In 1985, Injury in America identified the shortage of trained injury prevention professionals and scientists as a major impediment to the development of the field (NRC, 1985); this continues to be a significant barrier. Additionally, further education on injury prevention has to be incorporated into the education of health care professionals so that nurses, physicians, physician assistants, and nurse practitioners can integrate injury prevention into their clinical practice.
The need to train practitioners is confirmed by surveys of the staffs of state health departments, traffic safety agencies, and schools of public health (Harrington et al., 1988; Dana et al., 1990; Miara et al., 1990). A 1990 survey found that only 25 percent of health department personnel and 20 percent of traffic safety professionals had graduate-level coursework in injury epidemiology or prevention. Additionally, 92 percent of health department personnel and 47 percent of traffic safety staff requested additional training (Miara et al., 1990).
Most states do not currently have the resources to conduct training and continuing education for local agencies, nor do they have the capacity to keep current on the latest research and its application. Moreover, career paths are not well defined for injury prevention practitioners, and training opportunities are not readily available or accessible (in fact, state and local practitioners often have difficulty in obtaining travel approval to attend out-of-state conferences or training programs). Training and continuing education most often occur through state and national conferences and via sessions on injury prevention at the annual meetings of national professional organizations (e.g., the American Public Health Association). A one-week training course has been restarted recently by the Johns Hopkins Center for Injury Research and Policy. Although these developments are positive signs, they are of no value to those who cannot attend because of funding constraints.
Federal agencies provide training that is most often focused on specific injury topics. MCHB provides technical assistance to state maternal and child health agency staff through the Children's Safety Network (CSN) National Injury and Violence Prevention Resource Center. This information is targeted to maternal and child health practitioners and is focused on child and adolescent injury prevention. NHTSA offers regional workshops on traffic safety topics. The National Institute for Occupational Safety and Health (NIOSH) funds 15 Education and Research Centers (ERCs), primarily at universities, that offer continuing education courses in occupational health and safety. The Indian Health Service (IHS) offers an Injury Prevention Specialist Fellowship program that allows 10 to 20 IHS field staff to receive training in the use of data collection systems and the development of intervention strategies. These efforts are