Applying the multiphase optimization strategy to evaluate the feasibility and effectiveness of an online road safety education intervention for children and parents: a pilot study

BACKGROUND

Reports of children's engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents.

METHODS

Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses.

RESULTS

Main intervention feasibility findings include positive and critical feedback on the program's content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the "wheeling safety and skills" module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the 'wheeling safety and skills' module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component.

CONCLUSION

The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children's road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the "wheeling safety and skills" module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples.

WORD COUNT

9,391 (excludes abstract, tables, figures, abbreviations, and references).

Comparison of the Effect of Traffic Park-Based and School-Based Educational Interventions on Safe Road Crossing in Yazd Elementary School Students

INTRODUCTION

Traffic accidents are one of the most important health problems that cause many deaths every year. Scientific-practical interventions are needed to prevent traffic accidents. This study aimed to compare the effectiveness of traffic-based and school-based interventions on the safe road crossing in Yazd elementary school students.

METHODS

This interventional study was conducted on 132 students (66 males and 66 females) in two groups of school-based and traffic park-based intervention. A questionnaire was used to determine the safe crossing behavior score. Then, an educational intervention was administered to both groups. Two months after the intervention, safe crossing behavior was evaluated in both groups. Finally, the data were analyzed using SPSS software version 22.

RESULTS

In both groups, the score of safe crossing behavior was significantly increased after the intervention. The school-based group had significantly better behaviors compared to the traffic park-based group (P=0.001). There was a significant difference in the mean score of behavior between males and females and the intervention had a greater effect on female students (P=0.017).

CONCLUSION

Educational interventions and especially school-based intervention can be effective in improving the students' safe crossing behaviors.

A systematic review of technology-based interventions for unintentional injury prevention education and behaviour change

OBJECTIVE

The aims of this literature review are to (1) summarise how computer and mobile technology-based health behaviour change applications have been evaluated in unintentional injury prevention, (2) describe how these successes can be applied to injury-prevention programmes in the future and (3) identify research gaps.

METHODS

Studies included in this systematic review were education and behaviour change intervention trials and programme evaluations in which the intervention was delivered by either a computer or mobile technology and addressed an unintentional injury prevention topic. Articles were limited to those published in English and after 1990.

RESULTS

Among the 44 technology-based injury-prevention studies included in this review, 16 studies evaluated locally hosted software programmes, 4 studies offered kiosk-based programmes, 11 evaluated remotely hosted internet programmes, 2 studies used mobile technology or portable devices and 11 studies evaluated virtual-reality interventions. Locally hosted software programmes and remotely hosted internet programmes consistently increased knowledge and behaviours. Kiosk programmes showed evidence of modest knowledge and behaviour gains. Both programmes using mobile technology improved behaviours. Virtual-reality programmes consistently improved behaviours, but there were little gains in knowledge. No studies evaluated text-messaging programmes dedicated to injury prevention.

CONCLUSIONS

There is much potential for computer-based programmes to be used for injury-prevention behaviour change. The reviewed studies provide evidence that computer-based communication is effective in conveying information and influencing how participants think about an injury topic and adopt safety behaviours.

Comparing Performance within a Virtual Supermarket of Children with Traumatic Brain Injury to Typically Developing Children: A Pilot Study

The purpose of this study was to determine the usability of a virtual reality environment for pediatric traumatic brain injury (TBI) by assessing the performance of a simple virtual shopping task and comparing their results to typically developing peers. Twenty children with TBI and 20 typically developing children, matched in age and sex, “shopped” for four items in a virtual supermarket (VMall). A short feedback questionnaire, Borg's scale of perceived exertion, and the Zoo Map subtest from the Behavioral Assessment of the Dysexecutive Syndrome for Children were also administered. All of the children were able to complete a four-item test within the VMall. Overall, good usability was obtained. A significant difference in shopping performance was found between the two groups; the mean shopping time and number of mistakes was higher for the children with TBI. The use of a short shopping test within a functional virtual environment enabled detection of poorer performance of children with TBI that may be due to executive function deficits. Because the task was enjoyable and motivating, the VMall may also be used to enhance participation in instrumental activities of daily living and play for children with TBI.

Child Pedestrian Injury: A Review of Behavioral Risks and Preventive Strategies

Pedestrian injury is among the leading causes of pediatric death in the United States and much of the world. This paper is divided into two sections. First, we review the literature on behavioral risk factors for child injury. Cognitive and perceptual development risks are discussed. The roles of distraction, temperament and personality, and social influences from parents and peers are presented. We conclude the first section with brief reviews of environmental risks, pedestrian safety among special populations, and the role of sleep and fatigue on pediatric pedestrian safety. The second section of the review considers child pedestrian injury prevention strategies. Categorized by mode of presentation, we discuss parent instruction strategies, school-based instruction strategies (including crossing guards), and streetside training techniques. Technology-based training strategies using video, internet, and virtual reality are reviewed. We conclude the section on prevention with discussion of community-based interventions.

The effects of instructional interventions related to street crossing and individuals with disabilities

Adequate street crossing skills reduce the risk of injury and increase the functional independence of individuals with disabilities. This paper reviews research involving instructional interventions for street crossings with individuals with disabilities. Eight studies were included. There was evidence individuals could be taught street crossings using classroom based interventions, roadside instruction, or virtual reality technology. Classroom based methods were successful when involving strategies which promoted generalization of skills. Task analysis found the steps involved in street crossing included: stopping at the curb, looking left and right, walking quickly, walking within the crosswalk, and continuing to look left and right. A variety of instructional strategies were used, but the small body of literature did not allow clear identification of superior strategies.

Virtual reality and interactive digital game technology: new tools to address obesity and diabetes

The convergence of the exponential advances in virtual reality (VR)-enabling technologies with a growing body of clinical research and experience has fueled the evolution of the discipline of clinical VR. This article begins with a brief overview of methods for producing and delivering VR environments that can be accessed by users for a range of clinical health conditions. Interactive digital games and new forms of natural movement-based interface devices are also discussed in the context of the emerging area of exergaming, along with some of the early results from studies of energy expenditure during the use of these systems. While these results suggest that playing currently available active exergames uses significantly more energy than sedentary activities and is equivalent to a brisk walk, these activities do not reach the level of intensity that would match playing the actual sport, nor do they deliver the recommended daily amount of exercise for children. However, these results provide some support for the use of digital exergames using the current state of technology as a complement to, rather than a replacement, for regular exercise. This may change in the future as new advances in novel full-body interaction systems for providing vigorous interaction with digital games are expected to drive the creation of engaging, low-cost interactive game-based applications designed to increase exercise participation in persons at risk for obesity.