CARES Safety Center Partnership
CARES Safety Center Partnership
- Baltimore City Fire Department, Baltimore, MD
Please note that all data below was derived from the collaboration's nomination for the Collaboration Prize. None of the submitted data were independently verified for accuracy.
Injuries are the leading cause of death for children over the age of one and low-income, urban families are disproportionately impacted by injuries, including house fires, motor vehicle crashes, falls and poisonings, etc. In 1997, the Center for Injury Research and Policy (CIRP) at Johns Hopkins opened the first-of-its-kind hospital-based, safety resource center as one way to improve access to life-saving information and reduced-cost safety products for families. Families come to the Children's Safety Center (CSC) to talk one-on-one with a safety expert who tailors advice to the needs of the family. The educator will also recommend safety products, and for families who have limited income, offer a sliding-fee scale for needed products. As part of the CSC services, we established a partnership with the Baltimore City Fire Department (BCFD) to become a referral source to their smoke alarm program, where fire personnel install up to 3 smoke alarms in Baltimore City homes at no charge to the residents. Research conducted about the CSC documented that families who visited were more likely to adopt safety practices proven to keep children safe. However, the CSC's success was contingent upon families coming to it. Around this same time, the BCFD was exploring how to grow its existing fire safety education program. Their program at the time used a camper trailer outfitted with a "bedroom" that was used at local schools to teach children about fire safety. Together, CIRP and BCFD created the nexus for what ultimately became the CARES Safety Center Partnership.
Once we had the idea for a mobile safety center -- combining the fire department's trailer and fire safety messages with the CSC's focus on various other injury topics and access to reduced cost safety products -- we thought about who could help us bring our vision to life. Johns Hopkins Pediatric Trauma doctors and nurses were invited to join our efforts becuase of their professional expertise on treating injuries to children. Exhibit designers from the Maryland Science Center were asked to join our collaboration so that we could benefit from their expertise in developing engaging educational exhibits for both children and adults. Faculty and students from an area art college (Maryland Institute College of Art) were brought on board to help create the logo, color scheme and other collateral materials for the center. In general, partners were approached if 1) they had an expertise that would benefit our effort and 2) they shared broadly in the mission of keeping children and families healthy and safe.
Almost from the outset, it was apparent that CIRP and BCFD would be the primary partners because of our capacity and staff involvement. This was acknowledged in our partnership agreeement. Through consensus building, and over several monthly meetings, we developed a partnership agreement that outlined general operating principles and specific partner responsibilities. This approach allowed partners to define their own level of participation and involvement. It also clarified that our decisions should be guided by the community we serve. It also established which decisions were open for group input and which, by necessity, would be made unilaterally by one of the two primary partners. As the program has matured (since it was first estalished in 2003), the needs of the partnership have changed. In the early phase of the partnership (2003-2004) there were many decisions to make about the creation and funding of the safety center. During 2005-2008, CIRP received funding from the federal government to conduct a community-based trial of the effectiveness of the safety center as a vehicle to disseminate safety information to the community. During this phase, priorty decision making fell to CIRP and the needs of the research. Since 2009, CARES has been operating as a community service and decision making falls jointly between the two primary partners becuase of the primacy of their involvmenet in its day-to-day operatins. This phase of the collaboration requires more attention to more mundane administrative issues such as staff scheduling and training updates, upkeep of the vehicle, and record-keeping.
Frequent meetings to ensure open lines of communication were critical and coincided with a phase of our collaboration when partners were still building trust. As the collaboration has matured over the years, and as it followed the guidelines in our partnership agreement and achieved success, the frequency of partnership meetings has subsided. However, as we continue to mature through different phases of our partnership, we are sensitive to the need to share information and ideas with our partners. We have always emphasized transparency and openness in our decision making and this has served the partnership well over the years.
Meaurement of outcomes has changed over the years of the collaboration. Early, success was measured by our ability to convene and sustain the partnership and produce a forty-foot vehicle designed like a home to teach home and child safety to community members. Another phase used federal research dollars to answer questions about the impact of this approach as an "effective dissemination vehicle" to get injury prevention information and safety products into the homes of low-income, urban families. In our most recent 'community service' phase of the collaboration, we track the number of community events that the CARES Safety Center attends. More importantly, we track the number of adult and child visitors who interact with our health and safety educators on the vehicle, the number who receive education about various child and home safety topics, the number who purchase (or receive for free) safety products and receive safety services (like car seat installations or bike helmet fittings). We occassionally conduct "satisfaction" surveys to assess our visitor's perceptions about their experiences on the safety center.
Because we have integrated federally funded research into the overall service project, we have objective measures of our impact. Our CDC funded trial documented our success of integrating CARES into a Medicaid managed care clinic and showed that CARES was an effective way to increase visitors knowledge about various safety topics. We have also been approached by numerous other community, hospital and safety groups around the country for information about replicating our safety center. We are in the process of writing a replication guide that we will make available free-of-charge on the Internet to help guide the efforts of others interested in developing their own safety center collaboration.
The CARES Safety Center partnership filled a void in Baltimore by creating a sustained service that is able to comprehensively address the safety education and service needs of families with young children. Prior to our collaboration, the BCFD used their limited resources to send fire educators out to local schools to lecture kids about the importance of smoke alarms and practicing a fire escape plan. The Children’s Safety Center was limited in that it could only work with parents who took the effort to travel to our location inside the Hopkins children’s hospital. We joined forces and pooled resources to create a mobile safety center designed to address a variety of childhood injury hazards that could meet families where they live, work, worship and play – in their own neighborhoods and communities. We are able to reduce access barriers for urban families by combining education and services in a mobile service that reaches families where they are.
And reaching families has been a real success of the collaboration. For instance, in our first two years of operation, CARES was able to reach about 6000 visitors with its safety messages and services. In our last full year of service, 2009, we participated in 85 community events and reached more than 7000 people. From January – September 2010, we’ve attended 100 community events, already surpassing our 2009 numbers.
In addition to the increases in program delivery that we’ve enjoyed as the collaboration matures over the years, we have also realized some efficiencies through the collaboration. Perhaps the most significant cost savings come from having the CARES vehicle be considered part of the fleet of vehicles in the BCFD. This allows the CARES Safety Center to be serviced and maintained at no cost to the project. Moreover, because it is registered as a BCFD vehicle, insurance for the vehicle is also covered annually by the BCFD. These decisions (and costs savings) mean that all of our program resources go into covering staff and program expenses rather than vehicle maintenance or insurance.
It would be disingenuous to say that we have had cost reductions as a result of our collaboration. To the contrary, because of our collaborative effort, we have devoted more resources to injury prevention for Baltimore families by: 1) purchasing the vehicle,2) designing and building interactive and engaging educational exhibits, 3) developing educational materials that are appropriate for our audiences from both a cultural perspective and from a literacy level, 4) stocking our center with a variety of safety products that are “sold” to families on a sliding fee scale (including no cost at all if the family has no financial resources); and 5) staffing our center with both public health educators (from CIRP) and fire educators (from BCFD). We do believe that these “investments” in resources result in increased knowledge about safety hazards and how to reduce them; accurate and consistent use of safety products to prevent injuries; and enhanced attitudes about the importance of safety for children. We know the community appreciates the services because we continue to get requests for the safety center to visit churches, schools, medical clinics, community health fairs, and any other event that is likely to attract families with young children.
As with any prevention program, documenting what does NOT happen is always a challenge. We document the number of events we participate in , the number of visitors we educate, the number of services we provide, the number of products we distribute. But, we don't have the resources to follow up with families. For example, we may provide a car seat to a family at a reduced fee and have one our staff who is certified as a car seat techniciain install the car seat and educate the parent about how to properly position the child in the seat. If that family subsequently happens to be in a car crash, we do not systematically learn that our seat protected the child. Therefore, we are not able to claim a reduction in injuries to young children in Baltimore, even though that is the ultimate goal of our collaborative effort.
Effective injury prevention is a marathon and not a sprint, and we need to engage all sectors of society in the issue if we are to have a measureable impact in reducing the burden of injury. The CARES Safety Center Partnership brings together non-traditional partners in innovative and creative ways for the purpose of improving attention to the issue, enhancing educational messages for diverse audiences, or strengthening access to injury prevention services and products. We believe every community should have its own mobile safety center designed with an appreciation of the special strengths and resources of that community and tailored to address the most pressing injury problems for them. Awarding the CARES Safety Center Partnership with The Collaboration Prize would help shine a light on the opportunity that other communities can have to reduce the childhood injury problem in their area through creative and effective collaborations.
We were an odd grouping of partners from the start: academic researchers, fire fighters, art faculty and students, museum exhibit designers, trauma doctors and nurses, and parents. We knew that our non-conventional group would need a flexible “management” structure. As explained earlier, through consensus we developed a partnership agreement to provide a framework within which our collaboration could operate and grow. We defined decision making processes that would work for our group. This level of flexibility has allowed us to respond to new opportunities and to the realities of our collaborative.
When our collaborative first started, our major concern was actually creating the safety center itself. Luckily we did, with the help of graphic design and art faculty and students, children’s museum exhibit designers, trauma doctors and nurses and with input from the community. Once we got the mobile safety center operational, the task of the collaborative was to spread the word. The whole collaborative took on this responsibility by engaging with community groups and promoting the center among them. Next we needed to determine the safety center’s impact. The academic research partners took the lead on this task. Securing research funding from the federal government, CARES participated in a randomized controlled trial to see if it was an effective “vehicle” for disseminating safety information and products. We have transitioned back to a community service, again focusing on reaching out to various community groups and keeping an eye on emerging needs. For instance, an appreciation for the growing Hispanic communities in Baltimore lead to the realization that we needed to consider how our safety services and products would be received by such families. Similarly, we keep an eye on emerging injury areas. Recently the safety center has added two new exhibits: one on carbon monoxide poisoning risks in home and another on safe sleep practices for infants.
We define success by the fact that we are still a viable and growing community service. Every event we attend is a success because we are able to engage with more families and help educate them to childhood injuries and the ways to prevent or reduce them. Every day, a new parent is being ‘born’ who is likely to need information about the leading threat to her child’s health – unintentional injuries.