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Cobb Safety Village - Interactive Health and Safety Education

State: GA Type: Model Practice Year: 2015

Cobb and Douglas Public Health (CDPH), with our partners, promotes and protects the health and safety of over 900,000 residents of Cobb and Douglas counties. Cobb County has the 4th largest county population in Georgia, recorded at  707,442 in 2012. 67% is white, 26% black, 4% Asian, and 2% other; 12% is of Hispanic origin. The Hispanic population grew 83.2% from 2000 to 2011.Cobb County has a relatively young population with the median age at 34.4 years and over one fourth of the population (28.3%) under the age of 19. CDPH relies on long-term partnerships, including those with local schools and public safety, to provide public health services in the community.  Cobb County's school system (the 24th largest in the United States), combined with the Marietta City Schools and private and home-schooled children in the county, includes approximately 60,000 elementary school aged students. Over 18,000 of these students are in the second and fourth grade, which is the target audience for the Cobb County Safety Village. In Cobb County, external causes (including injuries) account for 21.2% of all emergency room visits from 2009-2012.  Most frequent causes of injury include “other unintentional injuries,” particularly falls and motor vehicle accidents.  The Cobb County Safety Village is a direct result of a fast-growing youth population in need of education related to health, safety and injury prevention. It is the most comprehensive safety training environment in the Southeast U.S.—a place where the walls come alive with knowledge while instructors share the most advanced techniques and ideas for making our community safer. The mission of the Safety Village is to provide the highest quality, interactive safety education available. This enables our residents to protect themselves and others from accidental death, injury and destruction of property. The objectives  of the Village are to (1) increase educational opportunities and knowledge related to the prevention of unintentional injury  from all sources,  (2) to increase long-term retention of safety messages and (3) increase the efficiency in delivering these messages so that police, fire and health professionals utilize their time well.  Village programs include: ·         Fire Prevention and Evacuation Safety, ·         Smoke Alarm Distribution, ·         Electrical and Gasoline Safety, ·         Appropriate Utilization of the 911 System,   ·         Home Crime Prevention, ·         Stranger Danger, ·         Gun Safety, ·         Pedestrian and Driver Safety, ·         Railroad Safety, ·         School Bus Safety, ·         Bike Safety, ·         Drowning Prevention, ·         Proper Use of Child Restraints in Cars, ·         Child Passenger Safety Seat Checks,   ·         Home Emergency Preparedness and Response ·         Proper Hand washing ·         Importance of Physical Activity Classes are conducted in simulated environments providing hands-on participation. Children and adults are engaged in interactive sessions where they correct safety hazards in “Sparky’s Apartment”, evacuate a home “on fire,” and ride bikes and drive miniature cars on full-size streets to learn “rules of the road. CDPH hosts a highly interactive Public Health and Safety building filled with learning modules that address: (1) home emergency preparedness, (2) immunizations, (3) hand washing, and (3) physical activity. In addition, Safe Kids (led by Cobb Public Health and WellStar Health System) is housed at the Village and  provides injury prevention education and car safety seat checks free to residents. Since the Village’s inception in 2009, Cobb County Fire and Emergency Services (CCFES) has seen a drop in fire-related fatalities and structural fires within the community, even within a growing population. Additionally, the CCFES  and its partners are reaching more students with the same number of staff than in previous years. The number of students able to take part in health and safety training has more than doubled to almost 20,000 students. Evaluation pre- and post-test data from students continue to show a marked increase in scores, which demonstrates better learning and retention of the safety messages.  As the Village has continued to demonstrate effectiveness through the interactive programs, requests from the public and private schools, home schooled residents, scout troops, and the general population  have increased. The Village now offers monthly Family Fun Days for all children,  quarterly Touch-a-Truck Events and regular classes for Senior Adults and Special Needs Children. It is the partnerships within the Cobb Safety Village which continues to make it successful.  The main education building was built and is managed by Cobb County Government and all exterior Village buildings, streets and equipment have been donated by local businesses. Safety Classes are taught by  Fire, Police, and Health Education staff.   More information can be found at www.cobbcounty.org/safetyvillage
Brief description of LHD – location, jurisdiction size, type of population served: Established in 1920, Cobb and Douglas Public Health (CDPH) is a health district serving two metropolitan counties in Georgia and a population of over 900,000. Our headquarters is located 10 minutes from the city center of Marietta and 20 minutes from downtown Atlanta. We are governed by two county Boards of Health. At CDPH, we remain committed more than ever to our mission, which is, with our partners, to protect and promote the health and safety of Cobb and Douglas County residents. CDPH employs approximately 325 employees and is divided into five centers: Community Health, Clinical Services, Environmental Health, and Emergency Preparedness, and Administration and 2 Offices for Communications, and Quality Management. CDPH provides a total of 20 mandated services to the community, some of which include our Chronic Disease Prevention, Environmental Health, WIC, Children First, Immunizations, Family Planning and Epidemiology and Disease Surveillance programs. Additionally, the agency continues to provide 9 non-mandated but critically important public health functions including Safe Kids/Injury Prevention, Adolescent Health and Youth Development, Breast and Cervical Cancer Prevention, Pharmacy, Early Intervention, Babies Born Healthy, an International Travel Health Clinic and our HIV Clinic. Cobb County is located 17 miles north of Atlanta along the scenic Chattahoochee River. The county’s 340 square miles include the municipalities of Marietta, Austell, Powder Springs, Smyrna, Acworth, Kennesaw, and suburban areas in unincorporated Cobb County. Cobb has the 4th largest county population in Georgia, recorded at 707,442 in 2012. Within this population, 67% is white, 26% black, 4% Asian, and 2% other; 12% is of Hispanic origin. Minority populations have shown the most growth in Cobb County especially, the Hispanic population growing 83.2% from 2000 to 2011. It is estimated that 11.3% (2009-2011) of residents live in poverty. The highest concentrations of poverty are in Marietta; however, southern portions of the county (including areas of Austell, Mableton and Powder Springs) also have relatively high proportions of persons living at or below the poverty level. Areas of the county with the highest percentage of Hispanic/Latino populations coincide with the highest areas of poverty, those with limited English proficiency and those who are uninsured. Approximately, 18.4% of Cobb County residents are uninsured (2009-2011) with the highest rate in the Hispanic population at 48.4%. The unemployment rate Cobb County in 2012 was 7.6%.   Statement of the problem/public health issue: Preventable deaths including accidents are a leading cause of premature death in Cobb County. Additionally, external causes (including injuries) account for 21.2% of all emergency room (ER) visits from 2009-2012. Most frequent causes of injury include “other unintentional injuries”, falls and motor vehicle accidents.  For youth ages 1-19 years old, “all other unintentional injuries” and falls are the rank as the top two leading causes of ER visits from 2008-2012.  The Cobb Safety Village is a direct result of a fast-growing youth population which needed education related to health, safety and injury prevention.  For decades, local Fire, Police, Public Health and others had provided health and safety education  within the school classrooms, but with a fast growing population and one of the largest school systems in the country (110,000 students), the reach and effectiveness of that model was challenged.  In 2000-2002, county leaders visited numerous sites in the US and Canada searching for the best model to teach safety messages. The result was the Cobb County Safety Village. What target population is affected by problem (please include relevant demographics)? What is target population size? What percentage did you reach? Cobb County's school system (the 24th largest in the United States), combined with the Marietta City Schools and private and home-schooled children in the county, consists of approximately 60,000 elementary school-aged students. Of those 60,000 elementary-school-aged students, approximately 18,000 are in the 2nd and 4th grades, which is the target audience for the Cobb Safety Village. During the 2012-2013 school year, approximately 65 percent of these students visited the Village. What has been done in the past to address the problem? Fire and Safety instruction was provided to the school systems starting in 1978. Instructors would travel to the classroom and were able to educate only small group of students in the classroom or within a small simulation module in a mobile trailer. Frequently, overtime fire educators were used to assist with classes.  The number and need for instruction continued to grow as the county population and the number of schools continued to increase.  Likewise, Cobb Public Health also sent educators into the classrooms to teach a variety of injury-prevention and other public health topics.  However, because of limited staff, our reach was extremely limited and the lecture-style presentations were not ideal for the target audience. Why is current/proposed practice better? The Cobb Safety Village walls literally come alive with knowledge while instructors share advanced techniques and ideas for making the Cobb community safer. At the Cobb Safety Village, many more students are able to participate in life saving fire education, personal safety and public health learning modules. Additionally, Cobb County Fire, Police and Public Health Staff have been able to provide additional education to over 200% more students without increasing the number of staff and saving the cost of travel. It has been estimated that we are saving  over $120,000 annually in just travel costs. The creation of the Safety Village also kept us from having to purchase a new mobile trailer when the original one needed replacement. Additionally, the Safety Village has allowed us to expand the curriculum to include roadway safety, pedestrian safety, gun safety, stranger danger and other programs sponsored by local partners which had never been taught before.  We also incorporated virtual public health and emergency preparedness experiences that can be modified, updated, monitored and maintained on line.   Is current practice innovative: The Safety Village has received numerous awards and accolades since it opened in August 2009 for being  one of the most innovative and high quality injury prevention centers in the US.  As the 2013 host to the International Safety Village Annual Conference, attendees from around the world came to this location to see the “best-practice” model.  The National Association of Counties awarded the Safety Village its 2010 NACo Achievement Award. The Safety Village was also designated "Best of Category" in the Children and Youth category. In 2012 we received the Georgia County Excellence Award from the Association of County Commissioners of Georgia and Georgia Trend magazine. Cobb's Safety Village was recognized for being one of the Southeast's most comprehensive community safety training environments. County Excellence Awards provide an opportunity to showcase programs developed by local governments that are having a positive impact on the community," ACCG executive director Jerry Griffin said in a statement. "The Cobb County Safety Village is a unique facility that will serve as a model for innovative approaches in safety training."   The CDC was so impressed with our model, they agreed to fund the creation of several learning modules for our Public Health building.   The entire campus is of course, tobacco free as well. Is current practice evidence-based? If yes, provide references (Examples of evidence-based guidelines include the Guide to Community Preventive Services, MMWR Recommendations and Reports, National Guideline Clearinghouses, and the USPSTF Recommendations.) Interactive learning, particularly through the use of new technology and fun activities to engage children have been well documented as an evidence-based strategy to improve comprehension and retention. A didactic approach is recommended for health education in "The Guide to Community Preventive Services" and "Guide to Clinical Preventive Services.” More specifically, the CDC's Community Guide outlines recommendations from the Community Preventative Services Task Force that school and community based physical education classes have short term outcomes including improved test scores, but also long term implications for improving healthy lifestyles through adulthood. Sources include: Kahn EB,Ramsey LT, Brownson R, et al. The effectiveness of interventions to increase physical activity: a systematic review. Am J Prev Med 2002;22(4S):73-107.  Task Force on Community Preventive Services. Recommendations to increase physical activity in communities. Am J Prev Med 2002;22 (4S):67-72.  Increasing physical activity. A report on recommendations of the Task Force on Community Preventive Services. MMWR 2001;50 (RR-18):1-16.  Icon Task Force on Community Preventive Services. Physical activity. Adobe PDF File.  Zaza S, Briss PA, Harris KW, eds. The Guide to Community Preventive Services: What Works to Promote Health? Atlanta (GA): Oxford University Press;2005:80-113.
Motor Vehicle Injuries|Nutrition, Physical Activity, and Obesity|Tobacco
The overall goal of the Safety Village was to construct a site to provide the highest quality safety education and training available. This enables our citizens to help protect themselves and others from accidental death, injury and destruction of property.  The entire 8-acre complex and its operation are the result of public-private partnerships.  Objective 1) Explore international best-practice safety education models that could be replicated in Cobb County: Between 2000-2002, numerous public leaders (including Public Health) from various sectors joined together to travel around the US and Canada to visit numerous injury prevention/fire education complexes in search of a model practice which could be replicated in Cobb County. As a result of those numerous (>10) visits and other research, the initial design of the Cobb Safety Village emerged.  Objective 2) Create a sustainable public –private partnership between County Government, Public Schools, Public Health and local private businesses through which safety education could be provided in the most efficient and effective manner for Cobb children and adults: Between 2003-2009, the Cobb Safety Village Foundation was formed and worked to attract businesses and contributions to design and build the main Education Center and the exterior Village campus.  Founding Board members include Cobb Public Health, WellStar Health System, Georgia Power, Arcadis Engineering, Cobb EMC, MopDog Creative and Strategy, Smallwood Reynolds Architects, Cobb School District, Marietta City Schools and others.    The Safety Village Educational Center (opened in 2009) includes numerous classrooms, a puppet theatre, a manned 911-training center, the Safe Kids Car Seat Check Bay and “Sparky’s Apartment” where students learn to correct safety hazards throughout the house, “go low and go” during a simulated fire (with smoke, fire alarms and heated bedroom doors) and to escape out of a window through the use of a fire ladder or knotted bedroom sheets.  Students also learn the importance of creating a family evacuation plan and common meeting place away from the home in case of an emergency.  Public Health was key in designing this Center, particularly the Car Seat Bay and the Tobacco-Free and “Asthma Prevention” Apartment for Sparky.  On the external campus (currently in process), numerous partners responded to construct the Village. A local architecture firm contributed their design time and resources.  An Engineering firm graded the land at no cost and the local electric company installed not only a building to teach about electrical safety, but did all the external wiring for street lights and other buildings. A local construction firm sponsored the creation of all the streets and the “Marietta Square” park. Cobb County Schools not only absorbs the transportation costs to make the Safety Village a mandated field trip for their 2nd and 4th graders, but they also donated a school bus that is used to teach bus safety. The list goes on and on about partners who have stepped up to contribute funds or in-kind services. Complete list available upon request.  Objective 3) Create a site which would be more efficient and effective at providing education to an increasing number of students: The Cobb County School District and the Marietta City School System were early partners who worked tirelessly to secure the funds to assure that all 2nd and 4th graders would be transported to this site at least one time/year. Additionally, they worked with Fire, Police and Public Health subject matter experts to assure that the teaching modules were interactive, educationally sound, age appropriate and that they met the Georgia requirements for school health and safety learning standards.  Lastly, the school systems have led the efforts to create pre- and post tests for the students, loaded them into their smart boards so that the assessments are electronic and they provide the summary evaluation data to us related to scores.  Objective 4) Within the Cobb Public Health building, the goal was to create and implement hands-on interactive safety and emergency preparedness training for children that aligns with local, state, and federal readiness guidelines as well as school system educational objectives: The following six modules, each led by an animated public health character, successfully met the project's objective: (1) "The Hand Washing Game" is designed to teach children the importance of good hand washing techniques. A hand washing song/rap was written by our own CDPH Communications Director to reinforce the lesson. (2) "Splat the Germs" is designed to teach children about germs. When activated, germs appear on the floor and the bottom portion of the wall as an animated nurse explains the importance of fighting germs. Children then stomp the virtual germs off the floor with their feet or off the wall with their hands. (3) "Are You Ready?" is Part 1 of the Emergency Preparedness learning module, in which children learn which items go into an Emergency Kit. This module is directly aligned with Strategic National Stockpile (SNS) concepts. (4) "Which is Better?" is Part 2 of the Preparedness module, and children select the most appropriate items to "drag" into the virtual emergency kit. (5) "Immunizations Are Good" helps children understand that vaccines are good, even though shots hurt. When the module is activated, virtual viruses drop down the wall and onto the floor. By stomping them with their hands or feet, children are able to "immunize" against viruses. And the germs turn into healthy heart character (6) "Let's Get Moving" was designed to emphasize the importance of physical activity. When activated, an animated public health educator leads kids through a popular low-impact dance set to an upbeat tune.  What did you do to achieve the goals and objectives; Steps taken to implement the program: 1)       Established the Cobb Safety Village Foundation Board to raise funds and develop curriculum 2)       Made numerous presentations or led tours to secure private and public partners 3)       Secured subject-matter experts at each step to assure state-of-the-art components 4)       Established strong evaluation components to assure learning goals and process efficiencies are met. 5)       Established an educational strategy for who we target/serve over time and how we roll out additional training modules.  Strategy also drives which partners we work to secure. For example, we are currently working to secure a home security company/partner to sponsor a building that would teach “home alone” safety to children and seniors.  Any criteria for who was selected to receive the practice (if applicable)? Initially, we worked with the local school systems to determine what age groups traditionally receive the injury prevention educational messages as part of Georgia Educational Standards.  Their feedback drove us to initially create the curriculum for 2nd and 4th graders throughout the Village, including in the Public Health Building.  What was the timeframe for the practice? 2000-2002 - International research and site visits 2003-2009 - Design and fundraising/putting money in budget reserves, construction of primary building 2009 - Opening of primary Safety Village Education Center 2009-present - Fundraising, design and construction of various sponsor buildings (e.g., Cobb & Douglas Public Health, Cobb EMC, Colonial Pipeline, Marietta Kiwanis, City of Kennesaw, Firehouse Subs). Continued development of curriculum for various age groups and populations. 2014-15 - Currently serving almost 20,000 students through Village educational programs and 600 families through Safe Kids Car Seat Checks. Significant increase in number of children served and significant improvement in learning safety messages as evidenced by pre-and post test evaluations.   Were other stakeholders involved? What was their role in the planning and implementation process? What does the LHD do to foster collaboration with community stakeholders? Describe the relationship(s) and how it furthers the practice goal(s):   The Cobb Safety Village is a model for community partnerships, bringing together numerous community leaders for the initial concept research, national site visits, project design, implementation, policy development, corporate sponsorship and ongoing operational support. More than 25 members are active with the Safety Village Foundation Board of Directors (list available upon request) and work tirelessly to raise funds, advise about operational issues and support community events related to the Village. Members represent county government, public safety, public health, education, the local hospital system, marketing, private businesses, and civic groups. All have worked diligently to make the Safety Village a reality without priority on individual credit. Stakeholders and partners have influenced the project every step of the way, from initial ideation of the Cobb County Safety Village as a whole to helping conceptualize education modules for the Cobb Public Health Interactive Technology Project. The Cobb Safety Village Board of Directors, through the Design and Development Committee (comprised of engineers, educators and construction experts), is tasked with reviewing, advising and approving all building and structures within the Village. They assisted with the initial design and future vision of the CDPH building. CDPH has built strong, long-term partnerships with more than 100 area health care providers, businesses, and community agencies, including the WellStar Health System (community NFP), Good Samaritan Health Center in Cobb, Community Health Center, Community Service Boards (mental health), individual medical practices, local county and city governments, Dobbins AFB, local school systems, local colleges and universities, Chambers of Commerce, numerous businesses, and faith-based organizations. Our Community Family Connection Collaborative (CFCC)—the Cobb Collaborative—also provides tremendous partnering opportunities. Any start up or in-kind costs and funding services associated with this practice? Please provide actual data, if possible. Else, provide an estimate of start-up costs/ budget breakdown. The main Safety Village Education Center was built with a combination of in-kind donations and funds from the Cobb Fire Department Reserves for a total cost of almost $5 million.   The external Village has been built with almost $1 million in cash and another $2 million in donated goods/services.  It is not yet finished, and new partners are joining regularly to sponsor particular educational areas of focus.  Direct costs associated with the Public Health building of the Safety Village include an initial investment of $72,000 that covered the cost of the building and a 20-year maintenance fund. The CDC contributed the costs of the interactive technology for $120,000. The in-kind costs associated with planning and consultation hours spent among CDPH Emergency Preparedness, Clinical and Prevention Services, and Health Education staff were tremendous. Even so, the end product resulted in improved pre/post test scores among children and saved countless hours which would have otherwise been spent in providing in-person trainings.
What did you find out? To what extent were your objectives achieved? Please re-state your objectives from the methodology section. To evaluate the effectiveness of the Cobb Safety Village participant attendance logs and special event attendance records are documented.  This year, almost 20,000 children will be taught through our programs at the Safety Village. The overall goal of the Cobb Safety Village learning modules is to educate kids about lifesaving fire skills and other injury prevention messages. For the 2014-2015 school year thus far, students had an average pre-test score of 56/100 and a post-test score of 92.75/100 for the entire Safety Village experience.  Examining the 2014-2015 questions which looked only at the public health learning objectives, students scored 49 on the pre-test and 94 on the post-tests.  The overall results from the 2013-2014 year showed students had a pre-test average of 52 and post-test of 92. The public health evaluation results that year showed a pre-test score of 44 and a post-test score of 93.   On average, results of pre-/post-tests reveal improved understanding of the importance of hand washing (correct scores related to hand washing increased from 10% on the pre-test to 80% on the post-test) and ways to prepare a home emergency kit (from 40% on the pre-test to 90% on the post-test).  Did you evaluate your practice? ·         List any primary data sources, who collected the data, and how (if applicable) Pre- and post-tests were administered by 2nd and 4th grade teachers in both the Cobb and Marietta Schools Systems. Data were collected via Smart-board technology and the results reported to the Cobb Safety Village on a quarterly basis. ·         List any secondary data sources used (if applicable) - NA ·         List performance measures used. Include process and outcome measures as appropriate. See below. ·         Describe how results were analyzed - See below ·         Were any modifications made to the practice as a result of the data findings? See below The pre and post test were designed by both school advisors and subject matter health and safety experts. The test results are reported to the Safety Village by class and by school. Over the past 2 years, as a result of performance on various questions, the school advisors and subject matter experts revised the curriculum to better address the learning gaps noted.  The full pre and post test questions are available upon request.
Lessons learned in relation to practice? Lessons learned in relation to partner collaboration (if applicable): As with all new community-based initiatives, particularly during challenging economic times, the Cobb Safety Village Leadership assured success by involving community partners from the initial concept stage, through all stages of planning and implementation. The Board has worked hard to develop a collaborative atmosphere that puts the goal of educating our children and keeping them safe above individual/agency acclaim. Many agencies have freely given their time, expertise and products to make the Safety Village a reality. One challenge for the Village has been the economic downturn over the past few years, which has resulted in many sponsors who anticipated hosting buildings having to delay this involvement because of business economics. It was also one of the challenges in finding funding to expand the CDPH interior technology modules. Another challenge has been to resist "being all things to all people".  As a result of the Safety Village's success and innovative approach, numerous other neighboring school systems and counties have campaigned hard to be included in the Village.  Additionally, many other populations have wanted to have their safety needs met. Fortunately the County Government leadership and the Foundation Board have held firm on growing the Village slowly and within our quality standards. WE have grown slowly from serving 2nd graders, to adding 4th graders, then to special needs children and seniors.  This past summer, we added curriculum for scout troops and home schoolers. This fall, we have added special events on a quarterly or monthly basis that would allow families to bring their children of many ages to experience the Village.   Is this practice better than what has been done before: After implementing the pre-/post-test assessments to measure concept comprehension, Cobb and Douglas Public Health has been able to evaluate and improve learning modules at the Cobb Public Safety Village.  This integrated evaluation program has allows CDPH to align modules with local, state, and federal readiness guidelines as well as school system educational objectives.  Our state Public Health and CDC partners have noted that we are one of the very few agencies to demonstrate learning of emergency preparedness concepts. Did you do a cost/benefit analysis? If so, describe: N/A Sustainability – is there sufficient stakeholder commitment to sustain the practice? Cobb and Douglas Public Health, along with partners including the Cobb County School District and Safety Village Board of Directors, are committed to sustaining the practice. More than 25 members are active with the safety Village Board of Directors (list available upon request) and work tirelessly to raise funds, advise about operational issues and support community events related to the Village. Members represent county government, public safety, public health, education, the local hospital system, marketing, private businesses, and civic groups. All have worked diligently to make the Safety Village a reality without priority on individual credit. Additionally, when private businesses sponsor a building/learning topic, their funds cover both the initial building and a 20-year maintenance fund that is managed by the Village.  This maintenance fund allows for repairs to the grounds and buildings as needed over time. Describe sustainability plans: 1)       Over time, as the practice continues to demonstrate effectiveness by improving knowledge and understanding of promoting health among students through the interactive modules, awareness and requests to schedule bus trips to visit the Village have only increased. The current modules are self-sufficient and county resources have been allocated to provide for health education staff to guide students through each session. New modules may be added to further educate students and adapt to changing public health needs and emerging issues. 2)       The Safety Village staff and Boards are constantly applying for grants to support various learning modules.  This has been successful for many areas through Police, Fire and Homeland Security agencies. 3)       The Village regularly hosts various fundraising and educational events (e.g., Touch a Truck) that result in additional funds going into the Safety Village budget. 4)       Cobb County Government budgets for the Safety Village as it does its other public services departments. Therefore, funds are allocated for educational staff and facilities annually. Cobb Public Health budgets to support the Village through our Safe Kids Cobb County agency and community coalition budgets.
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