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

ABSTRACT Objective: The purpose of this article is to describe a public school–based educational intervention (EI) designed to increase knowledge, improve attitudes, and change practices related to road safety. Methods: We used a mixed-methods evaluation of a road traffic safety baseline diagnosis conducted in 4 public schools, 2 primary and 2 secondary. Research was organized into 4 phases: (1) diagnosis, (2) EI design, (3) implementation, and (4) evaluation. We used convenience sampling (n = 219 students) across schools and applied a pre-/posttest design based on quantitative and qualitative data. The former related to surveys on road safety experiences, knowledge, attitudes, and practice and the latter to observation checklists, community mapping, ethnography, and focus groups. To compare pre–post scores, we used multilevel mixed-effect ordinal logistic regressions. We developed data matrices, field notes, and systematized community mapping. We also transcribed focus group discussions, generated categories, and carried out thematic analysis. Results: Ethnography indicated poor sidewalk conditions, no helmet or seat belt use, overcrowded public transportation, and no traffic lights or proper signals. Pedestrians did not use sidewalks and crossed streets unsafely. Subsequent to the intervention, however, the study population showed significant changes in their knowledge, practices, and attitudes. They identified road traffic incidents (RTIs) as the first cause of death among children and youth, and most understood that the solution to the problem was incumbent upon each and every individual. They also displayed increased perceptions of danger in practices such as traveling on overcrowded public transportation, failing to wear seat belts in cars and helmets on motorcycles, crossing the street while using mobile phones or playing with friends, and riding with drunk drivers. Changes varied according to gender, and students reported being able to carry out safe practices only when they were in control of the situation; for instance, as pedestrians. Conclusions: Because safe practices depend not only on children and youth but on the adults and social environment surrounding them, it is essential to engage parents, teachers, and decision makers in efforts to reduce RTIs. This will improve the establishment of commitments to impact social reality through consistent changes and mobilize greater resources for creating more secure communities in matters of road safety.

[1]  R. McClure,et al.  Community-based programmes to prevent pedestrian injuries in children 0–14 years: a systematic review , 2004, Injury control and safety promotion.

[2]  Ana M Novoa,et al.  [Evidence-based effectiveness of road safety interventions: a literature review]. , 2009, Gaceta sanitaria.

[3]  Pat Hall,et al.  Specific issues, exact locations: case study of a community mapping project to improve safety in a disadvantaged community. , 2012, Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals.

[4]  J E Blair,et al.  Social Marketing , 1995, AAOHN journal : official journal of the American Association of Occupational Health Nurses.

[5]  P. Atkinson,et al.  Making Sense of Qualitative Data: Complementary Research Strategies , 1996 .

[6]  Gillian Hotz,et al.  The WalkSafe Program: developing and evaluating the educational component. , 2009, The Journal of trauma.

[7]  J. Leblanc,et al.  Risk factors predisposing to pedestrian road traffic injury in children living in Lima, Peru: a case–control study , 2012, Archives of Disease in Childhood.

[8]  I. Roberts,et al.  Safety education of pedestrians for injury prevention: a systematic review of randomised controlled trials , 2002, BMJ : British Medical Journal.

[9]  A. G. Toro,et al.  LOS MODOS DE ANÁLISIS EN INVESTIGACIÓN CUALITATIVA EN SALUD: PERSPECTIVA CRÍTICA Y REFLEXIONES EN VOZ ALTA , 2002 .

[10]  Jason L. Powell,et al.  Community Organizing and Community Building for Health , 1998 .

[11]  Petra Kaufmann,et al.  Experimental And Quasi Experimental Designs For Research , 2016 .

[12]  M. Híjar,et al.  [Road traffic injuries among youth: measuring the impact of an educational intervention]. , 2008, Salud publica de Mexico.

[13]  Jeffrey C. Lunnen,et al.  Attitude change in youths after being exposed to different road safety interventions in two Mexican cities. , 2013, Injury.

[14]  R. Boruch,et al.  3 – Making the Case for Randomized Assignment to Treatments by Considering the Alternatives: Six Ways in Which Quasi-Experimental Evaluations In Compensatory Education Tend to Underestimate Effects , 1975 .

[15]  H. Chaiklin,et al.  Methodology and Epistemology for Social Science: Selected Papers , 1990 .

[16]  D. Campbell,et al.  Evolving Methods for Enhancing Validity@@@Methodology and Epistemology for Social Science: Selected Papers , 1990 .

[17]  Frank McKenna,et al.  Education in road safety - are we getting it right? , 2010 .

[18]  Steven J. Taylor,et al.  Introduction to Qualitative Research Methods: A Guidebook and Resource , 2015 .

[19]  S. Treviño-Siller,et al.  INTEGRAL STRATEGY TO EDUCATE MEXICAN YOUNGSTERS IN ROAD TRAFFIC ACCIDENT PREVENTION , 2010 .

[20]  Katherine Pérez,et al.  Efectividad de las intervenciones de seguridad vial basadas en la evidencia: una revisión de la literatura , 2009 .

[21]  Veronika Rivero Veras Pedagogía Del Oprimido , 2016 .

[22]  Martha Hı́jar,et al.  Accidentes de tránsito de vehículos de motor en la población joven: evaluación de una intervención educativa en Cuernavaca, Morelos , 2008 .

[23]  Charles DiMaggio,et al.  Roadway characteristics and pediatric pedestrian injury. , 2012, Epidemiologic reviews.

[24]  N. Léchopier " Experimental and quasi-experimental designs for research on teaching ", de Donald T. Campbell & Julian C. Stanley, (1963). , 2011 .

[25]  Gillian Hotz,et al.  WalkSafe: A School-Based Pedestrian Safety Intervention Program , 2004, Traffic injury prevention.

[26]  S. Noar,et al.  Does tailoring matter? Meta-analytic review of tailored print health behavior change interventions. , 2007, Psychological bulletin.

[27]  K. Glanz,et al.  Health behavior and health education : theory, research, and practice , 1991 .

[28]  Guohua Li,et al.  Effectiveness of a Safe Routes to School Program in Preventing School-Aged Pedestrian Injury , 2013, Pediatrics.

[29]  Martha Híjar,et al.  Pedestrian injuries in Mexico: a multi-method approach. , 2003, Social science & medicine.

[30]  R. Morrison Critical Issues in Qualitative Research Methods , 1994 .

[31]  N. Wallerstein,et al.  Empowerment Education: Freire's Ideas Adapted to Health Education , 1988, Health education quarterly.

[32]  Leticia Robles-Silva Dilemas éticos en el trabajo de campo: temas olvidados en la investigación cualitativa en salud en Iberoamérica , 2012 .

[33]  C. Parvanta,et al.  Public health communication: a planning framework. , 2002 .

[34]  A. Celis,et al.  Family characteristics and pedestrian injury risk in Mexican children , 2003, Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention.