Applying the multiphase optimization strategy to evaluate the feasibility and effectiveness of an online road safety education intervention for children and parents: a pilot study.

BACKGROUND: Reports of children's engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents. METHODS: Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses. RESULTS: Main intervention feasibility findings include positive and critical feedback on the program's content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the "wheeling safety and skills" module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the 'wheeling safety and skills' module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component. CONCLUSION: The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children's road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the "wheeling safety and skills" module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples. WORD COUNT: 9,391 (excludes abstract, tables, figures, abbreviations, and references).

Bus rapid transit as arterial corridor traffic calming: The relationship between transit infrastructure and motor vehicle operating speeds.

OBJECTIVES: This article presents an analysis of the traffic-calming effects of bus rapid transit (BRT) by studying changes to motor vehicle speeds before and after implementation of Albuquerque Rapid Transit (ART) infrastructure in Albuquerque, New Mexico. METHODS: While ART construction was completed in spring 2018, the BRT buses did not operate until December 2019; providing a unique opportunity to explore the influence of BRT infrastructure sans BRT buses (i.e., to tease apart the effects of BRT infrastructure and operations). We used validated data from StreetLight InSight to compare before/after changes to average motor vehicle speeds and 85th percentile motor vehicle speeds at 46 ART sites and 36 control sites. RESULTS: Findings suggest that infrastructure associated with BRT systems can improve traffic safety by reducing vehicle speeds. Speed decreases at the ART sites were especially strong in terms of 85th percentile decreases, suggesting that the BRT infrastructure is especially effective at limiting excessive speeding. Motor vehicle 85th-percentile speeds along the ART corridor were reduced by 11.5% (compared to a 5.8% decrease at control sites). The 85th-percentile speeds at the ART sites decreased from 32.3 mph to 28.6 mph, which is an especially important range for vulnerable road-user safety outcomes. While ART intersections saw the largest decreases in absolute speeds (a reduction of 4.1 mph in 85th-percentile speeds), ART mid-block sites had larger decreases relative to the control mid-block sites (decreases in 85th-percentile speeds were 73.7% greater at ART mid-block sites than at control mid-block sites). BRT-related lane reductions were linked with particularly strong speed reductions; there were 85th-percentile speed reductions of 4.1 mph (12.6%) when general vehicle lanes were removed versus 2.2 mph (7.8%) when lanes were not removed. CONCLUSIONS: Speed reductions were experienced across the ART corridor even though 87.0% of BRT locations did not have a change in posted speed limit, suggesting that physical changes to the roadway associated with BRT were impactful in terms of speed reductions and in turn could possibly promote traffic injury prevention by decreasing the number and severity of crashes.

Improving Autonomous Vehicle Perception through Evaluating LiDAR Capabilities and Handheld Retroreflectivity Assessments.

Road safety is a serious concern worldwide, and traffic signs play a critical role in confirming road safety, particularly in the context of AVs. Therefore, there is a need for ongoing advancements in traffic sign evaluation methodologies. This paper comprehensively analyzes the relationship between traffic sign retroreflectivity and LiDAR intensity to enhance visibility and communication on road networks. Using Python 3.10 programming and statistical techniques, we thoroughly analyzed handheld retroreflectivity coefficients alongside LiDAR intensity data from two LiDAR configurations: 2LRLiDAR and 1CLiDAR systems. The study focused specifically on RA1 and RA2 traffic sign classes, exploring correlations between retroreflectivity and intensity and identifying factors that may impact their performance. Our findings reveal variations in retroreflectivity compliance rates among different sign categories and color compositions, emphasizing the necessity for targeted interventions in sign design and production processes. Additionally, we observed distinct patterns in LiDAR intensity distributions, indicating the potential of LiDAR technology for assessing sign visibility. However, the limited correlations between retroreflectivity and LiDAR intensity underscore the need for further investigation and standardization efforts. This study provides valuable insights into optimizing traffic sign effectiveness, ultimately contributing to improved road safety conditions.

Unveiling Pakistan's transport problems: a call to safeguard public health.

Public transportation is an important mode of transportation in developing countries like Pakistan since it is accessible and convenient. But there are also serious health hazards associated with it, especially when it comes to the transmission of infectious diseases including COVID-19, TB, and Haemophilus influenzae. Worldwide transportation systems are vulnerable, as the COVID-19 pandemic has shown, underscoring the necessity for study and mitigating measures. The danger of disease transmission is increased in Pakistan by crowded metropolitan areas, inadequate sanitation, and low health awareness. In addition, congested public transportation and inadequate ventilation lead to reduced air quality and elevated stress levels among commuters. Comprehensive actions are needed to address these health hazards, such as promoting physical distance, improving cleanliness, enforcing traffic safety laws, and implementing policy changes that support sustainable transportation. Community involvement and advocacy are critical in campaigning for safer and more sustainable transportation networks. Pakistan can enhance public health outcomes and reduce the health hazards linked to public transportation by giving priority to these measures.

In-built network-wide road safety assessment methodologies for rural roads.

OBJECTIVE: Road traffic crashes are mainly caused by three concurrent factors: infrastructure, vehicle, and human factors. Regarding infrastructure, in recent decades, a series of management tools and procedures called Road Infrastructure Safety Management (RISM) have been proposed. The aim of RISM procedures is to support road authorities in the prevention and mitigation of future road traffic crashes. One of these procedures is the In-built Road Safety Assessment (IRSA) methodology. The peculiarity of an IRSA methodology is the underpinning method used to assign a score to a road section with the aim of identifying those road sections in a network with safety-related infrastructure deficiencies. The objective of this paper is to provide an overall literature review of existing methodologies used worldwide for network-wide road safety assessment for rural road. METHODS: The review was conducted following the guidelines provided by Joanna Briggs Institute (JBI) and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) checklist 2020. The characteristics of these methodologies were compared with respect to the following research questions: What are the general characteristics of IRSA methodologies? What risk method/index is applied? Which data collection method/technique is used? What types of road parameters are considered for the assessment? What is the level of expertise needed to implement the methodology? Where and how are the results validated? RESULTS: As a result, 14 IRSA methodologies were identified. Also, the review showed that similar road parameters were used including: operating speed, road surface, low curve radius, poor sight distance (horizontal and vertical curves), lane width, undivided road (median type), shoulder width, sight obstructions (landscape, obstacles and vegetation), absence of traffic signs and road markings, traffic flow (AADT), intersection quality and density of intersections/lateral accesses. CONCLUSIONS: Despite these similarities, some differences were observed in risk formulation, safety quantities of parameters, level of expertise required, and validation of studies. Researchers may use these findings to develop future road safety assessment methodologies, while road practitioners can make use of this in identifying suitable network-wide assessment methods for safety assessments of road infrastructures. Finally, a series of recommendations for future research work on IRSA methodologies is suggested.

Enabling CMF estimation in data-constrained scenarios: A semantic-encoding knowledge mining model.

Availability of more accurate Crash Modification Factors (CMFs) is crucial for evaluating the effectiveness of various road safety treatments and prioritizing infrastructure investment accordingly. While customized study for each countermeasure scenario is desired, the conventional CMF estimation approaches rely heavily on the availability of crash data at specific sites. This dependency may hinder the development of CMFs when it is impractical to collect data for recent implementations. Additionally, the transferability of CMF knowledge faces challenges, as the intrinsic similarities between different safety countermeasure scenarios are not fully explored. Aiming to fill these gaps, this study introduces a novel knowledge-mining framework for CMF prediction. This framework delves into the connections of existing countermeasure scenarios and reduces the reliance of CMF estimation on crash data availability and manual data collection. Specifically, it draws inspiration from human comprehension processes and introduces advanced Natural Language Processing (NLP) techniques to extract intricate variations and patterns from existing CMF knowledge. It effectively encodes unstructured countermeasure scenarios into machine-readable representations and models the complex relationships between scenarios and CMF values. This new data-driven framework provides a cost-effective and adaptable solution that complements the case-specific approaches for CMF estimation, which is particularly beneficial when availability of crash data imposes constraints. Experimental validation using real-world CMF Clearinghouse data demonstrates the effectiveness of this new approach, which shows significant accuracy improvements compared to the baseline methods. This approach provides insights into new possibilities of harnessing accumulated transportation knowledge in various applications.

Navigating Road Traffic Accidents in Jordan: A Retrospective Exploration of the Health and Economic Impacts.

Background Road traffic accidents (RTAs) are considered a major public health threat. The causes of RTAs are multifactorial, comprising both human and non-human factors. RTAs may result not only in detrimental health consequences but also in serious economic burdens. This study aimed to provide a retrospective overview of the health and economic impacts of RTAs in Jordan during the period 2013-2021, including the implemented multisectoral mitigation strategies. Methodology This study presents a retrospective chart review of the traffic reports published by the Public Security Directorate (PSD) in Jordan during the period 2013-2021. The examined variables were the total number of road accidents involving human injuries per year, average road accidents per day, annual deaths, average deaths per day, deaths per 100,000 population, annual number of injuries, average number of injuries per day, severity of human injury, number of registered vehicles, and the annual financial costs. Data were extracted from PSD reports and presented descriptively. Results The number of registered vehicles has risen from 1,263,754 in 2013 to 1,795,215 in 2021 with a 42.1% increase. This was also associated with an increase in the average RTAs per day from 28.0 in 2013 to 30.8 in 2021. The total number of RTAs that involved human injuries during the period 2013-2021 fluctuated with 8,451 in 2020 (lowest) and 11,241 in 2021 (highest). In the same period, annual deaths caused by RTAs peaked in 2013 with 768 deaths (highest) compared to 461 in 2020 (lowest). In the five years from 2017 to 2021, the total financial cost of RTAs in Jordan was nearly 1.561 billion Jordanian Dinars (~2.2 billion U.S. dollars) compared to 1.363 billion Jordanian Dinars (~1.92 billion U.S. dollars) in the five years from 2012 to 2016. Conclusions Targeting human and road infrastructure factors through effective government-society partnerships is crucial in mitigating the health and economic burden of RTAs in Jordan. More strict enforcement of traffic laws, along with incremental increases in the penalties for dangerous traffic violations, and regular road safety campaigns are expected to provide more control over the human factors of RTAs. Further research is needed to evaluate the impact of the recently amended traffic law on the trends of RTAs in the country.

Assessing the effect of automated speed enforcement and comprehensive measures on road safety in Rwanda.

OBJECTIVES: Daily, approximately 3,400 traffic-related deaths occur globally, with over 90% concentrated in low and middle-income countries (LMICs). Notably, Rwanda has one of the highest road traffic death rates in the world (29.7 per 100,000 people) and is the first low-income country to implement a national Automated Speed Enforcement (ASE) policy. The primary goal of this study is to evaluate the effectiveness of ASE cameras in reducing the primary outcome of road traffic deaths and secondary outcomes of serious injury crashes and fatal crashes. METHODS: The study used data on road traffic deaths, and serious injury and fatal crashes collected by the Rwanda National Police between 2010 and 2022. Interrupted time series (ITS) models were fit to quantify the association between ASE and change in road traffic crash outcomes, adjusted for COVID-19-related variables (such as the start of the pandemic, the closure of schools and bars), along with exposure variables (such as GDP and population), and other concurrent road safety measures (such as road safety campaigns). RESULTS: The ITS models show that the implementation of ASE cameras significantly reduced road traffic deaths, serious injury crashes, and fatal crashes at the provincial level. For instance, the implementation of ASE cameras in the whole of Rwanda in April 2021 was significantly associated with a 0.14 (95% CI [0.072, 0.212]) reduction in monthly death incidence, equating to a 38.16% monthly decrease compared to the period before their installation (January 2010-March 2021). CONCLUSION: This study emphasizes the significant association of ASE in Rwanda with improved road traffic crash outcomes, a result that may inform road safety policy in other LMICs. Rwanda has become the first low-income country to implement nationwide scaling of ASE in Africa, paving the way for the generation of valuable evidence on speed-related interventions. In addition to new knowledge generation, African road safety research efforts like this one are opportunities to grow academic and law enforcement cooperations while improving data systems and sources for future research benefits.

'Safety in the Grey Zone': Evaluation of a training program to improve the safety of incident responders on high-speed roads.

INTRODUCTION: Workers operating on high-speed roads (i.e., incident responders and emergency service workers) are at significant risk of being fatally injured while working. An identified gap in current prevention strategies is training focused on developing the skills of workers to effectively communicate and coordinate safety responses when operating on roads. METHODS: This study discusses the development of a program designed to optimize communication and coordination of safety practices at the scene of an incident on a high-speed road. The program is referred to as 'Safety in the Grey Zone.' The goal of the study is to present the results from an evaluation on its implementation across 23 sessions involving 158 participants from 7 incident response agencies in 1 state in Australia. RESULTS: The results of this study provide support for effectiveness in implementing the program as planned. The results also provide preliminary support for effectiveness of the program in achieving its learning outcomes as demonstrated by feedback received from participants following completion of the program. CONCLUSIONS: The findings of this study provide recommendations to consider in the program's future roll-out, as well as suggestions for future evaluations to assess the program's effectiveness in improving the safety of incident responders operating on high-speed roads.

[Checking the fitness to drive of senior citizens under German law-pending corrective measures to ensure road safety]. / Die Überprüfung der Fahreignung von Senioren nach deutschem Recht ­ Anstehende Korrekturbedarfe zur Gewährleistung der Verkehrssicherheit.

German driving licence law takes a reactive approach to dealing with suitability deficiencies of senior citizens. If the driver is no longer fit to drive and nevertheless participates in traffic, an administrative offence has been committed. If this endangers or injures other people or causes significant damage to property, it may even be a criminal offence. In addition to prosecuting these offences, the driving licence authority may restrict or even withdraw the licence issued. In this respect, senior citizens have a high degree of personal responsibility when assessing their fitness to drive. This article presents the current driving license law and discusses the need for changes.Legally, various corrections are required to the current Driving Licence Ordinance and its annexes. At present, there is no clear regulation regarding the general reduction in performance in old age for an event-related assessment of fitness to drive. In addition, in the event of doubts about fitness to drive, the driving licence authority should be expressly granted the power to order standardised driving tests. Furthermore, the legislator must take preventive measures to ensure road safety. He must no longer ignore the current accident situation. In view of the fact that senior citizens aged 75 and over are disproportionately involved in traffic accidents with personal injury in terms of their culpable behaviour, it is important to impose moderate restrictions on the personal responsibility of driving licence holders. This is especially true for sensory abilities, which are particularly important in road traffic. Seniors should therefore be required to undergo eye tests from the age of 75. From this age onwards, it also seems sensible to introduce compulsory advice on fitness to drive, preferably from your family doctor.

A scoping review of national policies for child road injury in China.

There has been limited examination of child road injury policies. This study aims to systematically characterize national policies relevant to child road safety in China over the past two decades and identify potential gaps based on the WHO child road safety framework. As a scoping review, this study searched for national policies for child road safety on the websites of government agencies. A total of 22,487 policies were searched, of which 103 policies issued by 37 institutions, were included in the analysis, including 12 policies jointly developed by multiple agencies. Mapping identified policies to strategies in the WHO framework, most WHO strategies requiring legislation were found to be in place in China and to fully meet the intent of the WHO recommendation. The single exception was in the area of child restraints which was deemed to not be fully covered due to a lack of eligible policies on enforcement of child restraint use laws. Two strategies requiring standards were fully covered; eight strategies requiring policy support were partially or not covered, mainly related to equipping emergency vehicles with child-appropriate medical equipment. Enhancing school bus safety was identified as a policy focus area in China beyond those recommended by the WHO framework. This study identified three areas for improvement: (1) strengthening road safety policies targeting children, (2) strengthening enforcement of legislation, e.g., child restraint use, and (3) increasing multiple-sector cooperation on policy formulation. Funding: Ye Jin is supported by the Scholarship from the George Institute for Global Health and Tuition Fee Scholarships from University of New South Wales.

Study of the necessity of a speed monitoring display at the returning chicane on a freeway bypass.

OBJECTIVE: Roadwork zones represent a hazardous place within the highway system, with higher crash rates and injury severity, often due to excessive speed and noncompliance with speed limits. On freeways, a common layout is to close a full roadway and to divert traffic onto the opposite roadway, with one lane closed to accommodate the redirected traffic, by driving through the median strip. In this scenario, the second chicane can be a hazardous point if it is not correctly signaled. This paper examines the need to install a speed monitoring display (SMD) before the returning chicane on a bypass. METHODS: A two-phase study was conducted on a Spanish freeway where a roadway was temporarily closed. Two measurement points were established on the bypass, one in the middle and one at the end, prior to the return chicane through the median strip. During Phase 1, the portable SMD was installed and during Phase 2, it was removed. The average and the 85th percentile of the speed distribution at each point during both phases were compared. Additionally, mean difference tests were conducted and a speed prediction model was developed. RESULTS: With the SMD, drivers reduced their speed from the midpoint to the returning chicane, within the range of 7-10 km/h. Conversely, upon removal of the SMD, motorists increased their speed while driving through the bypass, resulting in excessive speed at the most hazardous point, the chicane leading back to the original roadway. The difference in mean speed between the two phases was 18 km/h at the returning chicane. CONCLUSIONS: In addition to the traffic calming measures implemented prior to entering roadwork zones on freeways, which are conveniently established in the standards; it is necessary to evaluate potentially dangerous areas of the layout and implement additional measures where required. Specifically, in the case of final chicanes of bypasses with reduced radii, it is recommended that a speed monitoring display be installed as a mandatory element in order to inform drivers of this challenging segment. Highway administrations around the world should maintain a SMD at the returning chicane of a bypass while roadworks last.

Assessing the prevailing driver seatbelt compliance at Madina Zongo junction in Accra, Ghana: An observational study.

OBJECTIVE: This study aimed to examine the prevailing driver seatbelt compliance at the Madina Zongo junction in Accra, Ghana. METHODS: An unobtrusive observational survey was conducted from 6 to 8 am and 5 to 7 pm on weekdays at randomly designated locations near the junction. A total of 3,054 vehicles were observed throughout the observation period. The data collected were analyzed with SPSS version 26. Cross-tabulations and Pearson's Chi-square test were employed for thorough analysis. RESULTS: The study revealed an overall seatbelt compliance rate of slightly over half (54.1%) among drivers, with the following breakdowns in various vehicle categories: large buses (76.2%), medium buses (98.1%), minibuses (44.0%), private cars (70.5%), taxi/uber (53.0%), and trucks (41.1%). Notably, seatbelt compliance was higher among females at 98.4%, compared to males at 49.2%. The study also identified a correlation between driver's gender and vehicle type with seatbelt compliance. Conversely, no significant association was found between seatbelt compliance and either the time of day or day of the week. CONCLUSIONS: The study offers significant findings regarding seatbelt usage trends at the Madina Zongo junction in Accra. These insights provide a basis for recommending targeted interventions such as policy decisions, public health campaigns, communication strategies, better enforcement, and road safety training programs. These interventions aim to raise awareness of unsafe attitudes and behaviors among drivers to improve seatbelt compliance and ultimately enhance road safety for all road users.

The effect of guardrail color on driver behavior based on driving style along mountain curves.

OBJECTIVE: Mountain highways are linearly complex, with extensive curves and high accident injury rates, how to improve driving safety is the key to traffic safety management on mountain highways, and it also meets the need for harmonious and sustainable development of the society. Therefore, this study investigates the effects of different guardrail color configurations on the driving behavior of different styles of drivers when driving on mountainous curves from the perspective of improving road aids - guardrails. METHODS: A virtual reality experiment was designed using a driving simulator and VR technology, and 64 subjects were recruited to participate and complete the experiment. RESULTS: Drivers with non-adaptive driving styles (Reckless, Angry, Anxious) traveled at significantly higher speeds than subjects with adaptive driving styles (Cautious) on mountainous roads; drivers with Cautious styles had better lane-keeping ability when passing through different radii of curves as compared to non-adaptive drivers; and the red and yellow guardrails were more effective in decreasing the speeds at which drivers passed and in increasing the stability of lane-keeping. CONCLUSIONS: The results of the study show that the effectiveness of red and yellow guardrails is better, which provides a reference for the traffic management department to propose a standardized color setting of guardrails in mountainous areas, which is conducive to the development of more precise traffic management measures to reduce the occurrence of traffic accidents.

Carsim-based simulation study on the performances of raised speed deceleration facilities under different profiles.

OBJECTIVE: Studying the optimal profile shape and size of deceleration facilities suitable for low-speed environment roads under different speed control intervals. METHODS: Simulation modeling of deceleration facilities with various profile shapes and sizes and for vehicles in different speed intervals was performed using the vehicle dynamics simulation software Carsim. The height jumped by a vehicle's wheels, the vertical force on the wheels, and the vertical acceleration of the vehicle were used as indicators of ride comfort and operational stability for the various deceleration facility profiles. RESULTS: stability and comfort were related to the contour of the deceleration facility. Vertical forces were positively related to vehicle jump height, but the jump heights of vehicles passing through deceleration mounds with different planes at the same speed were not significantly different with increasing height. When the vehicle is traveling slowly, the vertical impact force on the vehicle is not significantly related to the speed loss of the vehicle. CONCLUSIONS: Within the speed range of 20-60 km/h and profile heights of 3-10.5 cm, the effectiveness ratings of circular high width and parabolic were basically at level 2 and level 3, but the circular high width had a more stable jump height and was the best profile form, followed by sinusoidal and parabolic, then isosceles trapezoidal, and lastly conventional speed bumps.

An enhanced method for evaluating the effectiveness of protective devices for road safety application.

This paper presents an enhanced probabilistic approach to estimate the real-world safety performance of new device concepts for road safety applications from the perspective of Powered Two-Wheeler (PTW) riders who suffer multiple injuries in different body regions. The proposed method estimates the overall effectiveness of safety devices for PTW riders by correlating computer simulations with various levels of actual injuries collected worldwide from accident databases. The study further develops the methodology initially presented by Johnny Korner in 1989 by introducing a new indicator, Global Potential Damage (GPD), that overcomes the limitations of the original method, encompassing six biomechanical injury indices estimated in five body regions. A Weibull regression model was fit to the field data using the Maximum Likelihood Method with boundaries at the 90% confidence level for the construction of novel injury risk curves for PTW riders. The modified methodology was applied for the holistic evaluation of the effectiveness of a new safety system, the Belted Safety Jacket (BSJ), in head-on collisions across multiple injury indices, body regions, vehicle types, and speed pairs without sub-optimizing it at specific crash severities. A virtual multi-body environment was employed to reproduce a selected set of crashes. The BSJ is a device concept comprising a vest with safety belts to restrict the rider's movements relative to the PTW during crashes. The BSJ exhibited 59% effectiveness, with an undoubted benefit to the head, neck, chest, and lower extremities. The results show that the proposed methodology enables an overall assessment of the injuries, thus improving the protection of PTW users. The novel indicator supports a robust evaluation of safety systems, specifically relevant in the context of PTW accidents.

Speeding behavior and associated factors in Buenos Aires, Argentina.

OBJECTIVE: Excessive speed is a major risk factor for serious injuries and death. However, speeding remains a pervasive problem around the world. This study aimed to investigate the factors associated with speeding behavior in the city of Buenos Aires, Argentina. METHODS: A sample of vehicles (n = 34,967) from ten locations in the city was observed in two waves during 2021. Measurements were made at different times and days of the week. Observation sites were free of intersections, traffic lights, speed bumps and cameras, allowing drivers to speed freely. Data on speed, drivers and vehicle types were collected. Factors associated with speeding were identified through logistic regression analyses. RESULTS: 15.3% of vehicles were observed to be speeding. Roads with posted speed limits of 40 km/h showed higher speeding compared to 60 km/h roads. 77% of vehicles traveled above 30 km/h on local roads, and 30% above 50 km/h on avenues. Motorcycles, both commercial and private, showed a higher percentage of speeding compared to all other vehicles. Speeding was lower among women, among adults over 60 years of age, and among those using cell phones. CONCLUSION: It is crucial to strengthen strategies for increased compliance with speed limits. Actions targeting motorcyclists must be a priority.

The development of a road safety policy index and its application in evaluating the effects of road safety policy.

The paper presents an exploratory study of a road safety policy index developed for Norway. The index consists of ten road safety measures for which data on their use from 1980 to 2021 are available. The ten measures were combined into an index which had an initial value of 50 in 1980 and increased to a value of 185 in 2021. To assess the application of the index in evaluating the effects of road safety policy, negative binomial regression models and multivariate time series models were developed for traffic fatalities, fatalities and serious injuries, and all injuries. The coefficient for the policy index was negative, indicating the road safety policy has contributed to reducing the number of fatalities and injuries. The size of this contribution can be estimated by means of at least three estimators that do not always produce identical values. There is little doubt about the sign of the relationship: a stronger road safety policy (as indicated by index values) is associated with a larger decline in fatalities and injuries. A precise quantification is, however, not possible. Different estimators of effect, all of which can be regarded as plausible, yield different results.

Translating global evidence into local implementation through technical assistance: a realist evaluation of the Bloomberg philanthropies initiative for global Road safety.

BACKGROUND: Traffic-related crashes are a leading cause of premature death and disability. The safe systems approach is an evidence-informed set of innovations to reduce traffic-related injuries and deaths. First developed in Sweden, global health actors are adapting the model to improve road safety in low- and middle-income countries via technical assistance (TA) programs; however, there is little evidence on road safety TA across contexts. This study investigated how, why, and under what conditions technical assistance influenced evidence-informed road safety in Accra (Ghana), Bogotá (Colombia), and Mumbai (India), using a case study of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS). METHODS: We conducted a realist evaluation with a multiple case study design to construct a program theory. Key informant interviews were conducted with 68 government officials, program staff, and other stakeholders. Documents were utilized to trace the evolution of the program. We used a retroductive analysis approach, drawing on the diffusion of innovation theory and guided by the context-mechanism-outcome approach to realist evaluation. RESULTS: TA can improve road safety capabilities and increase the uptake of evidence-informed interventions. Hands-on capacity building tailored to specific implementation needs improved implementers' understanding of new approaches. BIGRS generated novel, city-specific analytics that shifted the focus toward vulnerable road users. BIGRS and city officials launched pilots that brought evidence-informed approaches. This built confidence by demonstrating successful implementation and allowing government officials to gauge public perception. But pilots had to scale within existing city and national contexts. City champions, governance structures, existing political prioritization, and socio-cultural norms influenced scale-up. CONCLUSION: The program theory emphasizes the interaction of trust, credibility, champions and their authority, governance structures, political prioritization, and the implement-ability of international evidence in creating the conditions for road safety change. BIGRS continues to be a vehicle for improving road safety at scale and developing coalitions that assist governments in fulfilling their role as stewards of population well-being. Our findings improve understanding of the complex role of TA in translating evidence-informed interventions to country-level implementation and emphasize the importance of context-sensitive TA to increase impact.

The association between single and dual use of cannabis and alcohol and driving under the influence and riding with an impaired driver in a large sample of Canadian adolescents.

OBJECTIVE: Dual use of cannabis and alcohol has increased in adolescents, but limited research has examined how it relates to impaired driving or riding with an impaired driver (IDR) compared to single substance use. This study aimed to examine the odds of alcohol- and/or cannabis-IDR among adolescents based on their use of alcohol and/or cannabis, and whether associations differed by gender and age. METHODS: Cross-sectional survey data were used from a sample of 69,621 students attending 182 Canadian secondary schools in the 2021/22 school year. Multilevel logistic regression estimated the odds of exclusive alcohol-IDR, exclusive cannabis-IDR, and both alcohol and cannabis IDR (alcohol-cannabis-IDR). Substance use interactions with gender and age were tested. RESULTS: Overall, 14.7% of participants reported IDR; 7.5% reported exclusive alcohol-IDR, 3.2% reported exclusive cannabis-IDR, 4.0% reported alcohol-cannabis-IDR, and 7.4% were unsure if they had experienced IDR. The prevalence of IDR varied across substance use groups, 8.0% among nonuse, 21.9% among alcohol-only use, 35.9% among cannabis-only use, and 49.6% among dual use groups. Gender diverse, older, and students with lower socioeconomic status exhibited a higher likelihood of reporting alcohol-cannabis-IDR. Dual use was significantly associated with 9.5 times higher odds of alcohol-cannabis-IDR compared to alcohol-only use, and 3.0 times higher odds compared to cannabis-only use. Dual use was also associated with an increased likelihood of either alcohol- or cannabis-IDR. CONCLUSIONS: This study highlights that all students, regardless of substance use, are at risk of IDR, but students engaged in dual use of alcohol and cannabis face an elevated risk compared to both peers who do not use substances and those who use only a single substance. These findings emphasize the importance of targeted interventions that address the risks associated with IDR.