Pedestrian Safety, Street-crossing Ability
Conditions
Keywords
pedestrian safety, street-crossing ability, road-crossing, children, injury prevention
Brief summary
Pedestrian injuries are among the leading causes of morbidity and mortality in American children ages 7-8, but existing behavior-oriented interventions achieve only modest success. One limitation to existing interventions is that they fail to provide children with the repeated practice needed to develop the complex perceptual and cognitive skills required for safe pedestrian activity. Virtual reality (VR) offers a highly promising technique to train children in pedestrian safety skills. VR permits repeated unsupervised practice without risk of injury; automated feedback to children on success or failure in crossings; adjustment of traffic density and speed to match children's skill level; and an appealing and fun environment for training. The proposed research is designed to test the efficacy of virtual reality as a tool to train child pedestrians in safe street-crossing behavior. A randomized controlled trial will be conducted with four equal-sized groups of children ages 7-8 (total N = 240). One group will receive training in an interactive and immersive virtual pedestrian environment. The virtual environment, already developed, has been demonstrated to have face, construct, and convergent validity. The second group will receive pedestrian safety training via video and computer strategies that are most widely used in American schools today. The third group will receive what is judged to be the most efficacious treatment currently available, individualized behavioral training at streetside locations. The fourth and final group will serve as a no-contact control group. All participants in all groups will be exposed to a range of field- and laboratory-based measures of pedestrian skill during baseline and post-intervention visits, as well as during a six-month follow-up assessment. Primary analyses will be conducted through linear mixed models designed to test change over time in the four intervention groups. We hypothesize all children in active learning groups will increase pedestrian safety skills, but the largest increase will be among children in the virtual reality group.
Interventions
DEVICEvirtual pedestrian environment
a computer-driven virtual pedestrian environment
DEVICEcomputer and video
various computer-based and video-based programs such as Otto the Auto and WalkSafe
BEHAVIORALstreetside training
one-on-one training by an adult with the child at streetside locations, to teach children street-crossing skills
Sponsors
National Institutes of Health (NIH)
University of Alabama at Birmingham
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
7 Years to 8 Years
Healthy volunteers
Yes
Inclusion criteria
* 7 and 8 year old children living in Birmingham, Alabama, area
Exclusion criteria
* family plans to move within 6 months of recruitment * visual or perceptual impairment (e.g., blindness) that are uncorrected and would prevent valid participation in protocol * physical impairment (e.g., use of wheelchair) that would prevent valid participation in protocol * cognitive impairment (e.g., moderate mental retardation) that would prevent valid participation in protocol
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Street-crossing Ability | post-training and again 6 months later | average count of hits/close calls per participant in virtual environment, out of 30 crossings |
Countries
United States
Participant flow
Recruitment details
recruitment from a variety of community sources between October 2009 and September 2011
Pre-assignment details
9 excluded prior to group assignment, for these reasons: Not meeting inclusion criteria; child of incorrect age (n = 3) Not meeting inclusion criteria; child unable to understand protocol (n = 3) Did not complete baseline assessment (n = 3)
Participants by arm
| Arm | Count |
|---|---|
| Virtual Reality street-crossing training in a virtual pedestrian environment | 59 |
| Computer and Video exposure to training in pedestrian safety via computer software, internet games, and television videos | 57 |
| Streetside Training one-on-one training in street-crossing skills by an adult, at a streetside location | 57 |
| No-contact Control no-contact control group. | 58 |
| Total | 231 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 | FG003 |
|---|---|---|---|---|---|
| Overall Study | Lost to Follow-up | 7 | 5 | 5 | 3 |
Baseline characteristics
| Characteristic | Total | Virtual Reality | Computer and Video | Streetside Training | No-contact Control |
|---|---|---|---|---|---|
| Age, Categorical <=18 years | 231 Participants | 59 Participants | 57 Participants | 57 Participants | 58 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 0 Participants | 0 Participants | 0 Participants | 0 Participants | 0 Participants |
| Age, Continuous | 8.0 years STANDARD_DEVIATION 0.65 | 7.9 years STANDARD_DEVIATION 0.67 | 8.1 years STANDARD_DEVIATION 0.63 | 7.9 years STANDARD_DEVIATION 0.68 | 8.1 years STANDARD_DEVIATION 0.63 |
| Region of Enrollment United States | 231 participants | 59 participants | 57 participants | 57 participants | 58 participants |
| Sex: Female, Male Female | 132 Participants | 32 Participants | 35 Participants | 35 Participants | 30 Participants |
| Sex: Female, Male Male | 99 Participants | 27 Participants | 22 Participants | 22 Participants | 28 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk | EG003 affected / at risk |
|---|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — | — / — |
| other Total, other adverse events | 0 / 59 | 0 / 57 | 0 / 57 | 0 / 58 |
| serious Total, serious adverse events | 0 / 59 | 0 / 57 | 0 / 57 | 0 / 58 |
Outcome results
Primary
Street-crossing Ability
average count of hits/close calls per participant in virtual environment, out of 30 crossings
Time frame: post-training and again 6 months later
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Virtual Reality | Street-crossing Ability | post-intervention hits/close calls in VR | 2.7 number of hits/close calls | Standard Deviation 1.6 |
| Virtual Reality | Street-crossing Ability | 6 month follow-up hits/close calls in VR | 2.1 number of hits/close calls | Standard Deviation 1.4 |
| Streetside Training | Street-crossing Ability | 6 month follow-up hits/close calls in VR | 1.7 number of hits/close calls | Standard Deviation 1.1 |
| Streetside Training | Street-crossing Ability | post-intervention hits/close calls in VR | 2.3 number of hits/close calls | Standard Deviation 1.2 |
| Computer and Video | Street-crossing Ability | 6 month follow-up hits/close calls in VR | 2.3 number of hits/close calls | Standard Deviation 1.5 |
| Computer and Video | Street-crossing Ability | post-intervention hits/close calls in VR | 2.6 number of hits/close calls | Standard Deviation 1.6 |
| No-contact Control | Street-crossing Ability | post-intervention hits/close calls in VR | 3.0 number of hits/close calls | Standard Deviation 1.6 |
| No-contact Control | Street-crossing Ability | 6 month follow-up hits/close calls in VR | 2.6 number of hits/close calls | Standard Deviation 1.6 |
p-value: <0.05ANOVA