PEDESTRIAN SAFETY: Using New Technologies to Track Risk Courtney Hudson Injury Prevention TBI Coalition Coordinator, Akron Children’s Hospital Sharon Levi Head of Research, Beterem-Safe Kids Israel Nuong Nguyen Director of Programs, Vietnam, AIP Foundation Shane O’Connor, Moderator Communications Advisor, FedEx Global Citizenship
PREVCON July 30, 2015
Courtney Hudson, MPH, OCPS II, CPH Injury Prevention Traumatic Brain Injury Coalition Coordinator Akron Children’s Hospital Spatial Video Surveillance for Child Injury Prevention: Surveys of Pedestrian and Bicycle Behaviors in the City of Akron and Summit County, Ohio
www.akronchildrens.org/giving
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Ohio Department of Health (ODH) Youth Traumatic Brain Injury (TBI) Prevention Grant 2014-2018 ODH Injury Prevention Subgrantee Funding Statement: This work is funded either in whole or in part by a grant awarded by the Ohio Department of Health, Bureau of Healthy Ohio, Violence and Injury Prevention Program and as a sub-award of a grant issued by the Centers for Disease Control and Prevention (CDC), Preventive Health and Health Services Block Grant under the grant award number 3B01DP009042-13S1and CFDA number 93.991.
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Ohio Department of Health (ODH) Youth Traumatic Brain Injury (TBI) Prevention Grant • Five year grant cycle that began in 2014. • Funds a full-time TBI injury prevention coordinator. • Year one required surveillance be conducted of pedestrian safety and bicycle helmet usage. • Works closely with Safe Kids Summit County.
www.akronchildrens.org/giving
Safe Kids Summit County • Akron Children’s Hospital (ACH) has been the lead agency since 1992. • We have 50+ members including community volunteers, public health, police and fire departments, and businesses. • We work to keep all kids safe from preventable injuries. • Safe Kids Summit County helps to direct TBI grant activities. • 2014 began using local data to drive injury prevention programs. www.akronchildrens.org/giving
How the partnership with Kent State University GIS Health & Hazards Lab developed • March 2013, Dr. Andrew Curtis presented "Mapping Disparities: Geospatial Technologies Use in Public and Clinical Health" as part of the Translational Science Seminar Series. • At about the same time, a group in Summit County including Dr. Andrew Curtis had started meeting to address high lead levels in an area where refugees live. Project included GIS mapping. • April 2014, reached out to Drs. Andrew and Jackie Curtis to discuss the possible use of spatial video technology for surveillance of pedestrian safety and bike helmet usage. • Learned the term “spatial epidemiology”. • ODH approved the use of grant funds to cover the cost of the spatial video surveillance and hospital injury data analysis at the zip code level. • First contract with Kent State University (KSU) began June 11, 2014. www.akronchildrens.org/giving
Partnership with KSU GIS Health & Hazards Lab • ACH staff recognized that KSU had expertise outside of our scope of work. • Drs. Andrew and Jackie Curtis brought innovation, international experience and a willingness to work with us to yield the most beneficial outcomes. • Presented to Safe Kids Summit County, hospital and community partners, and at the Ohio Injury Prevention Partnership. www.akronchildrens.org/giving
Results of the GIS Video Surveillance KSU provided: • Detailed maps of all the surveillance sites. • Analysis of hospital injury data at the zip code level using ICD-9 and E-codes. • Overlaid results on a Summit County map. There has been an overwhelming response both within the hospital and community. The maps have allowed us to better target injury prevention interventions. www.akronchildrens.org/giving
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Composite Map of All Injury Classes by Rank
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Hot Spots / Cold Spots
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Year 2 Surveillance • Contract with KSU again to repeat surveillance at the same identified sites. • Include dogs that are loose, chained or could potentially bite children in the GIS surveillance. • With IRB approval, will share injury data at the street level.
www.akronchildrens.org/giving
Unintended Positive Outcomes of the Collaboration • Generated interest in injury prevention within the hospital and community • Strengthened the partnership between academia, health care providers and community agencies • Other data has been shared at no cost to ACH • Grant opportunities • Published articles • Poster presentations www.akronchildrens.org/giving
Acknowledgements at KSU Jacqueline W. Curtis, Ph.D.
Andrew Curtis, Ph.D.
Co-Director, GIS Health & Hazards Lab Department of Geography Kent State University
[email protected]
Co-Director, GIS Health & Hazards Lab Department of Geography Kent State University
[email protected]
Laura Schuch, MPH Department of Geography Kent State University
[email protected]
www.akronchildrens.org/giving
Other Acknowledgements Akron Children’s Hospital
Ohio Department of Health
Heather Wuensch Director of Community Benefit, Advocacy & Outreach External Affairs
Pam Rudolph Program Consultant Violence and Injury Prevention Program
Heather Trnka Injury Prevention Coalition Coordinator/Safe Kids Summit County Coalition Coordinator, External Affairs
www.akronchildrens.org/giving
Thank you! Please feel free to contact me with questions. Courtney Hudson, MPH, OCPS II, CPH Injury Prevention TBI Coalition Coordinator External Affairs Akron Children’s Hospital One Perkins Square Akron, Ohio 44308
[email protected] 330-543-0738
www.akronchildrens.org/giving
Children are walking everywhere! Innovative study of child pedestrian travel patterns and safety Sharon Levi, Victoria Gitelman, David Zaidel, Ido Prihed, Yotam Laor PREVCON – SKW Conference, July 2015
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Presentation Topics • • • • •
Introduction Research Objectives Methodology and Partners Results Conclusions and Implications for Child Pedestrian Safety
Child Injury in Israel Unintentional injuries are a primary cause of death and injuries among children and adolescents, both in Israel and worldwide.
Ivancovsky, M., Weiss, O., Kislev, S. Child Injuries in Israel: 'Beterem' National Report 2013. Petach-Tikva: 'Beterem - Safe Kids Israel', Publication No. 1086, December 2013. http://www.beterem.org/download/files/beterem_EN_1.pdf
Child Pedestrian Injuries • Worldwide children are injured as pedestrians more than any other mode of transportation; about 38% of all deaths of children on the road are pedestrians (WHO 2015)
• In Israel over a third of fatalities in road accidents are pedestrians and child pedestrian fatalities are relatively high as compared to total road fatalities (Israel’s National Road Safety Authority 2015)
• Research has shown that children and adolescents are particularly vulnerable due to cognitive traits, physical and behavioral characteristics (Schieber and Thompson 1996, AAP 2009, WHO 2013)
Child Travel Active travel and mobility are integral for a healthy lifestyle • For child pedestrians there is special concern regarding safe behavior and environment • Until recently there has been little research on child travel, in particular during leisure hours • More detailed information about trip patterns and activities of children and teens is required in order to improve safety and mobility
Research Objectives •
Identify characteristics and causes for increased risk to child and teen pedestrians
•
Study the interactions between child pedestrians, vehicles and travel companions
•
Demonstrate feasibility of advanced tools and methods for the study of child travel and behavior
Methodology Two phase study: • Phase 1: Travel Surveys self report via national web survey and real time travel collected using GPS devices and CAPI interviews in Jerusalem – Ages 6-12 • Phase 2: Crash data analysis, Video observations at road crossings and Travel Survey conducted using GPS programs on cellular phones and self report of trips in 3 cities– Ages 9-17
Phase 1: GPS Data Collection
Phase 2: Cellular Phone Data Collection Utilized 3 GPS tracking programs to collect data
Phase 2: Video Observations
Non-Signalized Two Lane Crossing
Partners
Universities – Faculty and Students Transport Agencies – National and Local
Parents and Children
Beterem Safe Kids Israel Technical Experts
Municipalities
Research Organizations
Phase 1: Travel Surveys • Children are active travelers throughout the day from a young age – making an average of 3.9 trips • Walking is the primary mode of transportation • Children walk alone – 16% of parents to children age 5-7 already allow children to walk alone for 10 minutes and 19% allow them to cross some streets
Phase 1: Travel Surveys • Children are crossing many streets - 65% of routes in Jerusalem included a road crossing and 11% included 4 or more crossings • Conflicts with vehicles – over 75% of children state that many times vehicles do not stop and give them the right of way • Parents do not prepare children for crossing- over 15% of those who allow their children to walk alone reported that they did not provide instructions on how to cross streets
Phase 1: Identifying Individual Child Travel Space
Phase 2: Crash Data Analysis • Pedestrians age 0-17 are 25% more likely to suffer severe injuries compared to adults • Most of the child and teen pedestrian injuries occur during the afternoon and evening (56%) with the highest concentration between 1-7 pm. • Children exhibit impulsive behavior, higher percentages of injuries following “jumping into the street” • Higher rates of child pedestrian injuries in weaker municipalities (small, periphery, lower socioeconomic level)
Phase 2: Video Observations of Pedestrian Crossings Age groups: • Teens exhibit more risk taking behaviors than the younger age groups, including cell-phone use • Children under age 9 more likely to be accompanied by an adult • Children with adults more likely to exhibit risk taking behavior such as crossing on red – demonstrating poor modeling!
Phase 2: Video Observations of Pedestrian Crossings Non-Signalized Single Lane Crossing Higher percentages of children who don’t stop before crossing and cross outside the crossing Non-Signalized Two Lane Crossings Over 57% of Children and Teens did not stop before crossing, 18% did not check for traffic Children did not receive right of way from vehicles- in particular in the second travel lane (9%) Signalized Crossings A. Sites near facilities and shops – more children crossing with adults on red and in conflict with vehicles; B. Sites in neighborhoods- children crossing alone, many teens using distractive devices.
Phase 2: Trip Survey Travel companions, N= 1,974 trips
Risks reported by children and teens on walking trips
Phase 2: Geographic Measures for the Sample At a city level able to analyze routes by speed: Identified that 47.5% of the routes were under 10 kmh and took place within the neighborhoods, at higher speeds of 10-25 kmh routes cross the city and at the highest speeds above 25 kmh we begin to see routes that depart from the city limits.
Implications for Child Pedestrian Safety • Walking is the primary transportation mode among children and teens in Israel to all destinations throughout the day • More work is necessary to increase walkability and safety in urban areas • The research point to both risk taking behaviors and unsafe environment characteristics that effect pedestrian safety • Parents and drivers have a significant role in improving child pedestrian safety • There are still knowledge gaps regarding pedestrian exposure • Feasibility of innovative data collection techniques has been proven but more work is necessary to refine analysis techniques and enhance results
Thank you for keeping our children safe! www.beterem.org Beterem Hotline
[email protected]
Assessing influential factors of road safety interventions in industrial zones PREVCON 2015 Safe Kids Worldwide Childhood Injury Prevention Convention Nguyen Dieu Nuong, Director of Programs Washington, D.C. – July 31, 2015
CONTENT 1. Background 2. Objective 3. Interventions 4. Evaluation methods 5. Key achievements 6. Lessons learned 7. Conclusions
BACKGROUND The challenge
Our response
• Oil and gas, chemical, agribusiness, and forestry companies rely on the transport of their product
• Research on projects promoting road safety in industrial zones is limited.
• Poor road conditions harm operations
• Our lessons learned are compiled from two projects in China and Vietnam.
• Industrial traffic endangers the communities affected by industrial development • Road crashes cost developing economies between 1-5% of their GDP
BACKGROUND Our response In 2012, AIP Foundation was commissioned to promote child pedestrian safety in communities affected by a gas development project in Kai County, Chongqing Province, China. After a successful pilot in 2014, we expanded a project to reduce the number of road crashes, fatalities, and injuries in communities around a refinery and petrochemical construction site in Thanh Hoa Province, Vietnam.
CC BACKGROUND: CHINA
Approximately 94% of the land is made up of mountains and hills Roads are windy, bumpy, of poor quality, and plagued by fog, rain, and industrial traffic 78% of students walk to and from school every day
CC BACKGROUND: VIETNAM
Motorcycles are the primary means of transport around the industrial zone Road users, especially men, lack important road safety knowledge and regularly practice risky road behavior
18% of primary school students report recent involvement in a crash
OBJECTIVE Assess influential factors in promoting road safety among populations, particularly children, affected by industrial development in China and Vietnam in order to inform project design and scale-up
CC INTERVENTIONS
Both projects were designed based on baseline/needs assessments and started with a small-scale pilot phase. The evaluation of each phase has informed the scale-up design.
Monitoring & evaluation
Road safety education
Stakeholder engagement and capacity building
Environmental modifications
Public awareness
CC INTERVENTIONS
Monitoring & evaluation
Road safety education
Stakeholder engagement and capacity building
Environmental modifications
Public awareness
Road safety has been taught to 53,650 students from 37 project schools in China. In Vietnam, the education component includes motorcycle driving training courses.
CC INTERVENTIONS
Monitoring & evaluation
Road safety education
Stakeholder engagement and capacity building
Environmental modifications
Public awareness
Stakeholders, including local officials, teachers, and parents, are invited to workshops to learn about the project and to build their own capacity to address road safety concerns.
CC INTERVENTIONS
Public events, movie nights, outdoor advertisements, and loudspeaker broadcasts spread the message on road safety to the broader community.
Monitoring & evaluation
Road safety education
Stakeholder engagement and capacity building
Environmental modifications
Public awareness
CC INTERVENTIONS
A small grants program allows school and local officials to apply for funding to install safer infrastructure around schools and blackspots.
Monitoring & evaluation
Road safety education
Stakeholder engagement and capacity building
Environmental modifications
Public awareness
EVALUATION METHODS Qualitative methods
Interviews and focus groups
Review workshops
• Who in the community, including parents, government officials, school administrators, and local organizations, are key actors in road safety issues? • What are the influential factors in promoting road safety among the community in the industrial zone? • What are the unexpected outcomes?
EVALUATION METHODS Quantitative methods
Questionnaires
Observations
• What is the target group’s knowledge of and attitude toward road safety? • What is the target group’s road behavior? • With what frequency and seriousness are members of the target group involved in crashes? • What is the road environment around schools and blackspots?
EVALUATION METHODS Kai County, Chongqing Province, China Baseline
Evaluation
Evaluation
Evaluation
of Phase 1
of Phase 2
of Phase 3
Thanh Hoa Province, Vietnam Needs
Review
workshop assessment
Q1
Q2
Q3 2012
Q4
Q1
Q2
Q3 2013
Q4
Q1
Q2
Q3 2014
Q4
Q1
Q2 2015
Q3
KEY ACHIEVEMENTS Reach Vietnam (Phase 2)
China (Phase 3)
80 193
618 107300 161534
3280
53650 36 548 Community members
KEY ACHIEVEMENTS Student Knowledge Primary student knowledge test results at target schools in Vietnam and China 80%
74%
70%
61%
60%
49%
50% 40% 30%
31%
20% 10% 0% Vietnam
China Baseline
Post-Phase 2
KEY ACHIEVEMENTS Student Attitude Primary students’ responses to questions on attitude at target schools in China 80% 68%
70% 60% 50% 40% 30%
28%
27%
20%
12%
10% 0% Students who feel safe traveling to school Baseline
Students who consider obeying traffic rules "inconvenient" Post-Phase 2
KEY ACHIEVEMENTS Students’ road crash experience Primary students’ road crash experience at target schools in Vietnam 20% 18%
18%
16% 14%
12%
12% 10% 8%
8%
6% 3%
4% 2%
2.2%
1.2%
0% Involved in road crash
Injured from road crash Baseline
Post-Phase 2
Hospitalized with road injury
KEY ACHIEVEMENTS Environmental modifications
LESSONS LEARNED Schools are not the only focal point • The community is adapting to increasing construction and traffic, as well as resulting relocation and rapid social change • Schools are a focal point, but projects in industrial zones must engage the whole community. • Community advocacy and stakeholder engagement have proven effective.
The Walking School Bus activity in China successfully involved local leaders, police, parents, and school teachers.
LESSONS LEARNED Community buy-in is slow, pays off • Communities have a high awareness about the risks of the industrial project. • Residents express high expectations for investor-sponsored interventions, because of the significant investment in the industrial projects. • It takes more time to build relationships and negotiate expectations because of the resentment the community may hold toward the investor. • Once those relationships are built, communities have a strong understanding of the benefits of the intervention and are more motivated to engage. • For example, both projects have leveraged the community demand and enthusiasm to implement a small grants program for environmental modifications, such as crosswalks and speed bumps.
CONCLUSIONS The main factor influencing success is the depth of community engagement Two key recommendations: • incorporate aspects of school- and communitybased education, as well as advocacy and stakeholder engagement • plan additional time and activities to build relationships and community investment in the project These recommendations are already being applied to a new initiative in Songkhla Province, Thailand.
THANK YOU For more information: Visit www.asiainjury.org Find us on Facebook Follow us on Twitter
Contact: Nguyen Dieu Nuong AIP Foundation Vietnam, Director of Programs 18bis/19 Nguyen Thi Minh Khai, Da Kao Ward, District 1, Ho Chi Minh City, Vietnam
[email protected] Tel: (84-8) 6299-1409
Thank you!
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