Campaign Slogan

A Nested Case-Control Study Among Elementary Students in a Public School on Fireworks Use
During the New Year Celebration, Philippines, 2012
AR De Guzman, MD, MCHM; VC de los Reyes, MD; MN Sucaldito, MD; EA Tayag, MD, FPSMID
Field Epidemiology Training Program, National Epidemiology Center, Department of Health, Philippines
BACKGROUND
OBJECTIVES
Fireworks Injury Prevention Program
1. To determine the percentage of students who used fireworks
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2. To determine the percentage of students who knew the 2011
campaign slogan
Aims to decrease fireworks-related injuries and deaths
Campaign Slogan: Aksyon: Paputok Injury Reduction (Call to
Action: Fireworks Injury Reduction)
3. To identify which campaign slogan would be best
remembered by the students
Results of 2011 Surveillance:
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4. To identify which images would prevent or stop students
from using fireworks
1,021 cases and four deaths
79% of injuries were males
5. To identify factors associated with fireworks use among the
students
23% were from the 6-10 years age group
86% were blast injuries
6. To recommend a campaign slogan for the 2012 firecracker
injury prevention program
METHODOLOGY
CONCLUSIONS
Descriptive Study
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1. Majority of the students did not use fireworks.
Calculated sample size
Conducted a survey using a standardized questionnaire
Encoded and analysed data using Epi Info 3.5.3
Health education for
family and friends
4. The best remembered slogan was “Iwas Paputok” (Avoid Fireworks Use).
Nested case-control
5. Image 2 (Piccolo-injured male) was chosen by majority of students as the
image which would prevent or stop them from using fireworks.
Case Definition
A Case was a Grade 1-5 student enrolled at Cecilio Apostol
Elementary School who used fireworks during the 2011
Christmas or New Year celebration.
A Control was a Grade 1-5 student enrolled at Cecilio Apostol
Elementary School who did not use fireworks during the
2011 Christmas or New Year celebration.
2011 Campaign Slogan
2. Reasons for fireworks use were for merriment and celebration of the holiday
season.
Family and friends encourage/give/
buy fireworks for children
ACTIONS TAKEN
Resisting
Forces
1. Presented the results and recommendations to involved Department of
Health agencies
2. Developed new health promotional strategies with stakeholders
Variable
SEX
Male
Female
AGE RANGE
MEDIAN AGE
No.
383
703 Students
%
54
320
46
5 years-14 years
8 years
Table 2. Reasons for Fireworks Use
Among Students (n= 337)
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Reasons
No.
%
A form of merriment
136
40
To celebrate Christmas/New Year
90
27
30
Reasons
No.
%
Feared getting injured
185
51
Forbidden by parents
77
21
Don’t know how to use
9
Table 4. Campaign Slogan Best Remembered
by Students (N=703)
No.
%
Avoid Fireworks Use
531
76
Against Fireworks Use
58
8
2011 Slogan
114
16
Figure 2. Proportion of Image in Slogan Which Would
Prevent/Stop Fireworks Use Among Students (N=703)
1. Cases were 4X more likely to know other individuals
who also used fireworks than controls
Fireworks are part of Filipino
Christmas and New Year celebrations
2. Cases were 2X more likely to choose Image 4 than
controls
Dancing
Table 5. Analysis of Factors Affecting Fireworks Use
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Variable
Odds Ratio
(95% CI)
p-value
Other Individuals Who
Used Fireworks
4.327
(3.0583-6.7178)
0.0000
Chose Poster 4
1.6495
(1.0839-2.5104)
0.0195
2
Post 2012 New Year Celebration Survey at Cecilio
Apostol Elementary School, Manila, March 2013
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What Did We Do Right?
Decrease of 90 (9%) cases in 2012 vs. 2011
Decrease of three (75%) deaths in 2012 vs. 2011
Decrease of 37 (13%) cases among <10 years in 2012 vs. 2011
2012 Slogan changed to APIR
Iwas Paputok
Use of blast images in health
education materials
Role of parents in preventing
fireworks injuries in a TV ad
Introduced dancing as alternative
merriment activity
Decrease of 21% of students who used fireworks
Survey at Cecilio Apostol, March 14, 2013
Integrity and Excellence in Field Epidemiology
Other noisemakers
WHAT HAPPENED NEXT?
2012 Fireworks Injury Surveillance Results:
9
Table 3. Reasons for Fireworks Non-Use
Among Students (n= 366)
2. Use of fireworks by minors
Use of alternative means of merriment
during celebrations
Analysis of Nested Case-Control Study
521 (74%) students knew an individual who used fireworks
Fig 1. Other Individuals Known by Students Who Used Fireworks (n=521)*
Creation of policies banning:
Only 48 (7%) students knew the 2011 campaign slogan
Slogan
Attitudes and Practices of Students on Fireworks Use
Also practised by others
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Yearly fireworks-related
injury surveillance
1. Sale of fireworks to minors
Prevention of Fireworks-Related Injuries
Campaign Slogan
Table 1. Student Demographics (N=703)
Driving
Forces
No policy banning use of
fireworks by children
RESULTS
Profile of Students
Yearly survey on
campaign slogan
Lack of knowledge on dangers
of fireworks use
Survey at Cecilio Apostol Elementary School, October 8, 2012
Blast Injury
Interventions to Prevent/Stop
Fireworks Use
Risk Factors for Fireworks Use
3. Reasons for non-use of fireworks were fear of being injured and following
parental advice.
Analytic Study
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DISCUSSION AND RECOMMENDATIONS