Center for Population Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico.
Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA.
J Epidemiol Community Health. 2023 Mar;77(3):140-146. doi: 10.1136/jech-2022-219335. Epub 2022 Dec 19.
Mexico City implemented the programme to prevent pedestrian injuries and deaths at dangerous road intersections, which included street-level design changes, such as visible pedestrian crossings, sidewalk widening, refuge islands, lane reductions, pedestrian signals and adjustment of traffic light timing at these intersections. Few studies in low and middle-income countries (LMICs) have evaluated the effect of such interventions on pedestrian safety.
Assess the effectiveness of the programme at reducing total, injury and fatal pedestrian-motor vehicle crashes.
Two-group quasi-experimental design. Monthly pedestrian crashes were obtained from the road incident database from Mexico City's Citizen Contact Center. The programme's effectiveness was evaluated by comparing 12 months preintervention to 12 months postintervention implementation using a negative binomial regression with random intercept with a difference-in-difference estimation. A qualitative comparative analysis was used to find the configuration of intersection characteristics and programme components associated with a decrease in pedestrian crashes.
Total pedestrian crashes were reduced by 21% (RR 0.79; 95% CI 0.62 to 0.99) after implementation of programme. This reduction was observed for pedestrian injury crashes (RR 0.79; 95% CI 0.62 to 1.00) and for fatal crashes (RR 0.61; 95% CI 0.13 to 2.92) although not statistically significant for the latter. A decrease in pedestrian crashes was found at the most complex intersections where more of the programme components was implemented.
The programme successfully decreased total and injury pedestrian crashes. Similar interventions may improve walking safety in other LMIC cities.
墨西哥城实施了预防行人在危险路口受伤和死亡的计划，其中包括街道层面的设计改变，如可见的行人横道、拓宽人行道、安全岛、车道减少、行人信号灯以及调整这些路口的交通信号灯时间。在中低收入国家（LMICs），很少有研究评估此类干预措施对行人安全的影响。
评估该计划在减少总行人-机动车碰撞、伤害和致命行人-机动车碰撞方面的效果。
采用两组准实验设计。每月行人碰撞事故从墨西哥城公民联络中心的道路事故数据库中获取。通过使用具有随机截距的负二项式回归进行差异分析，比较干预前 12 个月和干预后 12 个月的行人碰撞情况，评估计划的有效性。使用定性比较分析来确定与行人碰撞减少相关的交叉口特征和计划组件的配置。
实施该计划后，行人碰撞总数减少了 21%（RR 0.79；95%CI 0.62 至 0.99）。这一减少在行人受伤碰撞（RR 0.79；95%CI 0.62 至 1.00）和致命碰撞（RR 0.61；95%CI 0.13 至 2.92）中都有观察到，尽管后者没有统计学意义。在实施了更多计划组件的最复杂的交叉口，行人碰撞减少。
该计划成功减少了总行人碰撞和伤害行人碰撞。类似的干预措施可能会提高其他 LMIC 城市的步行安全性。
