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Empirical Studies

Supporting children’s participation in active travel: developing an online road safety intervention through a collaborative integrated knowledge translation approach

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Article: 2320183 | Received 18 Sep 2023, Accepted 14 Feb 2024, Published online: 03 Mar 2024

ABSTRACT

Even though regular engagement in physical activity (PA) among children can support their development and encourage the adoption of healthy lifelong habits, most do not achieve their recommended guidelines. Active travel (AT), or any form of human-powered travel (e.g., walking), can be a relatively accessible, manageable, and sustainable way to promote children’s PA. One common barrier to children’s engagement in AT, however, is a reported lack of education and training. To support children’s participation in AT, this paper presents the development of a comprehensive 4-module online road safety education intervention designed to improve children’s knowledge and confidence regarding AT. Using a qualitative integrated knowledge translation (iKT) approach undertaken with community collaborators (n = 50) containing expertise in health promotion, public safety, school administration, and transportation planning, our inductive thematic analysis generated fourth themes which constituted the foundation of the intervention modules: Active Travel Knowledge: Awareness of Benefits and Participation; Pedestrian Safety and Skills: Roles, Responsibilities, and Rules; Signs and Infrastructure: Identification, Literacy, and Behaviour; Wheeling Safety and Skills: Technical Training and Personal Maneuvers. Each theme/module was then linked to an explicit learning objective and connected to complementary knowledge activities, resources, and skill development exercises. Implications for research and practice are discussed.

1. Introduction

Child engagement in daily physical activity (PA) is linked with improved mental health (Biddle & Asare, Citation2011), physical health, and body composition and function (de Moraes Ferrari et al., Citation2015; Herman et al., Citation2015), and can mitigate the risk of chronic illnesses such as obesity, heart disease, and Type II diabetes (Figueroa-Munoz et al., Citation2001; Janssen & LeBlanc, Citation2010). However, population-level trends from several countries across the globe indicate that most children are not meeting their prescribed daily PA goals (Aubert et al., Citation2018). Active school travel (AST), or any form of human-powered travel (e.g., walking, cycling, wheeling) to/from school, is a relatively accessible option for many children to increase their daily PA (Henne et al., Citation2014; Mendoza et al., Citation2011). Yet despite these benefits, most children do not engage in AST (Grize et al., Citation2010; Rothman et al., Citation2018; e.g.; van der Ploeg et al., Citation2008). Several socio-environmental factors contribute this phenomenon. Notably, fears of “stranger danger” or social conflict (Banerjee et al., Citation2014), traffic-related safety concerns (Egli et al., Citation2020), and the presence or lack thereof pedestrian infrastructure and recreational facilities (Pont et al., Citation2009) have been documented. Two particularly important factors of increasing interest to researchers and intervention programmers are child road safety knowledge and pedestrian skill competencies (e.g., An & Yang, Citation2022; Barboza-Palomino et al., Citation2020; Pierce et al., Citation2014). As road safety knowledge and pedestrian skill competencies become more prominent in AST interventions, there is a need to ensure the comprehensiveness, transferability, and validity of such programmes. These developments are especially important as many extant AST education interventions have only used context-specific collaboration resources (Turner et al., Citation2004), ad-hoc materials (Malan et al., Citation2016), or have not been formally validated (e.g., Hotz et al., Citation2004). Therefore, the aim of this paper is to conceptualize and develop a multicomponent road safety knowledge intervention designed to support AST through collaborative processes with AST experts.

1.1. AST road safety knowledge, and education interventions

Child road safety and pedestrian skills play an important role in their mode of travel (MOT) decisions. In instances where children report higher levels of mastery regarding AST safety behaviours and skills, such dynamics can promote their engagement with active MOTs (Kullman & Palludan, Citation2011; Morris et al., Citation2022). Negative perceptions of the active MOTs (Hoffman et al., Citation2014), as well as a lack of knowledge regarding road safety, travel experience comfort (Ermagun & Samimi, Citation2015), and proper cycling skills (Frater & Kingham, Citation2020), however, can be significant barriers to AST. Notable specific examples of such barriers include speeding and other aggressive driving behaviours (K. Wilson et al., Citation2019), confusing infrastructure designs (e.g., T-junctions) (Gautam et al., Citation2021), trips featuring interactions with unfamiliar individuals (Crawford et al., Citation2017), and busy and difficult to navigate street crossings (Hashemi Juzdani et al., Citation2020; Shen et al., Citation2015). To address these negative influences and promote AST via improved road safety knowledge and pedestrian skills, comprehensive approaches to intervention programming are required. Evaluations of contemporary AST road safety literature have principally suggested that such educational interventions should seek to address knowledge, skills, habits, behaviours, values, and attitudes (Alonso Plá et al., Citation2016). Consequently, future programming could focus on the i) promotion of knowledge and understanding of traffic rules and situations; ii) improvement of skills through training and experience; and iii) strengthening and/or changing attitudes towards risk awareness, personal safety, and the safety of other road users (Assailly, Citation2017). While these suggestions have been offered, concerns abound about the evidence-based quality (McKenna, Citation2010) and effectiveness (Feenstra et al., Citation2014; Twisk et al., Citation2014) of AST education and road safety interventions.

1.2. AST intervention design

AST interventions have been conceptualized and implemented in a variety of different manners in recent decades (e.g., Larouche et al., Citation2018; Stewart, Citation2011). However, little research has examined and evaluated the methodological background and structure of the conceptualization processes regarding AST interventions. For instance, a recent review reported that most high-quality studies have been carried out in controlled classroom settings with specific classroom materials (McDonald et al., Citation2018). Among the methodological evaluations of larger multicomponent AST programmes, it has been reported that there is a general dearth of detail regarding their conceptualization and developmental processes (A. N. Buttazzoni et al., Citation2018). As the need for more rigorous developmental assessments has seemingly grown, recent studies have begun reporting findings related to AST intervention design processes. Of note, findings suggest that engaging in ample planning activities (e.g., ensuring buy-in, opportunities for engagement) (Koester et al., Citation2021) and “designing for diffusion,” or developing an approach for diffusion in a larger system (e.g., AST interventions with strategies for use in health promotion systems) (LaJeunesse et al., Citation2019) might improve the success of such interventions. Similarly, within the larger context of PA intervention design, approaches for programme development have identified the mobilization of intersectoral partnerships (e.g., informational, social, and behavioural, policy inputs) and engagement in capacity building partnerships (e.g., community stakeholders (Heath et al., Citation2012)) as effective strategies to generating materials with sufficient scope and relevance. Thus, the adaptation and application of these approaches to the conceptualization and designing of AST interventions, including road safety programmes, could help to address the noted criticisms of their development and serve to produce more effectual future programmes for practitioners.

1.3. Research aim and approach

To provide intervention programmers and practitioner audiences with an authoritative AST intervention to promote engagement, this study presents the conceptualization and development of a road safety education intervention via an integrated knowledge translation (iKT) approach. Our iKT approach was undertaken in collaboration with advocacy organizations, municipal policymakers, municipal urban planners, private planning consultants, law enforcement officers, schoolboard transportation officials, and transportation engineers. The aim of this study was thus to identify the relevant content areas, materials, and strategies needed to develop a comprehensive (i.e., multicomponent) road safety knowledge intervention to promote AST among children and parents.

1.3.1. iKT Approach

iKT is a process characterized through its research co-production between academic researchers and knowledge users (Kothari & Wathen, Citation2017). The overarching purpose of iKT is to generate relevant knowledge from those who “use” research (i.e., practitioners) and then iteratively refine this developed information to improve its practical applicability with the help from those who “do” research (i.e., academics) (Bowen & Graham, Citation2013; Kothari & Wathen, Citation2017). In the present paper, we used an iKT approach to ensure the inclusion of information-rich knowledge users and practitioner experts in service of enhancing the applicability, impact, and relevance (Boland et al., Citation2020) of our AST intervention. We therefore sought to develop a comprehensive road safety knowledge intervention via collaborating with AST experts across the research process. Specifically, we engaged our practitioner and expert collaborators in defining and providing feedback on the focus group questions, suggesting visual materials to use in the tool, and participating in semi-structured focus groups. These processes are detailed in the ensuing methods section.

2. Methods

2.1. Study context

This study was undertaken within the context of a regional Active and Safe Routes to School (ASRTS) initiative in Southwestern Ontario, Canada featuring an ongoing school travel plan (STP) programme. The onset of COVID-19 pandemic, however, propelled this regional STP programme evaluation to shift part of its focus towards developing additional programming tools (Buttazzoni, Pham, et al., Citation2023; Clark et al., Citation2023) and new multicomponent road safety interventions to use in future STPs for its primary target group: children between the ages 9–14 and their parents.Footnote1 Consequently, the present study included AST experts and practitioners from relevant professional fields from across the Canadian province of Ontario—the most populous province at ~ 15.5 million people (Ontario Ministry of Finance, Citation2023)—to investigate the latter focus regarding multicomponent intervention design.

2.2. Recruitment and sample

Purposive sampling techniques (Curtis et al., Citation2000) seeking to recruit AST experts from a variety of organizational and technical backgrounds were followed. After compiling a list of relevant organizations, potential participants were catalogued by our research team. Participants were initially contacted via email to participate in a virtual focus group to discuss the necessary materials and components required for the development of an AST education questionnaire. Eventually, 50 AST and road safety experts were recruited. Organizations and areas of expertise included local public health units, police departments, cycling promotion and education non-profits, student transportation services, various municipal departments (notably transportation and planning departments). Individual participants were grouped together with other individuals based on their availability.

It is important to note that parents and children were initially involved in the development of the questionnaire items through two pilot studies (Buttazzoni, Pham, et al., Citation2023) which assessed the reliability, face validity, and construct validity of the items with respect to their AST perceptions. Given that the first component of the ASRTS initiative focused on utilizing parents and children’s feedback to validate the questionnaire items, the second component (i.e., the current study) sought to conceptualize the items by consulting with experts who are more equipped to revise and organize the questions into their respective themes to reflect priority AST areas for future interventions, hence the exclusion of parents and children from the group discussion.

2.3. Study protocols

2.3.1. Road safety education questionnaire: organizing the focus groups discussions

As a part of our iKT approach, our research team worked with a select group of practitioners and experts to design a short AST knowledge questionnaire. The purpose of the questionnaire was twofold. First, the questionnaire was created to assist in the development of a focus group guide that would be appropriately structured to elicit feedback regarding important AST education concepts that participants believed should be considered in a road safety intervention through a consensus-building process (i.e., create a consensus outline for the intervention scope, content, strategies). In other words, the first purpose of the questionnaire was to gather feedback from participants (i.e., AST experts) regarding what they deemed to be priority areas that should be covered in our discussion of a future intervention. And second, the questionnaire was created to elicit feedback from AST experts on possible questions that would be used in future intervention assessments (i.e., important questions to include when evaluating the learning of intervention participants). Once the questionnaire was finalized, it was disseminated to all participants via an emailed pdf file prior to their respective focus group. Instructions were provided along with the questionnaire detailing that we sought feedback on all sections through posing multiple broad overarching questions (e.g., “How well do our existing questions allow us to understand the knowledge children have in road safety?” and “Are there any additional questions needed to evaluate a child’s road safety knowledge?”). Feedback from participants was strongly encouraged but not mandatory for inclusion in the focus groups.

The knowledge questionnaire presented to each participant was originally comprised of 28 questions related to various AST road safety topics (e.g., skills, background knowledge and awareness). Questions were developed from an exhaustive review of scholarly articles (e.g., Chen et al., Citation2017; Longmuir et al., Citation2018; McLaughlin & Glang, Citation2010; Morrongiello et al., Citation2018; Trifunović et al., Citation2017), as well as tools from provincial AST programming partners (Ontario Active School Travel, Citation2020) and transportation organizations (Canadian Automobile Association, Citationn.d..). Included questions sought to address commonly reported perceived barriers to AST (e.g., Ermagun & Samimi, Citation2015; Frater & Kingham, Citation2020) and safety concerns such as traffic safety knowledge, attitudes, and pedestrian behaviours (Treviño-Siller et al., Citation2017). Written feedback was collected from various participants prior to their respective focus group. Using this questionnaire feedback, our focus group guide was further refined to improve the depth and relevance of the conversations. For example, several broad prompting questions (e.g., “What are the key elements that grade 4 to 8 children should know about road safety?”) were revised by the research team, as were probing questions during our subsequent iterative data collection and analysis processes.

2.3.2. Focus group data collection

Ten virtual semi-structured focus groups were conducted via Microsoft Teams and Zoom between January-March 2022. A semi-structured approach was used to allow for autonomy and flexibility while ensuring a degree of comparability between groups (e.g., same prompting questions and probes) for analysis purposes (Axinn & Pearce, Citation2006). Two research team members attended each focus group: one to moderate the discussion and one to take notes. Notes were collected to document common themes across participant responses, inform the interpretation of results, and assess the theoretical saturation of the collected data (Saunders et al., Citation2018). All focus group conversations were completed in English, ranged from 21–59 minutes (averaged ~37 minutes), and generally featured 3–4 participants (occasional larger groups featured 6–7 participants). Consent to be recorded was provided verbally by all participants and recorded by a member of our research team. All focus groups were audio recorded by the research team and then transcribed via Microsoft Stream. Transcripts were verified for accuracy by an external undergraduate research assistant. Ethics approval for this study was granted by the Western University’s Non-Medical Research Ethics Board (REB #118382, Amendment 2021–118382–59646).

2.4. Data analysis

Focus group data were analysed using a bottom-up inductive thematic content and textual analysis approach (Braun & Clarke, Citation2006). Our inductive analysis began with the note takers on the team providing background context for each focus group transcript by consolidating the main points in their written records, as well as incorporating the provided questionnaire feedback received from participants regarding their identified priority areas and thoughts on assessment questions. As a part of these initial analyses, content analyses were required in order to systematically evaluate and extract (Hsieh & Shannon, Citation2005) relevant data (i.e., AST road safety education content) from multiple sources including suggested websites, reports, municipal strategies and plans, and other promotional and educational materials. This content analysis informed the interpretation of results (and the eventual structure of our intervention), and thus concluded prior to moving on to the ensuing thematic textual analysis of our focus group discussions.

With the background context established and initial content analyses framing the textual analysis of our focus group discussions completed, multiple research team members next began working on independently sorting and grouping repeating ideas, concepts, and sentiments through a line-by-line coding process. Once sorted, the research team came together to analyse these first-level codes further by separating and merging their repeating ideas, concepts, etc. as needed in order to develop larger, more descriptive second-level or intermediate codes (Auerbach & Silverstein, Citation2003). These intermediate sets of concepts were then subject to an iterative process wherein the research team visually mapped the relationships between concepts to create eight subthemes that would ultimately be paired together to develop the final four overarching themes in the findings. During this final analytical phase, all outstanding discrepancies between codes were addressed and discussed as needed until agreement was reached by the research team (Auerbach & Silverstein, Citation2003). Quotations were used to illustrate fundamental or essential information regarding the final themes developed; any potentially identifying information from presented quotes were removed and participants were assigned a unique ID based on focus group number and participant ID code (e.g., FG1, P01).

To ensure the comprehensiveness of our qualitative analyses, we made sure that our analytical processes included multiple measures of quality. Namely, we investigated a worthy topic, sought to build credibility, and develop rich rigour (Tracy, Citation2010). With respect to exploring a worthy topic, this study presents the development of a road safety knowledge intervention designed to support AST, an identified area of need for practitioners based on the many perceived education and knowledge barriers that have been previously reported (e.g., Buttazzoni, Nelson Ferguson, et al., Citation2023). In this way, the aim of this work within the field of AST programme design seeks to offer researchers and practitioners with what Guba and Lincoln (Citation2005) describe as “educative authenticity” via a relevant and suitable road safety intervention. Second, regarding credibility, our data collection and analysis processes were designed to develop thick description (Tracy, Citation2010) and abundant concrete detail (Bochner, Citation2000) in its findings. Our research processes thus aimed to account for complex specificity and circumstantiality (Geertz, Citation1973) related to AST through recruiting participants from a variety of different fields and locations, and applying an inductive analytical approach that provided flexibility in the generation of themes (i.e., recommendations for content, materials, subject areas). Last, regarding rich rigour, our research processes were structured to ensure the study contained appropriate theoretical constructs, as well as sample recruitment, data collection, and analytical procedures (Tracy, Citation2010). Seeking to provide practitioners with a useful tool, we applied an iKT approach to our conceptualization and development process (see above), and which also involved multiple research team members (A.B., J.P., K.N.F., E.F.) meeting during analysis to engage in “critical friends” (Smith & McGannon, Citation2018) procedures regarding different interpretations of our findings. Here we additionally conceptualized AST as an issue that must consider geographical, health, political, school, and urban planning factors. We therefore recruited a sample featuring AST experts and researchers, law enforcement, municipal policymakers, public health practitioners, school board representatives, and transportation planners. In line with this approach, we undertook our analytical processes, and specifically our line-by-line data coding, we considered the various aforementioned conceptual factors in our organizing of these codes into coherent and consistent groups that then formed the basis of the definitional parameters of the larger, final codes presented below.

3. Results

Our findings are organized according to the four themes (each with two sub-themes, see ) that were derived from our analysis which sought to ascertain what AST experts thought were the most important content, materials, and subject matter that should be included in a road safety education tool. The full intervention outline is presented in the discussion.

Table 1. Overview of findings for road safety intervention module development.

3.1. Active travel knowledge: awareness of benefits and participation

Perhaps the broadest area of emphasis to promote AST in a road safety education intervention highlighted by our participants was an awareness of the MOTs associated benefits. Here it was routinely suggested that developed materials and strategies focus on how the topic is framed and communicated, and that awareness materials should not assume too much and seek to positively introduce AST through content with messaging that is as accessible as possible.

3.1.1. Framing: make AST awareness easy to engage with

When discussing how best to effectively encourage awareness of AST and its associated benefits, it was frequently highlighted that AST is a relatively poorly understood MOT and should thus it should be presented with i) few assumptions of background knowledge and ii) encouraging narratives. For many practitioners there was a shared sentiment that promoting awareness of AST needed to be done in a direct way that underscores its basic positive benefits and relatively easy engagement. Suggestions here included creating activities that promote making use of local infrastructure, “We have a lot of trail systems in our community, we’re trying to promote children to use these trail systems … they interconnect with school systems, so we’re trying to promote kids to use the trails” (FG6, P04), and tying AST to other issue like climate change, “I’m wondering if you make air pollution one of the responses … [ask] which of the following would be benefits [of AST] … and it could be decreased air pollution” (FG1, P05). More broadly, it was suggested that intervention materials should educate participants about AST awareness through methods emphasizing clarity and positive messaging, as one official explained:

Most of our schools have designated high traffic intersections with crossing guards … The schools are always encouraging kids to “look for your school, your crossing guards. They’re your friends, they’ll help you cross.” So just emphasizing that role somewhere and the importance of it. Especially when you’re a grade four [student] … encourage the kids to look for that friendly adult. (FG8, P02)

Overall, topic framing was central in our conversations due to their belief it could stimulate engagement. Other suggestions argued for content that provided education to “empower” (FG2, P01) families to choose AST, or sought to develop awareness among drivers—which many parents are—to further “penetrate the public consciousness” (FG1, P04).

3.1.2. Communicating: ensuring accessibility of knowledge

Similarly essential to the successful promotion of AST awareness and its benefits in our road safety intervention was the prioritizing of communication to ensure the accessibility and legibility of information. Fundamental to this was how best to minimize the concerns of children and parents when being introduced to AST. One participant explained “ … we have all the road safety resources and there’s a lot of assumptions about where this information comes from, it could be like ‘did you learn this from friends, social media, family, or school’” (FG2, P02)? Being intentional about the communication, transparency, and accessibility of the education material was scrutinized by several participants who expressed the need to be proactive in simplifying AST and relating it to real-world examples to build a basic awareness:

But even include a definition to show them what the legislation says. “Ok, this is what AST constitutes: you can be on your blades, you could be on your own feet.” You almost need those little things for them to make that connection in their own minds, because I don’t think they’re [the younger children] in the position to kind of generate that … I just think it’s better to give them everything up front, let them go from there with it, and adapt that knowledge as they’re doing this. (FG1, P04)

Additionally, it was suggested that the accessibility of AST knowledge could be furthered by developing standardized materials like a “manual or a booklet” (FG1, P05), or educational materials that are attentive to different levels of background knowledge:

I think the kids that go through programs such as ours … [it’s the] language, I think making the assumption that they’re going to know it [is problematic]. Some of the grade sevens and eights might [understand AST concepts], but grade fours, fives, and sixes, probably not. So, I would just be mindful of that throughout the whole thing. (FG3, P02)

3.2. Pedestrian safety and skills: roles, responsibilities, and rules

Homing in on individual competencies, it was also widely recommended that any AST road safety intervention include content covering the specific roles, responsibilities, and rules for pedestrians. Such roles, responsibilities, and rules for children and parents were broken down into two general supporting themes that reiterated the importance of including i) a diversity of different examples, and ii) a clear focus on clear and simple instruction.

3.2.1. Diversity in examples and teaching modalities

Participants’ foremost thoughts pertaining to improving pedestrian safety knowledge and behaviour competencies tended to accentuate the need for diversity in road safety education modalities and teaching examples. Observing the many environments and changing social dynamics that pedestrians routinely face in trips to/from school, participants roundly lobbied in favour of demonstrating proper commuting behaviours through presenting materials covering different teaching scenarios and modalities:

One other thing that I thought about looking at all these questions and the age group, you get the 14-year-olds—I mean 10-year-olds get all their cell phones now—and so many of them are on their cell phone and everything else. They’re walking, they’re not looking. So, if they’re walking to school, often you’ll see them on streets walking and a car’s backing up out of a driveway. They don’t even look to see that there’s lights on a vehicle, like check that that vehicle sees you before walking along. (FG6, P01)

When we were developing our [local] pedestrian safety program, one of the things that came back huge that we were silent on is crossing in parking lots … especially because the school loading zone, all students are navigating and there’s not always cross blocks. You shouldn’t be afraid to walk through a parking lot—there’s definitely advantages to knowing how to do that safely. (FG5, P03)

You may not have seen it, they showed a picture of a four way intersection. The following picture shows a four-way intersection … The picture shows if I was standing on one of these corners and was about to cross the street [and asks:] “Where would I look?” (FG8, P01)

Collectively, this range of feedback was suggested to aid with improving both the applicability and equitability of a future intervention by providing different contemporary learning scenarios (e.g., dealing with varied contexts—parking lots) that will be familiar to participants from different geographic locations, as well as offer learning opportunities through visual methods, verbal activities, or paired tasks.

3.2.2. Clear and simple instruction

Educational content advocating proper pedestrian roles and responsibilities rules was typically linked with a need for clarity and simplicity in the presentation of such information. Simplicity in the structure of questions was a common point of feedback, most especially with respect to preventing confusion among younger child pedestrians. For example, this was argued to be critical for reinforcing pedestrian responsibilities such as “making eye contact with drivers because kids are always being told don’t talk to strangers, don’t engage with strangers” (FG6, P03), and “Making the difference as clear as possible with the walking on the right side and walking on the left side opposite traffic because … that might be a little bit confusing” (FG9, P01). Others elaborated that simple wording and clear visuals are likely to be much more intuitive for younger children:

I think when you’re using pictures, most particularly pictures of what children will see in their own natural environment, you get away from having them need to know what the proper word is to describe that thing, because a lot of times we organically pick up “Oh yes, that’s a traffic light, that’s a traffic signal” … get away from having to know the actual scientific name of that thing that you use every day. (FG3, P03)

Maybe some kind of orientation to this road situation, because even we’re making a lot of assumptions about what the kids already know based on the cars and the lines. It might make more sense to put a little child body where the start of the arrow is, or a solid line, or the cars being one color going in one direction and cars being another color going in the other direction and indicating the car directions. (FG2, P02)

Due to the complexity of and scope of various pedestrian rules and responsibilities, it was elaborated that these materials be relatively straightforward in service of facilitating fair learning opportunities for all participants.

3.3. Signs and infrastructure: identification, literacy, and behaviour

Participants also consistently reiterated the need to ensure the inclusion of educational content covering signage and general infrastructure concerns. Importantly here was an emphasis on contextualizing the presented content and material to encourage nuance in the learning process, and that literacy and behaviour materials feature realistic and/or relatable learning scenarios that participants can connect to their own community.

3.3.1. Contextualize approach, Be explicit about nuance

Being mindful that AST occurs within specific built, social, and policy environment contexts, participants expressed support for contextualizing and being explicit with nuance in educational materials. The inclusion of as much contextual detail as possible to attune learners to the subtleties of pedestrian signage knowledge and infrastructure use was regularly argued to be an essential feature of an effective road safety education intervention:

I think images [of proper pedestrian crossing in roundabouts] are huge. Again, being in Toronto we don’t have a lot of roundabouts in my neighborhood. My kids would never have seen one, so pictures of what that looks like in those lanes [is important for building] for context. (FG2, P02)

There’s some nuance there, like most of the laws state that you’re supposed to ride as far to the right as possible but [a cyclist] should also not be riding through potholes and stuff, and shouldn’t be riding in the “door zone” … There are more and more road cross sections that have protected bike lanes and protected intersections … you’re not just looking for a car, you’re looking for bikes before you cross. [the road] (FG9, P02)

I happened to drive through my kids’ school zone over the weekend and there was [a pedestrian crossing sign]. Even though it wasn’t during school hours, there were people standing right at that “stop for pedestrian sign,” so it just made me realize there’s a sign like this right out in front of my children’s school … It was like “ok, well if my kids came to that sign, it doesn’t mean you just get to go because the sign’s there.” So, [educational content should contemplate] what are the things that you need to consider or look for when you approach this sign? (FG1, P05)

Similarly, instruction of proper pedestrian behaviour was also suggested to be cognizant of local legislative contexts, “I think it might not be something that’s the same across the country; in Nova Scotia you are required by law to push the button before you go through one of those [crosswalks] … if you don’t, you’re at fault” (FG7, P05).

3.3.2. Provide realistic, relatable scenarios

Realism, or the authenticity of instructional materials, was argued to be important for developing decision-making process skills in common situations. Such circumstances often included those like “in many cases [where] there is no pedestrian crosswalk, and they [the child] are crossing in the middle of the block” (FG5, P01) or when pedestrians need to understand “signs that are given to pedestrians like ‘you can only cross on the other side of the intersection’ [signs], that sort of signage … they [the child] should understand what stop sign means versus what a yield sign means” (FG6, P07). Many experts expressed that rephrasing questions from identifying the signage to identifying the behaviour associated with it—for example, “Would it not be a better thing to have signs that would say stop, look both ways before proceeding and stuff like that on one side of the road” (FG6, P05)—would paint a more realistic learning scenario. This design would consequently offer a more advanced understanding of pedestrian signs:

… like a yield sign is confusing because the yield refers to the driver. It broaches that whole “who has the right of way” [issue]—the pedestrian always has the right of way. But they don’t put that on a roundabout, so maybe that’s something to think about. [in the intervention] (FG8, P01)

Relatability, meanwhile, participants used to refer to including material that is engaging, often through having participants apply learned content. Subsequently this consideration was posited to help shape and sharpen pedestrian decision-making skills:

I was going to say pose a question like “if there is no crosswalk,” “if there is no intersection,” [where/how do you cross? Then explain] … take that extra time to walk to the nearest intersection … that would alleviate a lot of running across the street. (FG4, P04)

Whether it’s by stop sign or stop light we try and encourage kids not to cross at that midblock … so many rules apply when you’re crossing a roundabout … having one of those types of questions [a participant dealing with a crossing situation] would be really good because it’s more of an education. (FG5, P03)

Collectively, the inclusion of more realistic and relatable materials covering sign and infrastructure literacy was contended to not only help with the comprehension of these topics, but also knowledge retention through making the learning process more applicable to the everyday pedestrian decision-making experiences.

3.4. Wheeling safety and skills: technical training and personal maneuvers

Beyond walking, it was extensively asserted that cycling and wheeling (e.g., scootering) skills and training content be covered. It was recommended that cycling-related materials emphasize technical knowledge and basic instruction with the MOT, as well as be delivered through a holistic lens where relevant behavioural knowledge was adequately paired with skill development material to provide learners with actionable learning.

3.4.1. Emphasis on basic and technical instruction

Due to its comparatively different nature (e.g., more equipment), wheeling safety and skills education was suggested to be developed with straightforward instruction. Cycling in particular was linked to several potential points of confusion as one participant catalogued, “How your bicycle works. How your scooter works … understanding your chain might come off; you have to put your chain back on. Understanding you need proper reflectors” (FG2, P01). It was additionally stressed that wheeling behaviour needed to consider the broader context to ensure high-quality education and avoid confusion, as one participant recounted a local experience:

I just think we have all these bike lanes that we’re piloting and they’re very confusing to our community, to our residents, to adults and youth, about how to use them … I think that there may be confusion … we need to consider how much awareness and understanding [there is] of how they’re actually used [and] their proper use. (FG6, P01)

Concurrently, it was expressed that there be opportunities to facilitate experiential learning (i.e., process of learning by doing) with cycling issues to improve relevance. Experiential-based learning activities were typically mentioned to encourage technical training with respect to helmet use and fitting, “ … the two fingers above the eyebrows, the V fitting right at the ear there, and then the one finger between the chin and the chin strap” (FG4, P01), and safe cycling behaviour such as knowing blind spots, “It might be more relevant for the cycling skills because you get closer to these trucks and you’re more prone to getting in the middle of that blind spot” (FG7, P01).

3.4.2. Holistic approach: complementary knowledge and skills education

Wheeling education content discussions were also characterized by an emphasis on implementing holistic approaches that feature complementary knowledge and skills material. This sentiment was linked to the aim of addressing the known barriers of confidence and comfort with the MOT, as well as the relevant legislative context, respectively:

[For] children and their parents it’s about making sure they have XYZ skills before they move onto the road … I would add on that if you’re able to integrate more questions about riding on the road, talking about positioning, you might want to highlight the door zone and find out if kids know about that because that’s really common thing when they first start riding on the road is that they tried to hug close as possible to the side. (FG7, P02)

To the best of my knowledge, we don’t have a bicycle bylaw here, but I do know that some neighboring municipalities do, and they are not defined by age but by the dimensions of the bicycle itself, so the size of the bicycle wheel. That might be something else to keep in mind. (FG6, P07)

Using holistic approaches for cycling education were also popular among participants because of a seemingly shared desire for more preventive education in the broader health promotion programming landscape. To illustrate this point, participants diagrammed larger behavioural goals like “Encouraging a sort of defensive mentality … You need to be visible, you need to be seen, and that applies when they’re on their bike, when they’re on their scooter” (FG3, P03), and “Learning how to cycle by yourself … the differences of the things that you do as a cyclist when you’re with your friends, your family, or by yourself” (FG2, P05). Pairing educational knowledge-based wheeling content with skills-focused lessons was, by several accounts, an approach participants felt was needed to make lessons more actionable for participants.

4. Discussion

In response to methodological issues pertaining to the quality (McKenna, Citation2010), effectiveness (Feenstra et al., Citation2014; Twisk et al., Citation2014), and design background (A. N. Buttazzoni et al., Citation2018) of AST interventions, this paper presents the conceptualization and development of a road safety intervention through a collaborative iKT approach with practitioners from multiple professional fields in Canada. Our research team recruited 50 participants with expertise in areas such as law enforcement, public health, public policy, school administration, and urban planning. An ensuing inductive analysis of ten virtual focus groups concluded with the generation of four overarching themes to structure our road safety intervention. In the following discussion we present the final intervention structure which contains four distinct intervention modules based on these themes and paired education strategies. The ensuing sections of this discussion cover the outline of the intervention, its practice implications, and the limitations of this work.

4.1. Intervention conceptualization

Based on our findings, as well as our team’s subsequent development process featuring the creation of module objectives and learning outcomes and combining these with specific education strategies, a complete outline of the multicomponent road safety intervention is presented in and . The process of taking the content of our findings and their thematic structure, pairing them with appropriate learning strategies and educational outcomes, and then combing these materials to create a coherent 4-module intervention was facilitated by the research team. To this end, we first paired our themes and subthemes (e.g., Module 2 – Pedestrian Safety Skills) with clear and robust AST learning objectives (e.g., Module 2 – To provide children and parents with the skills to demonstrate pedestrian road safety techniques). Secondly, once we had finalized our learning objectives, we developed a set of related learning outcomes to frame the purpose of each module. Finally, to generate a set of appropriate learning activities based on our findings, we drew on existing youth AST and physical activity education and promotion literature to identify strategies to pair with our findings and the delineated learning objectives and outcomes. After compiling our activities and organizing them in support of each of our modules, our team completed a final review of the entire intervention structure to ensure its coherence, comprehensiveness, and complementary quality (i.e., that the modules are distinct and non-repetitive, but also linked in service of delivering a complete educational experience).

Figure 1. Structural outline of the final version of the road safety intervention.

Figure 1. Structural outline of the final version of the road safety intervention.

Table 2. Final version of the developed road safety education intervention.

Mirroring the presented themes, four modules each featuring coordinated and complementary learning objectives and outcomes, and a comprehensive set of varied multi-modal activities to engage different learning strategies (e.g., story writing/journalling, matching games, online mapping), were created as a part of a larger multicomponent AST intervention for children and parents. Considering the variety of different commonly reported AST influences (Buttazzoni, Nelson Ferguson, et al., Citation2023), along with research recommendations for active travel researchers to attend to a wider set of modes in their work (Cook et al., Citation2022), the developed intervention was conceptualized and structured in collaboration with experts from multiple professional fields to best ensure its comprehensiveness with respect to overall scope and depth. In accordance with this approach, we sought to design objectives and incorporate educational strategies and materials specifically adapted to AST which aligned with previous implementation suggestions. We thus aimed to ensure the inclusion of sufficient planning activities (Koester et al., Citation2021), while also constructing the intervention in manner that its “designed for diffusion” (LaJeunesse et al., Citation2019) in larger school health and health promotion systems by creating an intervention with a variety of potential applications:

  1. independent mobility/AST promotion (e.g., Module 1: “explore the benefits of active transportation on physical, mental, and social well-being”),

  2. general AST/active transportation education (e.g., Module 2: “identify safety risks associated with being a pedestrian”), and

  3. pedestrian and cyclist skill development (e.g., Module 3: “teach children the concept of right of way, and how right of way applies to pedestrians and motorists at intersections”, and Module 4: “teach children how to ride safely on the road and/or sidewalk”).

4.2. Intervention development

Our focus group discussions with AST experts brought about a clear emphasis on educational content related to diffusing basic knowledge pertaining to the many associated benefits of regularly engaging with AST (see Module 1, ). This emphasis on implementing a proactive approach to encouraging AST behaviour and attitude change appears to align with other practice recommendations that have been suggested to disseminate knowledge of the various benefits of AST. Studies examining AST benefits have reported that children value the social aspects of their school journey (Hinckson, Citation2016), independent mobility can enhance children’s self-esteem (Waygood et al., Citation2017), and social relations can be an important means through which AST initiatives can be promoted (Love et al., Citation2020). Module 1, constructed with our accessibility and simplicity subthemes in mind, is structured to help facilitate an awareness of these social, and by extension mental and physical, health benefits. This module seeks to achieve these goals through familiarizing children with the definition of AST, teaching children about different active MOTs, exploring the health benefits of AST for both parents and children, and providing education about the environmental impacts of AST via strategies oriented towards reflection, action planning, and lifestyle adjustments. We therefore structured the module to have participants engage in tasks that encourage thinking of AST in terms of its accessibility. For instance, our intervention includes personal reflectionsFootnote2 which have been linked to improved levels of participation and care of PA (Bronikowski & Bronikowska, Citation2011) and personal action planning activities,Footnote3 which have helped in promoting PA through aiding participants in establishing priorities that can then be put into practice through personalized plans (Okely et al., Citation2011). We also included larger lifestyle-related strategiesFootnote4 that can be connected to the daily activities of participants. Such strategies have been indicated to effectively support PA through raising awareness among youth by improving their interest in physically active lifestyles and providing them with the skills to enable change (Lubans & Sylva, Citation2006). In our module we determined this strategy could be applied to encourage awareness of daily movement levels and aid in encouraging the adoption of AST.

Focus group discussions also identified the need for materials and content regarding pedestrian skill development, and signage and infrastructure literacy, for inclusion in a road safety education intervention (see Module 2 and 3, ). Such road safety foci appear prescient given that perceptions of social- and traffic-related safety in the context of AST have routinely been outlined as significant obstacles to participation (Banerjee et al., Citation2014; Crawford et al., Citation2017; Westman et al., Citation2017). Based on the expanded participant feedback, we structured Modules 2 and 3 to demonstrate pedestrian road safety techniques for parents and children, encourage children to be more aware of their surroundings when commuting, and have children and parents be able to identify pedestrian safety risks (Module 2). Moreover, Module 3 is designed to teach parents and children about how to navigate various traffic structures (i.e., road signs, construction signs), and children about the concept of “right of way” and its application in pedestrian commuting situations. In support of these learning objectives, we identified and adapted previously implemented PA education strategies emphasizing fostering social support and acceptance, and approaches promoting autonomy. Centering our module structure on suggestions for clarity, relatability, and context, social support educational strategies were adapted to ASTFootnote5 through the generation of pedestrian skill development and literacy as related activities. Research on PA engagement has reported encouraging outcomes through fostering peer support and social acceptance to create positive social contexts regarding PA behaviours (Lubans & Sylva, Citation2006). In this way, we envisaged these strategies as assisting in providing clarity regarding AST experiences and promoting a greater acceptance of the MOT. Strategies promoting autonomy,Footnote6,Footnote7 meanwhile, were incorporated to improve the relatability and contextual understanding of AST among children and parents. Such learning activities leverage autonomy-based learning approaches that have been reported to improve PA outcomes through the recognition and prioritization of personal safety concerns (Vonderwalde et al., Citation2019), and by creating personalized strategies that individuals link to self-identified motivation regarding their goal achievement (D. K. Wilson et al., Citation2008).

AST experts also advocated the essential nature of cycling and wheeling education and skills development in our road safety education intervention (see Module 4, ). These issues appear timely for an AST intervention as cycling and wheeling as a regular MOT for AST have been accompanied by a myriad of barriers including a lack of essential skills, gender dynamics (Nyström et al., Citation2023), a lack of access to personal safety equipment such as bicycle helmets (Pierce et al., Citation2014), and negative social attitudes (Frater & Kingham, Citation2020). Our intervention consequently seeks to teach children and parents how to ride safely on the road and/or sidewalk, and provide children with a holistic approach to expand their knowledge regarding how to apply their biking skills (see Module 4, ). Specifically we adapted strategies aiming to develop feelings of empowerment and create supportive learning environments for skills training to support our cycling/wheeling learning objectives as this approach has previously supported children’s engagement in cycling and enhance skills training, in addition to growing the visibility and social acceptance of cycling (Lenton & Finlay, Citation2018). Empowerment strategiesFootnote8,Footnote9 appear especially prudent for designing holistic cycling education content—we used these for the purposes of creating family-oriented lessons—given such strategies in PA education have noted utility in helping children include parents in their own personal learning processes aimed to improve their PA (Webber et al., Citation2008). Noting the potential of supportive environments to support behaviour change through fostering skill development (Elder et al., Citation2007), as well as motivational goal-setting strategies (e.g., intrinsic motivation, positive self-concept) to encourage PA (D. K. Wilson et al., Citation2005), module 4 leverages these strategiesFootnote10 to help participants acquire the technical skills required for cycling.

4.3. Practice implications

There are potential uses for this intervention among health promotion practitioners, planners, and school administrators. Our intervention design could be used to inform or aid in relevant legislation that targets transportation issues at different policy levels (e.g., school, community/municipal). Extant policies and practices targeting active transportation have focused on provisioning and promoting separated bicycle lanes, vehicle-free public spaces in city centres, media and publicity campaigns to encourage active transportation, and public transportation with cycling storage features (Winters et al., Citation2017). Health promotion practitioners and school administrators could pair one or multiple of our intervention modules with one or multiple of these policies to support AST. For instance, our Pedestrian Safety and Skills material could be used in tandem with media and publicity campaigns (e.g., social media, newsletters, prize competitions) to support the implementation or awareness of (Scheepers et al., Citation2014) school- or community-level AST promotions. Alternatively, as public transportation can contribute an additional 12–15 minutes of daily PA to users (Rissel et al., Citation2012), another possibility is that school health practitioners could use our modules related to AST awareness to encourage multimodal (e.g., city bus and walking) trips to/from school via improved knowledge of AST benefits, and specifically its links to PA outcomes. Planning practitioners may find value in utilizing elements of our intervention in coordination with planned policy changes. For example, as lower speed limits can reduce the overall convenience and attractiveness of car use and serve to increase active travel (Pucher et al., Citation2010), or as land-use policy such as smaller block size and mixed-use spaces (e.g., residential and commercial) have positive links to active commuting (Cui et al., Citation2014), our wheeling and cycling module could be used as an educational tool for target areas. Of note, these combined approaches could be employed in school communities which have recently been zoned for lower speed limits or are proximal to notable adjacent land-use projects.

4.4. Limitations

Potential interpretations and usage of this intervention should be considered alongside the following limitations. Foremost, the sample that was recruited in this study is local to Canada. The background knowledge base, experiences, and professional priorities of our participants are, consequently, very likely to reflect a collective perspective that is socio-geographically distinct to Canada. This study also did not recruit children or educators (i.e., specifically teachers). The subsequent lack of input from children and teachers may have resulted in certain materials and content being omitted that these groups may have believed are likely to be effective in such an intervention. Moreover, the absence of these stakeholders may have resulted in the omission of discussions pertaining to educational activities that children felt were most age-appropriate for their cohort, or alternatively conversations regarding strategies that parents and guardians thought might be the most effective at drawing in and ensuring their continued engagement in the intervention. Regarding the effectiveness of our developed intervention as it concerns their potential to significantly shape or change AST perspectives and beliefs, this is as yet uncertain. However, it should be noted, our research team is currently in the process of evaluating the feasibility and effectiveness of this intervention as presented here. Lastly, while we took numerous steps to the ensure the credibility and rigour of the research, as a result of our sample demographics and their geographics locations, we recognize that the knowledge bases which informed our intervention are likely best suited for urban and suburban contexts, rather than rural settings, as well as younger children (e.g., 6–7) and older teens (e.g., 15–17).

5. Conclusion

This paper presents the conceptualization and development of a road safety education intervention to support AST for children, principally those 9–14 years old, and their parents. Applying an iKT approach wherein our team worked with practitioners from multiple fields to co-produce a comprehensive intervention, our analysis presents four overarching themes which we subsequently developed into teaching modules. These components included a focus on i) improving the general knowledge of the awareness of benefits and participation associated with AST, ii) pedestrian road safety education, iii) general literacy regarding pedestrian signage and infrastructure, and iv) skill development related to cycling and wheeling MOTs. Future intervention development is encouraged to explore intervention design processes in other cultural contexts and with different target cohorts. While our team continues to test the feasibility and effectiveness of this tool, we reiterate the need for future AST promotion interventions to undergo comprehensive conceptualization, development, and implementation processes in furtherance of providing practitioners with more robust tools to utilize in their work.

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Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary Material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/17482631.2024.2320183

Additional information

Funding

Authors A.B. and K.N.F would like to thank Dr. Jason Gilliland, Director of the Human Environments Analysis Laboratory, for supporting their postdoctoral research associate positions which made this research possible. Financial support was provided through a Project Grant (#426684) from the Canadian Institutes of Health Research. Additional funding for K.N.F. was provided through a trainee award from the Children’s Health Research Institute.

Notes on contributors

Adrian Buttazzoni

Adrian Buttazzoni, PhD, is a Postdoctoral Associate in the School of Planning at University of Waterloo.

Julia Pham

Julia Pham, BMSc, is a Research Assistant with the Human Environments Analysis Lab (HEAL) in the Department of Geography at Western University.

Kendra Nelson Ferguson

Kendra Nelson Ferguson, PhD, is a Postdoctoral Associate in the Department of Geography at Western University.

Emma Fabri

Emma Fabri, MA, is a former Master’s student in the Department of Geography at Western University.

Andrew Clark

Andrew Clark, PhD, is a Project Coordinator in the Human Environments Analysis Laboratory.

Danielle Tobin

Danielle Tobin, PhD, is a Project Coordinator in the Human Environments Analysis Laboratory.

Nathaniel Frisbee

Nathaniel Frisbee, BA, is a Master’s student in the Department of Geography at Western University

Jason Gilliland

Jason Gilliland, PhD, is a Professor in the Department of Geography at Western University and the Director of the Human Environments Analysis Laboratory.

Notes

1. Children ages 9–14 and their parents and guardians are the primary target of our intervention as this is the cohort that our regional ASRTS and STP initiatives work with (e.g., A. N. Buttazzoni et al., Citation2019; K. Wilson et al., Citation2019).

2. “active travel passport”.

3. mapping activities, active travel story—our aim is to create action plans for different target areas based on an assessment of existing resources opportunities for AST.

4. “Hop!” web app.

5. “Road Safety Scavenger Hunt”.

6. “Match the Traffic Sign,” “iSpy Signs”.

7. “Take the Lead Game”.

8. “Identification and usage of various equipment” – aimed at empowering children (and parents) to feel comfortable with equipment.

9. “Teaching the cycling ABCs” – aimed empowering child desire to engage in cycling.

10. “Bike rodeo activities” teaching basic bike safety and handling skills needed for safe cycling—designed to have children snap a photo/video of them performing different procedures to program evaluators who will provide personalized motivational feedback.

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