Risk levels for suffering a traffic injury in primary health care. The LESIONAT project

Carlos Martín-Cantera, Daniel Prieto-Alhambra, Lydia Roig, Susana Valiente, Katherine Perez, Luis Garcia-Ortiz, Jordi Bel, Fernando Marques, Xavier Mundet, Xavier Bonafont, Marti Birules, Núria Soldevila, Elena Briones, LESIONAT Research Group, Carlos Martin-Cantera, Daniel Prieto-Alhambra, Catherine Pérez, Xavier Mundet, Fernando Marqués, Ma José Moya, Josep Maria Suelves, Carles Valero, Jordi Bel, Mauro Dona, Nuria Arrasa, Nuria Martinez, Xavier Flor, Lydia Roig, Xavier Bonafont, Silvia Granollers, José Luis del Val, Luis Garcia, Daniel Prieto-Alhambra, Inma Besora, Joan Canales, Ana Canto, Maria Clotet, Ruben Colominas, Mauro Dona, Lydia Garrido, Carmen Goicoa, Carme Jané, Carlos Martín, Estefania Rodrigo, Amalia Rodriguez, Esther Ros, Elizabeth Suarez, Julio Muñoz, Sonia Gonzalez, Concepció Lopez, Isabel Arias, Monica Espelt, Laura Haro, Jordi Lopez, Verónica Moldón, Marineus Puig, Carme Roca, Daniel Martinez, Marta Canela, Nuria Comas, Angeles Conesa, Silvia Garcia, Nuria Les, Sara Ribera, Pilar Baillo, Teresa Figueres, Maria Teresa Palou, Magdalena Camí, Rosa Company, Laura Marimon, José Manuel Albalad, Joan Bestard, Francesc Bragulat, Carmen Ciria, Joan Clotet, Clementina Gonzalez, Andriy Sukhlyak, Pepita Estany, Javier Romaní, Enric Vilella, Natàlia López, Enric Vilella, Carme Martí, Jordi Bel, Paula Alvarez, Maria Atero, Marta Comerma, Joaquim Enguix, Joan Juvateny, Mar Yuste, Francisco López, Eva Ares, Xavier Castán, Anna Galinsoga, Carmen Ioana Jarca, Santiago Ruiz, Mercè Serra, Maria Amparo Diez, Silvia Penalva, Adriana Sala, Carme Saludes, Carme Vallduriola, Elisabet Martorell, Nuria Carrera, Noemí De Miguel, Maria Teresa Espejo, Asunción Guarner, Jaume Martin, Cristina Muñoz, Beatriz Elena Murillo, Anna Maria Pedro, Nuria Ros, Gemma Saez, Mónica Zambrano, Nuria Soldevilla, Marti Birules, Marti Birules, Carmen Jumilla, Silvia Martin-Urda, Mode Marne, Lidia Viñas, Lydia Roig, Nuria Aznar, Carme Clopés, Araceli Comas, Anna Garcia, Carme Gómez, Maria Jose Manzano, Gemma Molina, Zaira Oliver, Josep Oliveras, Maria Teresa Ruiz, Ana Turnes, Rosa Vila, Maria Dolors Ylla, Ramon Casas, Antonia Fernandez, Iluminada Perea, Ana Maria Sánchez, Silvia Granollers, Lourdes Crespo, Silvia Granollers, Jesus Muniesa, Purificación Robles, Marta Vilanova, Cristina Alòs, Sonia Burch, Carme Domene, Montserrat Farrus, Montserrat Gamero, Xavier Mundet, Juan Antonio Pérez, Monica Serravinyals, Elisabeth Solf, Jordi Grau, Estefania Baeza, Susana Garcia, Manuela Hidalgo, Ana Parenata, Daniel Roca, Santiago Perez, Maria Montserrat Alsina, Gemma Armero, Gemma Baulies, Teresa Cabello, Elisabeth Celamin, Ester Comas, Adoració Ferrús, Maria Gloria Huerta, Maria Rosa Pérez, Santiago Pérez, Irene Ramos, Esther Toral, Susana Valiente, Xavier Flor, Montserrat Carmona, Montserrat Delgado, Alberto Fernández, Montserrat Mas, Maria Carme Munar, Belén Sanchez, Rosa Tosquella, Vicente Martinez, Maria Angeles Nuñez, Rosa Tosquella, Aurora Montoro, Maria Rosario Añaños, Gema Badell, Maria Victoria Burguera, Maria de la Serra Comas, Maria Mercè Escriche, Maria Estrella Garcia, Antonio López, Carlos Martín-Cantera, Daniel Prieto-Alhambra, Lydia Roig, Susana Valiente, Katherine Perez, Luis Garcia-Ortiz, Jordi Bel, Fernando Marques, Xavier Mundet, Xavier Bonafont, Marti Birules, Núria Soldevila, Elena Briones, LESIONAT Research Group, Carlos Martin-Cantera, Daniel Prieto-Alhambra, Catherine Pérez, Xavier Mundet, Fernando Marqués, Ma José Moya, Josep Maria Suelves, Carles Valero, Jordi Bel, Mauro Dona, Nuria Arrasa, Nuria Martinez, Xavier Flor, Lydia Roig, Xavier Bonafont, Silvia Granollers, José Luis del Val, Luis Garcia, Daniel Prieto-Alhambra, Inma Besora, Joan Canales, Ana Canto, Maria Clotet, Ruben Colominas, Mauro Dona, Lydia Garrido, Carmen Goicoa, Carme Jané, Carlos Martín, Estefania Rodrigo, Amalia Rodriguez, Esther Ros, Elizabeth Suarez, Julio Muñoz, Sonia Gonzalez, Concepció Lopez, Isabel Arias, Monica Espelt, Laura Haro, Jordi Lopez, Verónica Moldón, Marineus Puig, Carme Roca, Daniel Martinez, Marta Canela, Nuria Comas, Angeles Conesa, Silvia Garcia, Nuria Les, Sara Ribera, Pilar Baillo, Teresa Figueres, Maria Teresa Palou, Magdalena Camí, Rosa Company, Laura Marimon, José Manuel Albalad, Joan Bestard, Francesc Bragulat, Carmen Ciria, Joan Clotet, Clementina Gonzalez, Andriy Sukhlyak, Pepita Estany, Javier Romaní, Enric Vilella, Natàlia López, Enric Vilella, Carme Martí, Jordi Bel, Paula Alvarez, Maria Atero, Marta Comerma, Joaquim Enguix, Joan Juvateny, Mar Yuste, Francisco López, Eva Ares, Xavier Castán, Anna Galinsoga, Carmen Ioana Jarca, Santiago Ruiz, Mercè Serra, Maria Amparo Diez, Silvia Penalva, Adriana Sala, Carme Saludes, Carme Vallduriola, Elisabet Martorell, Nuria Carrera, Noemí De Miguel, Maria Teresa Espejo, Asunción Guarner, Jaume Martin, Cristina Muñoz, Beatriz Elena Murillo, Anna Maria Pedro, Nuria Ros, Gemma Saez, Mónica Zambrano, Nuria Soldevilla, Marti Birules, Marti Birules, Carmen Jumilla, Silvia Martin-Urda, Mode Marne, Lidia Viñas, Lydia Roig, Nuria Aznar, Carme Clopés, Araceli Comas, Anna Garcia, Carme Gómez, Maria Jose Manzano, Gemma Molina, Zaira Oliver, Josep Oliveras, Maria Teresa Ruiz, Ana Turnes, Rosa Vila, Maria Dolors Ylla, Ramon Casas, Antonia Fernandez, Iluminada Perea, Ana Maria Sánchez, Silvia Granollers, Lourdes Crespo, Silvia Granollers, Jesus Muniesa, Purificación Robles, Marta Vilanova, Cristina Alòs, Sonia Burch, Carme Domene, Montserrat Farrus, Montserrat Gamero, Xavier Mundet, Juan Antonio Pérez, Monica Serravinyals, Elisabeth Solf, Jordi Grau, Estefania Baeza, Susana Garcia, Manuela Hidalgo, Ana Parenata, Daniel Roca, Santiago Perez, Maria Montserrat Alsina, Gemma Armero, Gemma Baulies, Teresa Cabello, Elisabeth Celamin, Ester Comas, Adoració Ferrús, Maria Gloria Huerta, Maria Rosa Pérez, Santiago Pérez, Irene Ramos, Esther Toral, Susana Valiente, Xavier Flor, Montserrat Carmona, Montserrat Delgado, Alberto Fernández, Montserrat Mas, Maria Carme Munar, Belén Sanchez, Rosa Tosquella, Vicente Martinez, Maria Angeles Nuñez, Rosa Tosquella, Aurora Montoro, Maria Rosario Añaños, Gema Badell, Maria Victoria Burguera, Maria de la Serra Comas, Maria Mercè Escriche, Maria Estrella Garcia, Antonio López

Abstract

Background: Literature shows that not only are traffic injuries due to accidents, but that there is also a correlation between different chronic conditions, the consumption of certain types of drugs, the intake of psychoactive substances and the self perception of risk (Health Belief Model) and the impact/incidence of traffic accidents. There are few studies on these aspects in primary health care. THE OBJECTIVES of our study are: Main aim: To outline the distribution of risk factors associated with Road Traffic Injuries (RTI) in a driving population assigned to a group of primary health care centres in Barcelona province. Secondly, we aim to study the distribution of diverse risk factors related to the possibility of suffering an RTI according to age, sex and population groups, to assess the relationship between these same risk factors and self risk perception for suffering an RTI, and to outline the association between the number of risk factors and the history of reported collisions.

Design: Cross-sectional, multicentre study.

Setting: 25 urban health care centres.

Study population: Randomly selected sample of Spanish/Catalan speakers age 16 or above with a medical register in any of the 25 participating primary health care centres. N = 1540.Unit of study: Basic unit of care, consisting of a general practitioner and a nurse, both of whom caring for the same population (1,500 to 2,000 people per unit). Instruments of measurement: Data collection will be performed using a survey carried out by health professionals, who will use the clinical registers and the information reported by the patient during the visit to collect the baseline data: illnesses, medication intake, alcohol and psychoactive consumption, and self perception of risk.

Discussion: We expect to obtain a risk profile of the subjects in relation to RTI in the primary health care field, and to create a group for a prospective follow-up.

Trial registration: Clinical Trials.gov Identifier: NCT00778440.

Figures

Figure 1
Figure 1
Flow Chart: Algorithm of the study.

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Source: PubMed

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