The Public Health Commission, Mayor Bauman, and the Common Council designated safety and injury prevention as one of the top five health priority themes for the City of Madison. This priority health determination was the outcome of Health Quest, Madison's community health improvement process, which is being directed by the Madison Department of Public Health (MDPH).

Safety and injury prevention is also the focal point of the Greater Madison Safe Community Coalition (GMSCC). The Coalition consists of over 100 organizations and individuals committed to making Madison safer. Both the Coalition and the Madison Public Health Department wanted to learn more about the concerns of citizens related to injury prevention, and formed a partnership to host neighborhood listening sessions.

Ten safety and injury prevention listening sessions were convened from November 1999 to February 2000. Focus groups were held in five geographic locations covering Madison neighborhoods: Near East/East/Far East area; North area (2 sessions); West/Far West/South West area; South area; and Near West/Campus/Capitol area. Two special sessions were convened for non-English speaking populations-the Latino and Hmong communities. The other listening session was for youth only participants. A pilot session consisting of citywide neighborhood representatives was used to test the process. A total of 85 citizens participated in the sessions.

A facilitator, recorder and observer from MDPH and volunteers of GMSCC staffed each session. A standard format or process was used at each session to assure consistency. Participants discussed what was needed to be safe at home, safe at school or work, safe on the move, and safe in the neighborhood/community. All concerns cited were ranked to determine the most important issues. The session concluded with participants brainstorming solutions for the top rated issues. 

Traffic is the number one safety issue for Madison residents. Speeding, road rage, ignoring school zones and stop signs, traffic congestion and cut -through speeding are a few examples of traffic safety problems cited at the listening sessions. To solve these traffic problems, residents want to see increased police enforcement of traffic laws, increased driver and neighborhood education campaigns, and additions of traffic calming devices. Solutions to reducing traffic volume such as car pooling or increased use of Metro were also proposed.

Many of the proposed solutions for reducing speeding and traffic congestion are already in use. Citizens are supportive of enforcement efforts of the police Traffic Enforcement Safety Team (TEST), and of efforts by the Traffic Engineering Department to install traffic calming and speed reducing devices. Because of the high interest in traffic issues, the Public Health Commission recommends that traffic be the theme for the fall neighborhood summit.

The Public Health Department will continue its partnership with the GMSCC to improve safety. Staff from MDPH are actively involved in the planning and implementation of two of the Coalition's projects:

• Neighbor-to-Neighbor Safe Home Visits - trained neighborhood volunteers will conduct home safety assessments for their neighbors who are elderly or have families with young children; and
  
• Walk Our Children to School/Pedestrian Zone Campaign - working with schools, neighborhood associations and police to raise awareness and take action to improve pedestrian safety, particularly for children around schools.

Most importantly, MDPH will continue to work with neighborhoods and special populations to implement community-based solutions. For example, MDPH participated in a visioning process with the Northside Planning Council on health and safety strategic issues. Neighborhoods have been informed about listening session results and MDPH will distribute safety checklist magnets to all interested neighborhoods. This summer, beach postings warning the public of contaminated waters will be picture signs to accommodate the non-English speaking. The Department will also conduct safety education events this summer for Spanish-speaking families. The Public Health Department will continue to offer consultation about safety and injury prevention to neighborhoods as needed. 

Two neighborhood groups brainstormed solutions to improving gun and weapons safety. Safely storing weapons and free trigger locks was suggested as a way to help to decrease access to guns. Education was also proposed as a strategy for reducing gun violence. Although traffic was the only issue consistently addressed by neighborhood and special population groups, many other resourceful solutions were suggested. The following table is a sampling of these solutions:

Under the leadership of the Madison Department Public Health (MDPH), Health Quest, Madison's community health improvement process, has assessed the health of Madison and determined priorities for action planning. Assessing community health needs is a State mandated responsibility of local health departments and is consistent with the core public health functions of assessment, assurance and policy development prescribed by the Institute of Medicine. After extensive community involvement (including key informant discussion groups, a general public telephone survey, and a community ballot), the Madison Public Health Commission, the Mayor, and the Common Council designated safety and injury prevention as a priority health theme. (See Appendix 1 for the Common Council resolution).

Safety and injury prevention is also the focal point of the Greater Madison Safe Community Coalition (GMSCC). The Coalition consists of over 100 organizations and individuals committed to making Madison safer. City of Madison funds and a grant from the Wisconsin Bureau of Traffic Safety to MDPH support the Coalition. Both the Coalition and the Public Health Department wanted to learn more about the concerns of citizens related to injury prevention and formed a partnership to host neighborhood listening sessions.

• Identify safety and injury concerns in the community (perceived needs).
• Develop community-based solutions.
• Determine strategies to address issues of concern (MDPH).
• Determine Coalition projects and activities (GMSCC).
• Mobilize communities and neighborhoods to take action improve safety and reduce injuries

A total of ten safety and injury prevention listening sessions were convened. The first session, consisting of neighborhood representatives throughout the City was a pilot session to test the listening session process. Focus groups were then held in five geographic locations covering Madison neighborhoods: Near East/East/Far East area; North area (2 sessions); West/Far West/South West area; South area; and Near West/Campus/Capitol area. Two special sessions were convened for non-English speaking populations-the Latino and Hmong communities. The other special population listening session was for youth only participants. A total of 85 citizens participated in the sessions.

A key to the success of the focus groups was gaining neighborhood and community input. Extensive recruitment efforts were used to gain this input. A three-step process was used to recruit participants:

• Letters explaining the listening sessions were sent to neighborhood associations, business associations, senior coalitions, neighborhood planning councils, City Council alders, and Dane County Supervisors with a request to nominate citizens for the focus groups.
• Phone calls were also made to individuals and organizations: Dane County Youth Commission; United Refugee Service; and Community Living Alliance.
• E-mails were sent to neighborhood contacts and a Latino professional group list serve.
• Presentations and linkages were made to groups and organizations to solicit nominees: South Metropolitan Planning Council; Northside Planning Council; and the Hmong Association

• Send invitation letters to those nominated/named
• Follow up phone calls were made and e-mails were sent to individuals

• Follow-up letters were sent with background information and expectations.

The next step after recruitment was actually conducting the listening sessions. Sessions were held on the following dates:

• Pilot group -- November 3, 1999
• Near East/East/Far East area - November 16, 1999
• North area - November 17, 1999
• West/Far West/South West area - November 30, 1999
• South area - January 18, 2000
• Near West/Campus/Capitol area - January 20, 2000
• Youth Group - February 2, 2000
• Latino Community - February 3, 2000
• Hmong Community - February 5, 2000

Sessions were held in the early evening and a light supper was served. A facilitator, recorder and observer from MDPH and volunteers from GMSCC staffed each session. All staff members were trained prior to the sessions. Ideally, focus group numbers should range from between eight to 10 participants; however, there was one group of only four participants. The North side participants were split into two groups of ten each.

The first session was a pilot test of the format and process. The Neighborhood Organizing Committee for the 1999 Neighborhoods USA conference was chosen as the test group because this group consisted of neighborhood association representatives throughout the City of Madison. Very minimal modifications were made to the process, and results from the pilot session have been included in this analysis.

A standard format or process was used at each session to assure consistency, although for some groups such as the youth and Hmong groups, the format was slightly modified. Participants discussed safety and injury concerns related to being safe at home, safe at school or work, safe on the move, and safe in the neighborhood/community. After listing all concerns under each environment on flip charts, participants then ranked the most important issues by placing colored dots next to each topic. Participants had a total of five dots, which could be placed on five separate issues, or all five on one issue, or any other combination. The session concluded with participants brainstorming solutions to the top ranked issues. (See Appendix 2 for the listening session script.)

Over all, traffic issues received by far the most responses and received the most priority votes. In particular, speeding was a clear priority and was mentioned as a concern at every neighborhood listening session. Road rage or harassing behaviors was also frequently noted by neighborhoods, and was also of concern to the Hmong and youth communities. Another major concern identified at eight of the ten sessions, although not ranked as a priority, was the need for carbon monoxide detectors in order to be safe at home.

At each listening session, participants shared safety and injury concerns related to being safe at home, safe at work or school, safe on the move and safe in the neighborhood. This section summarizes the major concerns noted for each of these environments.

Responses related to home safety can be grouped or categorized as:

• elderly safety
• child/youth safety
• crime
• safety in older homes
• burns and fires
• falls
• environmental home hazards
• miscellaneous/other

Safety concerns for the elderly centered on living alone and vulnerability to crime. A wide range of child safety issues such as unsupervised children or need for child/baby "proofing" were identified. The recent City requirement to replace lead pipes in older homes may be the reason that lead pipes was the most significant safety concern for older homes. Criminal issues included home break-ins, domestic violence, graffiti and youth violence. Although 18 different fire related issues were mentioned, a lack of carbon monoxide detectors was the leading home safety concern. High water heater temperature was the other major fire/burn safety issue. Falls, especially falls due to stairs or falls of the elderly, were cited at seven listening sessions. Unsecured weapons and access to guns was the other major safe at home issue.

Crime and violent behaviors such a bullying or fighting were the most significant school safety issues. In addition to harassment, drug activities and gangs are major concerns. Lack of crossing guards, children darting out into traffic and traffic congestion around schools were examples of traffic hazard issues. Fourteen different problems related to school buildings (e.g., asbestos, poor ventilation, broken equipment, etc) were listed, but only the need to improve handicap accessibility was singled out for priority voting.

The fewest number of safety topics, only 28, were mentioned for safe at work, compared to 70+ issues cited for safe at home or on the move. Nor, were work safety issues easily categorized. Workplace violence, disaster preparedness and concern about parking lot safety were the most notable issues.

Safe on the move was not restricted to just motor vehicles or traffic, but also included biking, roller blading, and pedestrian safety. Nonetheless, traffic was still the number one safety issue for City residents. Traffic issues were the most frequently noted and received the highest number of priority ranking votes. Solutions for traffic problems were developed at all neighborhood listening sessions. Traffic problems ranged the gamut from stupid drivers to cell phone usage to animals in traffic, but topping the list of concerns in addition to speeding and road rage were ignoring crossing guards and school zones, cut through speeding (going fast through neighborhoods as a short cut) and lack of enforcement.

Pedestrian and bike safety were the next most important on the move safety concern. Short crossing signals and unsafe sidewalks, e.g. sidewalks in disrepair or un-removed snow, were concerns for pedestrians. Not wearing bikes helmets and debris or snow and ice in bike lanes were concerns for bikers.

The last topic discussed at the listening session was "What is needed to be safe in your neighborhood?" Participants were instructed to identify only issues that had not been previously mentioned. A wide range of diverse issues were listed under neighborhood safety such as elderly safety, crime/violence, disaster preparedness, lack of lighting and need for increased police presence. Drug activity stands out as the most important concern and was a major priority ranking for the youth and pilot listening sessions.

Several subjects were associated with more than one environment. Speeding, animal safety such as dogs running at large, access to guns or unsecured weapons, and elderly safety were listed under the safe at home, safe in the neighborhood and safe on the move environments. The need for better emergency planning or disaster preparedness was a problem for home, work and neighborhood safety.

Ten different listening sessions were held throughout the City. Several neighborhoods were grouped together for the East side, North side, West side, Campus area, and South side. Because of a large turnout there were two north area sessions. The first listening session was a pilot test of the format and consisted of neighborhood association representatives from all over the city. Special sessions were held for the Hmong and Latino communities in recognition of cultural and language barriers. Because young people were not likely to attend neighborhood sessions, a special youth session was convened.

Voting and ranking of the most significant safety issues occurred at each session. Sometimes groups combined several topics together under one heading, e.g., school and work place violence, and then voted and ranked the most critical issues. The following table shows the ranking of the top three issues for each area. (Note: Some issues were tied votes.)

Traffic issues such as speeding, heavy traffic volume and pedestrian safety were priority concerns. Other significant concerns were drug activity and access to weapons.

Listening session results from the Hmong, Latino and youth communities had a different flavor and focus. Language and culture are safety and injury prevention obstacles for Latinos and Hmong. Language barriers such as communicating with landlords about home safety concerns, or reporting emergencies or crimes are serious barriers to Spanish speaking people. Increased use of bilingual translators and materials and a bilingual 911 were suggested solutions for the Latino priority concern of "communication when feeling unsafe or in danger."

The Hmong clan leaders did not have one, single outstanding priority safety issue, but issues related to environmental health such as indoor air quality, carbon monoxide leaks, and workplace noise were highly rated. There was insufficient time to brainstorm solutions at the Hmong session, but there are plans to work on possible solutions in the future. 

The Dane County Youth Board participated in the youth listening session and was most concerned about abusing alcohol and drunk driving. Solutions proposed included:

• harsher punishment
• use of designated drivers
• stricter enforcement of underage drinking and supplying alcohol to minors laws

The other priority issue identified by teens was concerns about falls, especially stairs, at both home and school. An underlying current in the youth responses was teen risk- taking. Responses such as "tripping over trash cans," "falling down stairs," or "driving on the side walk" are related to risky behaviors such as showing off or trying to impress friends.

A summary of the priority ranked issues for each session is in Appendix 5.

Brainstorming solutions to safety and injury prevention problems was the most creative aspect of the listening sessions. After voting for the most significant issues, participants were asked to suggest solutions. Frequently, more than one issue was included in the brainstorming solutions sessions. For example, on the North side, concerns about lack of emergency preparedness at home, at work and in the neighborhood were combined under "disaster preparedness". At the Latino session, difficulty in reporting domestic violence, difficulty in calling 911, and lack of translated materials were included in the "inability to communicate when unsafe" solution.

The following table lists the solution topics for each session. As previously noted, some groups combined related topics and then brainstormed possible solutions. Due to time constraints, it was not always possible to develop solutions for all top rated issues.

All the ideas generated for each solution are included with the flip chart summaries in Appendix 4. Tallies of the priority votes for all sessions are in Appendix 5. Six groups generated solutions dealing with traffic and speeding. Many of the proposed solutions for reducing speeding and traffic congestion are already in use. Citizens definitely want speeding limits enforced, more visible police presence and greater use of the Traffic Enforcement Safety Team (TEST). Coupled with more enforcement is better education. Madison citizens support better driver education, media campaigns and neighborhood education efforts such as "Drive 25." Speed boards indicating speeds to motorists were frequently suggested as a good educational tool. Measures such as speed bumps and traffic barriers, better timing of traffic lights or more visible school zone flashing lights will help with traffic calming. System wide transit solutions were also proposed. Car pooling incentives, better use of Metro, more park and rides and light rail will decrease traffic volume. 

Two neighborhood groups brainstormed solutions to improving gun and weapons safety. Safely storing weapons and free trigger locks was suggested as a one way to decrease access. Education was also proposed as a strategy for reducing gun violence. Although traffic was the only issue consistently addressed by neighborhood and special population groups, many other resourceful solutions were suggested. Following is a sampling of these solutions.

The purposes of the listening sessions were to:

• Identify safety and injury concerns in the community (perceived needs).
• Develop community-based solutions.
• Determine strategies to address issues of concern (MDPH).
• Determine Coalition projects and activities (GMSCC).
• Mobilize communities and neighborhoods to take action to improve safety and reduce injuries

All of these steps have been accomplished. The most exciting part is that listening session participants have expressed interest in continuing involvement in safety and injury prevention which will ultimately accomplish the most important purpose --- mobilizing communities. The Public Health Department is currently undertaking these follow-up efforts and action plans:

• Listening session results will be shared with other City agencies, e.g., Traffic Engineering, Police, and Fire.
• Listening session results will be shared with neighborhood associations, community-based organizations, the Madison Public Health Commission, the Mayor and the Common Council.
• Edition 5 of Health Voice, the Health Quest newsletter, featured results of the listening sessions. Health Voice is distributed to over 750 community organizations, neighborhood associations, GMSCC members and conference participants.
• A presentation at the GMSCC spring general meeting helped direct the selection of Coalition action projects.

• Continued partnership with the GMSCC. Staff from MDPH are actively involved in the planning and implementation of two of the Coalition projects: 1) Neighbor-to- Neighbor Safe Home Visits - trained neighborhood volunteers will conduct home safety assessments for their neighbors who are elderly or have families with young children; and 2) Walk Our Children to School/Pedestrian Zone Campaign - working with schools, neighborhood associations and police to raise awareness and take action to improve pedestrian safety, particularly for children around schools.
• Provided safety and injury prevention education as the focus of Public Health Week (April 3-7, 2000). In conjunction with Madison Gas and Electric, Dane County Public Health Division, Madison Fire Department and Madison Area SAFE KIDS Coalition, "Germ Jam & Safety Stuff," an interactive awareness activity, was held for children ages preschool through third grade. Safety education activities were a house trailer with home safety hazards; "safety city" identifying electrical hazards; and "buckle bear" puppet show, booster seat promotion with remote fire dog, and car safety seat checks demonstrating occupant safety.
• Educated third grade class about home safety issues, especially for children home alone.
• Provided input to Northside Neighborhood Planning Council for their visioning and strategic planning process related to health and safety.
• Consultation to individual neighborhoods on safety and injury prevention.
• Provided home safety checklist magnets to all interested neighborhood associations.
• Recommended "Traffic Summit" as theme for annual neighborhoods conference to Mayor and planning group

• Helped plan, publicize and endorse "Silent Shoe" march-firearm violence prevention awareness event (May 31).
• Continued involvement with the Safe Nursery Working Group of the Madison Area SAFE KIDS Coalition, to raise awareness about potentially dangerous used nursery equipment and clothing at secondhand stores, day care centers, church nurseries and garage sales and churches.
• Safety Saturday is a safety awareness event for children and families sponsored by numerous city, county and private organizations

The ultimate goal of the listening sessions was to mobilize communities to take action to improve safety and reduce injuries. This goal has been met. Session participants have remained involved in safety improvement, and MDPH will continue its work with interested neighborhoods. Both MDPH and the GMSCC will continue in the future to work on follow up action plans to improve safety and reduce injuries.