An educational intervention in road safety among children and teenagers in Mexico.

OBJECTIVE: The purpose of this article is to describe a public school-based educational intervention (EI) designed to increase knowledge, improve attitudes, and change practices related to road safety. METHODS: We used a mixed-methods evaluation of a road traffic safety baseline diagnosis conducted in 4 public schools, 2 primary and 2 secondary. Research was organized into 4 phases: (1) diagnosis, (2) EI design, (3) implementation, and (4) evaluation. We used convenience sampling (n = 219 students) across schools and applied a pre-/posttest design based on quantitative and qualitative data. The former related to surveys on road safety experiences, knowledge, attitudes, and practice and the latter to observation checklists, community mapping, ethnography, and focus groups. To compare pre-post scores, we used multilevel mixed-effect ordinal logistic regressions. We developed data matrices, field notes, and systematized community mapping. We also transcribed focus group discussions, generated categories, and carried out thematic analysis. RESULTS: Ethnography indicated poor sidewalk conditions, no helmet or seat belt use, overcrowded public transportation, and no traffic lights or proper signals. Pedestrians did not use sidewalks and crossed streets unsafely. Subsequent to the intervention, however, the study population showed significant changes in their knowledge, practices, and attitudes. They identified road traffic incidents (RTIs) as the first cause of death among children and youth, and most understood that the solution to the problem was incumbent upon each and every individual. They also displayed increased perceptions of danger in practices such as traveling on overcrowded public transportation, failing to wear seat belts in cars and helmets on motorcycles, crossing the street while using mobile phones or playing with friends, and riding with drunk drivers. Changes varied according to gender, and students reported being able to carry out safe practices only when they were in control of the situation; for instance, as pedestrians. CONCLUSIONS: Because safe practices depend not only on children and youth but on the adults and social environment surrounding them, it is essential to engage parents, teachers, and decision makers in efforts to reduce RTIs. This will improve the establishment of commitments to impact social reality through consistent changes and mobilize greater resources for creating more secure communities in matters of road safety.

Prioritisation of road traffic injury interventions: results of a participative research with stakeholders in Mexico.

The objective of this study is to use a qualitative approach to prioritise road traffic injury (RTI) interventions for the city of Cuernavaca in Mexico. Seven focus group discussions and two nominal groups were held with participants representing different road users and social groups. All the focus group sessions were recorded and video filmed. Processing and analysis of the information gathered was done using qualitative methods. The problem of RTIs was well recognised by members of the local community, represented by participants in this study. The participants showed knowledge of the causes and related urban development dynamics. Participants identified possible interventions, and even rated them. The participatory approach utilised generated helpful insights and it enabled the researchers to identify key local actors and issues, for example, concerns of different road users, perception of certain factors and actors as causes of RTIs, and attitudes and behaviour within a specific physical environment. A prioritised list for 18 different interventions was developed. The first one will be implemented to prevent RTIs in the youth population. Understanding the social context to analyse the problem and possible solutions as seen by the community is important when analysing public health problems because it informs decision making when developing and implementing interventions.

Exclusive breast-feeding duration is associated with attitudinal, socioeconomic and biocultural determinants in three Latin American countries.

International health organizations have recommended exclusive breast-feeding (EBF) (i.e., breast milk as the only source of food) as the optimal infant feeding method during the first 4-6 mo of life. Therefore, it is important to document the determinants of EBF in different populations. Low-income urban women from Brazil (n = 446, 2 maternity wards), Honduras (n = 1582, 3 maternity wards) and Mexico (n = 765, 3 maternity wards) were interviewed at birth and in their homes at 1 mo and 2-4 mo after delivery. Multivariate survival analyses (Cox model) indicated that planned duration of EBF (all 3 countries), having a female infant, and not being employed (Brazil and Honduras), lower socioeconomic status (Honduras and Mexico) and higher birth weight (control hospital in Brazil and Honduras) were positively associated (P < or = 0.10) with EBF. Women who delivered in the maternity wards that had more developed breast-feeding promotion programs were more successful with EBF. The association between maternal education and EBF was modified by the maternity ward in Mexico and Honduras. Being > or = 18 y and having a partner living (Brazil) or not (Mexico) living at home were positively associated with EBF. These findings can contribute toward the design of EBF promotion efforts in Latin America.