Driver yield and safe child pedestrian crossing behavior promotion by a school traffic warden program at primary school crossings: A cluster-randomized trial

To determine the effect of a school traffic warden program on increasing driver yield and safe child pedestrian crossing behavior in Kampala, Uganda. We designed and implemented a school traffic warden program in specific school zones in Kampala, Uganda. We randomly assigned 34 primary schools in Kampala, in a 1:1 ratio, using a computer-generated randomization sequence, to control or intervention arms in a cluster randomized trial. Each school in the intervention group received one trained adult traffic warden stationed at roads adjacent to schools to help young children safely cross. The control schools continued with the standard of care. We extracted and coded outcome data from video recordings on driver yield and child crossing behavior (defined as waiting at the curb, looking both ways for oncoming vehicles, not running while crossing, and avoiding illegal crossing between vehicles) at baseline and after 6 months. Using a mixed effect modified Poisson regression model, we estimated the prevalence ratio to assess whether being in a school traffic warden program was associated with increased driver yield and safe crossing behavior. A higher proportion of drivers yielded to child pedestrians at crossings with a school traffic warden (aPR 7.2; 95% CI 4.42–11.82). Children were 70% more likely to demonstrate safe crossing behavior in the intervention clusters than in control clusters (aPR 1.7; 95% CI 1.04–2.85). A higher prevalence was recorded for walking while crossing (aPR 1.2; 95% CI 1.08–1.25) in the intervention clusters. The school traffic warden program is associated with increased driver yield and safe child pedestrian crossing behavior, i.e., stopping at the curb, walking while crossing, and not crossing between vehicles. Therefore, the school traffic warden program could be promoted to supplement other road safety measures, such as pedestrian safety road infrastructure, legislation, and enforcement that specifically protects children in school zones.

为明确乌干达坎帕拉市校园交通协管员项目对提升驾驶员礼让行人行为与儿童安全过街行为的影响，本研究在坎帕拉市特定校园区域设计并实施了校园交通协管员项目。研究采用整群随机对照试验（cluster randomized trial）设计，通过计算机生成的随机序列以1:1的比例将坎帕拉市34所小学随机分配至对照组与干预组。干预组的每所学校均配备1名经过培训的成人交通协管员，驻守于学校毗邻的道路旁，协助低龄儿童安全过街；对照组学校则维持常规交通管理标准。我们从基线及6个月后的视频录像中提取并编码了两类结局数据：驾驶员礼让行人行为与儿童过街行为，其中儿童过街行为定义为在路边等候、往返张望过往车辆、过街时不奔跑、避免在车辆间违规穿行。本研究采用混合效应修正泊松回归模型（mixed effect modified Poisson regression model）估算调整后患病率比（adjusted prevalence ratio, aPR），以评估参与校园交通协管员项目是否与驾驶员礼让行为及儿童安全过街行为的提升存在关联。结果显示，配备校园交通协管员的过街区域内，礼让儿童行人的驾驶员比例更高（aPR=7.2；95%置信区间CI：4.42~11.82）；干预组学校的儿童展现安全过街行为的概率较对照组高70%（aPR=1.7；95%CI：1.04~2.85）；此外，干预组中过街时保持步行的儿童比例更高（aPR=1.2；95%CI：1.08~1.25）。本研究表明，校园交通协管员项目与驾驶员礼让行为及儿童安全过街行为（即路边等候、过街时步行、避免在车辆间穿行）的提升显著相关。因此，校园交通协管员项目可作为补充举措，推广用于完善其他道路安全措施，例如专门保护校园区域儿童的行人安全道路基础设施、立法与执法工作。