very often.

“Police are very reluctant,” she said.  “I talk to them about how many tickets they’ve given, and usually the answer is ‘none,’ at least in Hillsborough County.  They’re very reluctant to stop a child on a bike.”

Nonetheless, she said, by 1998, helmet use had risen exponentially, to 67 percent in Hillsborough County.  So even without much enforcement, the law was accomplishing its purpose.

“I think the law has been great,” Liller said.  “We did an analysis of its efficacy.  We did show that helmet use has gone up, and we showed that injuries have gone down.  And that was great.  That was the intent of the law.  Injury prevention does its best, many times, when there’s a policy change or a legislative change, because it just reaches more people.”

Mahan agreed. “Having it as law is a big awareness raiser,” he said.  “It gets all over the papers and the news again and again.  The legislature is considering this measure.  That’s news.  The legislature passed it today.  That’s news.  The governor signed it into law.  That’s news again.  It went into effect today, so that’s news, too.

“For the majority of parents, who care so much about their kids, just the awareness-raising and then seeing other kids out there with their helmets on helped, but it took time.  As with any legislation, it takes about three years to get a good idea through.  It’s very hard to take a new idea on regulation to the legislature.”

“It was a very exciting time,” Liller said, “because, the first couple of times, I would go to the injury meetings, we’d work on the language of the law, and it just kept getting defeated.  The first year we did it, I think we just put it out there and said, ‘Let’s just see how it goes.’  The second year, we didn’t have the information about the penalty.  I still don’t like the penalty.  I don’t to this day.  But it was a really exciting process, and I’m so glad I was part of it.”

Still, Liller knows that no law is etched in stone.  The state threw a scare into helmet proponents and safety advocates in general when it partially repealed its motorcycle helmet law by limiting the requirement to riders under 21. “We were very afraid that they were going to repeal the bicycle helmet law, too, but so far, so good,” Liller said.  “They haven’t touched that law.  I think that’s because it’s for children.  I think if we would have had that helmet law for all ages, we would have been in trouble.”

“When I was at the state health office,” Mahan said, “the helmet law was a big plus, but at the same time, we lost the motorcycle helmet law, and that’s had tremendous consequences.”

The work continues

“We want it to become a norm,” Liller said of bicycle helmet use.  “We want it to be that, when these children have children, there won’t be any question when you get on a bike.  And we’re starting to see that.”

Mahan concurred.  He said he and his wife live two blocks from an elementary school, and the progress is easily visible.

“A lot of the kids are riding their bikes to school,” he said, “and every one of them has a helmet on.”

Work since the law’s passage has been geared toward bicycle helmet give-away programs.

“If you don’t have a helmet, we can find you one,” Liller said.  “We can find a program – Safe Kids, Tampa General, we can find somewhere to get you a helmet.”

Liller’s work on the law continues to influence safety initiatives.

“Our work has been in world publications about helmet use, about laws, about how it’s done,” she said.  “The Robert Wood Johnson Foundation wants to know about strategies, and it seems that the strategies that were developed in the ’90s – people are still really interested in those.  We were always pleased that our work is often cited as an example, even though many years have passed.”

Liller said she also is gratified to see the lasting validation of her and her colleagues’ methodology.

“It’s interesting that the work that we did is still being used.  If you run a program, you do some observational surveys.  You look at that helmet use on those kids.  You don’t just ask them.  You actually watch them.”

In the intervening years, Liller’s focus has shifted to high school sports injuries, but she remains committed to the legislation she helped to bring about, and she remains engaged with it, most recently as a content reviewer for the Robert Wood Johnson Foundation and the Wisconsin Population Health Institute for strategies they want to propose for child safety seats – and yes, bicycle helmets. Her message for the naysayers remains the same.

“We’re not telling children they can’t ride bikes,” she said.  “We’re not telling children they can’t have fun or anything else we were accused of so often.  Basically, it’s just taking necessary precautions.  There’s been some literature that says we should let kids take more risks.  We don’t want to stop anyone from taking risks or having fun or getting exercise.  We just don’t want a child to die from a perfectly preventable head injury.  We’re smarter now.”

Story by David Brothers, College of Public Health.  Photos courtesy of the National Highway Traffic Safety Association, Helmets On Heads, County Mayo and other sources.

The post COPH helped drive state’s bicycle helmet law appeared first on College of Public Health News.

In the summer of 2022, after a rash of mass shootings, the Association of Schools and Programs of Public Health (ASPPH) convened a task force on gun violence prevention made up of experts from 13 member schools.

Dr. Karen Liller, a USF College of Public Health Distinguished University Health Professor and injury-prevention researcher, was one of those experts.

The task force worked to review existing literature, identify needs and gaps and develop recommendations for strategies informed by evidence that can be used by schools and programs of public health, as well as the ASPPH as an organization, to help fight gun violence.

In January, the ASPPH’s task force released its report,  “Gun Violence Prevention: An Academic Public Health Framework.”

“It was our goal to develop recommendations that could be implemented over time so that schools and programs [of public health] and the ASPPH could develop and help lead strategies for significant change in a consistent manner,” Liller said.

The ASPPH’s recommendations center on four domains:

• Education and training
• Research
• Policy and advocacy
• Practice

Liller said some of the specific recommendations for schools and programs of public health include:

• Incorporating gun violence prevention into curricula and creating new curricula if needed.
• Providing seed funding for research on gun violence prevention.
• Actively advocating for change.
• Practicing community-based participatory research. “Students should be participating in a wide array of areas including internships and practicums related to gun violence prevention,” Liller explained.

Liller said she also hopes the ASPPH will work to develop a legislative agenda for gun violence prevention and provide a resource site for the modules and curricula on gun violence.

“It was important for me and the entire task force to make sure this report does not just sit on a shelf,” Liller noted. “We were careful to develop recommendations that are doable and include not only what schools and programs can do, but how the ASPPH can support our efforts. We will monitor our progress with real-time tracking while the ASPPH formally reevaluates the progress of the report’s recommendations in three years.”

Participating in the task force was a career highlight, Liller said.

“Working with this group of scientists was so fulfilling,” she commented. “It was exciting to hear a diversity of ideas as to how we can make change. We worked together well, and everyone did their part to review the information and develop and revise recommendations.”

Story by Donna Campisano, USF College of Public Health

The post COPH expert helps craft ASPPH gun violence prevention report appeared first on College of Public Health News.

USF College of Public Health (COPH) Professor Dr. Karen Liller has been recognized for her expertise on gun violence and injury prevention by both USF and the Association of Schools and Programs of Public Health (ASPPH).

Distinguished USF Health Professor

Liller was recently named a Distinguished USF Health Professor. 

Distinguished USF Health Professors are senior members of the USF Health faculty who hold the rank of professor and have distinguished themselves exceptionally among their peers, both within and outside of the university. The title is awarded through a process of nomination and external/internal peer review and identifies those holding it as outstanding members of their profession.

“I am so honored to receive this designation,” Liller said. “It’s very meaningful to me as I’m totally invested in bettering public health for our society and especially in decreasing injuries and deaths among children and youth. This has been my goal for over 30 years now in academia.”

COPH Dean Donna Petersen nominated Liller for the title noting in her nomination materials that Liller is an internationally recognized leader and expert in injury prevention in children and adolescents.

“The field of injury prevention is not a large one, and Dr. Liller chose to develop expertise in a wide variety of unintentional injuries experienced by children rather than focus on one injury alone,” Petersen wrote. “This eclectic approach allowed her to develop the Injury Prevention Guide, published by the American Public Health Association (APHA), demonstrating her expertise in myriad areas. For nearly 30 years she has translated her research findings to practice-based teaching, research and outreach interventions and the development of injury prevention laws and policies. She has received numerous awards and acknowledgments in the field, including being named most recently a Fulbright Specialist for her expertise in public health and injury prevention.”

Liller noted that receiving the Distinguished USF Health Professor title is not only a wonderful recognition for her, but it also recognizes all of the individuals on her teams throughout the years and the college.

“Having this award, I believe, allows the college to be known for the work of professors and their teams who are dedicated to advancing public health and translating their research to practice so that lasting changes can occur,” she commented. “Again, this is a huge honor, and I am very grateful.”

ASPPH National Gun Prevention Task Force

Due to her interest in and research on gun violence, Liller has also been invited to be a member of the ASPPH’s recently convened National Gun Prevention Task Force. 

The group, which consists of academic experts, is tasked with three objectives:

• Recommend policies that the ASPPH and its members can consider to be priorities in gun violence prevention.
• Articulate best practices.
• Create a repository of knowledge for the public to access.

The task force is set to meet five times—beginning in July—until the end of the year, with the goal of making deliverables available by year’s end.

“This is a true honor. I hope that gun violence prevention strategies will be carefully developed along with efficacious resources that are accessible to the public,” Liller said.

Story by Donna Campisano for USF College of Public Health

The post Dr. Karen Liller recognized for academic achievement by USF, tapped for expertise by ASPPH appeared first on College of Public Health News.

According to the Centers for Disease Control and Prevention (CDC), every hour seven people in this country die a violent death. 

A violent death, as defined by the CDC’s National Violent Death Reporting System (NVDRS), is a death by homicide, suicide, legal intervention (excluding execution), a firearms unintentional death or a death with an undetermined intent and a link to violence.

To help stop violent deaths, researchers, law enforcement and policy makers need to determine the “why” behind these acts.

“Knowing the why allows for much more efficacious and tailored prevention programs,” noted Dr. Karen Liller, a USF College of Public Health professor and injury expert. “These are critical answers to know for injury prevention.”  

Details Matter

In 2018, Florida joined the NVDRS. According to its website, “The NVDRS is the only state-based surveillance reporting system that pools more than 600 unique data elements from multiple sources [law enforcement, coroners, toxicology reports and medical examiners, for example] into an anonymous database. 

When the state joined the NVDRS, it partnered with Liller and her team to extract and analyze data on violent deaths. 

Liller is the principal investigator for the state contract and is working with colleagues from the COPH, including Drs. Nicholas Thomas and Abraham Salinas Miranda, abstractors Jennifer Ramirez, Elizabeth Amoros, MPH student Alexis DiBlanda and doctoral students Kelli Agrawal and Rolando Trejos.

“We receive death certificates and medical examiner data from the state to match with the law enforcement data to paint fuller pictures of the deaths,” Liller said. “Through a secure portal, we submit these data to the CDC for the NVDRS, utilizing over 600 variables in a defined dataset. With this linked information, NVDRS is able to provide a more complete picture of the circumstances that contribute to violent deaths.”

Violent death in Florida

Liller and her team have found that the leading cause of violent death in the state is suicide, and that males have a higher injury rate than females. 

“Suicides have long been the most common type of violent death, even though many individuals think about homicides before suicides,” Liller said. “This could be because of the media and other attention given to homicides rather than suicides. And the reasons why males have higher injury rates, in general, than females could be due to gender roles, aggression, risk-taking behaviors, etc.”

Not just how, but why

Understanding the circumstances that surround these deaths is critical, said Liller. 

“For example, if we discover from our data that young Black males who have committed suicide in Florida have experienced life events such as a change in residence or a diagnosis of depression, then programs in schools and communities can begin to target those issues and address coping mechanisms. This can be a step toward a more tailored program and one that can be better evaluated for efficacy. The more we know, the more we become better agents of change so that violent deaths may decrease,” she said.

Story by Donna Campisano, USF College of Public Health

The post Violent death surveillance data: Why sharing details matters appeared first on College of Public Health News.

When USF College of Public Health (COPH) professor Dr. Karen Liller was approached by the American Journal of Lifestyle Medicine to write an article on injury prevention, she switched gears and decided what was really needed was an article on the importance of physicians advocating for injury prevention measures. 

In October, the journal published “The Important Role for Physicians as Advocates for Firearm and Road Traffic Injury Prevention.” Liller wrote the piece along with Dr. Amber Mehmood, a trained surgeon and COPH associate professor.

“Physicians are typically trained to treat sick patients and focus on their health problems,” Mehmood explained. “The notion that gun control and traffic safety are not health problems has some role to play in physicians’ willingness to partake in gun safety and road injury prevention. Fortunately, this attitude is changing, and physicians are more open to looking beyond the traditional spectrum of ‘diseases.’ Our goal is to seize this opportunity and give them necessary tools that help them speak about public health, injury prevention, gun safety and other issues connected with individual and public health.”

Part of the problem, Liller said, is the lack of advocacy training students embarking on medical careers get.

“I believe that pre-med, medical school and internship/residency training needs to include coursework on how to be an advocate and participate in policy change,” commented Liller, who also directs the COPH’s Activist Lab. “Physicians are among our most trusted health professionals and their involvement would do much to enhance advocacy efforts. Recently I and the Activist lab led an interprofessional experience with medical and other health students on how to advocate for various environmental issues. This type of training needs to increase and be expanded. Physicians need to be comfortable asking questions of patients about injuries and injury prevention.”

What are some steps physicians can take to address public health issues like firearms safety and traffic injuries? Liller and Mehmood suggest that physicians:

• Take time to advise patients about preventing injuries, including counseling them about firearm safety and risks associated with firearm usage during in-office exams.
• Advocate for legislation and policies that—among other things—can improve access to mental health services and reduce access to high-capacity magazines and firearms.
• Intervene with education and counseling when treating patients in trauma centers.
• Promote safe roads practice and research.
• Form interprofessional alliances that tell the stories of injury survivors and highlight the dangers involved.
• Promote multidisciplinary research into injury prevention.
• Use evidence to inform public policy.

“Advocacy seeks to change upstream factors like laws, regulations, policies and institutional practices. These factors are the drivers of market availability, prices, and product standards that influence personal health choices. Bringing physicians with commitment and skills into the helm of health advocacy would be a huge win for clinical medicine as well as public health,” Mehmood said.

Liller said “Working with colleges of public health on developing academic coursework and practice experiences for physicians will allow their comfort level to increase in being advocates for change.  Our work together then will have much stronger results.”

Story by Donna Campisano, USF College of Public Health

The post Public health advocacy: Physicians need to take a bigger role appeared first on College of Public Health News.

According to the National Instant Criminal Background Check System (NICS), which is run by the FBI, background checks on people looking to buy firearms in July numbered 3,639,224. That’s in contrast to the 2,030,661 checks performed in July 2019.

“Background checks are highly correlated with gun sales, but they’re not perfect,” said Dr. Karen Liller, a USF College of Public Health (COPH) professor and expert in injury prevention. “This is because there are gun sales that take place privately and through other means where no background checks are required (for example, on the internet), so the weapons aren’t counted. In addition, multiple firearms could be purchased with one check, so we would miss those guns as well. However, background checks provide us with a good estimate overall of guns sold. This proxy is used by many firearm researchers.”

While the NICS numbers are national, state statistics are just as sobering. 

According to Liller, in March of 2020, Florida saw a 92 percent increase in background checks compared to last year at the same time. This jump corresponds to COVID-19. Background checks continued to go up in April and May. In June, a month of heightened social unrest that followed the death of George Floyd and calls to defund the police, there was a nearly 174 percent increase in background checks, followed by a 127 percent increase in July. “Four of the top 10 months for background checks from 2004-2020 were in March, April, June and July of 2020,” commented Liller.

Americans are experiencing helplessness and uncertainty, and gun ownership is often seen as a way to feel safer and more in control. 

“In the case of COVID-19, people have great uncertainty about the virus and their lives on a day-to-day basis,” explained Liller. “There was concern that there would be shortages, the economy was falling off, law enforcement may be unavailable and home invasions might occur.  In the case of the rioting, people again wanted control and a way to potentially defend themselves. The number of gun sales (measured through background checks) also increases when political forces make changes, such as calling for more stringent gun laws or electing a candidate who is advocating for additional firearm laws. People fear guns will become less available, so they buy them to make up for any shortfall. Finally, gun sales go up after tragedies such as school shootings.”

But while gun ownership may give people a sense of security, it’s not without its perils. 

“Access to weapons is a very serious matter, and when guns increase, so do the risks,” said Liller. “Research has clearly shown that more guns in the home leads to increases in homicide, suicide and unintentional firearm injuries and deaths. A gun in the home is much more likely to be used by and/or against a family member or friend than an intruder.”

Gun safety is always an important issue, but as firearm sales climb, it should be front and center on everyone’s mind. 

“A firearm is a major responsibility, and to avoid tragedy it cannot be easily accessible and available, especially to young household members or those going through a difficult time,” emphasized Liller. “Guns should always be stored unloaded and locked away. And bullets should also be kept in a locked location, away from the gun. Most children know where guns are stored in the home, even if parents believe they do not. It’s important to remember that COVID-19 will pass and, hopefully, there will be a strong position AND actions taken against racism in our country. However, a gun in the home that leads to a tragedy is forever.”

Story by Donna Campisano, USF College of Public Health

The post As COVID fears and racial tensions rise, so do gun sales—but why? appeared first on College of Public Health News.

Emergency medical services (EMS) teams routinely triage patients based on the severity of their injuries. But sometimes, says a new study conducted by USF College of Public Health (COPH) researchers, that triaging can go too far. The study, “Association of mechanism of injury with overtriage of injured youth patients as trauma alerts,” was published in 2019 in the journal Trauma Surgery & Acute Care Open.

Drs. Jessica Ryan, Barbara Orban and  Etienne Pracht began the study a few years ago, when Ryan was still a PhD student at the COPH. The group focused on the issue of “overtriaging” based on mechanism of injury, which refers to how a person was injured.

“I was always interested in youth patients,” said Ryan, who is now an assistant professor at the University of West Florida. “But I got more and more focused on trauma centers and EMS after working on similar research projects with Drs. Orban and Pracht.”

Overall, the study found that motor-vehicle traffic and firearm injuries were associated with overtriage. When these unfortunate accidents happen, they are also likely to cost more because overtriaging causes more personnel to be activated at the hospital and more resources to be used.

“Overtriage is a tough thing to improve, as trauma scenes are chaotic and EMS are trained to be cautious, especially with youth,” said Ryan. “It’s easy for me to say a patient was overtriaged in hindsight, when I’m looking at patient records, but in the moment, it can be more difficult.”

Despite the difficulty of trying to address these problems, Ryan does think that the team’s findings could lead to improved EMS responses, which may ultimately save money and decrease the burden on patients who are already dealing with plenty of stress from their experience. 

“I’m currently working on a research project to train EMS in situational awareness, which I define as the identification of relevant information, comprehension of it, and then projection of outcomes, to see if we can improve triage that way,” said Ryan. “Additionally, a goal of mine is to continue building research on the differences in costs and charges between not-for-profit and for-profit hospitals and trauma centers. Lowering trauma response charges would be a great way to start lowering the overall costs for trauma patients.”

Story by Cody Brown, USF College of Public Health

The post COPH research study associates firearm and motor vehicle injuries with higher medical costs appeared first on College of Public Health News.

Elementary school-aged children who participate in recreational sports are at greater risk of concussion than most other sports-related injuries. A new study published in PLOS ONE focused on children 5-11 years old who play recreational football, soccer and baseball/softball.

Karen Liller, PhD, professor of community and family health at the University of South Florida College of Public Health followed more than 1,500 athletes each year for two years in Hillsborough County, Florida. She and her colleagues collected baseline neurocognitive data using ImPACT Pediatric, the only FDA-approved concussion assessment tool for ages 5-11. The digital program asks athletes a number of questions pertaining to word memory, sequencing/attention, visual memory and reaction time. It was administered prior to practice and games to help prevent fatigue from impacting test performance.

Certified Athletic Trainers (ATCs) were hired to collect injury data using High School Reporting Information Online (RIO), an internet-based injury surveillance system. During the two-year study, 26 athletes were injured, 12 were diagnosed with a concussion. Of those concussions, ten occurred during boys’ and girls’ soccer, the remainder happened during recreational softball games.

“To date, research on sports injuries has largely been focused on high school and collegiate athletes. For child athletes, many sports/recreational activities are not organized for reporting injuries, so almost no data for this group have been collected,” said Liller. “No effective prevention strategies can be properly developed without the knowledge of the mechanisms related to these injuries including concussions.”

In addition to noting specific injuries, the RIO records how frequent each athlete participates in their sport, where they were located and what they were doing when they got hurt, and exactly how it happened. Researchers found the leading mechanisms of injury were caused by colliding with another athlete, contact with a playing apparatus and contact with playing surfaces. While none of the injuries required surgery, they did result in lost playing time.

The ATCs conducted several follow-up assessments for ImPACT Pediatric on the athletes diagnosed with concussions and found similar findings to baseline levels when they were returning to play. Liller highly recommends recreational programs utilize ATCs on all sidelines to better monitor concussions and injuries and provide proper pediatric treatment.

Reposted with permission from USF News.

The post Concussion is a leading cause of injury for children in recreational sports appeared first on College of Public Health News.

On June 11, the USF College of Public Health’s (COPH) Activist Lab, in partnership with USF Health, hosted a gun violence prevention and advocacy presentation.

Speakers at the event were David Hogg and Emma González, two students who survived the February 2018 mass shooting at Marjory Stoneman Douglas (MSD) High School in Parkland, Fla. A gunman (and former student), using a semi-automatic rifle, shot and killed 17 students and staff at the school and injured 17 others.

Both Hogg and González—who’s best known for her battle cry “We call BS”—are advocates for gun violence prevention. They helped form MSD Never Again, a gun control advocacy group founded by MSD students. They also helped organize March for Our Lives, the largest single-day protest against gun violence in U.S. history. Last summer, they toured the country speaking about gun violence prevention.

“Before the shooting, I was interested in broadcast journalism,” said Hogg, who will enter Harvard University in the fall to study public health policy, American history and government. “I was interested in telling people’s stories. Now I tell the stories of people who aren’t here, like Joaquin Oliver, who died at my school. He fled Venezuela with his family to escape violence, only to be killed in his own classroom in what was thought to be the safest school in Florida.”

Their USF talk, attended by roughly 150 students, faculty, staff and the public, focused on reframing gun violence from a political issue into a public health one.

“Guns and cigarettes have much in common—they both kill a lot of people,” commented Hogg. “But one is on the decline. We didn’t do that by banning cigarettes, we did it by limiting the amount of nicotine in them to make them less addictive. Same with guns. We are not asking for a ban on guns, just to reduce the demand for them.”

González, a student of social justice and social activism at New College of Florida in Sarasota, agreed.

“We’re not fighting for guns to be taken away. We’re fighting for banning assault weapons and high-capacity magazines, for better background checks, for more funding for gun violence prevention. When we actually sit down and talk with some of the protestors at our events, we agree on a lot.”

Hogg noted that just as diseases cluster, so does gun violence. He showed the audience a slide with clusters of dots.  Red dots were shooting deaths; yellow dots were shooting injuries.

“Those aren’t dots, they’re people. They’re friends. They’re kids. They’re young people who wanted to go to college, to go anywhere and have a future,” said Hogg, who was wearing a “Save Your Friends” t-shirt. “But that was all taken away because of gun violence. Even though this is a public health issue, it has become a political one because people make money off it. The NRA has as much to do with gun violence in America as the tobacco companies have to do with lung cancer.”

Both Hogg and González argue that gun violence can only be ended with research and  interventions—things like bringing after-school programs to poorer communities, increasing access to grocery stores and making mental health care more affordable and accessible.

They urged the audience:

• To vote. “This is not a Republican or Democrat issue,” said Hogg. “It’s about electing morally just leaders. You need to vote for your survival.”
• Organize and attend town hall meetings on gun violence.
• Get involved in groups, protests and marches.
• Encourage the medical community to hand out gun locks to their patients, much like bike helmets are distributed.
• Get into gun violence prevention research.  “I’m not just here to speak, I’m here to recruit,” said Hogg, who noted there are only eight researchers currently studying gun violence prevention in the country. “In the next few years, funding won’t be the problem. It will be the lack of people qualified and motivated to do the job.”

Other takeaways:

• “Our efforts have been incredibly successful. Now candidates are running on gun violence prevention, not the Second Amendment. The Second Amendment and not having kids go through school shootings are not mutually exclusive.”—David Hogg
• Speaking on the issue of arming teachers in classrooms: “It’s like fighting fire with fire. More guns makes the fire bigger. It’s not safe.”—Emma González
• Commenting on the need for more accessible and affordable mental health care, especially after mass shootings: “Most schools in America have a plan for what to do if there’s an active shooter. We talk about how we’re going to make this door bulletproof. But we don’t talk about what happens after the event, mental health wise. We don’t talk about the trauma it will cause and how to prevent the suicides that will follow.”—David Hogg
• “We can think, ‘How would our lives be different if this thing [the Parkland shootings] didn’t happen?’ But there are other things that have happened that are also really traumatizing and impactful. You have to roll with the punches you’re served.”—Emma González

In closing Hogg told the audience, “As a human being and an American, I choose to love rather than hate. I choose to fight for something, rather than solely against it. We may not be the generation to end gun violence, but we can be the first generation to take a step toward the finish line.”

Story by Donna Campisano, USF College of Public Health

The post Is gun violence a political or public health issue? Parkland school shooting survivors speak out appeared first on College of Public Health News.

Dr. Karen Liller, a USF College of Public Health professor of community and family health, has been appointed to serve on the Board of Scientific Counselors for the National Center for Injury Prevention and Control, part of the Centers for Disease Control and Prevention (CDC).

“I have been working in injury prevention for over 25 years,” Liller commented, “and this is a great honor.”

Karen Liller, PhD, a specialist in injury prevention who also directs the COPH’s Activist Lab, was recently appointed to the Board of Scientific Counselors for the CDC’s National Center of Injury Prevention and Control. (Photo by Caitlin Keough)

Liller, whose term has already started and runs until August 2022, is serving at the invitation of the Secretary of Health and Human Services (HHS) Alex Azar, II.

The board is comprised of 18 voting and 17 nonvoting members and is made up of government officials, behavioral scientists, epidemiologists, statisticians, criminologists and legal and medical professionals as well as others who specialize in injury management. Liller and her colleagues will meet several times a year at the CDC in Atlanta.

According to its charter, the purpose of the board is to “conduct, encourage and cooperate with” research pertaining to the prevention and control of injuries and violence due to things like homicides, motor vehicle crashes, falls, prescription drug overdoses and other incidents.

(Photo source Google Images)

Members are to advise the HHS secretary, the director of the CDC and the director of the National Center for Injury Prevention and Control on things such as surveillance, epidemiologic and intervention research and evidence-based strategies for injury and violence prevention.

“This is an important role because it enables us [the board] to advocate for different topics and hopefully affect policy change,” Liller said. “Between the advisory capacity of the board and its ability to recommend  approval for programs and research—both within the government and outside it—we can really make an impact on public health.   As I said earlier, this is a real honor and I am  thrilled to be a part of the board for the next several years.”

Story by Donna Campisano, USF College of Public Health

The post Dr. Karen Liller appointed to CDC injury prevention board appeared first on College of Public Health News.