ThinkFirst: Programs and Methods for Injury Prevention

The ThinkFirst National Injury Prevention Foundation was founded by the American Association of Neurological Surgeons and the Congress of Neurological Surgeons in 1986 to bring awareness to high incidence of traumatic injuries through community outreach programs. ThinkFirst’s mission is to prevent brain, spinal cord and other traumatic injuries through education, research and advocacy. ThinkFirst programs describe the various causes of injury, the affects injuries have on a person’s body, and measures one can take to reduce their risk for injury.

Through a network of chapters throughout the United States and 18 other countries, ThinkFirst incorporates curriculum and informative presentations into their six programs. Injury prevention educators help students understand that injuries are a leading cause of death and disability but are largely preventable through safe choices and interventions. Topics focus on safe and sober driving, safety belt use, helmet use, sports, bicycle and water safety, prevention of falls, avoiding violence and infant safety. Program studies demonstrate evidence of an increase in safety knowledge, attitudes and stated behavior changes among program participants.

To add reality for teens and youth, educators co-present with VIP speakers, Voices for Injury Prevention. VIP speakers are young adults who share the circumstances that led to their brain or spinal cord injury and how a permanent disability has affected them. Their stories resonate with teens, who can now picture the realities of neurotrauma and understand their vulnerability.

Programs, Tools and Curriculum

Program materials are developed by ThinkFirst committees.  Access to materials on the ThinkFirst is provided once chapters have completed training, and agreed to use the programs according to protocol, submitting any program translations or changes for approval.

Programs for students include ThinkFirst For Kids, ThinkFirst For Youth, ThinkFirst For Teens and ThinkFirst About Concussion. Programs at all levels explain brain and spinal cord anatomy, how injuries to these areas affect function and lifestyle, the importance of protecting the body and easy measures for reducing their risk for injury. Programs are given at various grade levels to reinforce the information.

ThinkFirst to Prevent Falls was developed in response to the high incidence of falls among older adults. Introductory programs, 1-2 hours in length, provide the basic information and handouts on preventing falls. Chapters include information on exercise classes and other related programs and resources at their hospital or in their community.

ThinkFirst For Your Baby (TFFYB) is a four-hour program for new and expectant parents, covering the issues of injury prevention for infants and young children. Shaken Baby Syndrome, SIDS, car seat safety, feeding, child-proofing the home, family safety and many other topics are covered. A separate three-hour training, provided by ThinkFirst, is required for instructors of this program.

Chapter Structure

Reducing the incidence of injuries is dependent on shifting the culture to one of safety. Widespread educational programs to various age groups helps create social norming and use of safety practices. The successful reach of ThinkFirst is due to availability of programs, the organized chapter structure and the working connection chapters have with each other and the Foundation. Annual chapter surveys track program delivery; an average of 7,000 presentations each year in the US reaches more than a half-million attendees a year. The most active state in the US is Michigan, with 23 chapters, providing an example of a model chapter network, capable of serving schools and communities throughout the state.

Each chapter has a chapter director, who coordinates the scheduling and delivery of presentations, and a physician, who serves as the medical director promoting awareness and support, and often presenting programs as well. Chapter directors are nurses, occupational therapists, physical therapists, physicians and other health educators who have completed ThinkFirst training. The chapter director is often a trauma injury prevention coordinator or community education instructor who has a designated role of community outreach in injury prevention education. Designated chapter director hours are key to reaching the population in a sufficient manner to promote a change.


ThinkFirst has established chapters in many countries, including Canada, Mexico, Peru, Italy, Jordan, Jamaica, Algeria, Nigeria, Senegal, Guinea, Columbia, Honduras, India, South Korea, Chile, Singapore, Qatar, Taiwan and others. Some have developed robust programs while others work with a smaller number of schools or programs, due to limited staff, resources or knowledge on program development.

In 2017 the WFNS Neurotrauma Committee, chaired by Dr. Tariq Khan, and the ThinkFirst Foundation, chaired by Dr. Rocco Armonda, created a task force to increase efforts in the promotion of injury prevention throughout the world. The WFNS Neurotrauma Prevention Task Force is focused on increasing program awareness among neurosurgeons, developing chapters and encouraging the development of chapter networks for maximum effect in reducing traumatic injury.  Additional Task Force organizers include Dr. Gail Rosseau, Chair of the WFNS-WHO Committee as well as ThinkFirst Board Member and Chair of the ThinkFirst International Committee.  Drs. Khan and Rosseau will be presenting WFNS and WHO NeuroTrauma Prevention programs at the ThinkFirst Conference during the 2018 AANS Annual Meeting in New Orleans. 

Information may be found at or by emailing This year’s ThinkFirst Conference on Injury Prevention and training will be held April 27-29 in New Orleans, Louisiana, USA.


August 2022