The Advocacy for Pedestrian Safety Study: Cluster Randomised Trial Evaluating a Political Advocacy Approach to Reduce Pedestrian Injuries in Deprived Communities

Towner, Elizabeth M.L.; Hills, Robert K.; Lyons, Ronan A.; Kendrick, Denise; Towner, Elizabeth; Coupland, Carol; Hayes, Mike; Christie, Nicola; Sleney, Judith; Jones, Sarah; Kimberlee, Richard; Rodgers, Sarah E.; Turner, Samantha; Brussoni, Mariana; Vinogradova, Yana; Sarvotham, Tinnu; Macey, Steven

Abstract

Objective: To determine whether advocacy targeted at local politicians leads to action to reduce the risk of pedestrian injury in deprived areas. Design: Cluster randomised controlled trial. Setting: 239 electoral wards in 57 local authorities in England and Wales. Participants: 617 elected local politicians. Interventions: Intervention group politicians were provided with tailored information packs, including maps of casualty sites, numbers injured and a synopsis of effective interventions. Main outcome measures: 25-30 months post intervention, primary outcomes included: electoral ward level: percentage of road traffic calmed; proportion with new interventions; school level: percentage with 20 mph zones, Safe Routes to School, pedestrian training or road safety education; politician level: percentage lobbying for safety measures. Secondary outcomes included politicians' interest and involvement in injury prevention, and facilitators and barriers to implementation. Results: Primary outcomes did not significantly differ: % difference in traffic calming (0.07, 95%CI: -0.07 to 0.20); proportion of schools with 20 mph zones (RR 1.47, 95%CI: 0.93 to 2.32), Safe Routes to School (RR 1.34, 95%CI: 0.83 to 2.17), pedestrian training (RR 1.23, 95%CI: 0.95 to 1.61) or other safety education (RR 1.16, 95%CI: 0.97 to 1.39). Intervention group politicians reported greater interest in child injury prevention (RR 1.09, 95%CI 1.03 to 1.16), belief in potential to help prevent injuries (RR 1.36, 95%CI 1.16 to 1.61), particularly pedestrian safety (RR 1.55, 95%CI 1.19 to 2.03). 63% of intervention politicians reported supporting new pedestrian safety schemes. The majority found the advocacy information surprising, interesting, effectively presented, and could identify suitable local interventions. Conclusions: This study demonstrates the feasibility of an innovative approach to translational public health by targeting local politicians in a randomised controlled trial. The intervention package was positively viewed and raised interest but changes in interventions were not statistically significance. Longer term supported advocacy may be needed. Trial Registration: Current Controlled Trials ISRCTN91381117. © 2013 Lyons et al.

• Journal Article Type: Article
• Publication Date: Apr 8, 2013
• Journal: PLoS ONE
• Electronic ISSN: 1932-6203
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 8
• Issue: 4
• Pages: e60158
• DOI: https://doi.org/10.1371/journal.pone.0060158
• Keywords: pedestrian safety, pedestrian injuries, deprived communities
• Public URL: https://uwe-repository.worktribe.com/output/932886
• Publisher URL: http://dx.doi.org/10.1371/journal.pone.0060158