oa Evidence-based safety education and training for traffic injury prevention

Safety education and training is one of the four basic injury prevention strategies, although there are concerns about its effectiveness. In this study, we aimed to summarize the scientific evidence on effectiveness of education and training for different road user groups. Cochrane Injuries Group, Pubmed, Campbell Systematic Reviews and TRID databases were searched for the relevant literature. Only systematic reviews or meta-analyses were recruited for this study. Pedestrian safety education can increase the knowledge of children and improve their road crossing behavior, but its effectiveness on road traffic injuries remained unknown. More evidence for adult pedestrians, especially elderly people is needed. Bicycle skill training for children and youth may increase their safety knowledge, but not necessarily improve their behavior or decrease their injury rates. Non-legislative interventions were found effective for increasing observed helmet use among bicyclists. Education only interventions were less effective than those providing free helmet. School based programs were less effective than community based. Motorcycle rider training has not found to be effective in reducing injuries. Mandatory pre-license rider training is an obstacle in motorcycle licensing process, so it indirectly reduces crashes through reduction in exposure. Quality research is needed to evaluate the effectiveness of rider training on crashes and injuries. Graduated Driving License (GDL) are designed to gradually introduce novice drivers to higher risk driving situations. GDL is effective in reducing crash rates among young drivers. Stronger GDL programs achieve greater fatality reduction. A systematic review on the effects of post-license driver education, provides no evidence of its effects on preventing road traffic crashes or injuries. Because of the large sample size included in the meta-analysis, the possibility of even modest benefits is rejected. School-based driver education can lead to early licensing, but there is no evidence that it reduces road crash involvement. The findings suggest that driver education may even lead to a modest but potentially important increase in the proportion of teenage drivers involved in road traffic crashes. There is strong evidence that education in combination with on-road training is effective on improving driving performance. There is moderate evidence that only educational intervention is not effective in reducing road traffic crashes. The evidence supports the effectiveness of interventions aimed at retraining older drivers. Review of the systematic reviews show that education only interventions are rarely effective on prevention of road traffic crashes. Except for some interventions like post-license driver education which has strong evidence based on large number of participants, in most of the subject interventions more rigorous investigation is needed especially in low- and middle- income countries.