Preventing unintentional injury in Western Australia

With reports of more than three Western Australians dying each day from injuries (e.g., falls, poisoning and transport), the rate of injury on the rise, and an annual cost of over $AUD 9.6 billion,^[1]reducing preventable injuries in Western Australia is a significant challenge.

To better understand and contextualise local challenges of unintentional injury prevention in Western Australia (WA), Injury Matters partnered with BehaviourWorks Australia (BWA) and the Sustainable Mobility and Safety Research Group at Monash to gain insights into the actions and influences that precede unintentional injuries across different settings, and what communication strategies could help to prevent them.

The research aimed to unpack and understand the following topics:

- Behavioural influences of unintentional injury (e.g., attitudes, norms, enablers and barriers);

- Self-reported incidence of injury prevention behaviours and/or contextual factors; and,

- How the community talks about the issue of injury prevention, and their suggestions for communication strategies.

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What did we do?

We took a three-step approach to conducting research for the project:

First, we conducted a rapid literature review that identified key barriers and facilitators to unintentional injury in the adult general population.
Second, we conducted a community survey that explored the barriers and facilitators and reported behaviours associated with unintentional injury in WA’s adult population. In 2022-23, we ran a second wave of the survey to ensure a larger and representative sample.
Third, we ran community focus groups to explore and unpack some behavioural influences measured in the survey, as well as to capture community reflections on public service campaigns.

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What did we find?

Findings from the review:

Findings from the rapid review suggested that behavioural influences were primarily individual factors (attitudes, capability, emotion) and social factors (social norms). Context also matters.

The review also found common preceding behaviours and influences of behaviour led to unintentional injury, such as wearing inappropriate clothing or inadequate protective gear, using inappropriate equipment and/or not maintaining equipment, not seeking, reading, or responding to available safety information, leaving hazards unattended, performing activities or tasks at the wrong location, time and/or at an inappropriate pace or state, and having inadequate supervision and/or not asking for help.

Findings from the survey:

The survey highlighted key predictors of ‘safe’ and ‘unsafe’ behaviours in the Western Australian adult population.

Key predictors of ‘safe’ behaviours included:

- Stronger reported involvement with the issue of injury prevention;

- Stronger beliefs that injuries are preventable;

- Lower reported habitual approach to completing tasks in familiar environments or that are completed often;

- Lower reactance to warning and public advice; and

- Living in Perth.

Key predictors of ‘unsafe’ behaviours included:

- Stronger reactance to advice or recommendations from others;

- Younger age;

- Higher reported habitual approach to completing tasks in familiar environments or that are completed often;

- Having sustained an injury in the past year; and

- Providing care to children under the age of 18.

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Findings from the focus group:

The majority of participants in the focus groups referred to injuries as ‘accidents’ or ‘accidental events’, and referred to safety as ‘prevention’ or ‘preventable events’. Three key themes that participants believed increased the risk of injury were: (i) being distracted, (ii) being in a holiday mood or being spontaneous, and (iii) being complacent or taking shortcuts.

The focus group research also revealed there was general agreement that public service campaigns can be useful–particularly, if they are practical and provide recommendations on what to do to reduce risk and if they remind people of the ‘why’ behind the recommendation. However, groups often raised that public service campaigns would not be enough to reduce injuries.

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What’s next/recommendations (if any):

The aim of this project was to provide Injury Matters with baseline data that would inform intervention development in subsequent phases of work. Thus, to address some of the limitations of the broad approach taken in this current phase of work, we recommend that the next phase of work shifts from the broad problem of ‘unintentional injury’ to a more targeted approach.

To meet this objective, we recommend two key steps:

Conduct a ‘deep dive’ to understand the barriers and facilitators, and conduct a review of what works to address these; and
Prioritise and co-design campaign options with key audiences.

Final remarks:

As with many social problems, injury prevention is highly complex. Understanding what drives our behaviour can help inform targeted interventions that make us take a moment and consider the risks, before we do something that leads to those unintentional injuries!

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^[1] Hendrie, Delia, et al. Incidence and costs of injury in WesternAustralia 2012. Chronic Disease Prevention Unit, 2016.

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