One-year impact of a multicomponent, street-level design intervention in Mexico City on pedestrian crashes: a quasi-experimental study.

BACKGROUND

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.

AIM

Assess the effectiveness of the programme at reducing total, injury and fatal pedestrian-motor vehicle crashes.

METHODS

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.

RESULTS

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.

CONCLUSION

The programme successfully decreased total and injury pedestrian crashes. Similar interventions may improve walking safety in other LMIC cities.