A cluster randomized trial to improve adolescent bicycling safety

PROJECT SUMMARY
Bicycling is a leading cause of childhood injuries and, second to motor vehicles, bicycles contribute to more
childhood injuries than any other consumer product. Approaches to increasing bicycling safety among youth
include bicycle safety education programs and parents also play a vital role as influencers of their child's
bicycle handling and traffic safety skills, perceptions, and self-efficacy. Bicycle safety education programs are
abundant, but little is known about their effectiveness in terms of behavior change. This cluster randomized
controlled trial will evaluate a community-based bicycle safety education program with and without an in-
person parent training component. We will recruit 180 early adolescent bicyclists (ages 9 to 12) and a
parent/guardian from local neighborhood centers after school and summer programs, where we have
conducted preliminary studies. Randomization into the three study groups will occur at the site-level.
Adolescent bicycles in all study group sites will be equipped with Pedal Portal, an innovative bicycle-mounted
GPS/video system developed by our research team to objectively observe bicycling risk exposure and
behaviors while bicycling. System data will be coded to measure bicycling exposure (hours, miles traveled,
routes) and the types and rates of safety-relevant events (near crashes, crashes), and safety-relevant
behaviors (e.g., following traffic rules, scanning for traffic at intersections). This will be the first randomized trial
to use GPS and video technology to evaluate the effectiveness of a youth bicycle safety intervention in
changing behavior. The control group will not receive any bicycle safety education programming. Participants
in the first intervention group (Bike Club) will receive a 12-hour bicycle safety education program. Participants
in the second intervention group (Bike Club Plus) will receive an enhanced version of the 12-hour bicycle
safety education program which will include a parent training session on bicycling safety best practices, child
development as it relates to bicycling, strategies for practice at home, and feedback on their adolescent's
bicycling performance. Our main hypotheses are that adolescents who receive the bicycle safety intervention
will have increased safety behaviors (e.g., helmet use, hazard recognition), reduced errors (e.g., riding against
traffic, swerving/wobbling), and increased knowledge, perceptions, and self-efficacy compared to the control
group; and adolescents whose parent receives the parent training will have even greater improvements in
study outcomes than those whose parents do not receive the training. If successful, approaches from this
study could be widely implemented to improve adolescent bicycling safety.