Community readiness and prevention of traumatic brain injury.

PRIMARY OBJECTIVE The study aimed to understand the readiness of rural communities to engage in community-initiated traumatic brain injury (TBI) prevention. The utility of state-wide TBI surveillance to monitor outcomes of local TBI prevention efforts was also assessed. RESEARCH DESIGN A quasi-experimental design was used to evaluate the effects of community-initiated TBI prevention programmes. METHODS AND PROCEDURES The Community Readiness model was used to assess changes in communities before and after programmes. Four rural counties in Colorado, US, were selected based on population composition and TBI rates. Key informants in each county were interviewed to determine community readiness stages to engage in prevention. The interviews were repeated 2 years later. RESULTS In two study counties TBI prevention activities were initiated. One county conducted a number of prevention activities and moved from 'vague awareness' to 'preplanning' stage. Three counties moved from 'denial' to 'vague awareness'. TBI surveillance did not capture rate changes in the counties. CONCLUSIONS The Community Readiness model identified counties more likely to engage in prevention and change was observed in readiness where programmes were undertaken as well as in counties where no new programmes were initiated. Detailed local TBI data is necessary to monitor outcomes of community interventions.