An educational intervention in road safety among children and teenagers in Mexico

Supporting children's participation in active travel: developing an online road safety intervention through a collaborative integrated knowledge translation approach

Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children's PA. One common barrier to children's engagement in AT, however, is a reported lack of education and training. To support children's participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children's knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.

Awareness level of safe driving knowledge and practice of specific population drivers: behavioral assessment and educational intervention

PURPOSE

This study aimed to assess car-driving behaviors and attitudes and to measure the changes in the knowledge and behavioral practices associated with road safety measures of 1333 randomly selected young-adult participants (aged 18-24 years) from Jazan University in Gizan city, Saudi Arabia.

METHODS

Data were collected using cross-sectional survey and quasi experimental pre- and post-evaluation educational intervention study including structured questionnaire and take-home educational material.

RESULTS

Results revealed that low compliance with the safety index significantly increased the risk of traffic injuries by 20% [OR = 0.80, 95% CI = (0.59-1.01)]. Whereas the medium category of the safety compliance index is significantly associated with an increasing number of injuries by 6% [OR = 0.94, 95% CI = (0.61-1.52)]. In contrast, both high and medium categories of risk behavior index increased the risk of traffic injuries [OR = 1.08, 95% CI = (0.82-1.43); OR = 0.80, 95% CI = (0.57-1.10), respectively]. Some improvement in risky behavioral practices was seen after the intervention including 'not playing loud music' [86.3%, (P = 0.05)], 'not using mobile phones' [89.4%, (P < 0.05)], and 'not using unprofessional checkups of the car' [71.5%, (P < 0.05)].

CONCLUSION

Ultimately, this unpleasant situation may recommend avoidance of these kinds of intermittent awareness programs; instead, embedding a continuous road safety learning within the life-long educational system as a better and more realistic intervention for reducing the number of road accidents and injuries. Further, establishing various modes of high-capacity city-link public transportation remains among the most recommended strategic and effective options that can curb road traffic injuries in the long run.

The Road Safety Education Program for Adolescents Using Social Media, Proving Increasing Knowledge, Beliefs, Attitudes, Intentions and Behavior

Deaths due to road traffic accidents (RTA) accounted for 2.46% of deaths out of the total deaths in Indonesia. Road safety education (RSE), as an effort to prevent RTA, focuses on increasing knowledge; however, variations of techniques, methods, and media are less used. This study aims to analyze the application of RSE innovations that have been compiled based on interests and needs of adolescents, which are expected to be able to increase knowledge, beliefs, attitudes, intentions, and safe driving behavior. This research used a quasi-experimental approach with a non-randomized pre-test–post-test control group design approach. The Zainafree Program intervention model was conducted for 6 weeks on 362 students who were selected using purposive sampling technique at two schools with the same characteristics. The bivariate analysis was conducted to observe the effect of the model on changes in knowledge, beliefs, attitudes, intentions, and behavior. We analyzed multivariately using GLM-RMA to determine the effectiveness of the model from various confounding factors. The Mann–Whitney test in the intervention and control group demonstrated a significant difference in the average post-test score of two on all dependent variables (p = 0.000). The results of the GLM-RMA test demonstrated the effect of the Zainafree Program on knowledge (p = 0.000; ETA Square = 35.1), beliefs (p = 0.000; ETA Square = 32.0), attitudes (p = 0.000; ETA Square = 50.9), intentions (p = 0.000, ETA Square = 20.7), and behavior (p = 0.000; ETA Square = 28.2), after adjusting for involvement between confounding variables (p = 0.000; ETA Square = 16.2), which demonstrated that the intervention was able to explain 16.2 changes that occur in the scores of five aspects together. The RSE program was proven to be successful in increasing students’ knowledge, beliefs, attitudes, intentions, and behavior compared to those who did not receive the program.

Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial

OBJECTIVE

To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries.

METHODS

This cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5-7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months.

RESULTS

Unintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405-0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001).

CONCLUSIONS

School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.

Effectiveness of School-Based Interventions in Reducing Unintentional Childhood Injuries: A Cluster Randomized Trial

Objective

To evaluate the effectiveness of school-based interventions in promoting child safety and reducing unintentional childhood injuries.

Methods

This cluster randomized trial with 1:1 allocation of clusters to intervention and control arm was conducted in the public and private schools of Dakshina Kannada district, Karnataka, over a period of 10 months. Study participants included children from standard 5–7 in schools selected for the study. 10 schools that could accommodate 1100 students each, were randomly allocated to the interventional and control arm. A comprehensive child safety and injury prevention module was developed based on the opinions of school teachers through focus group discussions. This module was periodically taught to the students of intervention arm by the teachers. The children in control arm did not receive any intervention. Outcome was assessed by determining the incidence of unintentional injuries and type of injuries from the questionnaire used at the baseline, and at the end of three, six, and ten months.

Results

Unintentional injuries declined progressively from baseline until the end of the study in both the interventional arm (from 52.9% to 2.5%) and control arm (from 44.7% to 32%) [AOR (95% CI) 0.458 (0.405–0.518); P value <0.001]. The decline in incidence of injuries in the interventional arm was higher than that in the control arm (50.4% vs 12.7%; P <0.001).

Conclusion

School based educational intervention using child safety and injury prevention modules is effective in reducing unintentional injuries among school children over a 10-month period.

Road Use Pattern and Street Crossing Habits of Schoolchildren in India

Road traffic accidents (RTAs) contribute significant DALYs in the global burden of diseases. Vulnerable groups particularly pedestrians and children are at an increased risk. Road use pattern, street crossing habits, and road safety awareness are important determinants of RTAs. The present study was carried out to assess the road use pattern and street crossing habits of schoolchildren. This cross-sectional study included 497 schoolchildren of 12–15 years. The interview technique was used as a tool for data collection on a predesigned questionnaire. A total of 40.4% of schoolchildren did not like to go to school alone and wanted somebody from the family to drop them to school. About one quarter of the students were afraid of traffic and expressed their inability to deal with traffic on the road. A total of 10.7% reported crossing the street in groups, and 1.4% reported running while crossing the street. Only 80.9% of students received some form of road safety training, and the parents and schools were the major source of information for such safety training. Age <14 years and a lower level of mother's education were found to be significant contributors for poor road crossing habit in univariate as well as multivariate analysis. The study suggests that the knowledge regarding safe road use and street crossing was lacking among study participants albeit in a small proportion only. Safety aspects can be partly strengthened by imparting practical knowledge about road use pattern, street crossing habits, and road safety procedures.

Prevention of childhood unintentional injuries in low- and middle-income countries: A systematic review

Injuries are a leading cause of death and disability among children. Numerous injury prevention strategies have been successful in high-income countries, but the majority of unintentional injuries happen to children living in low- and middle-income countries (LMICs). This project aims to delineate the childhood injury prevention initiatives in LMICs. For inclusion, peer-reviewed articles needed to address unintentional injury, include children <18, assess a prevention-related intervention, contain a control group, and be published after 1988. Two pairs of reviewers evaluated articles independently to determine study eligibility. 74 articles were included. 30 studies addressed road traffic injuries, 11 drowning, 8 burns, 3 falls, 8 poisonings, and 21 an unspecified injury type. The findings show positive effects on injury outcome measures following educational interventions, the need for longer follow-up periods after the intervention, the need for effectiveness trials for behavior change, and the need for an increase in injury prevention services in LMICs. This is the first systematic review to summarize the prevention initiatives for all types of childhood unintentional injuries in LMICs. Increased attention and funding are required to go beyond educational initiatives with self-reported measures and little follow-up time to robust interventions that will reduce the global burden of unintentional injuries among children.

Behavioral Health at School: Do Three Competences in Road Safety Education Impact the Protective Road Behaviors of Spanish Children?

Background: Education in road safety (also known as Road Safety Education-RSE) constitutes, nowadays, an emergent approach for improving present and future road behaviors, aiming at taking action against the current, and concerning, state-of-affairs of traffic crashes, through a behavioral perspective. In the case of children, and despite their overrepresentation in traffic injury figures, RSE-based strategies for behavioral health in transportation remain a "new" approach, whose impact still needs to be empirically tested. Objective: The aim of this study is to assess the impact of three key road safety skills of the Positive Attitudes, Risk perception and Knowledge of norms (PARK) model, addressed in RSE-based interventions, on the safe road behavior of Spanish children. Methods: For this cross-sectional study, a representative sample of 1930 (50.4% males and 49.6% females) Spanish children attending primary school, with a mean age of 10.1 (SD = 1.6) years, was gathered from 70 educational centers across all Spanish regions, through a national study on RSE and road safety. Results: Road safety skills show a positive relationship with children's self-reported safe behaviors on the road. However, the knowledge of traffic norms alone does not predict safe behaviors: it needs to be combined with risk perception and positive attitudes towards road safety. Furthermore, the degree of exposure to previous RSE interventions was shown to have an effect on the score obtained by children in each road safety skill; on the other hand, road misbehaviors observed in parents and peers had a negative impact on them. Conclusion: The outcomes of this study suggest that education in road safety is still a key process for the acquisition of safe habits, patterns and behaviors among young road users.

More aware, more protected: a cross-sectional study on road safety skills predicting the use of passive safety elements among Spanish teenagers

OBJECTIVE

This study had two objectives: first, to test the effects of sociodemographic variables, and the effects of three key road safety skills (knowledge-risk perception-attitudes) on the use of passive safety elements (PSEs) among teenagers; and second, to assess the differential impact of the study variables on PSEs use from a gender-based perspective.

SETTING AND PARTICIPANTS

This cross-sectional study was framed in the paradigm of primary care, and it involved students from several educational centres in Spain. A sample of 827 Spanish teenagers (52.4% females and 47.6% males) with a mean age of M=14.41-7 (12-19) years was used.

RESULTS

Through SEM modelling, we found that the use of PSEs is largely explained by psychosocial variables through the mediation of three road safety skills: risk perception (β=0.103^***), rule knowledge (β=0.095^*) and attitudes towards road safety (β=0.186^***). Furthermore, multigroup analyses showed that, although most variables explain the use of PSEs among teenagers in a similar way, key gender-based differences exist in this regard.

CONCLUSIONS

Road safety skills have a significant effect on the use of PSEs among Spanish teenagers, and gender explains some differences in the mechanisms which predict them. Also, in the study we discuss the need for strengthening school-based interventions aimed at helping this vulnerable group of road users acquire and develop positive behavioural competences.

Driven to succeed: Improving adolescents' driving behaviors through a personal narrative-based psychosocial intervention in Serbia

Globally, more adolescents die from road traffic fatalities than from any other cause, and males are significantly more vulnerable than females. Driver education interventions directed at males are less likely to succeed than those directed at females, and stronger optimistic bias and overconfidence bias have been implicated as likely reasons. We report results from a quasi-experiment conducted in Serbia, targeting male and female adolescents. Stratified by size, forty schools were randomly assigned to either a personal-narrative intervention or a no-intervention control arm. Data were collected before the intervention (N = 1449) and again six months later (N = 1072). Risk perceptions improved for both males and females, and injunctive norms improved for females. Improvements in overconfidence bias and descriptive norms were predictive of improvements in high-risk driving behaviors. A significant interaction between improvements in injunctive norms and the intervention revealed that males whose injunctive norms improved were significantly more likely to be affected by the intervention, compared to the other groups. Implications for interventions are discussed.

Factors behind not using child restrain(t) among hospital employees and general population: A case control study

BACKGROUND

Motor vehicle crash (MVC) related injury has been identified as a major public health concern. Child restrain (CR) seat belts can minimize the mortality and morbidity from MVC. The use for seat belts is substantially low in developing countries like Pakistan even though its use has been shown to decrease morbidity and mortality by a significant extent.

METHODS

This was a case control study with cases from the general population (GP) and controls from the Aga Khan University (AKU) employees in a 3:1 ratio. The study questionnaire was based on parameters like gender, education level, awareness and presence of CR and also assessed the frequency of usage, reasons for not using CR and the source of knowledge regarding CR use.

RESULTS

Out of 848 respondents, 212 were from AKU and 636 were from the GP. 96.7% from AKU had at least a bachelor's degree while less than half (42.6%) of those from the GP were graduate or above (P<0.001). A statistically significant difference was found between the two groups with drivers from AKU being generally more aware about CR and its use. 81.1% of the group from AKU compared to 59.7% from the general population were found to be aware of child restraint use (P<0.001). Media (40.6%) was found to be the most common source of information amongst the AKU employees.

CONCLUSION

Most motor vehicle related injuries in children can be prevented or their severity may be reduced by the use of appropriate child restraint seat belts.