1 / 18

Safety education of pedestrian a systematic review

Safety education of pedestrian a systematic review. O. Duperrex, F. Bunn, I. Roberts Sources of support: Institut de m é decine sociale et préventive, Geneva, Switzerland Cochrane Injuries Grant, UK Medical Research Council, UK. Road Deaths. World 1,391,000.

chung
Download Presentation

Safety education of pedestrian a systematic review

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Safety education of pedestriana systematic review O. Duperrex, F. Bunn, I. Roberts Sources of support: Institut de médecine sociale et préventive, Geneva, Switzerland Cochrane Injuries Grant, UK Medical Research Council, UK

  2. Road Deaths World 1,391,000

  3. Global problem: vulnerable pedestrians • over 1 million road deaths per year • fatality rate per billion passenger km: • pedestrians: 78 • car passengers: 5 • pedestrian deaths per year: • 280,000 children • 210,000 elderly

  4. Law enforcement Environnement Education Driver deaths Pedestrian crashes Pedestrian injuries Pedestrian behaviour disabilities attitude knowledge

  5. This Cochrane systematic review • is the result of a comprehensive search • in 10 transportation, educational and medical electronic databases • in 7 languages • contacts with authors & experts in the field • included only randomised controlled trials aimed at modifying pedestrian behaviour

  6. Results • Total hits 13 899 • Elligible 674 (5%) • Excluded • cohort study 1 • controlled non randomised 35 • RCT 5 • Included 15

  7. Methodological quality - generally poor (number of included RCTs = 15) adequate allocation concealment: 3 RCTs blinding of outcome assessment: 8 RCTs small study population (<200): 10 RCTs large losses to follow up in many studies

  8. Included studies(number of included RCTs) • conducted between 1976 to 1997 • Australia, Japan, Germany, UK, USA, Canada => none in low & middle income countries • participants 14 children (3y to 13y) 1 adults (institutionalised) 0 elderly

  9. Interventions(number of included RCTs) 8 direct education 7 indirect education - parents or teachers variety of settings: home - classroom - traffic situation variety of media: verbal - printed material - film - multi-media kit table-top model - mock intersection concert

  10. Outcomes • main outcomes: none crashes - deaths - injuries - disabilities • surrogate outcomes 6 behaviour - 5 attitude - 6 knowledge • big diversity • in the tools used to measure outcomes • in the conditions under which they were used • in the delays for post-test measurements (<1 to 8 mo) => no meta-analysis

  11. Effect of pedestrian education on behaviour - selection (5-9y) • Stop & look at the line of vision RR 1.79 (1.18 to 2.72) • Stop at the line of vision when crossing between parked cars RR 1.73 (1.39 to 2.14) • ’Safe behaviour' RR 2.13 (1.01 to 4.47) • Post-test Transfer Score SMD 0.83 (0.31 to 1.35)

  12. Indirect education versus No education Behaviour (observed) of 5 to 7 yr olds - post-test at 1 to 3 months RR (95%CI random) Stop & look at line of vision no distraction distraction (competition) 0.1 0.2 1 5 10 Favours control Favours intervention

  13. The effect of the intervention was lower in the later follow up period • 18 of the 24 behavioural outcomes, • 2 of the 4 attitude outcomes and • the 2 knowledge outcome measures. (6 RCTs)

  14. Law enforcement • Left out: • elderly • LMIC Environnement Education Driver deaths Pedestrian crashes Pedestrian injuries Pedestrian behaviour disabilities attitude ?? Education of children knowledge

  15. limitations • combined strategies overlooked • publication & other selection biases minimised but not excluded • poor quality of included trials • no trial from LMIC • outcomes of interest not usually measured • variety of interventions and outcomes: difficult to summarise

  16. challenges • identification of relevant studies - indexes • access to databases • search too sensitive • obtaining papers • variety of interventions and outcomes: difficult to summarise • time management - keep motivation for a marathon

  17. Thanks • to Frances Bunn and Ian Roberts for their support and participation as co-reviewers, • to authors who kindly replied to my requests, • to Reinhard Wentz and Irene Kwan for help with database searching and obtaining papers, • to Angela Huertas, Maaike Kruseman, Valdo Pezzoli and Finn Johnsen for help with translation, • to Marjan Loep from the Dutch Cochrane Centre for help with the Dutch titles, • to Toshihiko Yanagawa for help with translation and contacting Japanese experts.

  18. Published as: • Duperrex O, Roberts I, Bunn F. Safety education of pedestrians for injury prevention (Cochrane Review). In: The Cochrane Library, Issue 2, 2002. Oxford: Update Software. • Duperrex O., Bunn F. and Roberts I. Safety education of pedestrians for injury prevention: a systematic review of randomised controlled trials. BMJ. 2002 May 11; 324(7346):1129.

More Related