Systematic Review and Meta-Analysis of Behavioral Interventions to Improve Child Pedestrian Safety

Behavioural Science Research Informs Interventions to Reduce Child Injury – Panel Discussion

Shen

McClure

2016

Self Cite

Objective-Pedestrian injuries are a leading cause of child death, and may be reduced by training children to cross streets more safely. Such training is most effective when children receive repeated practice at the complex cognitive-perceptual task of judging moving traffic and selecting safe crossing gaps, but there is limited data on how much practice is required for children to reach adult levels of functioning. Using existing data, we examined how children's pedestrian skill changed over the course of six pedestrian safety training sessions, each comprised of 45 crossings within a virtual pedestrian environment.Methods-As part of a randomized controlled trial on pedestrian safety training, 59 children ages 7-8 crossed the street within a semi-immersive virtual pedestrian environment 270 times over a 3-week period (6 sessions of 45 crossings each). Feedback was provided after each crossing, and traffic speed and density was advanced as children's skill improved. Post-intervention pedestrian behavior was assessed a week later in the virtual environment and compared to adult behavior with identical traffic patterns.Results-Over the course of training, children entered traffic gaps more quickly and chose tighter gaps to cross within; their crossing efficiency appeared to increase. By the end of training, some aspects of children's pedestrian behavior was comparable to adult behavior but other aspects were not, indicating the training was worthwhile but insufficient for most children to achieve adult levels of functioning.Conclusions-Repeated practice in a simulated pedestrian environment helps children learn aspects of safe and efficient pedestrian behavior. Six twice-weekly training sessions of 45 crossings each were insufficient for children to reach adult pedestrian functioning, however, and future research should continue to study the trajectory and quantity of child pedestrian safety training needed for children to become competent pedestrians. HHS Public Access Author Manuscript Author ManuscriptAuthor Manuscript Author ManuscriptPedestrian injuries are among the leading causes of child death in the United States (US; NCIPC 2015) and worldwide (WHO 2013), leading to over 400 pediatric deaths and over 45,000 emergency-department treated injuries annually in the US (NCIPC 2015). A recent meta-analysis suggests efforts to teach children pedestrian safety can be effective (Schwebel, Barton et al. 2014). In particular, interventions designed to teach children to be more accurate in selecting safe traffic gaps to cross within can be effective. Such training is most effective when children receive repeated practice at the complex cognitive-perceptual task of judging moving traffic and selecting safe crossing gaps. This repeated practice can occur in vivo at street corners or in simulation (Schwebel, Barton et al. 2014).Theoretically, interventionists approach the challenge of pedestrian crossings from two primary perspectives. Some conceptualize the learning based on ecological theory (Gibson 1979;Grech...

supporting

confidence: 64%

122 How do children learn to cross the street? The process of pedestrian safety training

Behavioural Science Research Informs Interventions to Reduce Child Injury – Panel Discussion

Shen

McClure

2016

Self Cite

“…A recent systematic review of randomised controlled trials (RCTs) to teach children pedestrian safety uncovered 19 publications reporting 25 studies 9. Together, they indicate children's capacity to learn pedestrian skills.…”

Section: Introductionmentioning

confidence: 99%

Virtual reality by mobile smartphone: improving child pedestrian safety

Severson

et al. 2016

Inj Prev

Background Pedestrian injuries are a leading cause of paediatric injury. Effective, practical and cost-efficient behavioural interventions to teach young children street crossing skills are needed. They must be empirically supported and theoretically based. Virtual reality (VR) offers promise to fill this need and teach child pedestrian safety skills for several reasons, including: (A) repeated unsupervised practice without risk of injury, (B) automated feedback on crossing success or failure, (C) tailoring to child skill levels: (D) appealing and fun training environment, and (E) most recently given technological advances, potential for broad dissemination using mobile smartphone technology. Objectives and methods Extending previous work, we will evaluate delivery of an immersive pedestrian VR using mobile smartphones and the Google Cardboard platform, technology enabling standard smartphones to function as immersive VR delivery systems. We will overcome limitations of previous research suggesting children learnt some pedestrian skills after six VR training sessions but did not master adult-level pedestrian skills by implementing a randomised non-inferiority trial with two equal-sized groups of children ages 7–8 years (total N=498). All children will complete baseline, postintervention and 6-month follow-up assessments of pedestrian safety and up to 25 30-min pedestrian safety training trials until they reach adult levels of functioning. Half the children will be randomly assigned to train in Google Cardboard and the other half in a semi-immersive kiosk VR. Analysis of Covariance (ANCOVA) models will assess primary outcomes. Discussion If results are as hypothesised, mobile smartphones offer substantial potential to overcome barriers of dissemination and implementation and deliver pedestrian safety training to children worldwide.

“…A handful of published studies have considered ways to teach children relevant skills for safe pedestrian route selection (Schwebel et al, in press). The present research builds upon those studies.…”

Section: Training Children In Safe Pedestrian Route Selectionmentioning

confidence: 99%

Children’s pedestrian route selection: Efficacy of a video and internet training protocol

Transportation Research Part F: Traffic Psychology and Behaviou

McClure

2014

Self Cite

Objective This randomized controlled trial examined one aspect of child pedestrian behavior, route selection across intersections, to evaluate whether a combination of widely-available videos and websites effectively train children in safe pedestrian route selection compared to active pedestrian safety control training and a no-contact control group. Methods A sample of 231 seven- and eight-year-olds were randomly assigned to one of four groups: training with videos and internet websites, active control groups of individualized streetside training or training within a virtual pedestrian environment, or a no-contact control group. All training groups received six 30-minute training sessions. Pedestrian route selection was assessed using two strategies, vignettes accompanied by illustrations and tabletop models of intersections, on three occasions: prior to intervention group assignment, immediately post-training, and six months after training. Results Although there were differences in route selection over time, no time by condition interaction effects were significant (ps > .05), suggesting children in the video/internet training group did not learn pedestrian route selection skills at a rate different from those in the other training groups or those in the no-contact control group. Conclusion Safe route selection is a critical component of pedestrian safety. Our results suggest children may not learn route selection from widely-available videos or websites. Explanations for the null finding and implications for both research and future practice are discussed.