Development of the Iranian National road safety plan: Study protocol

Road safety lead agency challenges of three decades of intervention for road safety in Iran: implications for policy-makers

BACKGROUND

Road traffic crashes and associated injuries and mortalities are one of the big public health challenges, especially in low/middle-income countries. Road safety lead agency (RSLA) is a vital factor in the sustainable prevention and promotes road safety. In the recent decades, various policy interventions have been conducted for road safety in Iran. This study aimed at exploring the challenges of RSLA from the perspectives of stakeholders at various levels.

METHODS

A qualitative study was conducted. In-depth interviews and document reviews were used for data collection. To conduct interviews, different stakeholders at various levels such as policy-makers, senior national authorities, researchers and faculty members were selected. Data collection was conducted between November 2019 and June 2020. Thematic content analysis approach was used for data analysis.

RESULTS

The experts' perspectives were analysed and then categorised under five main themes including the role and position of the lead agency, the role and duties of the actors and players, translating policy into practice, intrasectoral and intersectoral cooperation and coordination and evidence production and application and a total of 22 subthemes were identified. The current structure of the RSLA is one of the main challenges emphasised by the research participants.

CONCLUSION

To achieve significant improvements in road safety at the national level, a strong management system and leadership body is a critical issue. Organisational reform to establish an effective unique lead agency is proposed to cope with RSLA challenges.

The effectiveness of fixed speed cameras on Iranian taxi drivers: An evaluation of the influential factors

Background

The adherence to speed limits can reduce deaths associated with road traffic injuries (RTIs) by more than a quarter. This study aimed to evaluate the effective factors on the speeding behavior of Iranian taxi drivers around fixed speed cameras.

Method

Telematics devices used in this study collected the location and speed of the vehicles. The units of analysis in this study were trips per camera, including 2.5 km before and after each camera. Linear regression analysis was used to identify kangaroo driving (KD), defined as trips with a significant V-shape in speed distribution around the camera. In the clustered camera zones, cameras were placed at regular intervals of approximately 3.5 km.

Findings

A total of 93,160 trips were recorded from 13,857,443 data points. There was an inverse association between drivers' age and KD with an odds ratio (OR) of 0.98 (95% confidence interval: 0.98-0.98). The intercity trips had a substantially higher probability of KD than urban trips (OR: 4.94 [4.73-5.16]). The tendency of drivers toward KD during the daylight hours vs. nighttime was significant for both urban (OR: 1.15 [1.06-1.25]) and intercity (OR: 1.18 [1.14-1.22]) trips. The 4 -8 a.m. period had the highest chance of KD in both urban (10.71% [7.41-14.53]) and intercity (44.13% [41.18-47.09]) trips. There was a significant decrease in the odds of KD inside the clustered camera zones (OR: 0.22 [0.20-0.25]).

Conclusion

The heterogeneous occurrence of KD in different locations and times indicates the necessity of evidence-based decision-making in urban planning to improve safe driving behaviors. The lower occurrence of KD in clustered camera zones could be a practical key to the effective control of speeding behaviors by helping in the efficient placement of cameras through sustainable development of cities and roads.

Setting research priorities to achieve long-term national road safety goals in Iran

Background

Road traffic crashes (RTCs) and its associated injuries are one of the most important public health problems in the world. In Iran, RTCs rank second in terms of mortality. To address this issue, there is a need for research-based interventions. Prioritizing researches using a variety of approaches and frameworks to determine the most effective interventions is a key nodal point in the RTCs' research policy planning cycle. Thus, this study aims to generate and prioritize research questions in the field of RTCs in Iran.

Methods

By adapting the Child Health and Nutrition Research Initiative (CHNRI) method, this study engaged 25 prominent Iranian academic leaders having role in setting Iran’s long-term road safety goals, a group of research funders, and policymakers. The experts' proposed research questions were independently scored on a set of criteria: feasibility, impact on health, impact on the economy, capacity building, and equity. Following the prioritization of Research Questions (RQs), they were all classified using the 5 Pillar frameworks.

Results

In total, 145 Research Questions were systematically scored by experts against five criteria. Iran's top 20 road traffic safety priorities were established. The RQs related to “road safety management” and “road and infrastructure” achieved a high frequency.

Conclusions

The top 20 research questions in the area of RTCs in Iran were determined by experts. The majority of these RQs were related to “road safety management”. The results of this study may contribute to the optimal use of resources in achieving long-term goals in the prevention and control of road traffic crashes and its related injuries. Considering these RQs as research investment options will improve the current status of Road Traffic Injuries (RTIs) at a national level and further advance toward compliance with international goals. If these research priorities are addressed, and their findings are implemented, we can anticipate a significant reduction in the number of crashes, injuries, and deaths.

Applying count time series to assess 13-year pedestrian mortality trend caused by traffic accidents in East-Azerbaijan province, Iran

In populated cities, pedestrian mortality is higher compared to other traffic mortalities. The current study aimed to describe the trend of pedestrian mortality in the East-Azerbaijan (Northwest of Iran) province from 2006 to 2019 and find the factors that affect the mortality number. Pedestrian mortality data from March 2006 to March 2019 was obtained from the Legal Medicine Organization database of Iran. Generalized Linear Auto Regressive Moving Average (GLARMA) models were used to assess the trend, and affecting factors of pedestrian mortality. According to the traffic accident data from 21 March 2006 until 20 March 2019 in East-Azerbaijan 24.11% of mortalities are related to pedestrians. Pedestrian mortality had a decreasing seasonal trend during 2006-2019. The result of the GLARMA model showed that age >65, being non-educated, cases with head trauma death cause, pre-hospital death, accident inside the city, vehicle type and self-employed jobs had a direct relation to pedestrian's mortality.

Hidden patterns among the fatally injured pedestrians in an Iranian population: application of categorical principal component analysis (CATPCA)

Background

Identifying hidden patterns and relationships among the features of the Fatal Pedestrian Road Traffic Injuries (FPRTI) can be effective in reducing pedestrian fatalities. This study is thus aimed to detect the patterns among the fatally injured pedestrians due to FPRTI in East Azerbaijan province, Iran.

Methods

This descriptive-analytic research was carried out based on the data of all 1782 FPRTI that occurred in East Azerbaijan, Iran from 2010 to 2019 collected by the forensic organization. Categorical Principal Component Analysis (CATPCA) was performed to recognize hidden patterns in the data by extracting principal components from the set of 13 features of FPRTI. The importance of each component was assessed by using the variance accounted for (VAF) index.

Results

The optimum number of components to fit the CATPCA model was six which explained 71.09% of the total variation. The first and most important component with VAF = 22.04% contained the demographic and socioeconomic characteristics of the killed pedestrians. The second-ranked component with VAF = 12.96% was related to the injury type. The third component with VAF = 10.56% was the severity of the injury. The fourth component with VAF = 9.07% was somehow related to the knowledge and observance of the traffic rules. The fifth component with VAF = 8.63% was about the quality of medical relief and finally, the sixth component with VAF = 7.82% dealt with environmental conditions.

Conclusion

CATPCA revealed hidden patterns among the fatally injured pedestrians in the form of six components. The revealed patterns showed that some interactions between correlated features led to a higher mortality rate.

Development of quality indicators to measure pre-hospital emergency medical services for road traffic injury

Background

Pre-Hospital Emergency Care (PEC) is a fundamental property of prevention of Road Traffic Injuries (RTIs). Thus, this sector requires a system for evaluation and performance improvement. This study aimed to develop quality indicators to measure PEC for RTIs.

Methods

Following the related literature review, 14 experts were interviewed through semi-structured interviews to identify Quality Measurement Indicators (QMIs). The extracted indicators were then categorized into three domains: structure, performance, and management. Finally, the identified QMIs were confirmed through two rounds of the Delphi technique.

Results

Using literature review 11 structural, 13 performance, and four managerial indicators (A total of 28 indicators) were identified. Also, four structural, four performance, and three managerial indicators (A total of 11indicators) were extracted from interviews with experts. Two indicators were excluded after two rounds of Delphi’s technics. Finally, 14 structural, 16 performance and, seven managerial indicators (A total of 37indicators) were finalized.

Conclusion

Due to the importance and high proportion of RTIs compared to other types of injuries, this study set out to design and evaluate the QMIs of PEC delivered for RTIs. The findings of this research contribute to measuring and planning aimed at improving the performance of PEC.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06238-1.