Core Competencies for Injury and Violence Prevention

Prevention and Preparedness

Thomas Songer, PhD, MPH, Shelli Stephens-Stidham, MPA, Corinne Peek-Asa, PhD, Ingrid Bou-Saada, MA, MPH, Wanda Hunter, MPH, Kristen Lindemer, MPH, and Carol Runyan, PhD for the National Training Initiative for Injury and Violence Prevention

Efforts to reduce the burden and suicides are consistently Several projects that pertain to an initiative to address this short- of injury and violence require a among the leading causes of death workforce training recently have coming. The primary objective of workforce that is knowledge- in the United States, particularly begun. The Advisory Committee this collaboration has been to able and skilled in prevention. for those aged 1 to 44 years.1,2 on Injury Prevention and Control identify, develop, and promote a However, there has been no Unintentional injuries and violence Working Group on Injury Control common understanding of the es- systematic process to ensure account for the largest proportion and Infrastructure Enhancement, sential skills and knowledge nec- that professionals possess the (18.5%) of years of potential life lost for example, has identified a set of essary for individuals to excel as necessary competencies. 1 To address this deficiency, before age 65 years. Nonfatal recommendations for strengthen- violence- and injury-prevention 8 we developed a set of core traumatic injuries and violence, in- ing the field. Several core compe- professionals in public health competencies for public health cluding youth and family violence, tency sets have also been devel- practice. We report on the com- practitioners in injury and vio- also have serious short- and long- oped to promote training and petency set identified to meet this lence prevention programs. term physical, psychological, and development in specific fields of objective. The core competencies ad- emotional consequences at the in- injury and violence prevention, in- dress domains including pub- dividual, family, and community cluding highway safety,9 youth vi- DEVELOPING THE CORE lic health significance, data, levels.3 For the year 2000, the olence in emergency department COMPETENCIES the design and implementa- 10 economic impact of injuries in the settings, construction work zone tion of prevention activities, United States was estimated at safety,11 and safety of health care Identifying fundamental com- evaluation, program manage- $406 billion.4 professionals from patient vio- petencies to guide future infra- ment, communication, stimu- 12 lating change, and continuing Current efforts to reduce the lence. Nine hundred individuals structure development is not education. Specific learning burden of injury and violence are have also received core instruction unique to the injury and violence objectives establish goals for often viewed as inadequate. Col- in violence prevention as part of the field. Core competencies were training in each domain. lectively, injury and violence pre- Prevent Violence Through Educa- first discussed by Prahalad and The competencies assist in vention efforts in health depart- tion, Networking, and Technical Hamel with respect to business efforts to reduce the burden of ments are low in scale and Assistance (PREVENT) program.13 practice in the 1990s.14 Their cen- injury and violence and can resources compared with activities These training efforts, though, are tral notion was that, over time, provide benchmarks against to reduce the major chronic and reaching and affecting public health companies develop key areas of which to assess progress in infectious diseases. One factor un- professionals involved in violence expertise that are distinctive to that professional capacity for injury derlying this observation is the now and injury prevention in a frag- company and critical to its long- and violence prevention. (Am well-recognized lack of infrastruc- mented fashion. No systematic term growth. J Public Health. 2009;99:600– 606. doi:10.2105/AJPH.2008. ture for injury and violence pre- process yet exists to address the In the time since the seminal 137331) vention in public health practice. needs of these professionals. work of Prahalad and Hamel, core Three major reports over the past 2 The State and Territorial Injury competencies have become an in- decades have pointed to this poor Prevention Directors Association tegral part of many business and INJURY AND VIOLENCE REMAIN infrastructure and the need to train (STIPDA) and the Society for the nonbusiness practices. Core com- significant public health issues. a workforce for effective efforts in Advancement of Violence and In- petency sets have been identified Road traffic crashes, homicides, reducing injuries and violence.5–7 jury Research have been leading throughout the public health field,

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including the widely publicized Joint Committee on Infrastructure Identifying Essential To answer this question, a core competencies for public Development. (The National As- Knowledge and Skills working group of NTI members health practice.15 Competency sets sociation of Injury Control Re- One issue quickly recognized discussed what made existing also exist in very specific areas of search Centers formally changed by the NTI was the lack of a practices in the field effective, injury and violence fields. How- its name in 2005 to the Society for consensus in the field regarding reviewed existing competency sets ever, unintentional injuries and the Advancement of Violence and what skills and knowledge are in several disciplines, reviewed violence encompass a broad Injury Research [SAVIR]. The distinctive and critical to success existing curricula in injury preven- range of causes, intentions, and collaboration outlined in this work in injury and violence prevention, and identified and imple- outcomes. Public health and other is now known as the SAVIR– tion practice. Thus, one of the mented needs assessments of wide-scale programs designed to STIPDA Joint Committee on In- first activities of the NTI was practicing professionals. The range reduce the burden of injuries and frastructure Development.) This to develop a protocol for identi- of material reviewed by the group violence need professionals with joint effort is unique in that it fying the essential knowledge is listed in the box on this page. a broad array of skills and brings together the expertise of and skills, or core competencies. knowledge. At present, there is no members from disparate disci- The process began by focusing Drafting Specific comprehensive and systematic plines: state-based public health discussion on the question, what Competencies and Learning way to ensure that those who injury and violence prevention do injury and violence preven- Objectives work to prevent injury and vio- practitioners and academic-based tion professionals need to know In drafting the core competen- lencepossessthecompetencies educators. The National Training to be effective? This is a funda- cies, the NTI working group necessary to be effective. Initiative for Injury and Violence mental question that has been quickly faced 2 strategic issues: In 2000, STIPDA and the Na- Prevention (NTI) was built from discussed and debated by prac- identifying the intended audience tional Association of Injury Con- this collaboration to focus on spe- titioners and researchers for for the competencies and deter- trol Research Centers formed the cific training efforts. decades. mining the level of specificity to

Materials Examined to Draft the Core Competencies for Injury and Violence Prevention: National Training Initiative for Injury and Violence Prevention Relevant Competency Sets Reviewed d Core competencies for public health professionals, Council on Linkages Between Academia and Public Health Practice.15 d The Public Health Workforce: An Agenda for the 21st Century, US Department of Health and Human Services.16 d Core competencies for injury prevention, Indian Health Service. d Core competencies for effective practice, Southern California Developing Center for Youth Violence Prevention.10 d Competencies for maternal and child health, Association of Teachers in Maternal and Child Health.17 Objective Materials Reviewed d State and Technical Assessment Team Review Guide, STIPDA.18 d Course objectives, Hopkins Summer Institute on Injury Prevention. d Canadian injury prevention and control curriculum, Canadian Collaborative Centres for Injury Prevention.19 d TEACH-VIP—international injury prevention curriculum, World Health Organization.20 Needs Assessments Reviewed d Training needs assessment, Education Development Center, 1989. d Pre-Vincent training needs assessment, University of North Carolina Injury Prevention Research Center, 1996. d Core capacity survey, STIPDA, 2000. d Education needs assessment, Canadian Collaborative Centres for Injury Prevention, 2000.21 d Training survey of health departments, NAICRC–STIPDA Joint Committee on Infrastructure Development, 2001. d Survey of Safe USA participants, NAICRC–STIPDA Joint Committee on Infrastructure Development, 2001.

Note. STIPDA=State and Territorial Injury Prevention Directors Association; NAICRC=National Association of Injury Control Research Centers. The National Association of Injury Control Research Centers formally changed its name in 2005 to the Society for the Advancement of Violence and Injury Research (SAVIR). The collaboration outlined in this work is now known as the SAVIR–STIPDA Joint Committee on Infrastructure Development.

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apply to the competencies. Injury and comment. A revised docu- policy development, and media experience in more than 1 work- and violence prevention is a broad ment based upon the full commit- relations. place. Altogether, the group had field encompassing different disci- tee comments was then approved Of the 62 individuals invited to meaningful experience in federal plines, including public health, law by majority vote, and a process for serve on the expert panel, 53 agencies, universities, local and enforcement, emergency medical external review of the document (85.5%) accepted the request to state health departments, and services, occupational health, was identified. comment. They were mailed a nonprofit organizations. More highway and traffic safety, and draft copy of the competencies and than half of the group had served others. The diversity of practices Expert Panel Review asked to provide overall general as a manager or supervisor at and approaches makes it difficult A panel of experts in violence- comments and specific thoughts some point in their tenure. to create a single competency set and injury-prevention practice and for each of the individual compe- The complement of comments that is appropriately relevant for research performed an external tencies. Responses were received from the panel members was all practitioners. As a result, the review of the draft competencies from 52 individuals. The charac- wide-ranging. To consider the competencies outlined here were and learning objectives. Nomina- teristics of these individuals are comments, the working group de- developed with a primary focus on tions for individuals to serve on outlined in Table 1. Overall, the veloped a structured template to public health practitioners. the panel were solicited from NTI respondents averaged 14.3 years standardize the presentation and Several discussions ensued re- committee members and the 6 of experience as an injury- or analysis by competency area. garding the level of specificity to participating organizations in the violence-prevention professional. Further, the group conducted a apply to the competencies. By NTI (the Centers for Disease Con- Many individuals (47%) had qualitative review to identify consensus, it was determined that trol and Prevention, National the identified relevant skills and Center for Injury Prevention and knowledge should be specific to Control; Indian Health Service; TABLE 1—Characteristics of the Expert Panel Respondents injury and violence programmatic Health Resources and Services (N=52) for Core Competencies for Injury and Violence needs. The working group, Administration, Maternal and Prevention: National Training Initiative for Injury and Violence though, also recognized that there Child Health Bureau; Children’s Prevention are areas of overlap between Safety Network; STIPDA; and public health practice and injury- National Association of Injury Characteristic % prevention practice and that some Control Research Centers). A total Area of expertise essential skills, such as building of 179 individuals were nomi- Unintentional injury 38.6 and evaluating programs, are ge- nated, of whom 62 were selected Intentional injury or violence 9.1 neric to both types of activities. To for the panel. Thirty members Both unintentional and intentional injury 52.3 avoid repeating the public health were from the participating orga- Place of work (experience>1 y) competencies for public health nizations in NTI. An additional 30 Federal agency 47.9 practice, in areas of overlapping members were selected from ex- University 47.9 essential skills, the working group ternal organizations, and 2 indi- Private or nonprofit organization 33.3 outlined and emphasized the sa- viduals were selected to serve as State health department 31.3 lient features of these skills as they technical experts in the compe- Hospital or health care organization 31.3 are applied in injury- and violence- tency development process. Se- Local health department 18.8 prevention practice. lection criteria for all panel Position (responsibility for>1 y) Next, the working group drafted members also considered the Manager or supervisor 64.6 8 core competencies and their re- need to balance the distribution Health educator 37.5 lated learning objectives. The of expertise across different levels Coalition leader or program coordinator 37.5 learning objectives were written to of research and practice, differ- University educator 31.3 provide future trainers and edu- ent areas of injury and violence Epidemiologist 29.2 cators with measurable goals for prevention expertise, and dif- Other public health position 25.0 the assessment of learning. The ferent levels of experience in the Physician 16.7 drafted competencies and learning competency concentrations, objectives were then presented to including data, program man- Note. Totals do not add to 100% because of multiple responses from individuals. the full NTI committee for review agement, program evaluation,

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common themes in the comments. because of the difficulty in devel- learning objective based upon the violence prevention in which a Major themes arising from the ex- oping specific skills sets for each type of position of the individual public health professional practices. pert panel comments included the audience with an interest in injury (e.g., manager, supervisor, field The competencies cover funda- use of unclear terminology or jar- or violence prevention. However, worker). This proficiency docu- mentals of injury and violence oc- gon, questions about which audi- the working group did revise the ment is currently available currence and prevention, the use of ence the competencies were di- competency set to change wording online.22 data in general and specific to pro- rected to, unclear competency to allow for the potential applica- grams, and the design and imple- objectives, missing competencies tion of the competencies to all Public Comment mentation of prevention activities. or missing objectives, and redun- types of practitioners, such as After due discussion of the ex- They also involve the evaluation of dant or overlapping objectives. those in law enforcement or pert panel comments, the core prevention activities, program The committee considered all emergency response. competency document was re- management, communication, ad- comments in the revision process. One major revision involved vised and then opened to the vocacy, and maintenance of com- First, the document was edited to the draft competency on dissemi- public for review and comment. petency. incorporate the consistent use of nation of information to policy- The public comment period was The competencies are (1) de- well-defined terms and to remove makers and leaders. Many panel open for 6 weeks in September scribe and explain injury and vio- jargon. The working group also members interpreted this compe- and October 2004. Invitations to lence as a major social and health revised the learning objectives for tency as addressing advocacy, but comment were sent by e-mail to a problem; (2) access, interpret, use, clarity and to reduce redundancy. not the need for injury- and vio- large group of injury prevention and present injury and violence Some panel members felt that the lence-prevention practitioners to professionals in the field, different data; (3) design and implement elements of collaboration and have communication skills. These from the expert panel, who were injury- or violence-prevention partnership, communication, and are varied, yet complementary then asked to distribute the invita- activities; (4) evaluate injury- or cultural competency were missing skills. In response, the working tion to their colleagues. The request violence-prevention activities; (5) in the draft competency set. To group recognized the need to dis- to comment was also posted on a build and manage an injury- or address this, the NTI working tinguish between these skills, and Web site.22 The respondents rep- violence-prevention program; (6) group integrated these issues into it revised the prior competency to resented 32 distinct agencies and disseminate information related to the learning objectives of the pertain to communication skills. organizations across the spectrum injury or violence prevention to existing competencies rather than Further, it added a new compe- of practice from the public, private, the community, other profes- adding additional competencies. tency to address advocacy and the academic, advocacy, and acute care sionals, key policymakers, and The intent of this decision was to ability to stimulate change in the perspectives. A protocol similar to leaders through diverse commu- avoid redundancy with the public community. that used to address the expert nication networks; (7) stimulate health core competencies and to The working group also dealt panel comments was used to ad- change related to injury or vio- reinforce how these general skills with concerns from the panel dress the public comments. On lence prevention through policy, apply to specific injury and vio- members that the competency consideration of the comments re- enforcement, advocacy, and edu- lence practices. objectives were too advanced for ceived, final revisions were made to cation; (8) maintain and further Next, the committee read- some practitioners. The working the competencies and to each develop competency as an injury- dressed issues related to the most group reaffirmed that the under- learning objective. or violence-prevention profes- appropriate primary audience for lying purpose of the competencies sional; and (9) demonstrate the the competencies. Some panel was to identify where the preven- THE COMPETENCIES knowledge, skills, and best prac- members felt that the competen- tion field should be in terms of tices necessary to address at least cies were too centered within knowledge and skills. It was rec- Nine essential competencies for 1 specific injury or violence topic public health, whereas other ognized that not all individuals will injury and violence prevention (e.g., motor vehicle occupant in- members expressed the view that be at the identified competency were identified by the NTI work- jury, intimate partner violence, fire the objectives were too advanced level at this time. It was also rec- ing group. Each competency also and burns, suicide, drowning, for some practitioners. To address ognized that different job positions has a detailed list of learning ob- child injury) and be able to the first perspective, the consensus require different levels of skills. jectives.22 The first 8 competencies serve as a resource to convey decision of the working group was Thus, it was decided to develop a describe general and foundational knowledge, skill, and best that the audience should remain second document that assigns a skills that are needed regardless practices to others regarding public health practitioners, level of proficiency to each of the specific area of injury or that area.

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Describe and Explain Injury Design and Implement Injury- barriers to evaluation, and be able Stimulate Change Through and Violence as a Social and or Violence-Prevention to develop an evaluation plan. Policy, Enforcement, Health Problem Activities Proficiency in this competency Advocacy, and Education This competency is the ability Individuals should be able to will enable an individual to design Fundamental objectives to this of an individual to understand the describe and understand how to or identify appropriate evalu- competency include the ability to basics of injury and violence. Spe- develop specific prevention initia- ation measures for an injury- develop a marketing plan for the cific learning objectives focus on tives, implement them, and main- or violence-prevention promotion of prevention activities the definition of unintentional in- tain them. Important components program. and an understanding of the differ- jury and intentional violence, the include identifying resources for ences between policy, education, mechanisms surrounding their prevention efforts, identifying and Build and Manage an Injury- lobbying, and advocacy. Individuals occurrence, how such events are explaining the role of stakeholders or Violence-Prevention should recognize what current laws, preventable, and where injury and in these activities, understanding Program policies, and regulations work, and violence stand as a significant the spectrum of prevention activi- Professionals with the respon- where gaps exist in these areas. public health issue. Other identi- ties (individual, institutional, com- sibility of overseeing programs Partnering and recognition of the fied objectives include an under- munity, etc.), and understanding should be capable managers. Im- role of allies and opponents in pol- standing of disparities in injury the role of conceptual models in portant management elements icy and advocacy are also needed. and violence, risk factors, how identifying prevention opportuni- for injury- or violence-prevention Proficiency in this competency will conceptual models are useful in ties. Other important issues in- programs include using partners enable an individual to identify ap- the area, and the importance of clude identifying different types of in developing program goals, propriate methods to effect safe collaboration for prevention ac- interventions (e.g., passive, active) understanding strategic planning, behavior. tivities. Proficiency in this compe- and their use in comprehensive having the ability to identify tency will enable an individual to programs, elements of an imple- funding sources, and writing Maintain and Develop explain why and how injury and mentation plan, and the influence proposals. Additional compo- Competency as a Professional violence are preventable and how of cultural and other factors on nents should include being This competency addresses the they should be prioritized in terms prevention efforts. Proficiency in skilled in budgeting, recognizing need for professionals to stay cur- of funding with other leading this competency will enable an strengths and limitations in rent with new developments in health problems. individual to develop effective in- programs, identifying leveraging research and practice. Identifying jury- or violence-prevention pro- opportunities, and using per- new information in journals and Access, Interpret, Use, and grams. formance standards. Proficiency electronic resources is one ele- Present Injury and Violence in this competency will enable ment of this process, as is under- Data Evaluate Injury- or Violence- an individual to sustain an standing the role of key profes- Specific learning objectives for Prevention Activities injury- or violence-prevention sional organizations in providing this data-based competency in- Evaluation of injury- or vio- program. new information and being able to clude the ability to identify data lence-prevention activities is often locate training resources. Profi- sources for injury and violence lacking in current programs. This Disseminate Information ciency in this competency will en- circumstances, the strengths and competency was designed to ad- Through Diverse able an individual to identify ap- weaknesses of existing surveil- dress this shortcoming. Important Communication Networks propriate continuing-education lance and classification systems, elements within this competency Practitioners should be able to opportunities for injury- or vio- the difference between qualitative include understanding why evalu- demonstrate competency in de- lence-prevention programming. and quantitative data in injury ation of programs is needed, how signing and delivering prevention scenarios, and the use of data for to incorporate evaluation into messages, in preparing presenta- Demonstrate Competency in policy, program planning, evalua- existing and new activities, the tion documents, and in media, an Injury- or Violence- tion, and advocacy. Proficiency in differing types of evaluation pro- public, and political relations. Prevention Topic this competency will enable an cesses, and elements of communi- Proficiency in this competency will The final competency addresses individual to understand where to cation of evaluation results. Com- enable an individual to commu- a specific topic area in injury or get appropriate data and how to petent individuals should also be nicate injury- or violence-preven- violence prevention and the ability interpret it and use it to develop able to identify partners in evalu- tion messages to appropriate au- of an individual to understand prevention activities. ation activities, understand diences. the dynamics of the topic area and

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the best practices for its preven- training effort in the field and, possesses the mix of skills required settings outside public health tion. This last competency was de- ultimately, the enhancement of the to best serve injury and violence practice should be careful to con- signed for individuals working in infrastructure necessary to prac- prevention in its setting.25 sider how the specific components specific programs or on specific tice injury and violence preven- The core competencies for in- of the competencies apply in their projects. For specific injury or vi- tion effectively. jury and violence prevention in- practice and make adaptations olence topics, an individual should As an example of this potential, tersect and overlap, in part, with accordingly. be able to describe the causes and the competencies provide a other existing competencies de- Coupled with high-quality, re- characteristics underlying them, framework to guide the develop- veloped for practicing profes- search-based training and consis- what major data sources exist, ment of a variety of training op- sionals. For example, competen- tent implementation of best prac- what populations are at risk, who portunities and curricula. The cies regarding data, program tices, the core competencies serve the primary stakeholders are in PREVENT project used the core development, evaluation, man- as an important step toward the area, major risk and protective competencies to guide its training agement, policy, and communica- addressing the enormous infra- factors, and what best practices programs for more than 900 vio- tion skills are fundamentally simi- structure gap in the field of injury exist for prevention activities. lence-prevention practitioners.13 lar to the skills broadly needed for and violence prevention, and ulti- Proficiency in this competency will Many more professionals in health public health practice.15 The in- mately may assist in the effort to enable an individual to become an departments, state agencies, local jury- and violence-prevention com- reduce the burden of injury. As expert in a particular topic area in organizations, and community coa- petencies, though, expand upon the progress is made, the core com- injury or violence prevention. litions might also benefit from the public health competencies by petencies can also help to establish use of the core competencies in this delving into how and why injury- benchmarks against which to as- DISCUSSION regard. The competencies can also and violence-prevention practices sess progress and identify con- be useful for guiding teaching ef- relate to these concepts. This over- tinuing challenges. j We have delineated the array forts in academic centers, where lap was an intended consequence in of knowledge and skills that en- many future prevention profes- the development of the competen- able or enhance the ability of sionals obtain their knowledge and cies, because it is recognized that About the Authors public health professionals in in- skills. It is also important to point professionals may change programs Thomas Songer is with the Center for Injury Research and Control, Department of Epi- jury and violence prevention to out that curriculum-based training or positions over time, both moving demiology, Graduate School of Public practice successfully. These com- is not the only means to achieve into and away from injury- or vio- Health, University of Pittsburgh, PA. At the petencies have been developed competency. 23 Several of these lence-prevention positions. Many time of the study, Shelli Stephens-Stidham was with the Injury Control Division, through an extensive review of competencies can be acquired objectives in the injury- and vio- Oklahoma State Department of Health, existing needs and practice and through additional work experience lence-prevention competency set, Oklahoma City. Corinne Peek-Asa is with the consideration of several other that incorporates the objectives of however, are independent of the the Department of Occupational and En- vironmental Health, College of Public competency sets. The competen- the competencies and complements public health competencies because Health, University of Iowa, Iowa City. cies represent one of the first the current practice of the individual. they relate to practices unique to Ingrid Bou-Saada is with the Injury and comprehensive standards for The core competencies have the injury- and violence-prevention Violence Prevention Branch, Division of Public Health, North Carolina Department training and assessment for public alternate uses in workplace set- field. of Health and Human Services, Raleigh. At health professionals interested in tings. They can be used, for ex- Although these carefully devel- the time of the study, Wanda Hunter was broad-based initiatives for injury ample, in self-assessment exer- oped core competencies are an with the Injury Prevention Research Center and Department of Social Medicine, Uni- and violence prevention. cises, needs assessments, and important step toward developing versity of North Carolina, Chapel Hill. The primary purpose of the performance evaluations. The infrastructure for injury and vio- Kristen Lindemer was with the State and competencies and their measur- competencies also identify a broad lence prevention, it is essential to Territorial Injury Prevention Directors As- sociation, Atlanta, GA. Carol Runyan is able objectives is to provide the benchmark of where an organi- note that these competencies are with the Injury Prevention Research Center public health professional with a zation should be. In this setting, it not static. As science and practice and the Department of Health Behavior standard set of skills for practice in is not expected that every individ- evolve and injury and violence and Health Education, University of North Carolina. Chapel Hill. injury- or violence-prevention ef- ual should be an expert in all of the patterns change, the competencies Requests for reprints should be sent to forts. The NTI envisions that this competencies to effectively carry will require regular review and T. J. Songer, Center for Injury Research and competency set will begin the out their jobs.24 It is important, periodic revision. In addition, al- Control, University of Pittsburgh, PARKV 203, 3520 Forbes Ave, Pittsburgh, PA process of development and however, that an organization have though the skill sets are envisioned 15261 (e-mail: [email protected]). implementation of a systematic a collection of staff that collectively as basic and universal, those in This article was accepted July 19, 2008.

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Author Contributions Berger, Christine Branche, Stephanie Violence and Health. Geneva, Switzerland: 15. Public Health Foundation, Council T. Songer chaired the committee that Bryn, Larry Cohen, Lisa Cohen Barrios, World Health Organization; 2002. on Linkages Between Academia and Harold Cully, Luann D’Ambrosio, Alan Public Health Practice. Core competen- developed the competencies; drafted 4. Finkelstein EA, Corso PS, Miller TR. Dellapenna Jr, Marci Diamond, Jim cies for public health professionals. competencies 2, 8, and 9; and led the Incidence and Economic Burden of Injuries Enders, Eugenia Eng, Lois Fingerhut, June 1999. Available at: http://www. writing of the article. S. Stephens-Stidham in the United States. New York, NY: Oxford Leroy Frazier, Andrea Gielen, David trainingfinder.org/competencies/ was a member of the competency devel- University Press; 2006. opment committee and drafted compe- Grossman, Anara Guard, Chris Hanna, list_nolevels.htm. Accessed September 30, tencies 3 and 9. C. Peek-Asa was a Stephen Hargarten, Roger Harrell, Janet 5. Institute of Medicine. Reducing the 2007. Holden, Janie Hutcherson, Lynn Jenkins, Burden of Injury— Advancing Prevention member of the competency development 16. The Public Health Workforce: An Murray Katcher, Art Kellerman, Marc and Treatment. Washington, DC: National committee and drafted competencies 4 Agenda for the 21st Century. Washington, Kolman, Alan Korn, Diana Kuklinski, Academy Press; 1999. and 9. I. Bou-Saada was an invited guest DC: Office of Disease Prevention and Maureen Lichtveld, Evelyn Lyons, Sue of the competency committee and drafted 6. National Committee for Injury Pre- Health Promotion, US Dept of Health and Mallonee, Christine Miara, Angela competencies 6, 7, and 9. W. Hunter was vention and Control. Injury Prevention: Human Services; 1997. Mickalide, Lenora Olson, Lloyd Potter, a member of the competency develop- Meeting the Challenge. New York, NY: Janet Saul, Ellen Schmidt, David Sleet, 17. Association of Teachers in Maternal ment committee, wrote the first draft of Oxford University Press; 1989. the competencies, and drafted compe- Lorann Stallones, Federico Vaca, Maria and Child Health. Competencies for ma- tency 5. K. Lindemer was a member of Vegega, Andre´s Villaveces, Rick 7. National Research Council and Insti- ternal and child health. February 2001. the competency development committee Waxweiler, Hank Weiss, Barak Wolff, Xan tute of Medicine. Injury in America: A Available at: http://www.atmch.org/ and drafted competency 1. C. Runyan co- Young, Janice Yuwiler, and Ronda Zakocs. Continuing Public Health Problem.Wash- documents/mchcomps.pdf. Accessed chairs and administers the National The administrative and intellectual ef- ington, DC: National Academy Press; September 10, 2008. forts of Theresa Cruz, Mariana Garrettson, Training Initiative, was principal investi- 1985. 18. The State and Territorial Assessment gator of the grants supporting this work, Carol Gunther-Mohr, J’Ingrid Mathis, and 8. Definition of injury and violence Team Review Guide. Atlanta, GA: State and reviewed drafts of the competencies. Emily van Schenkhof were integral to the prevention and control infrastructure. and Territorial Injury Prevention Direc- The National Training Initiative origi- development and revision of the compe- Atlanta, GA: Advisory Committee on In- tors Association; 2001. nated the notion to develop the competencies. A special thank you is due to these jury Prevention and Control Working tencies collectively as a group. All authors individuals for their commitment to the 19. Canadian Collaborative Centres for Group on Injury Control and Infrastruc- helped to conceptualize ideas, interpret project. The authors acknowledge and Injury Prevention and Control. Canadian ture Enhancement; 2004. comments, and review drafts of the thankthefollowing members of theNational injury prevention and control curriculum, article. Training Initiative for Injury and Violence 9. Transportation Research Board Joint final report. 2003. Available at: http:// Prevention for their review of the compe- Subcommittee on Safety Workforce De- www.canadianinjurycurriculum.ca/ tencies: Marilena Amoni, Nancy Bill, documents/FinalReportCIPCCpublic. Acknowledgments velopment. Core competencies for high- Stephanie Bryn, Theresa Cruz, Lynda Doll, way safety professionals. Washington, pdf. Accessed September 10, 2008. This work was supported by monetary Carolyn Fowler, Deborah French, Julie DC: Transportation Research Board; 20. TEACH-VIP, User’s Manual. funds from the Maternal and Child Health Gibbs-Long, Carol Gunther-Mohr, Susan 2006. NCHRP Research Results Digest Geneva, Switzerland: World Health Bureau at the Health Resources and Ser- Hardman, Alex Kelter, Lloyd Potter, Julie 302. Organization; 2005. vices Administration, the National Center Ross, Ellen Schmidt, Kelly Taylor, Maria for Injury Prevention and Control at the Vegega, Amber Williams, and David Zane. 10. Denninghoff KR,Knox L, Cunningham 21. Belton KL. Educational needs of Centers for Disease Control and Preven- The authors also acknowledge the indi- R, Partain S. Emergency medicine: compe- injury control practitioners in Canada. tion, the State and Territorial Injury Pre- viduals who provided comments on the tencies for youth violence prevention and Edmonton, Alberta: Department of Edu- vention Directors Association, and the core competencies when drafts of the control. Acad Emerg Med. 2002;9: cational Policy Studies, University of Society for the Advancement of Violence competencies were open to the public. 947–956. 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606 | Health Policy and Ethics | Peer Reviewed | Songer et al. American Journal of Public Health | April 2009, Vol 99, No. 4