isccc.globalak).docx · Web viewShenkursk is one of the oldest cities in the Russian European North. It is situated on the bank of the Vaga river, a tributary of the Northern Dvina

International Safe Community 2016-04-19Certifying Centre

Questions to be answered by the Community

Presentation of the Safe Community Program (To the web version)

Photo to illustrate the community1

Name of the Community: Shenkursk

Kind of Community2: Municipality

Country: Russia

Number of inhabitants in the community: 5073 in Year 2015

Safe Community Program started year/month: 01 January 2015 (date when the Shenkursk Injury Registry was started)International Safe Communities Network Membership: Designation year (only for re-certification application): No

1(Specification: JPG max 240 pixels per inch, high 2000 and length 2000 pixels)2A “Safe Community” can be: a Municipality, a County, a City or a District of a City working with safety promotion, Injury-, Violence- and Suicide-prevention and prevention of the consequences (human injuries) related to Natural Disaster, covering all age groups, gender and areas2

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Name of Certifier: International Safe Community Certifying Centre (ISCCC)Name of Co-certifier: ―Name of the Safe Community Support Centre: ―Info address on www for the Safe Community Program: https://new.vk.com/shenkursk_opasnosti_net

For further information please contact:

Name: Alexander KudryavtsevE- mail: [email protected]: (+7) 921 7212125Photo of contact person:

Name: Andrej GrjibovskiE- mail: [email protected]: (+47) 4526 8913Photo of contact person:

Name: Irina PitolinaE- mail: [email protected]: (+7) 921 4872446(to be contacted in Russian)Photo of contact person:

Community Overview – (suggested maximum 1 page) (To the web version)

Briefly describe the community, it’s history and development

Shenkursk is one of the oldest cities in the Russian European North. It is situated on the bank of the Vaga river, a tributary of the Northern Dvina. For the first time a settlement on the Vaga river was referred in the Charter of Knyaz Svyatoslav of Novgorod in 1137. In 1229, it was referred there as "Sheng-kurie", based on combination of two words: Shenga (a river that flows into the Vaga in four kilometres above the settlement) and Kuria (an old Russian word meaning an old river bed). Later the name was transferred into "Shenkursk" ("Шенкурск" - in Russian spelling).

Since 1780, Shenkursk is the county town under Arkhangelsk governorship and has got an emblem – a badger on green shield. A new general development plan of the town was developed at the same time. It served a basis for the building of the town until the middle of the 19th century. The town has traditional planning - it faces the Vaga waterway and has clear grid of city streets.

In 1899, there were 231 houses in Shenkursk, 52 retail shops, and an iron foundry. There were also two churches and the Holy Trinity Convent, founded in 1664. At the end of the 19th century the town had male spiritual school, three parish schools, hospital and pharmacy. The

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https://new.vk.com/shenkursk_opasnosti_net


city population at that time was 1500 people.

At the end of the 20th century Shenkursk had 8 industrial enterprises and 7 farms that produced timber, lumber, chemicals, products of field crops and livestock.

Currently, Shenkursk is the administrative and cultural center of the Shenkursk district with total area of 11.3 thousand square kilometers and total population of 13530. The town of Shenkursk is the only urban settlement in the district covering area of 3,89 square kilometers and having total population of 5073 (01 January 2015).

Dwelling stock. The total dwelling stock of Shenkursk is 146.5 thousand square meters. 34.0 % of the houses have central heating, 12.3 % have central water supply, 8.0 % have central sewerage.

Road network. The total length of the road network of Shenkursk is 26.37 km, of which 4.5 km are of concrete slabs, 4.5 km have asphalt pavement, 17.37 km are primer.

Transport. Distance from Shenkursk to the regional center (Arkhangelsk) is 373 km. Bus is the only public transport connecting Shenkursk with the regional center. Other bus routes connect the town with other municipalities in the district and in the Arkhangelsk region. Transport connections are complicated by absence of permanent bridge across the Vaga river. There is a pontoon bridge in summer and ice crossing in winter. There is a fairy crossing between the seasons but it is not functioning during the river freeze-up and break-up.

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Education. There is one kindergarten attended by about 500 children (1-7 years) from the town and adjacent areas in the district. There is also one high school that has about 800 pupils (7-18 years) from the town and the adjacent villages. The school is the place of studies for the vast majority of the school-age children in the town.

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Describe the Safe Community work so far – (suggested maximum 3 pages) (To the web version):

What are the political visions?

Leadership of the community belongs to United Russia, the current ruling political party in Russia. The Party was established by the current President Vladimir Putin at the times when he was a Prime Minister.

Why is the community interested in being a member of the International Safe Community network?

The leadership is a relatively young and ambitious team led by Sergei Kotlov, Head of the Shenkursk District Administration. The team is eager to make Shenkursk the first Safe Community in Russia. The expectations are that this will help to (i) substantially reduce injury rates, (ii) increase attractiveness of living in Shenkursk and reduce the outflow of young people to larger cities, (iii) make Shenkursk positively famous in Russia and abroad, and (iv) attract investments of regional, national and international levels.

Are there any unique injury prevention effort/s in the community? If so describe them briefly. (See specifications about Good Examples!)

The experience of International Safe Community movement has shown that effective tackling of the injury problem at local level is possible when grounded to local injury data. An outstanding example is the Harstad Safe Community in Norway that has reached substantial success in community-based prevention due to 30-year experience of injury surveillance.

With the "best experience" approach, a Russian-Norwegian project “Community-based injury prevention program and injury surveillance in Shenkursk” (later referred as the RUSS-Shenkursk project) was initiated in 2014 with the purpose to try to repeat the Harstad success story in Shenkursk. The main goal of the project is to implement community-level evidence-based injury prevention in Shenkursk with further dissemination of gained experience to other municipalities in the Northwestern Russia.

From 1 January 2015, the first Russian injury registry was established in Shenkursk by using the model of injury registration in Harstad, Norway. Since that time, data on all hospital and outpatient admissions with injuries to Shenkursk central district hospital are being collected using standard injury registration form. The collected data include information on type, place, time, preceding circumstances, involved factors, mechanism of accident, mechanism of injury, and socio-demographic characteristics of the injured.

The project has aroused high interest among local stakeholders and evoked their active participation. A reflection of that is the establishment of local cross-sectoral group for injury prevention and safety promotion, including a number of key persons responsible for safety issues in the area.

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Advantages already found as a result of the Safe Community work

So far, the observation is that the project and the connected development towards the Safe Community have facilitated growth of the feeling of unity and positive self-perception in the Shenkursk population. These seem associated with growing sense of belonging and more positive future perspectives. The observation is largely subjective but is partly confirmed by substantial reduction in non-fatal self-inflicted injuries in January-June of 2016 compared to the same period of 2015 (4-fold reduction in 0-17 year-olds and 45% reduction in adult population).

Are you facing any difficulties for implementing any safety promotion work in your community? If yes please describe briefly!

The difficulties we have are, apparently, commonplace. These are difficulties of releasing local funding for maintenance of the Injury Registry, for development and implementation of preventive interventions. Also, the difficulties are related to lack of human resources that are ready to spend time for prevention of injuries and safety promotion. Besides, due to busy executives it often happens that safety issues are relegated to “stand in a queue” if there are other pressing matters.

How much monetary resources are used for this Safe Community pro-gram? If possible provide a budget description. If voluntary services are used, please mention that also!

Main monetary resource

The initial and so far the main monetary basis of the Shenkursk Safe Community program is the RUSS-Shenkursk project, financed by the Norwegian Ministry of Health and Care Services. The project is run by the Norwegian Institute of Public Health (NIPH) with senior advisor Prof. Andrej Grjibovski being the project leader.

The project funds are used to achieve its key objectives: to establish a municipal injury registry and community-based injury prevention programme in Shenkursk using the experience from the Harstad Safe Community.

At the first year of the project (2014) the funding covered translations of the Harstad injury registration manuals from Norwegian into Russian, training seminars on injury registration for medical staff of the Shenkursk district hospital (one seminar in Harstad and in one Shenkursk), development and piloting of the injury registration schemes, facilities, materials and software basis, as well as participation of Shenkursk representatives in the 4th Regional European Safe Community Conference (Harstad, Norway, 3-5 June 2014). In 2014, the total funding allocated for the project by the Norwegian Ministry of Health was NOK 457153.

In the second year of the project (2015) the funding mainly covered launch and running of the Shenkursk Injury Registry as well as training of the representatives of local cross-sectoral group for injury prevention and safety promotion (one seminar in Harstad and in one

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Shenkursk). The training was targeting to make the local stakeholders learn and get practical examples (“success stories”) of how local injury data can be effectively used for planning and evaluating short interventions and long-term preventive programs. In other words, they have learned the functioning mechanisms of the Harstad Safe Community. Besides, the project funding have partly covered the activities of the Regional Rescue Service that have organized a number of thematic safety lessons and outdoor plays for pupils of the Shenkursk school and attendees of local kindergarten. In total, the funding allocated for the project by the Norwegian Ministry of Health in 2015 was NOK 516500.

In the third year of the project (2016) the funding covers 50% of running of the Shenkursk Injury Registry while the other half is taken over by the local authorities. Other expenses of the project include continued financing of the child injury prevention activities by the Regional Rescue Service and production of children safety booklets for parents. The project has also covered participation of the group from Shenkursk at the 12th World Conference on Injury Prevention and Safety Promotion (Tampere, Finland 18-21 September 2016). The total funding released for the project by the Norwegian Ministry of Health in 2016 is NOK 387000.

Other financial resources (2016)

Shenkursk district administration (financing of various injury prevention and safety pro-motion activities, total is not estimated; and in-kind contribution to the project equivalent to RuR 399124 in 2015): administrative support for the RUSS-Shenkursk project and guaranteed sustainable functioning of the injury registry and the community-based injury prevention programme after the project is over; active participation of the Major of Shenkursk and several other representatives of the administration in the cross-sectoral group for injury prevention and safety promotion; allocation of working time for planning and coordinating various injury prevention and safety promotion activities; providing premises and organizing meetings of the international working group of the RUSS-Shenkursk project in Shenkursk; financing of the Safe Community information campaign in Shenkursk and 25% coverage of salaries of the registry administrators (from 2016);

Shenkursk central district hospital (in-kind contribution equivalent to RuR 335200 in 2015): head physician of the hospital is the local manager of the injury registry and uses part of his working time for corresponding tasks, including participation in the cross-sec-toral group for injury prevention and safety promotion; providing and maintaining premises for accommodation of the Injury Registry; distribution of the children safety booklets for parents as a part of the Safe Community activities, and 25% coverage of salaries of the registry administrators (from 2016);

Arkhangelsk Regional Rescue Service (in-kind contribution, not estimated): organization of a series of thematic safety lessons at the Shenkursk school and kindergarten; organiza-tion of Safety Festival for children on the Shenkursk town day (26 June 2016);

Fire department of the Shenkursk district (in-kind contribution, not estimated): participa-tion of chief fire inspector in the cross-sectoral group for injury prevention and safety

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promotion; distribution of fire safety leaflets in the housing stock; organization of fire techniques show at the Safety Festival for children on the Shenkursk town day;

Arkhangelsk Regional Division of the Red Cross (in-kind contribution, not estimated): participation in the Safety Festival for children on the Shenkursk town day by organiza-tion of open-air first aid training;

Business council of the Shenkursk district (in-kind and monetary contribution, not esti-mated): participation of the chairman (Sergei Kukin) in the cross-sectoral group for injury prevention and safety promotion; participation in the Safe Community information cam-paign by distributing stickers with logo of Shenkursk Safe Community among customers of protective equipment (safety helmets, glasses and protective gloves to be used when working with the tools); selling of anti-slipping pads for shoes without trade margins;

Shenkursk district council of veterans (in-kind contribution, not estimated): voluntary ex-amination of houses and apartments of elderly people in Shenkursk using the “Check-list for safety assessment of the living environment of an elderly person”, developed on the basis of the analogue Harstad check list and the Shenkursk Injury data for 2015.

Shenkursk district weekly newspaper “Vazhsky Krai” (in-kind contribution, not esti-mated): regular publishing of materials describing and promoting activities of the Safe Community Program; administering of web-page of Shenkursk Safe Community within the popular Russian social network “VKontakte”;

Northern State Medical University (NSMU), Arkhangelsk, Russia (in-kind contribution equivalent to RuR 260922 in 2015): Dean of International Faculty of General Practitioner Alexander Kudryavtsev (MPH, PhD) is appointed to be the Russian coordinator of the RUSS-Shenkursk project with working time devoted to this project up to 400 hours per year; NSMU premises and equipment are used for the project activities (meetings, semi-nars, teleconferences, internet, phone lines); Master students in Public Health programme at the NSMU have their practical training in the RUSS-Shenkursk project (analyze injury data and prepare proposals of preventive programs);

UiT – The Arctic University of Norway, Tromsø, Norway (in-kind contribution equiva-lent to NOK 40000 in 2015): Postdoc of the Department of Community Medicine Alexander Kudryavtsev (MPH, PhD) used 20% of his working time for coordinating the RUSS-Shenkursk project in 2014-2015; allocation of PhD position* to the Shenkursk In-jury Registry.

* In 2016, the UiT has allocated a PhD position for the doctoral project with working title “Evidence-basis for injury prevention in Northwestern Russia: the Shenkursk Population-based Injury Registry Study”(2016-2020).

The research project is to lay basis for evidence-based injury prevention in Northwestern Russia through descriptive and analytic studies using the Shenkursk Injury Registry data and comparisons with Harstad Injury Data Base (Harstad, Norway). Specific objectives include description of methodology of injury

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registration in Shenkursk; identification of key injury problems and related modifiable factors at the setting using the registry data; investigation of possibilities of using Harstad experience for reducing the identified injury problems in Shenkursk through comparing the Shenkursk and Harstad injury data.

The PhD work is to be undertaken in four years with 75% work time spent on the PhD and the annual salary of RUR 620000. The Northern State Medical University, Arkhangelsk, Russia, provides working office. For stays at UiT (taking required courses and supervision) operational costs are provided through additional funds from UiT (up to RUR 300000 per year) and elsewhere.

The PhD student, Tatiana Unguryanu (Master of Public Health, Dr.Med.Sc.), is to start the project implementation from Autumn 2016. She is expected to become an important resource person for the Shenkursk Safe Community initiative, as she will be working on the Shenkursk Injury Registry nearly full-time for the four-year period.

Harstad University Hospital (UNN) (in-kind contribution, not estimated): providing origi-nal materials, manuals and software that are used for the running of Harstad Injury Data Base (the materials were allowed to be translated into Russian language and used as the basis for development of the Shenkursk Injury Registry); providing working time and sharing practical experience of the staff for training of the staff of the Shenkursk Injury Registry; leader of the Harstad Injury Data Base (Prof. Emeritus Børge Ytterstad at UiT, the President of the European Safe Community Network) devotes up to 100 hours per year for the RUSS-Shenkursk project; administrator of the Harstad Injury Data Base Ellen Nikolaisen devotes up to 100 per year for the project; facilities and premises are provided for the RUSS-Shenkursk project activities in Harstad (meetings, seminars, workshops);

Norsafety AS (in-kind contribution, not estimated): providing time and practical experi-ence of safety promotion and injury prevention for training and advising the Shenkursk cross-sectoral group for injury prevention and safety promotion (up to 300 hours in 2015); providing facilities and premises for the RUSS-Shenkursk project Harstad (meet-ings, seminars and workshops);

World Health Organization (monetary contribution of RuR 40000): financing participa-tion of the Irina Pitolina (Major of Shenkursk and Chairman of the cross-sectoral group for injury prevention and safety promotion) and Alexander Kudryavtsev (coordinator of the RUSS-Shenkursk project) at the Capacity building Workshop on Violence and Injury Prevention (TEACH VIP) in Moscow, Russia, 17-19 November 2015; within the seminar Alexander Kudryavtsev has delivered a lecture on the Safe Community model, municipal registry of injuries and injury prevention in Shenkursk.

Basics/Fundaments about the Safe Community work at the Executive level3 – (suggested maximum 4 pages) (To the web version)

3 Political and administrative leadership

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Injury risk overview in the community (summary from Indicator 5)

Summary results of the injury registration in January 2015 – June 2016

In January 2015 - June 2016, 2376 non-fatal injury cases were recorded in the injury registry. 1134 (47.7%) of the registered injuries have occurred on the territory of the town of Shenkursk, 868 (36.5%) have occurred at the adjacent areas in the Shenkursk district, 316 injury records (13.3%) had no data on place of injury, and 58 (2.4%) have occurred outside the territory of Shenkursk district. Further, the results are produced using data on the 1134 injury cases that have occurred on the territory of the town of Shenkursk.

The largest proportions of injuries were injuries to the head (ICD-10 codes S00-S09; 20.9%), injuries to the wrist and hand (S60-S69; 18.4%), injuries to the ankle and foot (S90-S99; 12.7%), injuries to the elbow and forearm (S50-S59; 9.0%); injuries to the knee and lower leg (S80-S89; 9.0%); injuries to the thorax (S20-S29; 7.8%), and injuries to the shoulder and upper arm (S40-S49; 5.8%).

According to the Abbreviated Injury Scale, 69% of injuries were minor, 25.3% were moderate, 4.6% were serious, 4 cases were severe, and only 2 were critical. Eleven injuries were fatal (3 suicides, 3 alcohol poisonings, 2 drownings, 1 homicide, 1 traffic accident, 1 injury with unclear cause). 7.5% of the injury cases were hospitalized.

Males constituted 55.9% of the injured. Children (0-17 years) were 30.2% of the cases, while elderly people (60+ years) accounted for 16.1%.

If splitting the cases into 10-year age groups, the largest proportions of injuries belong to 0-9 and 10-19 year-old groups (14.9% and 16.4%, correspondingly). If further stratifying by age and sex, the largest proportions of injuries belong to males aged 10-19 years (10.3%), 20-29 years (7.8%), 30-39 years (9.7%), and 40-49 years (8.2%).

For 2015, the highest injury risks were in age groups 20-29 years (205.0 per 1000) and 10-19 years (182.7 per 1000) (Table 1). After further stratification by sex, the highest injury risks were in males aged 20-29 years (268.4 per 1000), 10-19 years (215.2 per 1000) and 30-39 years (209.1 per 1000).

Almost a half of injuries (46.6%) occurred during leisure activities. One fourth (22.1%) of adult cases (18+ years) have reported using alcohol in the preceding 24 hours (30.0% of males and 12.1% of females) while 11.8% cases refused answering questions on alcohol use, possibly masking the non-reporting.

Only 31 (2.7%) injuries were reported to occur during paid work. The distribution of injuries by type of industries did not show clearly elevated risks associated with particular types of work. Although, forestry and woodworking, retail, education and other social services were types of industries mentioned more frequently.

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Most commonly injuries occurred on homestead lands, near houses (20.1%), in living rooms, bedrooms, or hallways (15.0%), in a residential area with no specifications (7.6%), and at the kitchen (5.2%).

Geographical analysis of injuries has not shown any "black spots" clearly. This may partly be explained by lacks of means to record GPS coordinates of the injuries. Besides, descriptions of places of injuries in the injury registration forms are often imprecise (with no addresses), and that complicates geographical analysis. The work plan for 2017 is to improve completeness and quality of data collected about places of injuries. This is being performed through additional instructions of injury registrators, adding the address field into the electronic template of the injury registry form (where the data is being typed from the paper-based injury registration forms), and ordering a detailed map of Shenkursk to be placed in the Injury Registry room where the injury registrators are entering the data into the registry. The latter should help to fill in the gaps in the geographical data when, for example, a place of injury is described by the patient as "near FENIX food store". A detailed map should help to get street names and numbers nearest houses in cases of similar descriptions.

Table 1. Injury risks in Shenkursk by age and sex, 2015

Age, years

All Males Females

Abs. Pop.IR per 1000



0-9 99 692 143.1 42 336 125.0 57 356 160.1 10-19 114 624 182.7 71 330 215.2 43 294 146.3 20-29 99 483 205.0 62 231 268.4 37 252 146.8 30-39 115 786 146.3 78 373 209.1 37 413 89.6 40-49 87 669 130.0 61 315 193.7 26 354 73.4 50-59 89 802 111.0 53 353 150.1 36 449 80.2 60-69 67 652 102.8 28 254 110.2 39 398 98.0 70+ 50 365 137.0 17 114 149.1 33 251 131.5

TOTAL 720 5073 141.9 412 2306 178.7 308 2767 111.3

The most common activities preceding an injury were “walking, coming in/out” (34.8%) and “doing smth with an object (a toy, tool, vehicle, human, animal, etc.)” (17.0%). Commonly mentioned categories of factors (external objects, events) involved in the preceding activities were “no object or external factor” (16.5%), “natural events and objects” (16.0%; mainly ice-covered surfaces), and “drinks” (5.1%; mainly alcohol).

The most common mechanisms of accidents were: "slipping" (17.1%); “error or lost control when handling an object (tool, vehicle, toy, material, human, animal)” (13.8%); "stumbling over" (7.7%); “quarrel, fighting, brawling” (7.6%), “release of physical force of human or animal, incl. unintentional” (7.1%), “stepping wrong” (6.1%), “jumping on, touching or taking smth (active role)” (5.1%). Commonly mentioned categories of factors involved in accident mechanisms were “natural events and objects” (17.0%; mainly ice-covered surfaces), “another human” (14.6%), “particle, fragment, splinter, structural element of smth” (7.4%;

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e.g, wooden boards and particles, metal nails and plates, pieces of glass, etc.), “part of building, excl. stairs” (5.9%; e.g., doors and door-inserted glasses, door thresholds and frames; floors of wood, laminate, linoleum).

The most common injury mechanisms were: “hit due to a fall on flat surface” (28.1%); “hit due to contact with material object, human, animal” (27.9%); “gripping, cutting, stabbing, abrasion” (16.7%); “hit due to falling from height (incl. falls on stairs)” (11.6%). Commonly mentioned categories of factors involved in injury mechanisms were “natural events and objects” (15.0%; mainly ice-covered surfaces), “particle, fragment, splinter, structural element of smth” (12.2%; e.g, wooden and metal materials and their parts, metal nails and plates, pieces of glass, etc.), “another human” (11.7%), “part of building, excl. stairs” (9.3%; e.g., floors, walls, doors, door thresholds and frames), “treated surface, outdoors” (4.3%; wooden, asphalt, stone-made outdoor surfaces and stairs).

Haddon’s type matrix summarising key injury risks and circumstances in Shenkursk

Mechanisms FactorsEnvironment

Physical Social

Preceding activity

walking, coming in/out;

handling an object

ice-covered and other slippery surfaces;

alcohol

homestead lands, areas near houses;

living rooms, bedrooms, hallways

and kitchens; roads, streets,

walkways

leisure time surroundings

Accident

slipping; error or lost control when handling an

object; stumbling over; stepping wrong;

release of physical force of a human or an

animal

ice-covered surfaces; other humans;

wooden boards and particles;

metal materials and their parts, metal nails

and plates; glass and its pieces;

floors of wood, laminate and

linoleum; walls, doors, door

thresholds and frames; hand tools;

animals; furniture

quarrel, fighting, brawling

Injury

hit due to a fall on surface;

hit due to contact with an object, human or

animal; gripping, cutting,

stabbing, abrasion; hit due to a fall from

height

The majority of injuries occurred between 09:00 and 21:00 (77.2%) with growing numbers in the evening: 09:00-12:00 – 12.1% of injuries; 12:00-15:00 – 15.0%; 15:00-18:00 (18.2%); 18:00-21:00 (22.5%).

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The distribution of injuries by days of week was nearly flat with slightly elevated proportion of cases belonging to Tuesdays (15.8%).

In the previous 12 months (July 2015 – June 2016), the largest proportions of injuries occurred in November (10.9%) and December (11.1), and smallest proportions were in July (6.2%) and September (5.5%).

Conclusions

The preventive interventions are likely to be effective if targeted towards leisure, domes-tic and other routine activities inside or nearby dwellings.

Removals of slippery surfaces (common attributes of accidents and injury mechanisms) have good potentials to be effective interventions. Promotion of use of protective devices when working with wooden and metal materials may also reduce injury rates.

A particular emphasis should be on reduction of alcohol consumption, reduction of injury risks due to loss of control under alcohol intoxication, reduction of alcohol-associated in-terpersonal violence.

Children and males in working age are the most vulnerable groups and require particular attention.

Which objectives are formulated for governing the Safe Community work?

Our key objectives at the present stage of the Safe Community work (when the injury registry is running and the cross-sectoral group functioning) are:

To ensure continued functioning of the registry, to maximize completeness and quality of the data, to introduce a system of recording GPS-coordinates for every injury place;

To make the best possible use of the registry data for development of effective interven-tions;

To broaden spectrum of town-level injury prevention and safety promotion activities;

To achieve constant reduction of injury rate in the town;

To engage public of the town with the Safe Community idea and create an environment facilitating self-identification of the population as the Safe Community;

Designation of Shenkursk as the first Russian Safe Community.

How is safety prioritized in the community budgets4 since the program started?

There are a number of safety promotion activities that are financed from the district budget in spite of the difficult and deteriorating financial situation. For, example, Shenkursk is one of a

4 Note here is meant both the operating budget and the capital budget

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few municipalities in the Arkhangelsk region that for the third summer has an official town’s beach, certified in accordance with all the requirements of the state sanitary and safety standard for a municipal beach. Many investments in 2015 were into establishment and maintaining of fire ponds that are easy to access by firemen in case of a fire. Due to these and other safety-related activities Shenkursk has won Arkhangelsk regional competition for being the best local authority in the field of population safety in category "Urban Settlement 2015". In other words, in terms of attention of the authorities to population safety it is the best urban settlement in Arkhangelsk region in 2015.

Are economic incentives5 used in order to increase safety? If so, describe these incentives!

So far, the economic incentives are limited, for example, to competitions of drawings “Safe community”, “We are in safety”, "Safe work in my view" that end up with awarding prizes to the winners (e.g., bicycle helmets, anti-slipping pads) and giving out souvenirs (e.g. light reflectors) to all the participants.

Beside your national regulation, are there any local regulations in the community, in order to increase safety introduced as a result of the pro-gram? If so, describe these local regulations!

Authorities at the municipal level do not have a right to issue local regulations. There is an initiated discussion with the Arkhangelsk Regional Assembly of Deputies concerning introduction of additional restrictions on the sales of alcohol in Shenkursk. This issue is quite delicate, because the experience of Gorbachev’s restrictions on alcohol sales on national level 1980 has displeased the population with the authorities. We are also cautious that restrictions of different kind (what is normally meant by regulations) may not be positively perceived by at least a part of the population and get unfavourably associated with the Safe Community idea.

Please attach an organizational chart for the Safe Community program at the political and administrative level based on their responsibilities

Organization chart for the Safe Community program:

5 By economic incentives means here to use money to stimulate a safer behaviour

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Leadership of the Russian-Norwegian project “Community-based injury prevention program and injury surveillance in Shenkursk” (the RUSS-Shenkursk project) plays an essential role in organization of the Safe Community work in 2014-2016. The project leader Prof. Andrej Grji-bovski and the coordinator Dr. Alexander Kudryavtsev have initiated the Safe Community program in Shenkursk as well as establishment of other key blocks in the chart:

The International Working Group (IWG) consists of representatives of key partners who have initiated the project and are responsible its implementation (NIPH - Andrej Grji-bovski is the project leader and the Chair of the group; NSMU - Alexander Kudryavtsev acts as daily leader of the project activities in Shenkursk; UiT and UNN - Prof. Emeritus Børge Ytterstad is the key advisor on community-level injury registration and commu-nity-based injury prevention; Norsafety - Kees Jan Verhage is an advisor on injury pre-vention and safety promotion at community level; Shenkursk municipal administration - Irina Pitolina is the head of the Shenkursk cross-sectoral group for injury prevention and safety promotion; Shenkursk central district hospital - Vasilii Anfimov is the local man-ager of the injury registry).

Shenkursk Injury Registry (ShIR) is the key source of local data that is used as evidence basis for injury prevention and safety promotion in Shenkursk as well the evaluation tool for these activities. The registry is the mainstay for the rest of the Safe Community work and the basis for fulfilling the Safe Community indicators 4, 5 and 6.

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The cross-sectoral group for injury prevention and safety promotion has been estab-lished by initiative of the project leadership in order to achieve the main goal of the project - implementation of evidence-based injury prevention in Shenkursk at the com-munity level. The project leadership and the IWG have also organized training of mem-bers of the local cross-sectoral group in evidence-based injury prevention and safety promotion on the basis of the Harstad experience and success stories. Further on, a num-ber of targeted work groups have naturally self-organized under the umbrella of the cross-sectoral group.

Describe the continuous improvements since designation (for re-certific-ation application only)

Not applicable.

Indicator 1 (suggested maximum 3 pages) (To the web version)“An infrastructure based on partnership and collaborations, governed by a cross-sector group that is responsible for safety promotion in their community“

1. Describe the cross-sector group for collaboration6, managing, coordinat-ing and planning the Safe Community program

The Shenkursk cross-sectoral group for injury prevention and safety promotion was established in October 2014. Membership of the group represents the key stakeholders responsible for safety issues in the area. The list of the group members has been changing over the two years. The current list of members is presented below.

Besides the listed members, the meetings of the cross-sectoral group are regularly attended by the leadership of the RUSS-Shenkursk project. International advisors from the IWG are also present when possible. The meetings are also commonly attended by a number of initiative citizens who are invited on the basis of the planned agenda. The meetings are being announced in the local newspaper, so some citizens may come and attend on own initiative.

The group meets twice a year. The standard agenda includes presentations of results of the injury registration (the most outstanding injury problems in preceding 6 months), planning of possible preventive activities, and distribution of responsibilities. Reports on implementation and achieved results of previously planned and ongoing injury prevention and safety promotion activities are also a part of the agenda.

a. List membership organizations and which sector they represent

At present time the cross-sectoral group consists of 12 members:

1. Major of Shenkursk, Chair (Irina Pitolina)2. The deputy head of the district administration (Viktor Parfenov)

6 By cross-sector collaboration means here collaboration between sectors in the society (public sector, business sector, voluntary sector)

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3. Head of the department of civil defense and emergency situations of the district adminis-tration (Sergei Smirnov)

4. Chief physician of the central district hospital (Vasilii Anfimov)5. Representative of the department for education of the district administration (Elena

Lapteva)6. Chief state fire inspector of the district (Sergei Deryabin)7. Head of the traffic police in the district (Arkadii Borisov)8. Chairman of the business council of the district (Sergei Kukin)9. Chairman of the public council of the district (Nikoly Tyapkin)10. Chairman of the town's council of veterans (Zinaida Bun'kova)11. Chairman of the town's council of youth (Zinaida Bun'kova)12. Chief editor of weekly newspaper of the district (Svetlana Soboleva)13. Injury registry administrator (Lyubov Kharlova)14. Injury registry administrator (Lyubov Burtseva)

b. How are the mayor, the executive committee and the chief execut-ive officers (or similar functions of the community) involved in the program?

Irina Pitolina, Major of Shenkursk, is the Chairman of the cross-sectoral group for injury prevention and safety promotion. She organises the group meetings and coordinates implementation of planned activities.

The majority of members of the cross-sectoral group have leading positions in safety-related organisations and thus are leaders of groups of subordinate employees who comprise or are involved into a working group dealing with a particular safety topic.

c. Who is chairing the cross-sector group?

Repeating the stated above, Irina Pitolina, Major of Shenkursk is chairing the group. De facto, she commonly has a co-chair - the leader or the coordinator of the RUSS-Shenkursk project.

2. Describe the inter-sectorial group for collaboration7, managing, coordin-ating and planning the Safe Community program

a. List membership organizations from the public sectorb. Who is chairing the inter-sectorial group?

Based on natural development of the Shenkursk Safe Community program we have not faced a need to establish what is called the inter-sectoral group. Absence of such a group in our case is compensated by having key representatives of the public sector (chair of the business coun-

7 By inter-sectorial collaboration we mean collaboration between sectors within the public sector

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cil of, chair of the public council, and chair of the council of veterans, and chair of the council of youth) as members of the cross-sectoral group.

3. How are the non-governmental organizations (NGO) (examples - Red Cross, pensioners organizations, sport organizations, parents and school organizations etc.) involved in the Safe Community work?

In 2016, Arkhangelsk Regional Division of the Red Cross participated in the Safety Festival for children on the Shenkursk’s town day. The representatives of the Red Cross have organized open-air first aid training as a part of the festival. At the concluding meeting of the festival there was made an agreement between the Major of Shenkursk and the Red Cross representatives concerning further involvements of the Red Cross in injury prevention and safety promotion activities in Shenkursk.

The public council of the Shenkursk district, the business council, the council of veterans, and the council of youth are represented in the Shenkursk cross-sectoral group for injury prevention and safety promotion since its establishment in 2014.

From 2016, Shenkursk district council of veterans is doing voluntary examinations of houses and apartments of elderly people in Shenkursk using the “Check-list for safety assessment of the living environment of an elderly person”.

Also from 2016 the business council of the Shenkursk district participates in the Safe Community information campaign by distributing stickers with logo of Shenkursk Safe Community among customers and promotes increase in sales of anti-slipping pads and other injury protective equipments.

From autumn 2016, the youth council, the public council and the business council are planning to start activities to reduce risks of falls on homestead lands and other areas nearby the houses by organising free delivery of sand (to be sprinkled on icy surfaces) to private houses and apartment buildings.

4. Are there any important organization (such as fire department, police, city planners, or any NGO) not engaged in your Safe Community work? If so, how does the community plan to incorporate their active involvement in the Safe community program?

Representative office of the Ministry of Internal Affairs (the municipal police) is so far not involved into the Safe Community program. This creates obstacles for effective tackling of violence prevention. The issue is planned to be resolved in autumn 2016 by inviting the head of municipal police to be a regular member of the cross-sectoral group.

Indicator 2 (suggested maximum 4 pages) (Table to the web version)“Long-term, sustainable programs covering genders and all ages, environments, and situations”

Mention the programs/projects (briefly) in each of the areas below. Please specify which sections of the population they specifically cover and which sectors of the community organizations that are involved in implementing them. Note! Include the work with genders, all ages and all environments and situations. Use the list below as a checklist.

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1. Traffic safety 2. Homes safety3. Leisure times safety4. Children safety 5. Elderly safety6. Work safety7. Violence prevention8. Suicide prevention9. Disaster preparedness and response10.Safe public places11.Hospitals safety12.Sports safety13.Water safety 14.Schools safety

The programs/projects presented under indicator 2 shall be listed in a table format as below. The table will be exhibited in the web version. The community can expand their description in a non-table format if that is necessary.

Programs/Projects

Name of the programs/Projects

Sectors and organizations involved in implementation

Age groups targeted by programs/projects

Environments covered by programs/projects

Situations covered by programs/projects

1.Traffic safety

Program "Improvement of operational condition of the road network and improvement of road safety on the territory of the Shenkursk municipality for 2016-2018"(passive measures, improvement of road safety and infrastructure)

District administration

All ages Streets, roads, sidewalks, roadways, roadsides, and crossroads

Road traffic

Child and the road (educational program)

Kindergarten, road police

3-7 years Street, road, sidewalk, roadway, roadside, crossroads

Road to a kindergarten, outdoor walks

Road safety rules (educational program)

School, road police

7-16 years Street, road, sidewalk, roadway, roadside, crossroads, private and public transport

Road to school, emergency situations

"Light up!" Road police, 7-11 years Street, Road to school,

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campaign (handing out reflectors to all pupils)

primary school sidewalk, roadway, roadside, crossroads

road traffic, outdoor walks in the dark

Pedestrian-oriented campaign “Frostwalker” (handing out anti-slipping pads for shoes)

RUSS-Shenkursk project, district administration, individual entrepreneur Kukina M.A., local newspaper

Adults Outdoors, streets, pedestrian walkways

Pedestrian walks

Assessment of knowledge of traffic rules by pupils

School, road police

7-11 years Street, sidewalk, roadway, roadside, crossroads.

Road to school, road traffic

2.Home safety

Distribution of fire safety leaflets in the housing stock

Fire department All ages Home Daily activities, fire alarm

Program for establishment and maintaining of fire ponds that are easy to access by firemen in case of a fire

Department of civil defence and emergency situations of the district administration

All ages Home Fire emergency

Creation and promotion of the logo of Shenkursk Safe Community where home safety is the key motive

RUSS-Shenkursk project, local newspaper

All ages Home and close surroundings

Not specified

Distribution of memos "Safe House" for parents*

RUSS-Shenkursk project, Local newspaper

0-7 years Home and close surroundings

Daily activities

3.Leisure times

Safety column in the district newspaper "Vazhski Krai»

RUSS-Shenkursk project, Shenkursk Injury Registry, local newspaper

All ages Home, outdoors

Daily activities, leisure time and other frequent context situations of injuries

Creation and maintaining of a web-page of Shenkursk Safe Community in Russian social network “VKontakte”

RUSS-Shenkursk project, Shenkursk Injury Registry, local newspaper

All ages Home, outdoors

Daily activities, leisure time and other frequent context situations of injuries

Competition of young cyclists "Safe Wheel"

School, road police, children and youth centre

7-16 years Outdoors, streets

Cycling

4.Childrens safety

Children safety booklets for parents

RUSS-Shenkursk project, paediatric polyclinic,

0-6 months

6 months

Home, outdoors, water bodies,

Daily activities, outdoor recreation,

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kindergarten, primary school

- 2 years 2-4 years 4-6 years Primary

school age

nature, road traffic

transportation

Bringing up safety issues at parental meetings

Kindergarten, school, boarding school, road police

3-18 years Home, school, outdoors

Daily activities

Safety classes “How to call out the firemen?”, “Look out, it’s the mercury!”, “Safe behaviour in the forest”, “Animals living in the city”, “Traveling in the safety country”, “Vocational guidance”, "Freezing over," "Home alone," "Safe streets", "Dangerous games at home," "Dangerous games in the street."

RUSS-Shenkursk project, Arkhangelsk Regional Rescue Service, kindergarten, school

3-7 years6-18 years

Home, outdoors, water bodies, nature

Daily activities, contacts with dangerous objects and substances, dangerous activities and situations

Safety essentials for pre-school children

Kindergarten 3-7 years Home, street, public transport

Dealing with strangers, flammable and other dangerous objects, animals, poisonous plants

"Safety Week": educational sessions, discussions, contests, games on safety topics, excursions around the town's streets pedestrian crossings, crossroads, and the river

Kindergarten 3-7 years Home, street, water bodies

Daily activities, road traffic

Fire training with children (evacuation of children from the building in case of fire)

Kindergarten 3-7 years Kindergarten Fire emergency

Information folders for parents “Baby safety”

Kindergarten 3-7 years Road, forest, home.

Road traffic, outdoor walks, contacts with strangers

“Outward world” Primary school 6-11 years The road from Sports, outdoor

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(educational program)

home to school, playgrounds, streets. School, home. Nature.

games. Emergency situations and first aid for minor injuries (bruises, cuts, burns), frostbite, overheating.Safe behaviour rules. Traffic rules. Fire safety, the basic rules for handling gas, electricity, water. Rules of safe behaviour in nature in different seasons.

Educational game- sessions “Home alone” with children

Representatives of Emergencies Ministry in Arkhangelsk

6-11 years Home Children left alone at home

Distribution of leaflets “"Freeze-up" "Dangerous fireworks"

Kindergarten, school

3-7 years6-18 years

Home, outdoors, water bodies.

Period when the river is freezing up, events with fireworks

Classroom meetings and discussions on safety topics:safe behavior on the water bodies during the spring break-up and fall freeze-up;safety in fire-risk period;behavior on reservoirs in a bathing period;safe use of pyrotechnics

School, traffic police, fire and emergency departments

6-18 years Home, outdoors, forest, water bodies.

Period when the river is freezing and braking up, events with fireworks

“Basics of life safety” (educational program)

Secondary school 11-16 years Home, roads kindergarten, school, public places, nature.

Fire, road traffic.Dangerous situations of social character.Active leisure in nature. Survival in the natural environment. Terrorist attack, explosions. Emergency situations of natural character.Man-made

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emergencies.First aid. Kidnapping or abduction.

Contests drawings and essays on safety topics

Children and youth centre, RUSS-Shenkursk project, district administration, school, kindergarten

3-17 years Home, roads kindergarten, school, public places, nature

Daily activities, transportation

Maintaining "ABC of safety" stand at school

Road police, school

3-17 years Street, road, sidewalk, roadway, roadside, crossroads.

Road traffic

Traffic safety action at the beginning of holidays at school "Safe holidays for children”

School, road police

6-17 years Streets, crossroads, pedestrian crossings

Leisure activities of children

Outdoor safety festival for children (on town’s day)

District administration, Regional Rescue Service, Fire department, Red Cross

3-17 years Home, school, public places

Fire.Emergency situations of natural character.Man-made emergencies.First aid.

5. Elderly safety

Examination of homes of the elderly using the “Check-list for safety assessment of living environment of an elderly person”

RUSS-Shenkursk project, NSMU (master students), council of veterans of the Shenkursk district

60+ Home and nearby surroundings, public places

Daily activities

Courses for the elderly in physical exercises to train the dynamic balance, strengthen muscles and improve walking*

District administration, Culture and sports palace

60+ Home and nearby surroundings

Daily activities

6.Work safety

Labor Protection Day (various events along compliance with safety regulations at a workplace)

School, regional NGO

Working ages

Workplace Paid job

Training on labor safety

District administration, Interregional Analytical Center for Occupational Safety

Working ages

Workplace Paid job

Campaign “Safe RUSS-Shenkursk Males at Home, Work with

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sawing” (free safety glasses / gloves when purchasing an sawing equipment)*

project, district administration, individual entrepreneur Kukina M.A., local newspaper

working ages

workplace. sawing electric/ motorised sawing equipment

Poster contest on the theme of the World Day of Safety and Labour Protection 2016 "Stress at the workplace: a collective challenge"


Working ages

Workplace Paid job

Fire evacuation training

Fire department, educational institutions

All ages Workplace Fire

Children's drawing contest "Safe work in my view"

District administration, school

Children 6-17 years

School, workplace

Paid job, housework

7.Violence prevention

Program "Prevention of offenses in the Shenkursk district (2014-2016)" (visits of young offenders to prisons, psychological assistance to their families)

District administration, Commission on minors and their rights protection

6-17 years, young offenders

School, college

Not specified

Patronage of disadvantaged citizens, including offenders and of returnees from prison

Police department All ages Homes, workplaces

Social maladjustment and isolation, risk of committing new illegal actions

Distribution of booklets "We are against terrorism"

Commission on minors and their rights protection

6-17 years School, college, public places

Risk of a terrorist attack

Distribution of booklets "Stop smoking spice "

Commission on minors and their rights protection

6-17 years Leisure time Risk of involvement in the use of illicit substances and related violence

8.Suicide prevention

Helpline "Hope" Botygina Svetlana, teacher and psychologist at the Shenkursk school

People with suicidal ideas

Not specified Suicidal tendencies

Screening for suicidal tendencies at school and psychological support to children at risk

Botygina Svetlana, teacher and psychologist at the Shenkursk school

11-17 years School Suicidal tendencies

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Prevention of suicides among adolescents (campaign "You - are not alone", information materials for the population, establishing cooperation in providing assistance to minors in crisis situations)

Botygina Svetlana, teacher and psychologist at the Shenkursk school

11-17 years Home, school Suicidal tendencies

9.Disaster preparedness and response

Program "Protection of the population and territories of Shenkursk from emergency situations, 2014-2017"


All ages Not specified Natural and human-made disasters, emergency situations

Informing the population (by use of municipal loud speakers) about the prohibition of the river crossings in the period of freeze-up and ice drift; shore patrols during periods of freeze-up and ice drift and penalties for violators


All ages River Freeze-up and ice drift

Training in fire safety civil defence and actions in emergency situations

School Children 6-17 years, and staff of the school

School School-level education

Entertaining team acumen game “Fire safety”

Children's recreation camps "Chaika" and "Altair", school of children's art, local library

Children 10-16 years

Home, school, outdoors

Fire

Maintaining anti-terrorism stand at the school

School, OSH specialist

All ages School, public places

Terrorist attack

Open-air public first aid training (as a part of the Safety festival)

Red Cross, school All ages Not specified An accident with an injury, disaster

10. Public places safety

Distribution of posters of Shenkursk Injury Registry in Public Places

District administration, RUSS-Shenkursk project, Central District Hospital

All ages Public places Daily activities

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Placement of Shenkursk Safe Community banner at the central town’s square

District administration, RUSS-Shenkursk project, local newspaper


Development of town map with designations dangerous places*

District administration, RUSS-Shenkursk project, local newspaper


Production of safety signs and holding a live installation "Be careful!" at places with high density of injuries in the town*

District administration, school


Sprinkling sand on slippery areas (in winter time)

District administration, RUSS-Shenkursk project, council of youth

All ages Public places, homestead lands

Daily outdoor activities

11. Hospitals safety

Not developed **

12.Sports safety

Program "Development of physical culture, sports and more effective implementation of youth policy in Shenkursk district in 2014-2016" (increasing the availability of equipped sports facilities for young people)

Department of culture, tourism, sports and youth policy of the Shenkursk district administration,school, college

7-18 years Sports facilities

Sports, physical training

In 2014, local children's football club has got new football field with safe artificial covering. In 2016 , the children's football team received a full set of football outfit, including protective shields.

Regional charity fund "Kind world", district administration, housing management company "Cozy Town"

3-18 years Football stadium

Sports (football)

13.Water Maintaining Department of All ages Town’s beach Leisure

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safety town’s beach (one of the few beaches in Arkhangelsk region that are certified in accordance with all the requirements of the state sanitary and safety standard for a municipal beach)

civil defence and emergency situations of the district administration

Distribution of leaflets, booklets "Safety on the water in the summer""Carefully, break-up!"


Children living in summer camps

Water bodies Leisure on water in summer, break-up

14.Schools safety(also see section on children's safety)

Instruction of teachers on protection of life and health of children

School 6-17 years School School-level education

Traffic safety action at the beginning of the school-year "Attention: children!"

School, road police

6-17 years School and nearby surroundings

Way to school and back

* To be implemented from autumn 2016

** The program on Hospital safety is not developed. It has not been a priority due to weak evidence of the need: the Injury Registry data have got only 8 cases of injuries on the territory of Shenkursk Central District Hospital in the first 18 months of the injury registration (0,7% of the total 1134 injuries in Shenkursk in the period). Only one of the 8 injuries was really a medical one – “accidental pricking with a used needle”. The other 7 were common domestic accident types “have slipped outside” (2), “stumbled on a threshold” (1), “was hit by an aggressive visitor” (1), “pinched hand in the door” (1), “awkwardly turned” (1), “stumbled on a stone” (1). So the hospital area is not the “black spot”, and we have not identified hospital-based modifiable factors to be addressed by a program. So there is no rationale for the program so far.

Are some of these programs/projects mentioned above overseen by other or-ganizations and/or from other agencies than from the community? Please identify the specific programs and explain how the community is involved?

Several of the presented preventive programs are overseen by the RUSS-Shenkursk project (see column “Sectors and organizations involved in implementation” in the table above), in-volving a number of external organizations (see pages 13-14). The leadership of the RUS-Shenkursk project is involved in development of ideas and planning of the programs and/or partially covers the expenses required for the implementation.

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For example, the project leadership came up with an idea to make up “Children safety book-lets for parents” on the basis of the booklets developed by Norwegian Directorate of Health. They have obtained permission to translate the Norwegian booklets into Russian, have covered the translation, design of the Russian versions, and the printing expenses. Thereafter, the booklets are handed over to paediatric polyclinic of the central district hospitals where they are distributed among parents who visit polyclinic with their children. Besides, a part of the total amount booklets is handed over to the Mayor of Shenkursk who (via educational de-partment of the district administration) has organized distribution of the booklets at the par-ental meetings in kindergarten and primary school, as well as to young couples at the local of-fice of civil registration.

Another external organisation that is rather active in Shenkursk is the Arkhangelsk Regional Rescue Service (located in Arkhangelsk). It has become involved due to good contacts with the project leadership. Since 2014, the Rescue Service regularly visits Shenkursk (at least twice a year) and organises safety classes on a number of palpitating topics at local kinder-garten and school, and gradually hands over these activities to local pedagogues. In 2016, the Rescue Service was also the “key player” in the outdoor safety festival for children on Shen-kursk town’s day. By the initiative of the Rescue Service, Arkhangelsk Regional Red Cross representatives have also participated in the festival by organising the open-air first aid train-ing. All these activities are being performed in cooperation with Shenkursk district adminis-tration, local police and fire department. Involvement of the Rescue Service and the Red Cross in Shenkursk are free of charge (in kind contributions) while their travels to Shenkursk (gasoline, accommodation, meals) are covered by the RUS-Shenkursk project. We believe this is good way of collaboration for the safety purposes, and it has resulted in durable con-tacts between the Shenkursk administration and the Rescue Service.

Indicator 3 (suggested maximum 3-4 pages) (Table to the web version)“Programs that target high-risk groups and environments and programs that promote safety for vulnerable groups”

Mention (briefly) the programs/projects that cover the high-risk groups and environments as well as vulnerable groups to increase their safety. For each group describe how the group is involved in the program/project!

How are the high-risk and/or vulnerable group/s identified?

In Shenkursk, identification of the vulnerable groups is being performed on the basis of the Shenkursk injury registry as well as on the experience of other communities.

For example, a Table 1 on page 10, shows that the highest risk groups males aged 10-19 years, 20-29 years, and 30-39 years. So the majority of the Safe Community Activities have this group among the targets.

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We also see elevated risks of injuries in children and elderly people, and these are shown as vulnerable groups in numerous literature sources. Therefore, the majority of programs we have developed are targeting the young, and also the elderly are covered by quite a number.

Examples of high risks groups:Use this list as a checklist and comment if some of the groups are seen as vulnerable in the community. If a group is not considered as a vulnerable group in the community please explain why!

1. Indigenous people2. Socioeconomic risk groups3. Minority groups within the community, including workplaces 4. People at risk for intentional injuries, including victims of crime and self-

harm5. Abused women, men, elderly and children6. People with mental illness, developmental delays or other disabilities7. People participating in unsafe sports and recreation settings 8. Homeless 9. People at risk for injuries from natural disasters 10.People living or working near high-risk environments (for example a par-

ticular road or intersection, a water hazard etc.)11.People at risk due to religion, appearance, ethnicity or sexual prefer-

ences 12.Examples of high-risk environments in the community:

a. Areas with risk for land-slide b. Areas in high risk for earthquake c. Areas with very dens traffic near schools d. Others?

The programs/projects presented under indicator 3 shall be listed in a table format as below. The table will help the reader to get an overview. The table will be exhibited in the web version. The community can expand their description in a non-table format if that is necessary.

High-risk, vulnerable groups and environments targeted

Names of programs/Projects

Sectors and organizations involved in implementation

Age-groups targeted by programs/projects

Environments covered by programs/projects

Situations covered by programs/Projects

1.Socioeco-nomic risk groups

Providing advisory and correctional assistance to parents with problems of different dependencies and to families in

District administration, police

All Home Alcohol and drug dependence, poor family conditions

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socially dangerous situationsPatronage of children in disadvantaged families (prevention of abandonment, improvement of the home environment, provision of places in boarding schools, treatment of parents with alcohol and drug problems, medical care, regular visits of social workers and policemen)

Centre for social service of the population of the district administration, police department

0-17 years Homes Children living in disadvantaged families

Patronage of lonely elderly people (regular visits of social workers, prevention of abandonment, improvement of the home environment in terms of fire safety, provision of medicines and drug intake control, memos on how to take and store medicines)

Centre for social service of the population of the district administration

Elderly Homes Elderly people living alone

Patronage of immobile disabled people (regular visits of social workers, memos about how to take care immobile patients)

Centre for social service of the population of the district administration

Immobile disabled people

Homes Immobile disabled person at home

Providing Centre for All Not specified Situations when

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temporary housing and warm clothing to homeless victims of fires (prevention of hypothermia, frostbite)

social service of the population of the district administration

citizens are left without shelter and clothing due to fire

2.People with mental ill-ness, mental delays or other disabil-ities

Program "Improving accessibility of facilities and services for disabled people in the Shenkursk municipal district " (equipment of public buildings with handrails, ramps, doorways, toilets for the disabled; training guiding dogs)


All Public places Use of public places and services by disabled people

3.Homeless Providing warm clothing to homeless people in winter time (prevention of hypothermia, frostbite)

Centre for social service of the population of the district administration, department of civil defence and emergency situations of the district administration

Not specified (mainly adults)

Places of living of homeless people (city dump, abandoned houses)

Cold winter weather

Are some of these programs/projects mentioned above overseen by other or-ganizations and/or from other agencies than from the community? Please identify the specific programs/projects and explain how the community is in-volved!

Indicator 4 (suggested maximum 3-4 pages) (Summary to the web version)“Programs that are based on the available evidence”8.

8 ‘Evidence-based strategies/programs’ are understood to be strategies/programs that have been evaluated and demonstrated to be effectively using available research results

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Of all the programs/projects listed in Indicator 2 and Indicator 3, please specify if they are ‘evidence-based’? Those identified as ‘evidence-based’ please describe the source(s) of the evidence. Have any contacts been established with Safe Community Support Centre, scientific institutions or other organizations about the development and/or implementation of evidence-based strategies? If yes: Which ones? What has been the extent of their guidance?

The injury prevention activities in Shenkursk are based on local injury data of the Shenkursk Injury Registry. It is used as the basis for revealing common types of injuries, common accident and injury mechanisms and involved factors. These data provide solid evidence basis for injury prevention.

For example, examination of houses and apartments of elderly people in Shenkursk is being performed using the “Check-list for safety assessment of the living environment of an elderly person” that was developed on the basis of the analogue Harstad check-list and the Shenkursk Injury data for 2015. The list allows identification of factors that commonly become parts of accident mechanisms. Removal of such factors leads to malfunctioning of potential accident mechanisms and thus allows reducing injury occurrence.

Another example is a special attention to the problem of slippery surfaces. The injury registry data has shown that an ice-covered surface is the most common factor involved in injury-preceding activities, mechanisms of accidents and mechanisms of injuries (see pages 10-11). Besides, slipping was is the leading mechanism of an injury accident. For these reason, in 2015 the cross-sectoral group for injury prevention and safety promotion has initiated sells of anti-slipping pads for shoes without trade margins in one of the stores. In December 2016, 1000 of the anti-slipping pads for shoes of different size were purchased from the funds of the RUSS-Shenkursk project and are being distributed among adult population in winter 2016-2017 within a number of public events.

The routine work of the Shenkursk cross-sectoral group for injury prevention and safety promotion involves reviews of results of local injury registration, identifies key outstanding injury problems as well as common accident and injury mechanisms and involved factors. Based on that, removable or modifiable factors are being identified. Finally, the preventive activities are planned and implemented in a way that they target these removable and/or modifiable factors. Effects of the interventions are being judged again using the injury registry data (if the previously common accidents and injuries go down, the intervention is considered successful).

As described above, the RUSS-Shenkursk project and the Shenkursk Safe Community is developed and is being implemented on example of Harstad Safe Community and with involvement of Harstad representatives: Prof. Emeritus Børge Ytterstad (UiT and UNN) and Kees Jan Verhage (Norsafety) are the key advisors on community-level injury registration, on injury prevention and safety promotion at community level.

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Indicator 5 (suggested maximum 4 pages) (Summary to the web version under Basics/Fundaments about the Safe Community work at the Executive level2)“Programs that document the frequency and causes of injuries”

1. What data sources are in use to assess the risk for injuries and plan for injury prevention in the community?

The Shenkursk Injury Registry and Arkhangelsk regional centre for analysis of medical information are the two main sources of injury data in the community. The injury registration is performed using the standard injury registration list (Attachment A) and this covers nearly all medically treated injuries in Shenkursk.

The completeness of the registry was 76% in the January - June 2015, and this should have raised after due to a number of targeted activities and improved logistics. Assessment of completeness of the registry in July 2015 – June 2016 is in currently being performed via matching of the registry with regular information system of the hospital. The system includes records of all medical care services provided by the hospital for the purposes of getting paid from medical insurance companies.

A weakness of the registry is that injuries that lead to immediate death do not get any medical treatment and pass by the hospital to forensic department that is located in Velsk (a larger town in Arkhangelsk region; distance from Shenkursk is 130 km). These are neither recorded in the registry, nor in the routine information system of the hospital. In order to fill up the gap, the data on all the fatal injuries in the Shenkursk district is being regularly requested from Arkhangelsk Regional centre for analysis of medical information. The centre is the organisation that routinely collects various data from all medical institutions in the Arkhangelsk region, including forensic offices, departments and bureaus. The data we get from the Centre is limited to a number of variables (age, sex, date of death, settlement of living without exact address, settlement of death without exact address, ICD-10 code of the cause of death), so additional contacts with the Shenkursk police are commonly required in order to find out where exactly the case have occurred, what were the preceding activities, the accident and the injury mechanisms.

2. Does the community have any injury surveillance system? If yes, please describe the system and the main findings from the injury surveillance!

The key findings of the Shenkursk Injury Registry for the period from 01 January 2015 to 30 June 2016 are presented above under item “Injury risk overview in the community (summary from Indicator 5)”.

3. Are household surveys used for collection of information about injuries, risk environments and risk situations? If yes, please describe the system and the main findings from the household surveys!

No. Household surveys have not been used for collection of information about injuries in Shenkursk.

4. Who records injury data for the community (examples: hospitals, health centres, dentists, ambulance staff, schools, care of the elderly organiza-tions, local police)?

The injury registration is performed using the standard injury registration list. The lists are

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being filled by injured patients, their relatives, or doctors at admission to the Shenkursk central district hospital (out-patient department, in-patient department, or ambulance). The information from the lists is entered into electronic database, built on the platform of Epi Info 7. This work is being performed by two part-time registry administrators (two nurses of the hospital who have gone through a special training). The data on fatal cases is collected from Arkhangelsk regional centre for analysis of medical information and is being added up from police records.

5. Describe how and by whom the data is analysed

In 2015-2016, the data have been analysed by coordinator of the RUSS-Shenkursk project Alexander Kudryavtsev (PhD in Health Sciences, Dean of International Faculty of General Practitioner, incl. Master’s Program in Public Health). Some parts of the analyses were performed by Master students in Public Health under his supervision. From autumn 2016, a PhD student (Tatiana Unguryanu) will work on the Shenkursk Injury Data under supervision of Alexander Kudryavtsev and will become the main analyst of the registry data.

6. Describe the methods and findings of risk assessment in the community

The Shenkursk Injury Registry is used as the basis for the risk assessments, i.e. for revealing high-risk groups, common types of injuries, common accident and injury mechanisms and factors that commonly become parts of accident mechanisms.

The Shenkursk cross-sectoral group for injury prevention and safety promotion reviews results of the injury registration, identifies key outstanding injury problems as well as common accident and injury mechanisms, and involved factors. Based on that, removable or modifiable factors are being identified. Finally, the preventive activities are planned and implemented in a way that they target these removable and/or modifiable factors. Effects of the interventions are being judged again using the injury registry data (if the previously common accidents and injuries go down, the intervention is considered successful).

7. Describe to whom the findings of risk assessments are distributed in or-der to promote safety and prevent injuries in the community

The results of risk assessments are distributed among members of the cross-sectoral group for injury prevention and safety promotion. One of the members, Svetlala Soboleva, is the chief-editor of the local weekly newspaper “Vazhski Krai”. She arranges regular publications of the findings of the injury registration, including the results of risk assessments.

8. If possible exhibit in a table the injury data since the program started

Please see the attached presentation.

Indicator 6 (suggested maximum 4-5 pages) (Summary to the web version) “Evaluation measures to assess their programs, processes and the effects of change”

1. Does the community have an evaluation plan for the overall Safe Com-munity program? If yes, describe the plan.

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a. Describe how the community evaluates the implementation pro-cess of various programs/projects in program

The Shenkursk cross-sectoral group for injury prevention regularly monitors the on-going preventive activities. This is being done through listening and discussing reports of the leaders of corresponding working groups at the meetings of the cross-sectoral group (twice a year).

b. Describe how the community evaluates the outcome of various programs/projects in the program

c. Describe how the community evaluates the impacts of various pro-grams/projects in the program

b and c: The Shenkursk cross-sectoral group for injury prevention and safety promotion regularly reviews results of the injury registration, identifies key outstanding injury problems as well as common accident and injury mechanisms, involved factors. Based on that, removable or modifiable factors are being identified. Further on, preventive activities are planned and implemented in a way that they target the removable and/or modifiable factors.

Since the Safe Community program has started in Shenkursk only in 2014 and the first year was devoted to building up the injury registration, most of preventive activities have been developed and launched in 2015 and 2016 (after reasonable amount of the required evidence was generated). For that reason, the evaluation work with respect to outputs and impacts is at its early stages. Nevertheless, there is a clear common understanding in the cross-sectoral group that the effects of the interventions are to be judged using the injury registry data. If the previously common accidents and injuries are addressed by an intervention and later appear less frequently (confirmed by statistical significance), the intervention is considered successful.

It should be also added here that the injury registration in Shenkursk covers all injuries that are medically treated at the central district hospital, including injuries occurring in the town and on other non-urban territories of the district. However, preventive activities are only covering the town without substantial leakages to adjacent areas. This scheme is built up intentionally because it allows using the non-urban territories of the district as a comparison site when investigating the effects of the programs in the town. For example, there should be a stronger evidence of a preventive effect when there is negative slope of injury incidence in the town, but it is not observed for the non-urban area.

2. To whom and how are the results of the evaluations disseminated?

The results of evaluations are available to the members of the cross-sectoral group for injury prevention and safety promotion, and the summaries are published in the local weekly newspaper “Vazhski Krai” (i.e. become available to public).

3. What are the specific effects or impacts that can be attributed to the Safe Community movement?

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It is unlikely that the effects become evident in about a year from the start of the preventive part of the program. Also the completeness of the injury registry (currently being assessed) seems to have risen after its first assessment for the first six months of the registration. Due to this reason we should see a false increase in injury rate, and that is nonsense to present. After the second completeness assessment (for the period from July 2015 to June 2016) is finished in September and the necessary adjustments are made, we are ready to provide the expert group with the short-term changes in the injury rates that go along the Safe Community pro-gram. Our expectation is that there should be reduction in child injury rate as the major part of the early started activities was addressing children.

Indicator 7 (suggested maximum 2 pages) “On-going participation in national and international Safe Communities networks”

1. Describe the participation of the community in the International Safe Community network! (Examples: sharing experiences via international newsletter and/or international conferences; seeking advice or visiting other communities or support centres in other countries)

The idea of building up the first Russian Safe Community in Shenkurk was born at the Second European Regional Safe Community Conference (Reykjavik, Iceland, May 19-20, 2010) between a PhD student Alexander Kudryavtsev, his supervisor Prof. Børge Ytterstad. The idea was evoked back after the doctoral defence of Alexander Kudryavtsev in Arkhangelsk, where Prof. Leif Svanström was the first opponent.

After the RUSS-Shenkursk project has started in 2014, the group representing Shenkursk was attending the 4th European Regional Conference in (Harstad, Norway, 3-5 June 2014). The project and the plan for the first Russian Safe Community on the basis of the Harstad experience was presented there as the key note presentation. Participation in the conference was followed by a training workshop on injury registration for medical staff of the Shenkursk district hospital in Harstad. In the same year the second seminar on the same topic was organized in Shenkursk and was lead by Harstad representatives

In 2015, a group representing the Shenkursk cross-sectoral group for injury prevention and safety promotion had one training seminar in Harstad and in one training seminar Shenkursk. The seminars were to train local stakeholders in evidence-based injury prevention and gave them practical examples (“success stories”) of how the local data can be effectively used for planning and evaluating interventions.

In 2016, a group from Shenkursk is going to attend at the 12th World Conference on Injury Prevention and Safety Promotion (Tampere, Finland 18-21 September 2016). It is going to make an oral presentation titled “ESTABLISHMENT OF THE FIRST RUSSIAN INJURY REGISTRY IN SHENKURSK”.

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2. Describe the participation of the community in the National Safe Com-munity network! (Examples: benchmarking, collaborations and sharing experiences via national newsletter and/or national conferences; seeking advice or visiting other communities or support centres in the country)

There is no national Safe Community network. We hope Shenkursk will become the first Safe Community in Russian and will take the leading role in building up the Network.

3. What are the expectations of the community from membership in the In-ternational Safe Community network? (to the web version)

Repeating what is already stated above, the expectations are that membership will help to (i) substantially reduce injury rates, (ii) increase attractiveness of living in Shenkursk and reduce the outflow of young people to larger cities, (iii) make Shenkursk positively famous in Russia and abroad, and (iv) attract investments of regional, national and international levels.

4. With what can the community contribute to the International Safe Com-munity network? (E.g. good examples, innovative approaches, ideas, ex-pertise in a given area) (to the web version)

Our Safe Community Work has been initiated by an international group of experienced epidemiologists, and the injury registry is built up with various underlying research perspectives in their minds. So the expectations are that the Shenkursk Safe Community will add up to the evidence of the effectiveness of the Safe Community approach by a number of publications in international peer-reviewed journals.

Besides, Shenkursk is viewed as a pilot Russian town to become an International Safe Community. If this quasi-experiment is a success, the Shenkursk experience will be disseminated all over Russia and this may substantially promote and enlarge the International Safe Community network by many new Russian members in future.

5. Will the designation ceremony coincide with any international confer-ence, seminar or other forms of international or national exchange?

Our optimistic plan was to have the designation ceremony at the 12th World Conference on Injury Prevention and Safety Promotion (Tampere, Finland 18-21 September 2016). However, we used more time for development of this application than it was initially planned so the plan has become scarcely realistic. Anyway, we would be glad to have the designation ceremony by the end of 2016 as some of the attributary expenses can be covered from this year budget of the RUSS-Shenkursk project (the agreement with the Donors is already in place).

6. The community is interested in collaboration with other communities in the following areas or to solve the following problems (to the web ver-sion): (Please list)

Injury registries and comparative studies Scientific evidence of the effectiveness of the Safe Community approach Reduction of alcohol related injuries Reduction of injury risks under alcohol intoxication

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Homes safety Leisure times safety Children safety Elderly safety Violence prevention Suicide prevention Sports safety

Notes: Designation Ceremony dates. Please list desirable dates.

September-December 2016

Did the community receive advice to fill up this form? If yes, from whom

No. We have got an example of the application for re-designation of the Harstad Safe Community, but it was of substantially different outline.

Did the community get any help to fill up this form in English? If yes, from whom

The form was filled by the coordinator of the RUSS-Shenkursk Dr. Alexander Kudryavtsev (Arkhangelsk, Russia) and edited by the project leader Prof. Andrej Grjibovski (Oslo, Norway).

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Documents

isccc.globalak).docx · Web viewShenkursk is one of the oldest cities in the Russian European North. It is situated on the bank of the Vaga river, a tributary of the Northern Dvina