RESUMO
Elderly pedestrians are involved in disproportionately more vehicle-pedestrian crashes than younger age groups. Training programs have been found to be effective in training children in pedestrian behaviours that improve their safety, however there is no consensus on whether older adults benefit from training. This systematic review aimed to identify whether training is effective for older adult pedestrians through analysis of training type, modalities, and the lasting effects of training. A systematic search of Medline, PsycINFO, and Scopus was conducted in March 2022 and updated in September 2023. Eight studies met the criteria all of which were high quality. Four distinct training types were found: physical (e.g., training physical strength or balance), behavioural (e.g., training specific pedestrian safety behaviours), cognitive (e.g., training reaction time and executive functioning), and educational (training knowledge about pedestrian safety behaviours). Physical training types were found to be most effective, followed by behavioural, cognitive, and educational respectively. Twelve pedestrian behaviours were measured across the eight studies. Reaction time was the most effectively trained outcome, followed by missed crossing opportunities. Errors of stimuli, median accepted time gap, initiation time and crossing were not effectively trained. The effects of training were maintained at follow-up for missed crossing opportunities only. There was preliminary evidence of potential efficacy of training for specific pedestrian safety behaviours, however, the long-term efficacy of training was not promising. Theory-driven research is needed to better understand why some behaviours are more trainable than others. More research is also needed to determine the real-world generalisability if training is to be recommended for older adult pedestrians.
RESUMO
BACKGROUND: Hazard perception (HP) has been argued to improve with experience, with numerous training programs having been developed in an attempt to fast track the development of this critical safety skill. To date, there has been little synthesis of these methods. OBJECTIVE: The present study sought to synthesise the literature for all road users to capture the breadth of methodologies and intervention types, and quantify their efficacy. DATA SOURCES: A systematic review of both peer reviewed and non-peer-reviewed literature was completed. A total of 57 papers were found to have met inclusion criteria. RESULTS: Research into hazard perception has focused primarily on drivers (with 42 studies), with a limited number of studies focusing on vulnerable road users, including motorcyclists (3 studies), cyclists (7 studies) and pedestrians (5 studies). Training was found to have a large significant effect on improving hazard perception skills for drivers (g = 0.78) and cyclists (g = 0.97), a moderate effect for pedestrians (g = 0.64) and small effect for motorcyclists (g = 0.42). There was considerable heterogeneity in the findings, with the efficacy of training varying as a function of the hazard perception skill being measured, the type of training enacted (active, passive or combined) and the number of sessions of training (single or multiple). Active training and single sessions were found to yield more consistent significant improvements in hazard perception. CONCLUSIONS: This study found that HP training improved HP skill across all road user groups with generally moderate to large effects identified. HP training should employ a training method that actively engages the participants in the training task. Preliminary results suggest that a single session of training may be sufficient to improve HP skill however more research is needed into the delivery of these single sessions and long-term retention. Further research is also required to determine whether improvements in early-stage skills translate to improvements in responses on the road, and the long-term retention of the skills developed through training.