Carol W Runyan

• Managing Director at Colorado School of Public Health

Purpose To examine the association of increasing access to affordable housing through the Low-income Housing Tax Credit Program with non-fatal intimate partner violence (IPV) among women. Methods We used 2005–2014 data from the State Emergency Department Database (SEDD) and the low-income housing tax credit (LIHTC) program, a federal program provi...

The goal of this project was to determine whether screening youth and parents for firearm presence and imbedding those results in the electronic medical record (EMR) increased health care provider (HCP) documentation of firearms and subsequent delivery of a safe storage message. The study took place in a large adolescent medicine practice. Fifty-si...

Background: While some suicide prevention initiatives distribute locking devices for firearms and medication, little evidence exists to guide the selection of devices. Aims: This study aimed to describe safety standards for locking devices and compare parental acceptance rates for different types of devices. Method: As part of the larger SAFETY Stu...

Statement of Purpose To examine the association of the availability of housing units through the low-income housing tax credit (LIHTC) program with rates of child maltreatment reports and intimate partner violence (IPV) related homicides at the state level. Methods/Approach We conducted secondary data analyses of the National Child Abuse and Negle...

Introduction Poverty broadly and financial stress owing to housing insecurity specifically are associated with an increased risk of child maltreatment. Therefore, it is possible that a program designed to increase access to affordable housing such as the Low-Income Housing Tax Credit program could reduce child maltreatment. The purpose of this stud...

The most severe outcome of intimate partner violence (IPV) is IPV-related homicide. Access to affordable housing may both facilitate exit from abusive relationships and reduce financial-related stress in intimate relationships, potentially preventing IPV-related homicide. We examined the association of the availability of rental housing through the...

Purpose The purpose of this study was to examine whether the choice of means by persons who die by suicide is associated with a prior psychiatric diagnosis. Methods In this cross-sectional study, we analyzed suicide surveillance data from 18 states reporting to the National Violent Death Reporting System (NVDRS) between 2003 and 2014. NVDRS compil...

Objective: To evaluate prescribers' reactions and self-reported intentions to change prescribing behavior in response to opioid-prescribing report cards. Design: We surveyed a sample of licensed prescribers in the state of Colorado registered with the state's prescription drug monitoring program (PDMP). Setting: In 2018, Colorado disseminated...

Background More than half of adolescents have jobs in summer or sometime during the year. While employers are ultimately responsible for their safety, parents are often important in helping their children navigate the work environment. Our study examines the attitudes, beliefs and types of involvement parents have in their children’s work. Methods...

Counseling parents to reduce access to firearms and other potentially lethal suicide methods is commonly known as lethal means counseling (LMC). The current study explores the experiences that emergency department-based behavioural health clinicians described having as they provided lethal means counseling to parents of adolescents at risk for suic...

Study objective We evaluate whether a counseling intervention implemented at the hospital level resulted in safer firearm and medication storage by caregivers of youths aged 10 to 17 years after their child’s evaluation in the emergency department (ED) for a behavioral health concern. Methods We used a stepped-wedge clustered design rolled out at...

Introduction To address youth suicide, we recruited seven emergency departments (EDs) for what we believe is the first controlled trial of an intervention to promote safer firearm and medication storage after a child was seen in an ED by a behavioural health clinician. We provided training and a common protocol that required behavioural health clin...

In this chapter, we draw on the epidemiology of child abuse to make the case for the importance of taking a public health approach to the problem. From there, we describe the elements of a public health approach and apply them to the prevention of child abuse and neglect, distinguishing the public health perspectives from those of other disciplines...

This case study examines the development of the Colorado Essentials for Childhood project, a collective impact effort to prevent child maltreatment, over a five-year period (September 2013–August 2018). We conducted semi-structured key informant interviews with 26 project stakeholders to understand how the project’s priorities evolved, along with t...

Objectives: We examined factors grounded in the theory of planned behavior that influence gun retailers' willingness to provide temporary, voluntary firearm storage for suicide prevention. Methods: We conducted a cross-sectional survey of gun retailers in the US mountain west. Analyses included descriptive statistics and ordered logistic regression...

Objectives: To examine the perceived benefits of and barriers to law enforcement agencies providing increased access to voluntary and temporary firearm storage. Methods: We surveyed 448 police chiefs and sheriffs in 8 US Mountain West states about firearm storage practices, benefits of and barriers to storage, and related attitudes and beliefs....

Suicide is a critical public health problem, resulting in more than 40,000 deaths a year in the United States (U.S.) and 800,000 globally. Provision of mental health services is a key component of a comprehensive population-based approach to prevention. State licensing boards in some U.S. states require mental health practitioners to be trained in...

Counseling about reducing access to lethal means of suicide, especially firearms, is a recommended practice in emergency departments (EDs) but does not occur routinely. Understanding influencers of decisions makers in health care (ED nurse leaders, mental health providers) and temporary firearm storage (law enforcement and gun retailers) could enha...

Introduction: For ED patients at risk of suicide, counseling to reduce access to lethal means (including firearms) is recommended yet not routine. To enhance practice uptake, we sought to examine the attitudes and beliefs of emergency nurse leaders concerning the acceptability and effectiveness of lethal-means counseling. Methods: We invited a n...

Introduction Safe storage of guns outside the household while someone is at risk for suicide is important for suicide prevention. Some gun retailers offer temporary firearm storage as a community resource. Others may be willing if perceived barriers can be addressed. Methods We invited all gun retailers in eight Mountain West states to respond to...

Introduction: Lethal means counseling of suicidal individuals in emergency departments has the potential to reduce suicide. This study examines the provision of lethal means counseling and the presence of written protocols in a region with high rates of both firearm ownership and suicide. Methods: In 2015-2016, emergency department nurse manager...

Objectives: To examine the extent to which law enforcement agencies (LEAs) and gun retailers are willing to offer voluntary, temporary storage as a part of an overall suicide prevention effort. Methods: We invited all LEAs and gun retailers in 8 US states to respond to questionnaires asking about their willingness to offer temporary gun storage...

Purpose Safe storage of guns is critical to suicide prevention. This study examines the extent to which law enforcement agencies (LEAs) and gun retailers (GRs) are willing to offer safe gun storage in a variety of circumstances, including mental health crises. Methods We invited, with two follow-up reminders, all LEAs and GRs with storefronts in t...

The presence of firearms in the home increases the risk of suicide for residents. As a result, clinicians and professional organizations recommend counseling about temporary removal of firearms from the home of potentially suicidal individuals. In some states, however, firearm laws may affect the ability to easily transfer a gun temporarily to redu...

Introduction: A youth’s emergency department (ED) visit for suicidal behaviors or ideation provides an opportunity to counsel families about securing medications and firearms (i.e., lethal means counseling). Methods: In this quality improvement project drawing on the Counseling on Access to Lethal Means (CALM) model, we trained 16 psychiatric emer...

Purpose This study will present the prevalence of self-reported marijuana and alcohol impaired driving, compare perceived risks of driving under the influence of alcohol versus marijuana, and examine risk factors associated with impaired driving. Methods Data are from a telephone survey conducted by the Colorado Department of Transportation in 2014...

There is an underappreciation among the general public and among health professionals that firearms are implicated in just over half of all suicide deaths. Suicide attempts with firearms are much more lethal than attempts using other methods, with more than 85% of individuals using a firearm dying compared to 2% for individuals using poisoning, 31%...

To understand the potential public health and social justice implications of criminal background screening on college admissions, we examined postsecondary institutions’ reasons for collecting or not collecting applicants’ criminal justice information. We invited heads of admissions from 300 randomly sampled postsecondary institutions to complete a...

Few methods have been defined for evaluating the individual and collective impacts of academic research centers. In this project, with input from injury center directors, we systematically defined indicators to assess the progress and contributions of individual Injury Control Research Centers (ICRCs) and, ultimately, to monitor progress of the ove...

This article describes health promotion programming in senior centers around the leading causes of death in adults age 65 and older. A national sample of 500 senior centers participated in a telephone interview from June to November 2006. Descriptive statistics were used to summarize programs offered, and chi-square statistics were used to compare...

Invited Commentary on "Child Maltreatment Prevention - Finding Common Ground with Unintentional Injury Prevention."

Objectives: Many colleges assess criminal histories during the admissions process, in part, to address violence on campus. This study sought to examine the utility of screening as a means of reducing violence. Methods: Using cohort and case-control analyses, we identified college misconduct through college records and self-reports on a confident...

The PREVENT (Preventing Violence through Education, Networking, and Technical Assistance) project trained violence practitioners across the USA in Primary Prevention of Violence techniques (PPV). The purpose of this study is to describe the development and psychometric properties of the subscales of the PREVENT PPV Self Assessment. Of 800 participa...

Objective: To determine whether recommended robbery prevention strategies also protect against workplace homicide committed by a perpetrator who has a relationship with either the workplace or an employee (prior-relationship homicide). Methods: A case-control study examining the relationship between recommended violence prevention strategies and...

The severity of non-fatal work-related injuries has seldom been examined among young workers. We estimated the extent and distribution of workdays lost due to non-fatal work injuries using compensation data. Data are from the Brazilian Institute of Social Insurance, for 2006. The study population is comprised of all insured workers of age 16-24. De...

Death certificates and medical examiner records have been useful yet imperfect data sources for work-related fatality research and surveillance among adult workers. It is unclear whether this holds for work-related fatalities among adolescent workers who suffer unique detection challenges in part because they are not often thought of as workers. Th...

Scholars and practitioners from multiple perspectives, including developmental science, sociology, business, medicine, and public health, have considered the implications of employment for young people. We summarize a series of meetings designed to synthesize information from these perspectives and derive recommendations to guide research, practice...

This study examined the prevalence of senior centres providing multi-component falls prevention education and the perceived barriers in implementing this education. A telephone interview was conducted in 2006 with 500 senior centres nationwide. Centre directors were asked about the types of multi-component falls prevention education offered (ie, ba...

Individuals with disabilities have an elevated risk of residential injury. However, the prevalence of home hazards and safety practices among households where an individual with a disability resides is unknown. This study examined patterns of home hazards and safety practices among 1003 households across the United States in 2002. Households with a...

Little is known about how social aspects of the work environment influence exposures or safety practices affecting young construction workers. Our objective was to investigate whether working on a construction site with a small number of workers (≤10 vs. 11-50) or having a family-firm connection (working in a family-owned firm or one in which a fam...

This study investigated adolescent worker fatalities involving violations of the child labor laws and/or Occupational Safety and Health Administration (OSHA) standards, as well as the enforcement activity involved in each case. Medical examiner records were used to identify work-related deaths among adolescents ages 11-17 between 1990 and 2008 and...

To obtain national estimates of the annual cumulative incidence and incidence density of severe non-fatal injuries using compensation benefits data from the Brazilian National Social Security Institute (INSS), and to describe their sociodemographic distribution among workers aged under 25 years. Data are records of health-related compensation benef...

Background/Purpose. Monitoring and evaluation of research centers is complex, but may be helpful for both internal quality improvement and programmatic monitoring and decision-making by funding agencies. This project was designed to develop indicators that can be used for both purposes. Methods. We relied on several qualitative methods, including l...

Background and Objectives: Work has multiple effects on youth, both positive and negative. On average, 17.6 million workers under age 25 are employed in the US, with an injury morbidity rate (5.0 per 100 FTE) twice as high as for workers over age 25. Scholarship addressing youth employment spans multiple disciplines yet with limited integration. Th...

Child maltreatment is a key risk factor for violent behavior in youth. Although neglect is the most prevalent form of childhood maltreatment, its contribution to development of violence is unclear, as is the potential mediating role of social bonds. This study assesses the relationship between childhood neglect before age 8 and the development of e...

Objectives: The objectives of this study are to measure occupational health literacy(OHL) among adolescents and determine whether OHL is associated with adolescents' risk of work-related injury. Methods: Survey data were collected in five schools across the US from 2,277 14- to 18-year-olds with work experience. Self-reported injury experience and...

Objectives To obtain national estimates of annual cumulative incidence of severe non-fatal injuries using compensation benefits data from the Brazilian National Social Security Institute (INSS), and to describe their socio-demographic distribution among workers under age 25. Methods Data are records of health-related compensation benefits from the...

Adolescents work in varied environments and are exposed to hazards. Parents of these working adolescents have an opportunity to help them select jobs and address worker safety issues with employers. The present study conducted telephonic interviews among a national sample of 922 working adolescents along with one parent of each to examine the invol...

Local and national surveillance systems are in place that identify occupational deaths. However, due to certain restrictions, they are limited in their ability to accurately count these deaths among adolescent workers. In this population-based study, we relied on primary data from the North Carolina medical examiner system to identify and describe...

Though the restaurant industry may not be thought of as a high-risk environment in terms of serious or fatal injury, falls are a significant problem, accounting for a substantial share of injuries annually in this industry. As Verma et al 1 point out, costs are higher for older than younger workers, even though younger workers comprise a larger sha...

Purpose: Hundreds of thousands of US adolescents are employed in violation of the child labor laws annually putting them at risk of injury and death. We examined work-related fatalities in North Carolina among 11- to 17-year-olds during 1991-2008 to determine whether violations of the child labor laws (CLL) and OSHA standards were implicated. We al...

For most types of injury and violence, mortality and morbidity rates in North Carolina are worse than those of the nation. The costs in lives and dollars are enormous. The state has not provided the necessary resources for tackling the problem, devoting barely $6 per death to preventive efforts and failing to ensure that the public health workforce...

No one who reads this journal should need to ask ‘who is Susan Baker?’ given her more than four decades of leadership in injury control. She has been honoured by many academic and scientific organisations in public health and medicine recognising her numerous contributions to the field of public health, including a Bad Guy of the Month award from R...

This study investigated awareness and knowledge of U.S. child labor laws among a nationally representative sample of 677 working adolescents and their parents. Findings demonstrate broad awareness of the child labor laws among adolescents, but little knowledge of the laws' specific provisions among either youth or their parents.

Background The role of the social context is becoming more widely examined in workplace safety studies. We explored two aspects of the social environment of teens employed in construction. The presence of a family-firm connection (a youth works with or for a family member) and work group size (the total number of workers on a job site), believed to...

We examine the workplace experiences of Ontario youth in the service sector, with a particular interest in hazard exposures, safety training and supervision. A cross-sectional telephone survey in 2008 of working youth aged 14-18. Items queried respondents about the tasks performed, worker training and supervision. The study parallels one already pu...

Background Although the hazardous tasks adolescent workers perform in service and retail industries are well documented, little is known about the extent to which young workers recognize these tasks as hazardous or dangerous.Methods Using data from a nationally representative cross-sectional telephone survey conducted in 2003, we examined hazardous...

To develop and evaluate the characteristics of an instrument for assessing core competencies for injury and violence prevention. We developed a preliminary tool and pilot tested it with a small sample. After refining the tool, we recruited 401 participants to respond to the questions and provide information about demographic characteristics, injury...

Violence on college campuses has attracted considerable media attention in recent years as a result of several high-profile shootings, including those at Virginia Tech and Northern Illinois Universities. These shootings, however, are only the most visible form of student violence. Although college students are less likely to be victims of violent c...

The objective of this study was to examine the reported practices of construction firms and the beliefs of firm managers/supervisors with respect to employing youth under age 18 and ensuring their safety. The participants in this study were firm representatives from 54, mostly small to medium sized, construction firms in North Carolina. Survey resp...

The specialty of emergency medical services (EMS) has been challenged to take up community prevention activities as a part of its service mission. Though outcome evaluations of these activities have been published, there are no reports of programs' process evaluations. Orange County EMS initiated, in 1998, the "Welcome to the World" (WTTW) program,...

Most research regarding the perpetration of occupational homicide has focused on robbery-related violence; relatively little is known about the circumstances surrounding non-robbery-related occupational homicides and interventions that may prevent these events. A case series was assembled and utilized to examine occupational homicides that were and...

This study was designed to examine the attitudes and beliefs of the parents of working adolescents related to the safety of the employment of their children. A cross-sectional telephone survey was conducted in 2003 among English-speaking parents of working adolescents aged 14-18 years in the continental United States. Questions addressed parental c...

In 2000, the State and Territorial Injury Prevention Directors’ Association (STIPDA) and the National Association of Injury Control Research Centers (NAICRC), later reorganized to form SAVIR, formed the Joint Committee on Infrastructure Development with the goal of developing the infrastructure for the field. The group unanimously agreed that there...

Efforts to reduce the burden of injury and violence require a workforce that is knowledgeable and skilled in prevention. However, there has been no systematic process to ensure that professionals possess the necessary competencies. To address this deficiency, we developed a set of core competencies for public health practitioners in injury and viol...

Practitioners in domestic violence and sexual assault programs have been encouraged by the National Center for Injury Prevention and Control to enhance their activities in violence prevention; however, many practitioners have not been trained in prevention concepts and strategies. Therefore, a needs assessment was undertaken with practitioners in t...

Many unintentional injuries occur in the home, but little research has considered the specific vulnerability of people with disabilities. Cross-sectional study examining nationally representative data from the 2004-2006 National Health Interview Surveys. Adults aged 18 and older who reported having an unintentional, non-motor vehicle-related injury...

Prior research indicates that working adolescents seek care for the toxic effects of on-the-job chemical and environmental hazard exposures. This cross-sectional survey of a nationally representative sample of 866 adolescent workers in the retail and service sector examines their exposures, personal protective equipment (PPE) use, and training. Two...

Arguing in this journal that injury and violence are important public health problems is surely preaching to the choir. What is perhaps less obvious is the issue of how well prepared public health systems are to lead prevention efforts. This paper addresses that issue and recommends policy directions to strengthen infrastructure. In the USA, state...

We investigated child labor violations among US adolescents working in the retail and service industries. We used interview data from a nationally representative sample of working adolescents, and investigated reports of select child labor violations (e.g., hours, equipment, and work permits). We computed weighted percentages of respondents reporti...

This paper presents practical frameworks for developing and comparing approaches to improve adolescent motor-vehicle safety by merging concepts from the fields of developmental psychology and injury prevention and combining these with elements of a policy-analysis approach. Together, these models offer conceptual foundations for identifying interve...

Although safe firearm storage is a promising injury prevention strategy, many parents do not keep their firearms unloaded and locked up. Using the theory of planned behavior as a guiding conceptual framework, this study examines factors associated with safe storage among married women with children and who have firearms in their homes. Data come fr...

Background: US child labor laws are intended to protect the health of young workers by restricting the time youth can devote to work and the types of occupations/tasks they are allowed to perform. The extent of violations of these laws is unknown. With adolescent occupational injuries numbering in the hundreds of thousands annually it is questionab...

To examine the extent to which US women's self-protection strategies are associated with either their personal or vicarious victimization experiences. A cross-sectional random digit dial telephone survey. Continental United States. Non-institutionalized, English-speaking women, age 18 and older. Women's self-protection strategies. 1800 US women wer...

Abstract Injuries are the leading cause of death for children under age 19. Prevention efforts focus on eliminating hazards or changing individuals' behavior. Few interventions address psychosocial factors that contribute to injuries. Home visiting programs target families' functioning and help parents overcome barriers that inhibit their readiness...

Our goal was to examine the hazard exposures, work experiences, and workplace safety training of adolescents employed in retail and service jobs in the United States. This was a cross-sectional telephone survey among working adolescents, 14 to 18 years old, in the continental United States. Data were collected in 2003. Survey items measured self-re...

Violence against women (VAW) is widespread and linked to negative public health and social outcomes. Research on VAW, however, has largely been limited to convenience samples and on variable definitions of violence, hindering our ability to fully characterize this important problem nationally and among subgroups of women. Using a population-based n...

Injury control practice would be easy if only there were packaged programs that were sure to work in any setting and that all one had to do was open them up, implement them and—Voilá—watch the rates of injury decline. It would be like having a simple cake mix that works anywhere with only the addition of water. But this is not the case. Few highly...

To describe the working conditions of adolescents employed in construction in North Carolina, documenting hazards, safety practices, and prohibited activities. A cross-sectional telephone survey. North Carolina. Adolescents (aged <18 years) with work permits for the construction industry in North Carolina during summer 2001. Types of jobs, work tas...

Training practitioners to use evidence-based approaches to the primary prevention of violence is challenging as a result of the dearth of well-evaluated intervention programs and the lack of familiarity of some practitioners in drawing critically on existing literature. An element of the National Training Initiative in Injury and Violence Preventio...

Parenting books are a commonly used source of information on how to keep children and adolescents safe from injuries, the leading cause of death and disability for children aged 1 to 18 years. The content and the quality of the messages contained in these books have not been evaluated formally. The objective of this study was to determine the quant...

We sought to describe the use of discretionary protective equipment among high school athletes and to examine social and behavioral determinants contributing to equipment usage. We analyzed data from a 3-year (1996-1999), stratified, 2-stage cluster sample of athletes engaged in 12 organized sports in 100 North Carolina high schools (n=19728 athlet...

Use of protective equipment is an important sports injury prevention strategy, yet use of protective equipment by high school athletes has seldom been studied. The authors analyzed data from a 3-year (1996-1999), stratified, two-stage cluster sample of athletes from 12 organized sports in 100 North Carolina high schools (n = 19,728 athlete-seasons)...

To examine the working conditions of teenagers in five sites, examining the presence of factors associated with workplace violence and considering workers' concerns about safety and training to deal with violent circumstances. Teenage workers, aged 14-17 years, with employment experience in retail industries in five sites (North Carolina; Brockton,...