Systematic review and meta-analysis of behavioral interventions to improve child pedestrian safety.
OBJECTIVE
Pedestrian injuries represent a pediatric public health challenge. This systematic review/meta-analysis evaluated behavioral interventions to teach children pedestrian safety.


METHODS
Multiple strategies derived eligible manuscripts (published before April 1, 2013, randomized design, evaluated behavioral child pedestrian safety interventions). Screening 1,951 abstracts yielded 125 full-text retrievals. 25 were retained for data extraction, and 6 were later omitted due to insufficient data. In all, 19 articles reporting 25 studies were included. Risk of bias and quality of evidence were assessed.


RESULTS
Behavioral interventions generally improve children's pedestrian safety, both immediately after training and at follow-up several months later. Quality of the evidence was low to moderate. Available evidence suggested interventions targeting dash-out prevention, crossing at parked cars, and selecting safe routes across intersections were effective. Individualized/small-group training for children was the most effective training strategy based on available evidence.


CONCLUSIONS
Behaviorally based interventions improve children's pedestrian safety. Efforts should continue to develop creative, cost-efficient, and effective interventions.
['Schwebel|David C|DC|', 'Barton|Benjamin K|BK|', 'Shen|Jiabin|J|', 'Wells|Hayley L|HL|', 'Bogar|Ashley|A|', 'Heath|Gretchen|G|', 'McCullough|David|D|']
D000063:Accidents, Traffic D001521:Behavior Therapy D002648:Child D006801:Humans D000069636:Pedestrians D012449:Safety
systematic review meta-analysis public health accidents and injuries evidence-based practice prevention/control