Tello Kathleen Trejo, Hughey Sarah M, Porto Sarah C, Hart Molly, Benson Anna
College of Charleston, School of Education, Health, and Human Performance, Department of Health and Human Performance, Charleston, South Carolina, United States.
J Healthy Eat Act Living. 2022 Aug 25;2(2):45-59. eCollection 2022.
Road user fatalities account for a leading cause of preventable death in Latin America with pedestrians and bicyclists at higher risk for more extensive injuries as compared to other road users. Despite these vulnerable road user (VRU) risks, encouraging individuals to walk and cycle is an important public health strategy for addressing the region's obesity epidemic through promoting physical activity via active transportation (AT). However, in order to promote AT as a viable source of physical activity, safety of the VRU must be considered. The purpose of this systematic review and metasummary is to describe the effectiveness of interventions that have been implemented in Latin America to improve pedestrian and bicyclist safety. A systematic search of public health, policy, and engineering databases was completed using terms generated through the PICO method. The PRISMA framework was used for article screening. Eight articles detailing nine interventions across four countries were included for final synthesis and organized according to the Three E's Model of Injury Prevention, including three education-based interventions, two engineering, three enforcements, and one utilizing all Three E's. VRU outcomes assessed ranged from attitudes and behaviors to fatal injuries, with only enforcement-based interventions reporting on the latter. No interventions reported on non-fatal injury outcomes. Interventions rooted in each arm of the Three E's demonstrated limited ability to improve VRU outcomes, with enforcement-based interventions providing the strongest body of evidence. Findings demonstrate the limited research on VRU safety in Latin America, and further efforts should be of urgent public health priority.
在拉丁美洲，道路使用者死亡是可预防死亡的主要原因之一，与其他道路使用者相比，行人和骑自行车的人遭受更广泛伤害的风险更高。尽管存在这些弱势道路使用者（VRU）风险，但鼓励人们步行和骑自行车是一项重要的公共卫生策略，通过主动交通（AT）促进身体活动来应对该地区的肥胖流行问题。然而，为了将主动交通作为一种可行的身体活动来源加以推广，必须考虑弱势道路使用者的安全。本系统评价和元总结的目的是描述拉丁美洲为提高行人和骑自行车者安全而实施的干预措施的有效性。使用通过PICO方法生成的术语对公共卫生、政策和工程数据库进行了系统检索。采用PRISMA框架进行文章筛选。纳入了八篇详细介绍四个国家九项干预措施的文章进行最终综合分析，并根据伤害预防的“3E”模型进行组织，其中包括三项基于教育的干预措施、两项工程干预措施、三项执法干预措施以及一项综合运用所有“3E”的干预措施。评估的弱势道路使用者结果范围从态度和行为到致命伤害，只有基于执法的干预措施报告了后者。没有干预措施报告非致命伤害结果。源于“3E”各方面的干预措施在改善弱势道路使用者结果方面的能力有限，基于执法的干预措施提供了最有力的证据。研究结果表明拉丁美洲对弱势道路使用者安全的研究有限，进一步的努力应成为紧迫的公共卫生优先事项。
