29 Mar 2018

Alfred trauma program hits home with teenagers; study

Prevent Alcohol and Risk-related Trauma in Youth (P.A.R.T.Y.)
program is a trauma prevention and health promotion initiative
by Anne Crawford

Research evaluating an injury awareness program run at The Alfred Hospital that uses vivid clinical reality has demonstrated the program’s effectiveness in changing perceptions of risk-taking in adolescents.

The Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) Program has been run at the National Trauma Research Institute (NTRI) since 2009, aiming to change safety perceptions including those surrounding driving after alcohol, seat-belt use and other risk-taking activities.

The study is an Australia-first for the school-based program, which runs in every state and territory except the Northern Territory.

Injury is the leading cause of death among young Australians, accounting for two-thirds of fatalities in those under 24 years. In 2015, 22% of road deaths were young people aged
18–25 years, despite the cohort accounting for only 13% of licensed drivers.

But death is only part of the picture – P.A.R.T.Y. provides real-life examples of young people who survive horrific incidents but have their lives changed irrevocably because of them.

The one-day program walks the students through The Alfred sequentially from the time a patient is admitted to the emergency department, through intensive care, the trauma ward, burns ward, to rehabilitation and life afterwards. As they move through the hospital, the teenagers hear the stories from trauma patients, families, paramedics, doctors, nurses and allied health professionals.

 “We’re here to show the real impact of trauma and of making a bad decision,” said Program Coordinator and first author Anna Gunn. “We educate through story.”

Examples are tailored to the age bracket; coward punches, sporting/recreational injuries, brawls, road trauma, incidents that occur because of alcohol or distraction by media such as mobile phones or from wearing headphones – a new concern in this generation.

Ms Gunn, a teacher and paramedic, tells of her own experience of arriving at an accident scene where a student in headphones had been hit by a tram, scalped and semi-conscious, the textbooks that spoke of his ambitions in life scattered on the road around him.

Just over 2500 adolescents aged 16 to 18 years participated in the study run by researchers at the NTRI and Emergency and Trauma Centre, and led by senior author Professor Biswadev Mitra, Head of Clinical Research at the NTRI. All were senior school students – from 104 schools or educational organisations – who attended the program from 2011 to 2016.

Recent feedback has mentioned the program, developed in Canada 30 years ago, as “very powerful”, “a real eye opener and wake-up call” and saying it, “Made us rethink our actions”.

The students were surveyed before the program, immediately after it and three to five months post-program on. The results;
  • Pre-program, 1130 (86%) participants reported that they were “definitely not” likely to drive after drinking alcohol, a figure that improved to 94% immediately post-program then slipped to 93%  3–5 months post-program.
  • Designating a safe driver after drinking was reported by 97% pre-program, 98% immediately post-program and 98.2% 3–5 months post-program.
  • The perception of sustaining ‘definite’ injury after a motor vehicle crash without a seat belt increased from 60% to 80% immediately post-program and 69% 3–5 months post-program.
  • The possibility of sustaining ‘definite’ injury after risk-taking activities was reported by 12% pre-program, 36% post-program and 23% 3–5 months post-program.
“They actually saw the real consequence of risk and through that their perception of the likelihood of being injured improved significantly,” Ms Gunn said. “It’s great to have their perceptions change and to give participants the tools to save lives and improve outcomes.”

The next step was to address the decay in figures after three months, possibly in a follow-up community-based program enlisting the participants’ teachers, Ms Gunn said.

The program, funded by AAMI and Victorian Department of Health and Human Services, is also delivered to young adults from the Victorian court system, Navy trainees and as an outreach program replicating the hospital setting in regional performing arts centres. Data from a study into perception changes among adolescents attending the latter is currently being analysed.

Gunn J, McLeod J, Chapman R, Ball H, Fitzgerald M, Howard T, Cameron P, Mitra B. Effect of the Prevent Alcohol and Risk-Related Trauma in Youth (P.A.R.T.Y.) Program among senior school students. Emerg Med Australas. 2018 Jan 21. doi: 10.1111/1742-6723.12878. [Epub ahead of print]

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