Interactive Education is Associated With Lower Incidence of Pedestrian-Related Injury in Children

Abstract

<div class="section"> <a class="named-anchor" id="S1"> <!-- named anchor --> </a> <h5 class="title" id="d64929e206">Background</h5> <p id="P6">Pedestrian-related injuries are a significant contributor to preventable mortality and disability in children. We hypothesized that interactive pedestrian safety education is associated with increased knowledge, safe crosswalk behaviors, and lower incidence of pedestrian-related injuries in elementary school-aged children. </p> </div><div class="section"> <a class="named-anchor" id="S2"> <!-- named anchor --> </a> <h5 class="title" id="d64929e211">Methods</h5> <p id="P7">An interactive street crossing simulation was implemented at target elementary schools in Los Angeles County beginning in 2009. Mixed-methods were used to evaluate the impact of this intervention. Multiple-choice exams were used to test pedestrian safety knowledge, anonymous observations were used to assess street-crossing behaviors, and statewide traffic records were used to report pedestrian injuries in elementary school-aged (4–11 y) children in participating school districts. Pedestrian injury incidence was compared one year before and after the intervention, standardized to the incidence in the entire city of Los Angeles. </p> </div><div class="section"> <a class="named-anchor" id="S3"> <!-- named anchor --> </a> <h5 class="title" id="d64929e216">Results</h5> <p id="P8">A total of 1424 and 1522 children completed the pre-test and post-test, respectively. Correct answers increased for nine out of ten questions (all p&lt;0.01). Children more frequently looked both ways before crossing the street after the intervention (10% vs 41%, p&lt;0.001). There were 6 reported pedestrian-related injuries in intervention school districts in the year prior to the intervention and 2 injuries in the year after the intervention, resulting in a significantly lower injury incidence (standardized rate ratio 0.28; 95% CI, 0.11–0.73). </p> </div><div class="section"> <a class="named-anchor" id="S4"> <!-- named anchor --> </a> <h5 class="title" id="d64929e221">Conclusion</h5> <p id="P9">Pedestrian safety education at Los Angeles elementary schools was associated with increased knowledge, safe street crossing behavior, and lower incidence of pediatric pedestrian-related injury. Formal pedestrian safety education should be considered with injury prevention efforts in similar urban communities. </p> </div>