Effectiveness of a school-based road safety educational program for lower secondary school students in Denmark: A cluster-randomized controlled trial.

Road accidents are one of the leading causes of death and injuries among adolescents and young adults. Road safety education programs aim to promote safe traffic behavior through information, skills training or fear appeals. During the last decade, an intervention type using victim testimonials has been developed. These types of programs aim to promote road safety by connecting a personal narrative of choices and consequences to the beliefs and behaviors of the audience. Studies on the effectiveness of this type of road safety programs among youngsters who are not yet drivers are still limited. This study used a cluster-randomized and controlled trial design to examine the effect of a Danish school-based road safety educational program using testimonials for students in lower secondary schools in Denmark on a) knowledge of risks factors in traffic and b) two types of behavior specifically relevant for the pre-driver target group: seatbelt use and safe bicycle behavior. Our analysis sample comprised 1007 students from 57 schools with a matched baseline and four-month follow-up response. Linear regression analyses suggest a small positive effect on the students' knowledge of the three most important risk factors in traffic but not on the age group most at risk. Concerning seatbelt use or overall cycling behavior no effect was found, although a small positive effect was found on helmet use. Neither was the effectiveness modified by gender, parental educational background, or risky cycling behavior at baseline. Although classroom-based interventions using testimonials may have the potential to increase knowledge of risk factors in traffic among adolescents, translating knowledge into safe traffic behavior is challenging. More studies are needed on how to further adapt the intervention to an age group who are not yet drivers. Such research may focus on mechanisms of change including the age-specific relevance of the ambassador's testimonial and on employing strong elements of action guidance.

Use of a smart electrically assisted bicycle (VELIS) in the health field -Proof of concept.

Physical activity (PA) is highly recommended in the management of most chronic diseases. For these patients, the smart electric bicycle can be effective to improve adherence to this behavior. The E-bike used in this study (called VELIS) has an innovative onboard technology that allows for subject monitoring and the engine power is designed to adapt to the user's abilities. A prerequisite for the use of the VELIS with patients is to initially carry out a pilot study on healthy subjects. The objective was to evaluate the impact of the customizable settings on physiological parameters and to ensure this prototype's efficiency and safety of use. Twelve healthy participants with various profiles (physical condition, used to cycling or not) were included. They have completed four times a 14 km itinerary with various settings of the VELIS. We recorded GPS data, heart rate and perceived exertion. Based on exercise intensity, we confirm that riding an E-bike should be considered as a physical activity. Safety of the participants is ensured by the engine brake. Recordings show that it took between 1 and 3 min for the novice to become familiar with the VELIS and to get optimal assistance. The main finding of this pilot study confirms that VELIS is an easy to use and secure tool to make PA approachable, whatever the level of training in healthy subjects.

Accelerating Motor Skill Acquisition for Bicycle Riding in Children with ASD: A Pilot Study.

Motor impairment is common in autism spectrum disorder (ASD) and, as such, a potential target for interventions to improve adaptive functioning. This study investigated motor skill acquisition in children with ASD (n = 15, 12 males; ages 7-16 years) during iCan Bike Camp, a 1-week, community-based intervention (5 × 75-min sessions) to teach independent bicycle riding. After completing the camp's task-oriented, individualized training program, all participants demonstrated motor skill acquisition on the bicycle, and nine participants rode independently at least 70 feet. Exploratory analyses showed that motor coordination and social communication correlated with rates of skill acquisition. These findings indicate the feasibility and efficacy of brief, community-based motor interventions to teach bicycle riding-an important developmental skill supporting adaptive functioning-to children with ASD.

Pedals and Pedagogy: Cycles of Hope and Health.

The Kalihi Valley Instructional Bike Exchange (KVIBE) is an innovative youth bike program housed in Kokua Kalihi Valley Family Comprehensive Services (KKV), a community health center in Honolulu, Hawai'i. KVIBE utilizes a popular education model to raise the social consciousness of its youth participants, who are primarily working class, Indigenous, and native to the Philippines or the Pacific Islands, especially Micronesia. Initially designed as a bike repair program where youth could earn a bicycle through sweat equity, KVIBE has grown into an educational space that teaches bicycle mechanics as well as personal history and identity. The KVIBE curriculum incorporates a social determinants of health approach with the Four Connections Framework, an Indigenous health framework developed by KKV and the Islander Institute. This article shares details of this program, as a pedagogical model for programs to engage underserved and marginalized Asian, Pacific Islander and Native Hawaiian youth who suffer from displacement and historical trauma via colonization. Additionally, this article speaks to the importance of seeing marginalized youth not as an at-risk group but as agents in creating community health.

Getting at Mode Share: Comparing 3 Methods of Travel Mode Measurement for School Travel Research.

BACKGROUND: Mode share is an important metric for active school travel programs. Common methods for measuring mode share include Hands Up surveys and family surveys, but these require teacher and parental involvement. We used these methods as part of an evaluation of a school-based bicycle training program, and added a novel observational count approach. This paper compares mode share results across the 3 methods. METHODS: We collected data over 2015-2017 at 16 elementary schools. Our outcome of interest was mode share (walk, drive, and bicycle). RESULTS: We found variations in travel mode estimates between methods and across schools. Overall most school journeys were made by walking (55.7% by observational counts, 46.3% by Hands Up surveys, and 51.5% by family surveys) or car (42.5%, 51.4%, and 46.2%, respectively), and a small proportion by bicycle (1.8%, 2.3%, and 2.2%, respectively). At individual schools, Hands Up and family survey results were similar; there was less agreement between these and observational counts. CONCLUSION: School travel practitioners face pragmatic choices in data collection. Observational counts are a nonintrusive method suited for school-wide travel patterns. Hands up and family surveys may be more appropriate for assessing differences between classrooms, ages, or family characteristics.

Underreporting, crash severity and fault assignment of minor crashes in China - a study based on self-reported surveys.

Unreported minor crashes have importance as a surrogate for more serious crashes that require infrastructure, education, and enforcement strategies; and they still inflict damages. To study factors that influence underreporting, cause, and severity of minor crashes; a survey was performed in Kunming and Beijing to collect self-reported personal characteristics and crash history data of the three major urban road users in China: automobile drivers, bicycle riders and electric bike (e-bike) riders. Underreporting rates of automobile to automobile, automobile to non-motorized vehicle, and non-motorized vehicle to non-motorized vehicle crashes are 56%, 77% and 94%, respectively. Minor crashes with higher reported injury severity levels are more likely to be reported. E-bike riders without a driver's license are more likely to cause crashes. Licensing and education could be an effective way to reduce their crashes. The party that is not at fault in a crash is more likely to sustain high level of injury.

Fostering bicycling culture in the institutional policy planning of cities / A promoção da bicicultura na política institucional de planejamento das cidades

ABSTRACT The objective this research understand perspective of cycloactivists South Region of Brazil in the promotion biciculture in their respective territories. We interviewed six cycloactivists with inclusion criteria: a) being militant cyclo-activist; b) holding political office and c) developing citizenship projects in both public and private management. From the phenomenological-hermeneutic methodology emerged units of meaning 'The cycling activist movement organization', 'educational processes experienced for fostering bicycle culture' and 'planning of public policy' resulting in the category 'urban cycling as sustainable active mobility'. We consider phenomenon bicycling represents the need to value human at scale coexistence in road traffic with potential for political transformation in city planning.

RESUMO O objetivo da pesquisa é de compreender a perspectiva de cicloativistas da Região Sul do Brasil na promoção da bicicultura em seus respectivos territórios. Entrevistamos seis cicloativistas tendo como critérios de inclusão a) ser cicloativista militante; b) ocupação de cargo político e c) desenvolvimento de projetos de cidadania na gestão pública e iniciativa privada. A partir da metodologia Fenomenológica-Hermenêutica, emergiram as unidades de significado "organização do movimento cicloativista", "processos educativos vivenciados na promoção da bicicultura" e "planejamento da política pública" que resultaram na categoria 'ciclismo urbano como mobilidade ativa sustentável'. Consideramos que, o fenômeno ciclismo urbano representa a necessidade de valorização da convivência à escala humana no trânsito com potencial de transformação política no planejamento das cidades.

The efficacy of a brief hazard perception interventional program for child bicyclists to improve perceptive standards.

INTRODUCTION: Even though child bicyclists are highly vulnerable in traffic only few studies focused on providing child bicyclists with means to enhance their abilities to deal with the complexity of dynamic traffic situations. The current study therefore evaluated whether a brief hazard perception intervention might be effective to improve hazard perception skills in child bicyclists towards a level more comparable to adult bicyclists. METHODS: Eighty children of the fourth grade (9.03 ±â€¯0.43 years; 34 girls) and forty-six adults (34.67 ±â€¯14.25 years age; 24 woman) first performed a Hazard Perception test for bicyclists. Response rate, reaction times, first fixation, duration of the first fixation, dwell time and total number of fixations on the events were measured. Next, the children took part in the HP intervention in which video clips of dangerous traffic situations were presented. The intervention comprised two classroom sessions of one hour (1/week). A post-test was performed one day after and the retention-test three weeks after the intervention. RESULTS: Children responded to more covert hazards immediately after the intervention (p < 0.05), but did not improve their response rate for overt hazards. Reaction times for the covert hazards improved on the post-test (p < 0.001) compared to the pre-test but this effect was reduced on the retention test. There was no effect of the intervention for entry time of the first fixation but the duration of the first fixation increased for the covert hazards (p < 0.05). Children made fewer fixations on the event compared to adults (p < 0.001), except for the covert hazards on the retention-test. The training also increased the number of fixations for the overt hazards on the post-test (p < 0.001) and the retention-test (p < 0.001) but only increased on the retention test for the covert hazards (p < 0.001). CONCLUSION: The results demonstrated that a brief intervention for training hazard perception skills in child bicyclists is able to improve children's situation awareness and hazard perception for potential dangerous situations. The training, however, was too short to improve children to higher adult levels.

Bike skills training for children with cerebral palsy: protocol for a randomised controlled trial.

INTRODUCTION: Two-wheel bike riding can be a goal for children with cerebral palsy (CP) and a means of participating in physical activity. It is possible for some children with CP to ride a two-wheel bike; however, currently far fewer can ride compared with their typically developing peers. Evidence supports training targeted towards goals of the child with CP and their family; yet there is little evidence to guide best-practice bike skills training. Task-specific training may lead to attainment of two-wheel bike-specific goals. This study aims to determine if a novel task-specific approach to training two-wheel bike skills is more effective than a parent-led home programme for attaining individualised two-wheel bike-specific goals in independently ambulant children with CP aged 6-15 years. METHODS AND ANALYSIS: Sixty eligible children with CP (Gross Motor Function Classification System levels I-II) aged 6-15 years with goals relating to riding a two-wheel bike will be randomised to either a novel task-specific centre-based group programme (intervention) or a parent-led home-based programme (comparison), both involving a 1-week intervention period. The primary outcome is goal attainment in the week following the intervention period (T1). Secondary outcomes include: goal attainment and participation in physical activity at 3 months postintervention (T2) and bike skills, attendance and involvement in bike riding, self-perception and functional skills at T1 and T2. Economic appraisal will involve cost-effectiveness and cost-utility analyses. Adherence of clinicians and parents to the intervention and comparison protocols will be assessed. Linear and logistic regression will be used to assess the effect of the intervention, adjusted for site as used in the randomisation process. ETHICS AND DISSEMINATION: This study was approved by the Human Research and Ethics Committees at The Royal Children's Hospital (#36209). Results will be disseminated via peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: NCT03003026; Pre-results.

Comparison of physiological measures obtained using the Lode Excalibur Sport cycle ergometer and Tacx i-Magic home training device.

BACKGROUND: The aim of this study was to compare several physiological measures obtained using a criterion cycle ergometer (Lode Excalibur Sport) and a commercially-available home training device (Tacx i-Magic). METHODS: In a randomized, counterbalanced order, eight male amateur club level cyclists (age 30.4±3.5 years, body mass 75.8±8.1 kg, stature 1.75±0.06 m) completed a submaximal and maximal incremental test on both the Lode Excalibur Sport and the Tacx i-Magic. RESULTS: Data from the submaximal incremental test revealed that HR was significantly greater during the Lode trials at power outputs of 250 W (P=0.003), 280 W (P<0.001), and 310 W (P<0.001). V̇O2 was significantly greater during the Lode trials at 310 W (P=0.001) and blood lactate was significantly greater during the Lode trials at 310 W (P=0.004). RER was significantly greater during the Lode trials at 310 W (P<0.001). The power output corresponding to the lactate threshold (POLT) was not significantly different between the ergometers (P>0.05). The power output corresponding to a blood lactate concentration of 4 mmol/L (PO4), was significantly greater (P=0.003) during the Tacx trials. V̇O2max was not different between the ergometers (P>0.05), however, the power output associated with V̇O2max (POV̇O2max) (P=0.02), and peak power output (PPO) (P=0.006), were significantly different. CONCLUSIONS: Cyclists should exercise caution when transferring laboratory based physiological measures to the Tacx i-Magic during exercise >250 W.

Cyclist-related content in novice driver education and training.

In Australia, the increasing public profile and policy interest in cycling contrasts with variable cycling participation rates across jurisdictions (Australian Bicycle Council, 2017) and lack of cyclist-specific infrastructure. Cyclists and drivers often share road space, usually without indication from the built environment about how to maximise each other's safety and utility. Yet despite this regular interaction, cyclists are largely absent from the driver licensing process in Australia. That is, novice drivers are not taught how to share the road with cyclists. This case study used a mixed methods approach to examine the cyclist-related content in the Graduated Driver Licensing System (GDLS) in the Australian Capital Territory (ACT). The case study was conducted in four stages: 1) content analysis of all documents used through the GDLS; 2) observations of the Road Ready course and learner driver lessons; 3) online survey; and, 4) semi-structured interviews. Cyclists are rarely mentioned in the GDLS in the ACT and references often constructed cyclists as problematic or were based in instructors' personal opinion (rather than scripted responses). Outcomes from this study have directly informed a new vulnerable road user driver licence competency in the ACT and findings include recommendations for greater inclusion of cyclists in the driver licensing system.

On the use of naturalistic methods to examine safety-relevant behaviours amongst children and evaluate a cycling education program.

School-based cycling education programs aim to improve cycling safety and participation amongst children. Available research suggests that typical programs, which focus on bicycle manoeuvring skills, have limited effects on behaviour observed on a track or planned route. The current study uses theoretically more valid, naturalistic cycling data, to evaluate Safe Cycle, a program that incorporates hazard and self-awareness training. Soon after Safe Cycle was delivered at treatment schools, research bicycles instrumented with a rearward- and a forward-facing camera were loaned to six children from treatment schools and six children from (waitlist) control schools. In each group half the children were in Year 6, and half were in Year 7/8. Each child was instructed to ride the research bicycle instead of their own bicycle for the 1-2 weeks that they had a research bicycle. Video data were reduced using a purpose-designed coding scheme that identified whether participants performed specific safety-relevant behaviours in appropriate circumstances. While the participants controlled their bicycles well, gave way appropriately to traffic at intersections, and stopped at red lights, participants frequently removed one or both hands from the handlebars, and seldom signalled turns, conducted over-shoulder-checks when changing lanes, or looked in multiple directions at intersections (except when crossing a road). While aspects of design and small sample sizes limited evaluation findings, this research demonstrated the feasibility and potential of naturalistic data to support cycling education program evaluation. Further, the study substantially extended available naturalistic study of children's cycling behaviour to highlight behaviours which might be targeted by cycling safety initiatives.

Hazard perception training in young bicyclists improves early detection of risk: A cluster-randomized controlled trial.

INTRODUCTION: Since child bicyclists are more likely to get involved in a traffic crash, there is a stringent need to provide child bicyclists with tailored interventions in order to enhance their capabilities to deal with the complexity of traffic situations. The current study therefore aimed to test the effectiveness of a hazard anticipation training in young bicyclists by means of eye tracking technology. METHODS: A cluster-randomized controlled design was used in which participating schools were randomly assigned to the intervention or the control group. At first, a baseline hazard anticipation test was carried out in the intervention group (78 children; 9.56±0.38years of age) and the control group (46 children; 9.58±0.41years of age). Child bicyclists who participated in the intervention followed the training that consisted of two classroom sessions. In each session children were presented with video clips from the perspective of a bicyclist encountering various (potentially) dangerous traffic situations. Following the intervention, a post-test directly after the training and a retention test three weeks later were completed. The control group received the intervention after the retention test. RESULTS: Trained child bicyclists were found to detect more hazards and reacted quicker compared to the control group that did not receive the training. However, the training did not result in improvements in anticipatory visual search behaviour. CONCLUSION: Trained child bicyclists seemed to have developed a better processing regarding potential dangerous situations but were not able to 'see' the hazard sooner. The potential of a brief hazard anticipation training is discussed.

Bike Desks in the Classroom: Energy Expenditure, Physical Health, Cognitive Performance, Brain Functioning, and Academic Performance.

BACKGROUND: Physical activity is positively associated with physical health, cognitive performance, brain functioning and academic performance. The aim of this study is to investigate the influence of bike desks in the classroom on adolescents' energy expenditure, physical health, cognitive performance, brain functioning and academic performance. METHODS: Forty-four adolescents were randomly assigned to control group (CG) or intervention group (IG). During 5 months, the IG used a bike desk for 4 class hours/week. Energy expenditure was measured during 6 consecutive days. Anthropometric parameters, aerobic fitness, academic performance, cognitive performance and brain functioning were assessed before (T0) and after (T1) the intervention. RESULTS: Energy expenditure of the IG was significantly higher during the class hours in which they used the bike desks relative to normal class hours. The CG had a significantly higher BMI at T1 relative to T0 while this was not significantly different for the IG. Aerobic fitness was significantly better in the IG at T1 relative to T0. No significant effects on academic performance cognitive performance and brain functioning were observed. CONCLUSIONS: As the implementation of bike desks in the classroom did not interfere with adolescents' academic performance, this can be seen as an effective means of reducing in-class sedentary time and improving adolescents' physical health.

Long-Term Effects of Education and Legislation Enforcement on All-Age Bicycle Helmet Use: A Longitudinal Study.

Bicycle-related injuries are a leading cause of child and youth hospitalizations in Canada. The use of helmets while bicycling reduces the risk of brain injuries. This study investigated the long-term effect of legislation coupled with enforcement to improve helmet use rates. We conducted a longitudinal observational study of helmet use at 9, 11, and 14 years after bicycle helmet legislation was enacted. Data were compared to baseline observations collected after legislation was passed in 1997. A comprehensive enforcement and educational diversion program, Operation Headway-Noggin Knowledge (OP-NK), was developed and implemented in partnership with regional police during the study period. Helmet use was sustained throughout the post-legislation period, from 75.3 % in the year legislation was enacted to 94.2 % 14 years post-legislation. The increase in helmet use was seen among all age groups and genders. Helmet legislation was not associated with changes in bicycle ridership over the study years. OP-NK was associated with improved enforcement efforts as evidenced by the number of tickets issued to noncompliant bicycle riders. This observational study spans a 16-year study period extending from pre-legislation to 14 years post all-age bicycle helmet legislation. Our study results demonstrate that a comprehensive approach that couples education and awareness with ongoing enforcement of helmet legislation is associated with long-term sustained helmet use rates. The diversion program described herein is listed among best practices by the Public Health Agency of Canada.

Learning game for training child bicyclists' situation awareness.

Encouraging more children to bicycle would produce both environmental and health benefits, but bicycling accidents are a major source of injuries and fatalities among children. One reason for this may be children's less developed hazard perception skills. We assume that children's situation awareness could be trained with a computer based learning game, which should also improve their hazard perception skills. In this paper, we present a prototype for such a game and pilot it with 8-9year old children. The game consisted of videos filmed from a bicyclist's perspective. Using a touchscreen, the player's task was to point out targets early enough to gain points. The targets were either overt (other visible road users on a potentially conflicting course) or covert (occlusions, i.e. locations where other road users could suddenly emerge). If a target was missed or identified too late, the video was paused and feedback was given. The game was tested with 49 children from the 2nd grade of primary school (aged 8-9). 31 young adults (aged 22-34) played the game for comparison. The effect of the game on situation awareness was assessed with situation awareness tests in a crossover design. Similar videos were used in the tests as in the game, but instead of pointing out the targets while watching, the video was suddenly masked and participants were asked to locate all targets which had been present just before the masking, choosing among several possible locations. Their performance was analyzed using Signal Detection Theory and answer latencies. The game decreased answer latency and marginally changed response bias in a less conservative direction for both children and adults, but it did not significantly increase sensitivity for targets. Adults performed better in the tests and in the game, and it was possible to satisfactorily predict group membership based on the scores. Children found it especially difficult to find covert targets. Overall, the described version of the learning game cannot be regarded as an effective tool for situation awareness/hazard perception training, but ways to improve the game are discussed.

Barriers and Facilitators for Generalizing Cycling Skills Learned at Camp to Home.

Many children with disabling conditions do not acquire the skills to successfully ride a 2-wheeled bicycle. The aim was to describe cycling patterns before and after an innovative learn-to-ride bike camp and factors that facilitate or hinder the generalization of skills developed at camp to home. Parents and children participated in semistructured interviews 3-4 mo postcamp. Transcripts were examined deductively for participation and contextual influences using a template of codes approach. None of the children were successfully riding a 2-wheeled bicycle before camp. Two patterns of participation were evident from narrative descriptions of postcamp riding: "riders" and "not there yet." Major facilitating factors were the camp itself, the interaction between the camp and the health service, and continued parent involvement. The program transferred well to home for children who were riding independently on the last day of camp. Ongoing support is needed for children "not there yet."

[Prevention of bicycle accidents]. / Prävention von Fahrradfahrerunfällen.

For a very precise analysis of all injured bicyclists in Germany it would be important to have definitions for "severely injured", "seriously injured" and "critically injured". By this, e.g., two-thirds of surgically treated bicyclists who are not registered by the police could become available for a general analysis. Elderly bicyclists (> 60 years) are a minority (10 %) but represent a majority (50 %) of all fatalities. They profit most by wearing a helmet and would be less injured by using special bicycle bags, switching on their hearing aids and following all traffic rules. E-bikes are used more and more (145 % more in 2012 vs. 2011) with 600,000 at the end of 2011 and are increasingly involved in accidents but still have a lack of legislation. So even for pedelecs 45 with 500 W and a possible speed of 45 km/h there is still no legislative demand for the use of a protecting helmet. 96 % of all injured cyclists in Germany had more than 0.5 ‰ alcohol in their blood, 86 % more than 1.1 ‰ and 59 % more than 1.7 ‰. Fatalities are seen in 24.2 % of cases without any collision partner. Therefore the ADFC calls for a limit of 1.1 ‰. Some virtual studies conclude that integrated sensors in bicycle helmets which would interact with sensors in cars could prevent collisions or reduce the severity of injury by stopping the cars automatically. Integrated sensors in cars with opening angles of 180° enable about 93 % of all bicyclists to be detected leading to a high rate of injury avoidance and/or mitigation. Hanging lamps reduce with 35 % significantly bicycle accidents for children, traffic education for children and special trainings for elderly bicyclists are also recommended as prevention tools. As long as helmet use for bicyclists in Germany rates only 9 % on average and legislative orders for using a helmet will not be in force in the near future, coming up campaigns seem to be necessary to be promoted by the Deutscher Verkehrssicherheitsrat as, e.g., "Helmets are cool". Also, spots in TV should be broadcasted like "The 7th sense" or "Traffic compass", which were warning car drivers many years ago of moments of danger but now they could be used to warn bicyclists of life-threatening situations in traffic.

Evaluating traffic informers: testing the behavioral and social-cognitive effects of an adolescent bicycle safety education program.

In The Netherlands, 12-24 years old are over-represented in the total number of traffic fatalities and injuries. In this study, the traffic informer program - designed to promote safe traffic behavior in the pre-driver population - was experimentally evaluated, with a specific focus on bicycle use. Students were subjected to graphic videos of traffic accidents and listened to a first-person narrative provided by a traffic accident victim. The influence of the program on concepts derived from the theory of planned behavior and protection motivation theory (attitudes, norms, self-efficacy, risk-perception, intention and behavior) was assessed. Students from various schools (N=1593;M age=15 years, SD=.84) participated in a quasi-experimental study, either in an experimental or a control group, completing self-report questionnaires one week prior to the program implementation and approximately one month after the program implementation. Mixed regression analyses showed significant positive and negative time × intervention interaction effects on attitude toward traffic violations, relative attitude toward traffic safety, and risk comparison, but not on intention and behavior. More research is needed to find effective behavioral change techniques (other than increasing risk awareness) for promoting safe traffic behavior in adolescents. Research is also needed to address how these can be translated into effective interventions and educational programs.