1 / 25

ADRIAN DAVIS

Explore the importance of evidence-based decision-making in road safety, debunk common misconceptions, and advocate for policy shifts based on solid research findings. Bridging the gap between knowledge and practice.

wkiser
Download Presentation

ADRIAN DAVIS

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. ADRIAN DAVIS

  2. Effective decision-making in road safety: The primacy of an evidence-based approach Adrian Davis BA, PhD FFPH Public Health & Transport Consultant Visiting Professor, University of the West of England

  3. Medicine, Public Health and Road Safety • MD William Haddon Jr - Dir, National HighwaySafetyBureau, devised ‘Haddon’sMatrix to assess factors related to personal, vector and environmental attributes before, during and after an injury or death. • Noted that ‘accident’ was inappropriate term • Proposed a series of countermeasures to reduce damage produced by energy transfer starting from the prevention of the marshalling of energy in the first place

  4. The bounded reality triad of local govt

  5. Translating findings and evidence “It has been acknowledged that a large gulf remains between what we know and what we practise. Hence a task, if not the main task, is to improve knowledge transfer.” International Public Health Symposium on Environment and Health Research. WHO 2008 Science for Policy, Policy for Science: Bridging the Gap, Madrid, Spain, 20–22 October 2008 Report, Copenhagen: WHO Regional Office for Europe

  6. Evidence in local government “The successes of the evidence-based healthcare movement have been much trumpeted… Strikingly, local government work on the determinants of health appears to be one arena in which this paradigm was largely absent.” Phillips, G., Green, J 2015 Working for the public health: politics, localism and epistemologies of practice, Sociology of Health & Illness, 37(4).

  7. Evidence or common sense?

  8. Meanings of evidence “Concepts of evidence vary among professionals, disciplinary and social groups: for example, scientists have traditionally adopted different standards of evidence to lawyers.” Rychetnik, L., Wise, M. 2004 Advocating evidence-based health promotion: reflections and a way forward, Health Promotion International, 19(2): 247-257.

  9. Some insights on recent practice “I have never considered research as a method of looking at a particular road safety issue. Whilst aware that obviously research was being undertaken, and from time to time hearing about it, I have never given it much credence [or] seriously looked at it as any more than general information’’ Hewson, P. 2007 Evidence-based practice in road casualty reduction, Injury Prevention, 3;291-292

  10. Dominance of common sense “Interventions are commonly designed without evidence of having gone through this kind of process [rational system for selecting options], with no formal analysis of either the target behaviour or the theoretically predicted mechanisms of action. They are based on implicit common sense models of behaviour.” Mitchie, S., van Stralen, M., West, R. 2011 The behaviour change wheel: A new method for characterising and designing behaviour change interventions, Implementation Science, 6:42 “Common sense” means the incoherent set of generally held assumptions and beliefs common to any given society. Gramsci, A. 1971

  11. ‘Common sense’ applied to road safety • Educational interventions appear plausible. Eg, one practitioner proposes that ‘it is inconceivable that less training behind the wheel is better than more training‘ • Yet, highly skilled drivers had more crashes rather than fewer. The problem of a skills based approach has continued to this day... We might, then, conclude that vehicle control is a necessary condition for safe driving, but there is little evidence that it is a sufficient condition. • Having spent a career in transport safety, Ezra Hauer (2007) concluded that “the prevailing culture is to think that… road safety can be delivered on the basis of opinion, folklore, tradition, intuition and personal experience‘. McKenna, F. 2010 Education in Road Safety. Are we getting it right?London: RAC Foundation.

  12. An Evidence hierarchy is not ‘common sense’

  13. The prevention paradox and population strategies applied to transport • Interventions addressing a large number of people who are at a small risk may be more effective in reducing injury and illness than interventions addressing small numbers at high risk.. Theoretical distribution of the exposure to risk of road death and injury, showing a reduction in the average exposure for the entire continuum of risk (dotted line).

  14. Speed: A view from a trainer • “The vast majority of front-line officers and their immediate supervisors do not understand the importance of shifting the speed distribution to the left. They remain convinced that their principal task is to apprehend those speeding at very high levels.” Johnston, I. 2010 Beyond “best practice” road safety thinking and systems management - a case for culture change, Safety Science, 48 1175-1181

  15. I think therefore I… go with evidence

  16. Two major challenges • How powerful is any driver for change in moving to a default evidenced-based approach to road safety (and transport planning generally)? • Up-skilling in undertaking of interventions, evaluation, and understanding and application of the findings of robust studies

  17. Safe Systems to the rescue? • Focus on crash prevention, and if this is not possible, to reduce crash severity • Traffic systems must be designed and operated to be error-tolerant, particularly through increased predictability in systems operation • Latent errors in what is an inherently dangerous traffic system must be reduced • All elements are inter-related and responsibility for safety must be shared across all players and coordinated Johnston, I 2010 Beyond “best practice” road safety thinking and systems management - a case for culture change, Safety Science, 48 1175-1181

  18. Proposition: Using most robust available evidence as standard • Should not all transport departments have someone trained in evidence reviews... to ensure managers and politicians have the best available evidence? • … As we have had in Bristol City Council for past 8 years

  19. 20mph speed limits: Building and using an evidence base • Design pilot with qualitative and quantitative measurements • Review 20mph literature internationally for health and other impacts • Commission primary research to support programme • Bid for research funding ieNIHR • Built links with key researchers in the field and policy experts internationally • Clear evidence audit trail of rationale for policy and practice decisions

  20. Being there – co-located/embedded

  21. Some final thoughts…

  22. Summary • Barrier to knowledge exchange which weakens chances for successful road safety interventions • Driving forces mismatches – pragmatism, politics, common sense (aided by media), often set against the importance of robust evidence • Finding ways to enable robust evidence to be given greater prominence – includes co-location specialists, & up skilling staff, and utilising more translational research • Driving force – potentially Safe Systems thinking – but beware of ‘hollowed-out’ versions

  23. Thank you • adrian.davis@phonecoop.coop • www.travelwest.info/evidence • www.pteg.net • http://www.euro.who.int/en/health-topics/environment-and-health/Transport-and-health • www.elsevier.com/locate/jth

More Related