Large research Projects

This study seeks to evaluate the use of BEP programs in Iowa, focusing in particular on the effects of sanctions as an incentive for batterer compliance with treatment and subsequent reduction in repeat domestic abuse offenses. Examples of sanctions used in Iowa include arrest for re-assault or violation of a no-contact order, enhanced charges and/or penalties for repeat offenses, court monitoring, jail-time for failing to comply with court orders, probation, intensive supervision, electronic monitoring, and work-release. We hypothesize that weak sanctions and variable enforcement of these sanctions will predict poor completion rates as well as higher repeat domestic abuse rates. This study will include both county level and individual level examinations of the effects of sanctions and will further examine differences in sanctions between urban, urban-influenced, and rural counties in Iowa. This will be a retrospective cohort study. The cohort will be comprised of all individuals in Iowa who were convicted for a domestic abuse related offense between July 1, 2000 and June 31, 2003. Each cohort member will be tracked from this “index arrest” for three years after the date of their BEP release for any repeat domestic abuse and other criminal offenses.

Identify differences in the characteristics of driving video segments between urban and rural youth. Baseline data collection has been completed for an urban teen study utilizing event-triggered video, and these data will be compared to the rural cohort that has been followed for over a year. We will examine differences as they relate to the type of roadway, type of triggering event, social contexts associated with triggering events, and changes in driving errors before and after the feedback is implemented. This comparison will be important when tailoring the intervention and evaluation for different populations.

Automobile driving is a crucial aspect of everyday life, yet vehicular crashes represent a serious public health problem. Patients with epilepsy are at elevated risk for automobile crashes, causing great personal suffering and financial costs to society. Most collisions involving epileptic drivers are not seizure related but may instead result from cognitive effects upon driving performance of epilepsy and antiepileptic drugs (AEDs). Several million American drivers take AEDs for treatment of medical conditions besides epilepsy and may also be at risk for cognitive impairments that can reduce driving performance. Empirical evidence of the effects of AEDs on driving performance would enable development of driving guidelines that could lower the risk of injurious motor vehicle collisions; however, this evidence is currently lacking. The broad goal of our project is to determine the specific effects of the most commonly utilized AED, phenytoin, by assessing driving performance and cognitive abilities in neurologically normal volunteers taking phenytoin in a randomized, double-blind, placebo-controlled, crossover study. Our proposed experiments will assess: (1) cognitive functions using standardized neuropsychological tests (of attention, perception, memory, and executive functions), (2) driving performance during phenytoin and placebo administration, and (3) the effects of phenytoin-related cognitive performance upon driving performance. To measure driving performance, we will use a state-of-the-art fixed-base interactive driving simulator that allows us to observe driver errors in an environment that is challenging yet safe for the driver and tester, under conditions of optimal stimulus and response control. The results of this study of 30 drivers treated with phenytoin and placebo will increase the understanding of the role of AED-related cognitive impairment on driving safety errors. A better understanding of the impact of AEDs upon driving performance is necessary to rationally develop interventions that could help prevent crashes by drivers treated with AEDs.

Bicycle crashes are among the most common causes of severe injuries in childhood. Approximately 600,000 bicycle-related injuries are treated in emergency rooms each year. Children between the ages of 5 and 15 represent a particularly vulnerable segment of the population, having the highest rate of injury per million cycling trips. Motor vehicles are involved in approximately one-third of all bicycle-related brain injuries and in 90% of all fatalities resulting from bicycle crashes. Furthermore, many of these collisions between bicycles and motor vehicles occur at intersections. Despite growing national concern over promoting children's bicycling safety, the underlying causes of bicycle crashes remain poorly understood. One reason why we know so little about the behaviors that put children at risk for bicycling injuries is that it is difficult to study bicycling behavior without putting research participants at risk for injury. Another reason we know so little about the causes of bicycling crashes is that it is difficult to study bicycling behavior in a controlled environment. Advances in virtual environment technology, however, offer a way of addressing the problem of bicycling safety in a controlled manner without putting children at risk for injury. Using an immersive, interactive bicycling simulator, we can safely present children with the same kinds of bicycling challenges as they confront in the real environment. The overall aim of this project is to use an immersive, interactive bicycling simulator to examine how child cyclists negotiate challenging, everyday road-crossing situations. More specifically, we will examine how children and adults respond to four challenging road-crossing scenarios in our virtual environment: 1) traffic that comes from two directions; 2) 2-lane traffic that varies in speed; 3) traffic that comes from two directions and varies in speed; and 4) head-on traffic that turns left in front of the cyclist. Together, these studies will provide important information about the underlying causes of bicycle crashes that will lay the groundwork for the development of intervention strategies for reducing bicycling injuries.

Intimate Partner Violence (IPV) is widely recognized as an important public health problem because of its high prevalence, its potential for serious physical injury, including death, its association with poor physical and mental health outcomes, and its burden on health services. However, few trials have assessed the effectiveness of IPV interventions, and available evaluations have shown limited success. Most studies have targeted IPV survivors admitted to shelters, rather than community-dwelling women identified from clinical settings; the latter women are likely to be younger and at an earlier stage in the "cycle of abuse". Although IPV is equally prevalent in urban and rural populations, few studies have focused on women residing rural areas. The proposed study has been designed in response to these deficiencies in the research literature. Specifically, we will conduct a cross-sectional study to collect important baseline data on the IPV experiences, related health correlates, and access to local IPV resources in a consecutive sample of 1000 reproductive aged women attending a large women's health clinic in central Iowa. Nearly 40% of patients attending this clinic reside in rural areas. The specific aims of this cross-sectional study are to: 1) estimate IPV prevalence; 2) identify demographic and health correlates of IPV victims; 3) assess steps IPV victims have taken to increase their safety, and the barriers they encountered; and 4) conduct geographical information systems analyses to determine accessibility of community resources to IPV victims, particularly for those living in rural areas. Guided by the findings of this study, we plan to identify sustainable IPV intervention strategies that will be acceptable to this population and tailored to individual women’s resources and needs for community support and medical care. Our proposed intervention will be a community-based endeavor to strengthen the social support networks of battered women, ideally before the battering has been brought to the attention of any health or legal authorities. Without baseline data on this target population, IPV prevention programs are likely to fail or possibly place women at an even greater risk of violence. Thus, the proposed cross-sectional study will lay the necessary groundwork to develop and test a future individualized, community-based intervention program targeted to both rural and city dwelling women in Iowa.

Athletic injuries frequently have a profound negative impact on athletes’ psychological health, as well as their physical health. Depression and anxiety are typically experienced by injured athletes, and these emotions are harmful and can hinder the recovery process. On the other hand, social support is an important coping resource for injured athletes, which can help reduce the emotional symptoms following an injury. While intensive medical efforts are provided to speed injured athlete’s physical healing, relatively few studies have addressed psychological recovery from an athletic injury, including changes in depression and anxiety. No study exists that prospectively examines the influence of social support on both physical and psychological recovery from an athletic injury. In this project, we will adopt a prospective study design with repeated measures to identify the relationship between athletic injury and the symptoms of depression and anxiety among Division I athletes involved in National Collegiate Athletic Association (NCAA) competitive sports. We will also define the influence of perceived social support (both its availability and helpfulness) on physical and psychological recovery from injury. This research will support the development of interventions that incorporate social support to reduce the psychological distress of injured athletes and facilitate their recovery and return to play.

Intimate partner violence is a major cause of injuries to women and children, and the primary cause of intentional injuries. The goal of the proposed research is to integrate the approaches of public health and clinical psychology to explain the longitudinal course of intimate partner violence and its impact on women’s physical and psychological health. There are three aims to the proposed research. The first aim is to describe and predict the course of intimate partner violence—both psychological and physical violence, over a 12-month period. The second aim is to demonstrate the impact of intimate partner violence on women’s physical and psychological health. The third aim is to demonstrate that the impact of intimate partner violence on women’s health is modified by (a) women’s interpretations of their partner’s violence, (b) women’s emotional reactions following the violence, (c) the frequency of the aggressor’s alcohol use during violent episodes, and (d) rurality. Advertisements will be placed in newspapers and ad circulars in Benton, Washington, Cedar, Jones, Linn, and Johnson Counties to recruit female participants aged 18-55 who have been living with a male partner for at least four months. The sample will comprise 100 moderately victimized women and 100 severely victimized women, based on Straus’ (1979) Conflict Tactics Scales classifications, with the goal of recruiting at least half of the participants from rural communities. Data will be collected via 60-minute in-person sessions at Time 1 and via 60-minute telephone sessions at Times 2-4, for a total of four waves of data collection over a 12-month period. Data collection is expected to take 20 months to complete. Questionnaires will be administered to assess demographics, relationship history, psychological and physical violence, physical health, depression and anxiety. A semi-structured interview will be administered to assess violence-related injury and the factors modifying the impact of intimate partner violence on women’s health (interpretations, emotional reactions, alcohol use, rurality). Participants will be paid $30 for each wave of data collection. Growth curve analyses will be conducted to examine the longitudinal course of violence and to test the specific hypotheses. The findings from the proposed study will be used by the Principal Investigator to develop an empirically driven primary prevention program targeting intimate partner violence.

The goal of the Iowa FACE Program is to reduce the number of traumatic occupational fatalities in Iowa and the nation by establishing a fatal occupational injury surveillance system, conducting on-site investigations of the fatal incidents, identifying risk factors for such injuries, developing prevention strategies, and disseminating the results of these efforts. This goal is achieved through well balanced surveillance and research activities, and an information dissemination program. The University of Iowa brings institutional strengths in occupational medicine, epidemiology, industrial hygiene, agricultural engineering, and public health to identify strategies to prevent fatal injuries in the workplace. The Office of the State Medical Examiner is an important partner in the Iowa FACE Program bringing forensic expertise and timely access to occupational death notification.

Since 1985, Iowa has had a law requiring all young children riding in motor vehicles to be properly protected through the use of child seats, booster seats, and/or seat belts. In 2004, the Iowa Legislature revised the requirements of our child passenger safety law. The revised law now requires that: • Children must ride in an appropriate rear-facing child safety seat until one year of age and at least 20 pounds. • Children must ride in a child safety seat or a booster seat through the age of 5 years. • Children ages 6 through 10 must ride in a booster seat and/or seat belt. In order to measure compliance with the law and to direct educational efforts, observational usage surveys have been conducted annually since 1988. The surveys are funded by the Governor's Traffic Safety Bureau (GTSB) within the Iowa Department of Public Safety. The GTSB has contracted with The University of Iowa Injury Prevention Research Center (UI IPRC) to conduct these child passenger safety surveys since 1996. Each summer over 3,000 children up to ten years of age are observed at thirty-six locations across the state. Information collected includes age of child, restraint use, location in the vehicle, type of vehicle, and restraint use of the driver. The data is analyzed and compared to previous years.

Drivers in their first six months of licensure have the highest crash rates of all drivers, leading to high rates of injury for themselves, their passengers, and those they hit. Parents play a critical role in the driving experience of their children. Policy approaches, such as Graduated Driver's Licensing Systems, and educational programs that encourage parents to define driving rules and restrictions have shown some success in reducing teen risky driving. However, methods to increase parental involvement in teaching driving skills and encouraging safe driving behaviors have not been widely tested. Such interventions can augment existing GDL systems by increasing parental knowledge and involvement in learning to drive. The long-range goal of this research is to develop a sustainable and generalizable intervention that will reduce crashes and related injuries among teen drivers by increasing safe driving practices. We propose to conduct a randomized trial of an educational intervention for parents of newly licensed teenaged drivers to increase parental involvement in teaching driving skills and safe driving behavior. Six schools in small towns in the state of Iowa have agreed to participate. These schools are all within 50 miles of Des Moines, Iowa's largest city, which will lead to driving exposure in rural and town environments. The intervention will have two components: the intervention content and the intervention delivery. The intervention content includes specific driving goals that parents meet with their teen drivers that focus on skills and behavior. This project will be conducted in a rural population, so skills for driving on rural roads will be included. The delivery of the intervention will use motivational interviewing, a successful and age-appropriate health behavior communication technique that has shown great success in related health fields. 250 parents and their teens will be individually randomized into intervention and control groups. The intervention group will receive a tailored, in-person intervention with a Traffic Safety Specialist, with follow-up intervention phone calls at one, three, and six months. The control group will be a "usual care" group who will receive driving safety materials available to all new drivers and their parents. Parents and teens will be followed to see if intervention parents meet the intervention's driving goals and to see if the parents and teens report improved driving skills and behaviors in the intervention compared with the control group.