Few studies have evaluated the effectiveness of comprehensive pedestrian safety interventions in changing the behaviors of drivers and pedestrians to promote safety. New and better quality research is needed to examine the effectiveness of theory-driven interventions that include both educational and enforcement components, such as the Watch for Me NC program implemented in North Carolina.  The purpose of this effort was to estimate the effects of the Watch for Me NC law enforcement program on driver behavior, specifically driver yielding rates at crosswalks. A total of 24,941 drivers were observed in 11,817 crossing events at 16 crosswalks in five municipalities that implemented the Watch for Me NC program over a 6-month time period. Generalized Estimating Equations (GEE) were developed to estimate driver yielding rates, accounting for repeated sampling at the crossing sites and other factors related to driver behaviors. Results indicate that driver yielding rates measured before and after the Watch for Me NC program was conducted were largely static at standard enforcement sites but improved slightly (between 4 and 7% on average) at sites receiving enhanced enforcement as part of the Watch for Me NC program. Several other variables, including characteristics of the roadway, the crosswalk, and time of day, were also found to have a significant relationship with driver yielding rates. This study provides new evidence of the factors associated with driver yielding behaviors that could be used by health practitioners and transportation agencies in developing policies and behavioral or environmental interventions to prevent pedestrian-related crashes and injuries.

Background:   We describe results from eight American Indian/Alaska Native Tribes/Tribal Organizations funded by CDC’s Tribal Motor Vehicle Injury Prevention Program (TMVIPP).  Projects were required to collect data for measurable workplan objectives, and to implement evidence-based strategies to reduce motor vehicle crash (MVC) injuries by addressing:  1) seatbelt use; 2) child safety seat use; and 3) driving under the influence (DUI). 

Methods:  As part of a four-year technical assistance contract, the authors provided tools and ongoing support to facilitate collection of data to document the extent to which projects achieved their objectives.  We summarized descriptive results across projects using:  1) annual workplans; 2) progress reports; 3) restraint use data; and 4) enforcement, MVC, and MVC injury/fatality data.

Results/Outcomes:   Seven of eight projects documented increases in seatbelt use (2%-175%), with five achieving objectives.  Five of five projects documented increases in child safety seat use (6%-40%), with four achieving objectives.  Two of four projects met objectives to reduce alcohol-involved MVC injuries (23%-70%) and alcohol-involved MVC fatalities (56%-86%).  For projects focused on policy-level change:  three of six passed new Tribal seatbelt use laws; three of five passed new child safety seat laws; and one of three passed enhanced DUI laws. 

Conclusions:  CDC TMVIPP provided technical assistance to support the development of measurable objectives, restraint use data collection, and tracking of enforcement, MVC, and MVC injury/fatality data.  Despite challenges to collect data locally, on-going technical assistance to support data collection and analysis efforts ensured the ability of these Tribal traffic safety projects to document results.

Objective: Teenage drivers are most at risk for motor vehicle collision and for using mobile technologies while driving.  Various distracted driving laws exist in the U.S., but their effectiveness remains unknown.  

Methods: Data from the 2013 Youth Risk Behavior Surveillance System were merged with each state’s legislation.  The prevalence of texting while driving(TWD) was assessed among population subgroups, different types of laws, modes of enforcement, average state fines, and the presence of licensure delay for violations using log binomial regression for complex surveys. 

Results: The prevalence of TWD was 39.0% in the 30 days prior to survey. Compared to states with the strictest bans, the adjusted prevalence ratio of texting was 1.20 (95% CI 1.05, 1.37) in states with no bans, 1.32 (95% CI 1.08, 1.60) in states with young driver bans only, 1.29 (95% CI 1.04, 1.59) in states with texting bans for certain ages but no young driver all cellphone bans, and 1.31 (95% CI 1.06, 1.61) in states with universal texting bans only.  The adjusted prevalence of TWD did not differ by secondary vs. primary enforcement (PR=1.04; 95% CI 0.92, 1.17) or with fines >$100 vs. ≤$100 (PR=1.03; 95% CI 0.83, 1.27).  The adjusted prevalence of TWD was 27% less in states with licensure delay (PR=0.73; 95% CI 0.62, 0.88). 

Conclusions: The prevalence of TWD may be lower in states with the strictest bans because they are easier for the public to interpret and less challenging to enforce.  Licensure delay may dissuade young drivers from engaging in risky behaviors.

Background/Purpose: Bicycling is positive for the environment, the economy and individual health. However, safety concerns can be a barrier to cycling in the US, preventing individuals from gaining significant health benefits. We studied environmental factors contributing to the severity of injuries resulting from collisions of bicycles with motor-vehicles. 

Methods: We obtained 131,432 police reports for crashes occurring between 2000 and 2014 from the states of Illinois, Missouri, New York, North Dakota, Ohio, and the City of Minneapolis. The injuries were classified as: “severe” including fatal and incapacitating, and “moderate/minor” including non-incapacitating, possible or no injuries. Information on environmental factors such as weather, lighting level and road surface condition at the time of crash was extracted from crash reports. Logistic regression was used to assess the association between severity of injury and environmental variables.

Results/Outcomes: Of all reported crashes, 14,936 (11.4%) resulted in severe injuries. Crashes at dawn (Odds Ratio=1.63, 95% Confidence Interval 1.39, 1.91), dark - road lighted (OR 1.34, 95% CI 1.28, 1.40), and dark - road unlighted (OR =2.04, 95% CI 1.84, 2.25) were associated with higher odds of severe injuries as compared to crashes during daylight. Weather and road surface conditions were not significantly associated with severity of injuries.

Conclusion: Our findings suggest that lighting plays an important role in severe crash outcomes.  The difference between lighted and unlighted roads suggests that environmental interventions such as adding street lighting may help reduce severe crashes.

Keywords: Bicycle; Environment; Injury Severity; Crash, Lighting

Purpose: To evaluate the effects of Michigan’s partial motorcycle helmet law repeal (MPHLR) on helmet use and head injury among crash-involved riders requiring trauma care. Methods: Using probabilistic linkage, adult (≥16-y/o) registry data from 23-trauma centers was cross-linked to state police crash-records for motorcycle crashes occurring 12-months before/after the MPHLR (4/12/11-4/12/13). Rates of head injury and helmet use were compared. Multivariate regression examined the effect of helmet use on head injury. Hospital service utilization was examined. Results: 1,094 patients were identified. No differences were noted before and after MPHLR with regards to rider socio-demographics, alcohol intoxication [BAC>80-g/dL] and crash-related speed limits. Helmet use decreased after MPHLR (91%-vs.-66%, p<0.001), while rates of head injury increased (48%-vs.-57%, p<0.01). Helmet non-use (AOR=2.96) and alcohol intoxication (AOR=3.10) both increased the odds of a head injury among trauma center patients. After adjusting for socio-demographics, unhelmeted riders were more likely intoxicated (AOR=2.51), traveling in a lower speed limit zone (AOR=0.97), Medicaid/self-pay (AOR=1.56) and in the post-MPHLR cohort (AOR=5.60). Unhelmeted riders also had higher utilization of hospital services, including ICU admission (39%-vs-24%, p<0.001) and ventilator care (28%-vs-17%, p<0.001). Conclusions: MPHLR has led to a 27% decline in helmet use and an 18% increase in head injury rates among crash-involved riders requiring trauma care. Helmet non-use was found to triple the odds of a head injury and significantly increased hospital service utilization in this patient population. Until repeals are reversed, innovative strategies to increase helmet use should be explored to prevent negative health outcomes and added medical costs.