Pedestrian Education Research Articles

Child Pedestrian Safety.

The field of pedestrian safety has advanced with new evidence related to pediatric pedestrian education, the risks of distracted walking, the benefits of design and programming in safe routes to school, and the emergence of the "Vision Zero" strategy to eliminate all traffic fatalities and severe injuries while increasing safe, healthy, equitable mobility for all. This statement is a revision of the 2009 American Academy of Pediatrics policy statement "Pedestrian Safety" and is accompanied by a technical report (www.pediatrics.org/cgi/doi/10.1542/peds.2023-062508) providing additional detail to support recommendations. This statement is intended to assist practicing pediatricians to offer evidence-based advice to families about the benefits of active transportation and the specific risks and safety precautions to consider for child pedestrians at different ages. For community pediatricians and the American Academy of Pediatrics, the statement provides an overview of specific programs and policies that, if implemented, could foster independent mobility for children while increasing pediatric pedestrian safety. This statement identifies trends in public health and urban design relevant to pedestrian safety.

Epidemiology and Prevention of Child Pedestrian Injury.

This report supports policy recommendations in the accompanying policy statement "Child Pedestrian Safety" (www.pediatrics.org/cgi/doi/10.1542/peds.2023-62506). It reviews trends in public health and urban design relevant to pedestrian safety and provides information to assist practicing pediatricians discussing the benefits of active transportation and the specific risks and safety precautions to consider for child pedestrians at different ages. The report offers the evidence base for which programs and policies that, if implemented, could foster independent mobility for children while increasing pediatric pedestrian safety. Since the previous policy statement was published in 2009, the field of pedestrian safety has advanced with new evidence related to pediatric pedestrian education, the risks of distracted walking, the benefits of design and programming in safe routes to school, and the emergence of the "Vision Zero" public health and safety initiatives to prevent all serious and fatal transportation injuries.

Children's Road-Crossing Behavior: Emotional Decision Making and Emotion-Based Temperamental Fear and Anger.

Child pedestrian injuries represent a global public health burden. To date, most research on psychosocial factors affecting children's risk of pedestrian injury focused on cognitive aspects of children's functioning in traffic. Recent evidence suggests, however, that emotional aspects such as temperament-based fear and anger/frustration, as well as executive function-based emotional decision making, may also affect children's safety in traffic. This study examined the role of emotions on children's pedestrian behavior. Three hypotheses were considered: (a) emotion-based temperament factors of fear and anger/frustration will predict children's risky decisions and behaviors; (b) emotional decision making will predict risky pedestrian decisions and behaviors; and (c) children's pedestrian decision making will mediate relations between emotion and risky pedestrian behavior. The role of gender was also considered. In total, 140 6- to 7-year-old children (M = 6.7 years, SD = 0.39; 51% girls) participated. Parent-report subscales of Child Behavior Questionnaire measured temperamental fear and anger/frustration. The Hungry Donkey Task, a modified version of Iowa Gambling Task for children, measured children's emotional decision making, and a mobile virtual reality pedestrian environment measured child pedestrian behavior. Greater anger/frustration, lesser fear, and more emotional decision making all predicted poorer pedestrian decision making. The mediational model demonstrated that pedestrian decision making, as assessed by delays entering safe traffic gaps, mediated the relation between emotion and risky pedestrian behavior. Analyses stratified by gender showed stronger mediation results for girls than for boys. These results support the influence of emotions on child pedestrian behavior and reinforce the need to incorporate emotion regulation training into child pedestrian education programs.

Using crowd sourcing to locate and characterize conflicts for vulnerable modes

Most agencies and decision-makers rely on crash and crash severity (property damage only, injury or fatality) data to assess transportation safety; however, in the context of public health where perceptions of safety may influence the willingness to adopt active transportation modes (e.g. bicycling and walking), pedestrian-motor vehicle and other similar conflicts types may define a better performance measure for safety assessment. In the field of transportation safety, an absolute conflict occurs when two parties’ paths cross and one of the parties must undertake an evasive maneuver (e.g. change direction or stop) to avoid a crash. Other less severe conflicts where paths cross but no evasive maneuver is required may also impact public perceptions of safety especially for vulnerable modes. Most of the existing literature focuses on vehicle conflicts. While in the past several years, more research has investigated bicycle and pedestrian conflicts, most of this has focused on the intersection environment. A comprehensive analysis of conflicts appears critical. The major objective of this study is two fold: 1) Development of an innovative and cost effective conflict data collection technique to better understand the conflicts (and their severity) involving vulnerable road users (e.g. bicycle/pedestrian, bicycle/motor vehicle, and pedestrian/motor vehicle) and their severity. 2) Test the effectiveness and practicality of the approach taken and its associated crowd sourced data collection. In an endeavor to undertake these objectives, the researchers developed an android-based crowd-sourced data collection app. The crowd-source data collected using the app is compared with traditional fatality data for hot spot analysis. At the end, the app users provide feedback about the overall competency of the app interface and the performance of its features to the app developers. If widely adopted, the app will enable communities to create their own data collection efforts to identify dangerous sites within their neighborhoods. Agencies will have a valuable data source at low-cost to help inform their decision making related to bicycle and pedestrian education, encouragement, enforcement, programs, policies, and infrastructure design and planning.

A study of fatal pedestrian crashes at rural low-volume road intersections in southwest China

ABSTRACTObjective: Although intersections correspond to a small proportion of the entire roadway system, they account for a disproportionally high number of fatal pedestrian crashes, especially on rural roads situated in low- and middle-income countries. This article examines pedestrian safety at rural intersections and suggests applicable accident prevention treatments by providing an in-depth analysis of 28 fatal pedestrian crashes from 8 low-volume roads in southwest China.Methods: The driving reliability and error analysis method (DREAM) is a method to support a systematic classification of accident causation information and to facilitate aggregation of that information into patterns of contributing factors. This is the first time that DREAM was used to analyze pedestrian–vehicle crashes and provide suggestions for road improvements in China.Results: The key issues adversely affecting pedestrian safety can be organized in 4 distinctive thematic categories, namely, deficient intersection safety infrastructure, lack of pedestrian safety education, inadequate driver training, and insufficient traffic law enforcement. Given that resources for traffic safety investments in rural areas are limited, it is determined that the potential countermeasures should focus on low-cost, easily implementable, and long-lasting measures increasing the visibility and predictability of pedestrian movement and reducing speeding and irresponsible driving among drivers and risk-taking behaviors among pedestrians.Conclusions: Accident prevention treatments are suggested based on their suitability for rural areas in southwest China. These countermeasures include introducing better access management and traffic calming treatments, providing more opportunities for pedestrian education, and enhancing the quality of driver training and traffic law enforcement.

Pedestrian Mortality Trends In Children Over Four Decades In Transitional Lithuania

The aim of the study was to examine the long-term trends in pedestrian mortality for children (aged 0 to 14 years) and young people (aged 15 to 19 years) over four decades in transitional Lithuania. Methods. Road traffic fatality data were obtained from Statistics Lithuania and the Archives of Health Information Centre. Trends were analysed by linear regression using “Independence” as a slopechanging intervention in 1991 and population as a further explanatory factor in structural time series models. Results. The impact of the interventions, along with the reforms and changes related with the Independence, on pedestrian fatality trends in our time series model was found highly statistically significant for children 0 to 14 years (p<0.001) and still significant for young people 15 to 19 years (p<0.05). No significant impact on the trend of road traffic deaths was found for the “control-groups” of non-pedestrian road users in the age group 0 to 14 years and adult pedestrians (over 19 years of age). For the age group 15 to 19 years the effect of reforms was also significant for non-pedestrians (p<0.05). These results indicate that the effect of measures and changes used in the post-independence period was more specific in children that participated in road traffic as pedestrians than in adult pedestrians, or in nonpedestrian road users. Conclusions. Pedestrian deaths in Lithuania fell significantly in the age groups 0-14 and 15-19 years. A declining trend was found in road traffic fatalities and in pedestrian deaths in transitional Lithuania in the post-independence period. Socioeconomic and political transformations, systematic reforms in healthcare along with sustainable preventive measures may have contributed to this decrease. Targeted road safety measures were road traffic regulations, pedestrian education and environmentally based prevention measures. As child pedestrians are the most vulnerable group of road users, continued road safety education and promotion are recommended in order to maintain this trend, and to involve adult pedestrians in this development.

Annual pediatric pedestrian education does not improve pedestrian behavior

Annual pediatric pedestrian education does not improve pedestrian behavior

Annual Pediatric Pedestrian Education Does Not Improve Pedestrian Behavior

Pediatric pedestrian injuries are a major health care concern, specifically in urban centers. An educational program (WalkSafe), given one time during the school year, has been shown to improve childhood pedestrian safety. We examined whether this program could create similar long-term cognitive and behavioral changes in our school-aged children. An established pediatric pedestrian curriculum was modified slightly for use in our area. Students K-fourth grade were exposed to the program once annually for 2 years. The program was carried out weekly for 3 consecutive weeks. The first and third sessions consisted of an educational module given by the classroom teacher. The second week consisted of an interactive assembly that allowed the children to demonstrate good pedestrian safety using a simulated street. Short- and intermediate-term cognitive knowledge was evaluated using standardized pre-, post- and 3-month follow-up tests. Long-term knowledge was assessed by comparing scores as students advanced in grade from year 1 to 2 of the program (K to first, first to second, etc.). At six schools during year 2, pedestrian behavior was measured through direct observation of children on city streets before and after administering the program. The project was approved by university and school board institutional review boards. During the 2 years, 1,564 students from nine schools were educated. In both years of the program, students in all grades had a significant gain in test scores immediately after and at 3 months compared with baseline knowledge. In contrast, only students moving from grade 3 to 4 demonstrated long-term retention (K→1: 7.7 vs. 6.7; grade 1→2: 7.8 vs. 6.7; grade 2→3: 7.3 vs. 6.8; grade 3→4: 7.1 vs. 8.0; all p < 0.05 year 2 pretest vs. year 1 3-month posttest; analysis of variance and generalized linear model). Only 30% of children walk with an adult. Direct observation showed 64% of children stopped at the curb but only 8% looked left-right-left. Children walking alone were more likely to cross mid-block compared with those walking with an adult (12% vs. 3%; p < 0.001) and also tend to look left-right-left significantly more than those walking with an adult (67% vs. 20%; p < 0.0001). A one-time annual educational program resulted in long-term knowledge retention between grades 3 and 4 only. In contrast, scores in younger grades reverted to baseline pretest values seen in year 1. Short- and intermediate-term knowledge gains were seen in all grades for both years. Because older children more often walk alone, we postulate that the improved retention may be the result of repeated exposure and practice as a pedestrian. Cognitive knowledge did not appear to translate into improved pedestrian behavior. Walking with an adult also had a negative impact on observed pedestrian safety behavior. The efficacy and impact of a one-time educational program may be insufficient to change long-term behavior and must be reevaluated.

Safety education of pedestrians for injury prevention: a systematic review of randomised controlled trials

Objectives: To quantify the effectiveness of safety education of pedestrians.Design: Systematic review of randomised controlled trials of safety education programmes for pedestrians of all ages.Main outcome measures: Effect of safety...

Safety education of pedestrians for injury prevention.

Each year about one million people die and about 10 million are seriously injured on the world's roads. Educational measures to teach pedestrians how to cope with the traffic environment are considered to be an essential component of any prevention strategy, and pedestrian education has been recommended in many countries. However, as resources available for road safety are limited, a key question concerns the relative effectiveness of different prevention strategies. To quantify the effectiveness of pedestrian safety education programmes in preventing pedestrian-motor vehicle collisions. We searched the Injuries Group specialised register, Cochrane Controlled Trials Register, TRANSPORT, MEDLINE, EMBASE, ERIC, PSYCHLIT, SPECTR, and the WHO database on the Internet. We checked reference lists of relevant reviews and papers and contacted experts in the field. Most database searching was conducted in 1999. Randomised controlled trials of safety education programmes for pedestrians of all ages. One reviewer screened records. Two reviewers independently extracted data and assessed methodological quality of trials. Because of differences in the types of interventions and outcome measures used in the trials, meta-analyses were not carried out. We found 15 randomised-controlled trials of pedestrian safety education programmes, conducted between 1976 and 1997. Methodological quality of the included trials was generally poor. Allocation concealment was adequate in three trials, outcome assessment was blinded in eight, and in most of the studies large numbers of participants were lost to follow-up. Study participants were children in 14 studies and institutionalised adults in one. Eight studies involved the direct education of participants, seven used parents as educators. No trials were conducted in a developing country and there were none of pedestrian safety training in the elderly. None of the included trials assessed the effect of pedestrian safety education on the occurrence of pedestrian injury but six trials assessed the effect on observed behaviour. Some of these trials showed evidence of behavioural change following pedestrian safety education but it is difficult to predict what effect this might have on pedestrian injury risk. Pedestrian safety education can result in improvement in children's knowledge and can change observed road crossing behaviour but whether this reduces the risk of pedestrian motor vehicle collision and injury occurrence is unknown. There is evidence that changes in safety knowledge and observed behaviour decline with time suggesting that safety education must be repeated at regular intervals.

Recent Trends in Road Traffic Accident Parameters in Nigeria

This study aims at examining the nature of the rising trends in road traffic accident phenomenon in Nigeria, using data for the period 1990 1995. It examines the spatiotemporal variations of road traffic accident parameters, in addition to studying the fatality (severity) and injury indices as well as the health risk for each state, and the country in general. The paper observes a downward trend in all road traffic accident parameters, with fatal and serious cases declining as much as 33% and 24% respectively, although, the number of person killed during the period experienced an increase. Regionally, the performance varied among the states of the country, with Lagos, Ogun, Niger, Edo, Kano, Kogi, Delta, Jigawa, Sokoto, Cross River States and Abuja (Federal Capital Territory) recording high trends in all cases. These states thus need some more attention from all the agents of road safety in the country. The study concludes that, in addition to the behavioural modification approach which has not been emphasized enough, a lot more still needs to be done in such areas as maintenance of road transport infrastructure, vehicle road worthiness inspection, driver retraining and potential driver training, pedestrian education proper accident data collection, recording, storage and retrieval and finally law enforcement.

Safer roads for children in the United Arab Emirates

A study was conducted to obtain a representative view of the parents of primary school children regarding which strategies should be employed to reduce the toll of road traffic accidents in the United Arab Emirates. A cross-sectional population-based study was conducted in Al-Ain, UAE, in which parents were asked to give their suggestions on how to make the roads safer for their children. Strategies aimed at reducing vehicle speed, improved personal driving, adherence to existing rules, and driver and pedestrian education were regarded as paramount. There is widespread awareness of road safety problems in the country and the public appears ready to accept major safety initiatives by government agencies.

Preventing childhood unintentional injuries--what works? A literature review.

The aim of this paper is to report on a systematic review of the world literature to provide information about the most effective forms of health promotion interventions to reduce childhood (0-14 years) unintentional injuries. The findings are of relevance to policy makers at a local or national level, to practitioners and researchers. The relevant literature has been identified through the use of electronic databases, hand searching of journals, scanning reference lists, and consultation with key informants. Examples of interventions that have been effective in reducing injury include: bicycle helmet legislation, area wide traffic calming measures, child safety restraint legislation, child resistant containers to prevent poisoning, and window bars to prevent falls. Interventions effective in changing behaviour include bicycle helmet education and legislation, child restraint legislation, child restraint loan schemes, child restraint educational campaigns, pedestrian education aimed at the child/parent, provision of smoke detectors, and parent education on home hazard reduction. For the community based campaigns, the key to success has been the sustained use of surveillance systems, the commitment of interagency cooperation and the time needed to develop networks and implement a range of interventions. Education, environmental modification and legislation all have a part to play and their effect in combination is important. The design of evaluations in injury prevention needs to be improved so that more reliable evidence can be obtained. Better information is needed on process, so that successful strategies can be replicated elsewhere. There is also a need for literature reviews on effectiveness to be updated regularly and for their findings to be widely disseminated to policy makers, researchers, and practitioners.

Evaluation of Pedestrian Safety Education Programs for Young Children: A Review of Methodologies

A review of the research methodologies used to evaluate the effectiveness of pedestrian education programs for children is presented in this paper. Since pedestrian injuries are one of the leading causes of morbidity and mortality among young children it is necessary to identify and evaluate interventions which will reduce the incidence and severity of these injuries. There are, however, many methodological difficulties to be overcome by researchers attempting to establish the merit of such programs. For example, selection bias in school-based programs, lack of strict criteria for follow-up of all subjects, and an inability to control for confounding because relevant variables are not rigorously monitored are just some of the methodological limitations. This paper identifies a number of limitations and aspects of evaluation which are of ten omitted and suggests ways in which these problems may be addressed in future research.

Preventing child pedestrian injury: pedestrian education or traffic calming?

The traditional approach to the prevention of child pedestrian injuries in New Zealand is pedestrian education. However, none of the programs currently being implemented in New Zealand have ever been shown to reduce injury rates. The allocation of scarce resources to pedestrian education must therefore be questioned. In this paper we estimate the number of serious child pedestrian injuries which might be prevented if the resources allocated to pedestrian education were allocated instead to environmental approaches, in particular, to traffic calming. It is estimated that approximately 18 hospitalisations of child pedestrians could be prevented each year under this alternative resource allocation, disregarding any other benefits of traffic calming. These results emphasise the need to consider the potential sacrifices involved in the allocation of scarce resources to child pedestrian education.

TRAFFIC REGULATION AS A MEANS OF PREVENTING INJURY AND DEATH FROM STREET VEHICLES

Mortality in New York City from auto accidents increased 735 per cent in 1917 over previous averages, and 940 per cent in 1918. Figures are duplicated elsewhere. Dr. Byrne urges radical measures of restriction and calls for a campaign for standard regulations with real penalties. He considers education of pedestrians and children very necessary.