The Quest for Childhood Injury Prevention - Embodied in Safety Quest

When I joined the Injury Prevention Program at UMass Memorial Children’s Medical Center in 2000 as the Pediatric Trauma Medical Director, I found 650 pediatric trauma patients were being admitted each year. Fully 90 percent of these injuries were preventable, as I learned from my mentor, Dr. Barbara Barlow, founder of the Injury Free Coalition for Kids.

To make a dent in childhood injury prevention in Central MA, which was incidentally the #1 killer of children under the age of 19, we tried many avenues. Bike rodeos where we did helmet fittings. Car seat safety checkpoints to ensure that car seats were used and used properly (50 percent are not). Home safety kits with room-by-room information on eliminating household hazards. Promoting the use of ski helmets at our local ski venues. Working with the Juvenile Court system to create a program for 1st time Driving Offenders to have them spend a day in the Trauma Center to help them better understand the consequences of their reckless choices (TEEN RIDE-Reality Informed Drivers Education). This reduced the recidivism of these driving offenders from 35 percent to 7 percent.

And of course, we established the Greater Worcester Gun Buy Back Program, Goods for Guns, that has taken over 4,000 guns off the streets of Worcester and 25 collaborative communities. Central Massachusetts boasts the lowest penetrating trauma rate of any county in the Commonwealth.

Our flagship program was rolled out in 2008-Mobile Safety Street (MSS). It visited thousands of students in the Worcester Public Schools and other Central MA elementary schools. We had a brilliant Injury Prevention Educator, Allison Rook Burr, who worked with the school systems to integrate the MSS program into the health curriculum of the schools, so it was not an extra burden on the school systems. It demonstrated 40 indoor and 40 outdoor safety behaviors using a hands-on experience. We published papers verifying that students who participated in the MSS program had a 50 percent better understanding of the injury prevention information and better retained that information at 6 months post experience by a factor of 25 percent.

Unfortunately, the vehicle in storage during the winter of 2017 was severely damaged and the necessary funding to refurbish it could not be found. We wanted to revive it, but the situation looked dire. With all the Injury Prevention efforts that we had made, surely complemented by the Massachusetts Legislators that helped pass great ordinances on helmets, ATV, Texting and Driving, improved junior operator licensing regulations, drunk driving, all helped us realize a reduction of trauma admissions to 200+/year. Injury Prevention was winning. But MSS was dead in the water.

The lifesaver came when the Office of Philanthropy at UMass Memorial Health learned that the Fundación MAPFRE had read about the MSS program and wanted to explore a partnership to restart it. But times had changed and Fundación MAPFRE had great experience in their home country of Spain with using Virtual Reality instead of the hands-on model we had previously developed.

After a couple years planning and developing, we brought the new Safety Quest program to 5th grade classrooms this September 2023. As of October 1, over 900 students have already participated in the innovative, new program. The UMMH Injury Prevention team, the UMMH Office of Philanthropy, Fundación MAPFRE representatives, and CTP Boston met regularly to develop curriculum, map out the RV, and work on all the thousands of details that it takes to create a program like this one. We landed on 4 different games. 1.) Escape Artist: With young experts guiding students on a fire education journey, students are quizzed on safe behaviors in the event of a home fire and are then put to the test in this virtual experience, asked to show what they would do to escape a fire. 2.) Street Smarts: Young people learn the importance of paying attention to their surroundings when traveling the streets. On touchscreen tablets, students adopt an animated character who will make their way around a neighborhood by foot and by bicycle. They gain points by avoiding obstacles and making safe choices. 3.) Home Hazard Hunt: This gesture-based game is the signature experience of Safety Quest. Students spend time in the house and outside in the playground and pool area, identifying potential hazards. They will earn points for all the dangers they find. 4.) Look Both Ways Charades: In this game, students are tasked with acting out or describing words revolving around water, home, fire, and road safety. This game takes place outside the vehicle but is designed to spark conversation and keep the students engaged. We are planning to test a cohort of students before and after their visit to Safety Quest and 6 months later to establish the efficacy of virtual reality in this type of education.

“I wanted to reach out and thank you for bringing Safety Quest to our students,” said School Resource Officer Tracy Flagg of Winchendon, MA. “I received great feedback from staff and students. It was fun to watch the students participate.”

Michael Hirsh, MD, Director of the Injury Prevention Program at UMMHC and the Medical Director for the Worcester division of Public Health