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BACKGROUND: Traffic-related crashes are a leading cause of premature death and disability. The safe systems approach is an evidence-informed set of innovations to reduce traffic-related injuries and deaths. First developed in Sweden, global health actors are adapting the model to improve road safety in low- and middle-income countries via technical assistance (TA) programs; however, there is little evidence on road safety TA across contexts. This study investigated how, why, and under what conditions technical assistance influenced evidence-informed road safety in Accra (Ghana), Bogotá (Colombia), and Mumbai (India), using a case study of the Bloomberg Philanthropies Initiative for Global Road Safety (BIGRS). METHODS: We conducted a realist evaluation with a multiple case study design to construct a program theory. Key informant interviews were conducted with 68 government officials, program staff, and other stakeholders. Documents were utilized to trace the evolution of the program. We used a retroductive analysis approach, drawing on the diffusion of innovation theory and guided by the context-mechanism-outcome approach to realist evaluation. RESULTS: TA can improve road safety capabilities and increase the uptake of evidence-informed interventions. Hands-on capacity building tailored to specific implementation needs improved implementers' understanding of new approaches. BIGRS generated novel, city-specific analytics that shifted the focus toward vulnerable road users. BIGRS and city officials launched pilots that brought evidence-informed approaches. This built confidence by demonstrating successful implementation and allowing government officials to gauge public perception. But pilots had to scale within existing city and national contexts. City champions, governance structures, existing political prioritization, and socio-cultural norms influenced scale-up. CONCLUSION: The program theory emphasizes the interaction of trust, credibility, champions and their authority, governance structures, political prioritization, and the implement-ability of international evidence in creating the conditions for road safety change. BIGRS continues to be a vehicle for improving road safety at scale and developing coalitions that assist governments in fulfilling their role as stewards of population well-being. Our findings improve understanding of the complex role of TA in translating evidence-informed interventions to country-level implementation and emphasize the importance of context-sensitive TA to increase impact.

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OBJECTIVE: Excessive speed is a major risk factor for serious injuries and death. However, speeding remains a pervasive problem around the world. This study aimed to investigate the factors associated with speeding behavior in the city of Buenos Aires, Argentina. METHODS: A sample of vehicles (n = 34,967) from ten locations in the city was observed in two waves during 2021. Measurements were made at different times and days of the week. Observation sites were free of intersections, traffic lights, speed bumps and cameras, allowing drivers to speed freely. Data on speed, drivers and vehicle types were collected. Factors associated with speeding were identified through logistic regression analyses. RESULTS: 15.3% of vehicles were observed to be speeding. Roads with posted speed limits of 40 km/h showed higher speeding compared to 60 km/h roads. 77% of vehicles traveled above 30 km/h on local roads, and 30% above 50 km/h on avenues. Motorcycles, both commercial and private, showed a higher percentage of speeding compared to all other vehicles. Speeding was lower among women, among adults over 60 years of age, and among those using cell phones. CONCLUSION: It is crucial to strengthen strategies for increased compliance with speed limits. Actions targeting motorcyclists must be a priority.

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Speed limits are an evidence-based intervention to prevent traffic collisions and deaths, yet their impact on air pollution in cities is understudied. The objective of this study was to investigate the association between lower speed limits and air pollution. We leverage the introduction of a new road safety policy in Mexico City in December 2015 which lowered speed limits, increased fines, and installed speed radars to enforce compliance. We tested whether the policy had an impact on particulate matter (PM2.5) and nitrogen dioxide (NO2) at the city level, and whether air-quality monitoring stations' proximity to speed radars moderated this effect due to more acceleration and deceleration around radars. NO2 and PM2.5 concentrations from January 2014 to December 2018 were obtained from the National System of Air Quality Information. Air-quality monitoring stations were classified as in close-proximity or far-from-speed radars. Interrupted time series analyses were conducted for each outcome separately, using linear mixed models and adjusting for seasonality and time-varying confounders: registered vehicles, temperature, wind-speed and relative humidity. The results suggest improvement in both contaminants after the speed limits policy. For NO2, the pre-policy trend was flat, while the post-policy trend showed a decline in concentrations of 0.04 ppb/week. For PM2.5, concentrations were increasing pre-policy by 0.08 µg/m3 per week, then this trend flattened in the post-policy period to a weekly, non-significant, increase of 0.03 µg/m3 (p = 0.08). Air-quality monitors' proximity to speed radars did not moderate the effect of the policy on either of the pollutants. In conclusion, the speed limits policy implemented in Mexico City in 2015 was associated with improvements in air pollution.

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The media plays a key role in shaping the public's perception of road safety. This study analyzes the newspaper coverage and framing of motor vehicle crashes (MVCs) and road safety in Argentina, South America. The content of 304 articles published by 15 newspapers in November 2020 was reviewed. The results show that episodically framed news stories (focused on a single event or incident) prevail over thematically framed articles. MVCs are presented primarily as 'police' events and tend to receive more coverage when fatalities are involved. There is limited information provided on contextual and risk factors, and road safety advice is rarely included. Speeding, infrastructure, alcohol and other human-related variables are the most cited risk factors. Very few articles mention the use of protective devices (seat-belt, helmet and child restraint system). Although motorcyclists represent 40% of RTC deaths in Argentina, only 20% of the news coverage was about them. News coverage was quite similar in national and regional newspapers. There is an opportunity for the media to help build a better road safety culture, but significant changes in news framing are required. Practical recommendations for editors, journalists and road safety practitioners are provided.

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INTRODUCTION: The global motorcycle market has grown significantly, with over 770 million vehicles estimated to be in use worldwide. Motorcycle-related road traffic deaths in low and middle-income countries (LMICs) like Colombia are concerning, comprising 30% of all reported fatalities. Cartagena has an average of 70 motorcycle-related deaths annually between 2019 and 2022, making it a high-risk area for motorcyclists. OBJECTIVE: The study aimed to identify factors associated with motorcyclist safety at unsignalized three-legged and four-legged intersections in Cartagena by observing the behavior of the motorcyclists and the analysis of the potential traffic conflicts. The observational analysis focused on the access of motorcyclists from a secondary road to a main road since it is the behavior offered by the most significant road interaction and the potential risk of traffic conflicts due to crossing. METHODS: The observational process was consolidated at ten three-legged intersections and seven four-legged intersections. Thirty-six hours of videos were collected considering different time slots and weekdays randomly distributed during September 2019 and March 2020. The selection of the intersections included different vehicular flows and road safety conditions. The variables considered in the study were: interaction with other road users, motorcyclist behavior, vehicle handling, potential distractors, and safety elements. The study used the Swedish Traffic Conflict Technique to analyze conflict analysis, incorporating the Post Encroachment Time (PET) measurement. The analysis was developed with descriptive and inferential statistical techniques. The collected variables were analyzed individually (frequency analysis), and contrasts were conducted with the PET values. The study evaluated associations between motorcycles and other motorized road actors at intersections about behaviors and crossroads. RESULTS: In the Records, 10,281 motorcycle accesses at three and four-Legged Intersections were interactions with other road users, where 2417 and 1903 resulted in potential traffic conflicts, respectively. Average potential conflicts per hour were 115 and 127 at three and four-legged intersections. At the two intersections, the average PET values in motorcycles were between 2.09 and 2.10 s, while in the other motorized road users, it averaged around 2.67 to 2.71 s. In the road conditions, it was identified that intersections with a traffic flow of<10,000 vehicles/day and poor visibility to the left of the intersection lead to more unsafe conditions for motorcyclists. Motorcycle taxi drivers were the user group most frequently involved in traffic conflicts. Actions on the part of motorcyclists, such as risky behaviors, not using helmets, not using turn signals, and not waiting patiently for access, showed a relationship with the potential for traffic conflicts. Finally, turns to the left, particularly the indirect turn to the left on the opposite road, showed a greater risk of traffic conflicts. CONCLUSIONS: The study found that motorcycles exhibit more severe traffic conflicts than motorized vehicles at intersections. Infrastructure conditions significantly impact the risk of intersection conflicts. Individual behaviors such as not stopping at intersections and driving recklessly increased the risk of traffic conflicts. The study recommends improving infrastructure such as visibility and signaling and implementing separators to reduce travel speed and traffic conflicts for motorcycles.

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OBJECTIVE: In this study, we aim to identify social typologies of pedestrian crashes considering demographics, health impacts, involved vehicle, temporality of the collision, and place of impact in Hermosillo, Mexico. METHODS: A socio-spatial analysis was performed by using local urban planning information and vehicles-pedestrian crashes records collected by the police department (N = 950) between 2014 and 2017. Multiple Correspondence Analysis and Hierarchical Cluster Analysis were used to determine typologies. Geographical distribution of typologies was obtained with spatial analysis techniques. RESULTS: The results suggest there are four typologies, which portray the physical vulnerability of pedestrians, which reflect the vulnerability to collisions associated to the variables age, gender, and street speed limits. Findings show that children are more likely to be injured during weekends in residential zones (Typology 1), while older females are more likely to be injured during the first three days of the week (Monday - Wednesday) in the downtown area (Typology 2). Injured males during the afternoon in arterial streets represented the most frequent cluster (Typology 3). Also, males were likely to be severely injured by heavy trucks during nighttime in peri-urban areas (Typology 4). These findings indicate that vulnerability and risk exposure vary according to the type of pedestrian involved in the crash, which are linked to the types of places they visit. CONCLUSIONS: The design of the built environment plays a major role in the number of pedestrian injuries particularly when it favors motor vehicles over pedestrians or non-motorized vehicles. Because traffic crashes are considered preventable events, cities must embrace a diversity of mobility modes and incorporate the appropriate infrastructures that safeguard the lives of all their travelers, especially pedestrians.

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Objective: To identify the temporal trend in mortality and years of life lost to death or disability (DALY) due to motorcycle accidents in males from Latin America and the Caribbean from 2010 to 2019, using estimates produced by the Global Burden of Disease (GBD) study. Method: In this ecological study, the time series was analyzed using a piecewise linear regression model (joinpoint) to estimate and test the annual percent change and the average annual percent change with a 95% confidence interval. Results: The super-region defined by GBD 2019 as Latin America and the Caribbean ranked first globally in mortality and DALY for male motorcyclists aged 15-49 in 2019. Rates increased significantly from 2010 to 2013, with a significant reduction in both after this period. During the analyzed decade, the Tropical Latin America sub-region (Brazil and Paraguay) had the highest mortality and DALY rates in the population of interest; nevertheless, this was the only sub-region achieving a significant reduction in these rates. The Caribbean sub-region (Bermuda, Dominica, Suriname, Guyana, Belize, Bahamas, Puerto Rico, Saint Lucia, Dominican Republic, Haiti, Saint Kitts and Nevis, U.S. Virgin Islands, Grenada, Trinidad and Tobago, Barbados, Saint Vincent and the Grenadines, Antigua and Barbuda, Cuba e Jamaica) showed a significant increase in both rates over the same period, while Andean Latin America (Ecuador, Bolivia and Peru) and Central Latin America (Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Honduras, and Venezuela) remained stable. Conclusions: The data underscore the importance of developing surveillance actions aimed at preventing motorcycle accidents, since the observed declining rates are still insufficient to address the morbidity and mortality associated with road accidents as a public health problem.

Objetivo: Determinar la tendencia temporal de la mortalidad y los años de vida perdidos por muerte o ajustados por discapacidad (AVAD) de hombres por accidentes de motocicleta en América Latina y el Caribe en el período 2010-2019, a partir de las estimaciones del estudio de la carga mundial de enfermedades (CME). Métodos: En este estudio ecológico se analizaron las series temporales mediante el modelo de regresión lineal segmentada (joinpoint), con cálculo y comprobación del cambio porcentual anual y del cambio porcentual anual promedio, con un intervalo de confianza del 95%. Resultados: La región de América Latina y el Caribe definida por el estudio de la CME ocupó el primer lugar a nivel mundial en mortalidad y AVAD de motociclistas varones de 15 a 49 años en el 2019. Las tasas tuvieron un notable aumento del 2010 al 2013, y ambas registraron una reducción importante después de ese período. En la década analizada, la subregión de América Latina Tropical (Brasil y Paraguay) presentó las mayores tasas de mortalidad y de AVAD en la población de estudio, pero fue la única con una reducción importante de las mismas. La subregión del Caribe (Antigua y Barbuda, Bahamas, Barbados, Belice, Bermudas, Cuba, Dominica, Granada, Guyana, Haití, Islas Vírgenes de Estados Unidos, Jamaica, Puerto Rico, República Dominicana, Saint Kits y Nevis, San Vicente y las Granadinas, Santa Lucía, Suriname, y Trinidad y Tabago) mostró un aumento importante de ambas tasas, mientras que América Latina Andina (Bolivia, Ecuador y Perú) y América Latina Central (Colombia, Costa Rica, El Salvador, Guatemala, Honduras, México, Nicaragua, Panamá y Venezuela) se mantuvieron estables. Conclusiones: Los datos refuerzan la importancia de las actividades de vigilancia destinadas a prevenir los accidentes de motocicleta, puesto que la reducción observada de las tasas aún es insuficiente para abordar la morbimortalidad por accidentes de tráfico como problema de salud pública.

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RESUMO Objetivo. Identificar a tendência temporal da mortalidade e dos anos de vida perdidos por morte ou incapacidade (DALY) de homens por acidente motociclístico na América Latina e Caribe no período de 2010 a 2019, utilizando estimativas do estudo Global Burden of Disease (GBD). Métodos. Este estudo ecológico analisou a série temporal pelo modelo de regressão linear segmentada (joinpoint), estimando-se e testando-se a variação percentual anual e a variação percentual anual média, com intervalo de confiança de 95%. Resultados. A grande região da América Latina e Caribe definida pelo GBD ocupou o primeiro lugar global em mortalidade e DALY de motociclistas homens de 15 a 49 anos em 2019. As taxas aumentaram significativamente de 2010 a 2013, havendo redução significativa de ambas após esse período. Durante a década analisada, a sub-região da América Latina Tropical (Brasil e Paraguai) apresentou as maiores taxas de mortalidade e DALY na população em estudo, porém foi a única com redução significativa das mesmas; a sub-região do Caribe (Bermudas, Dominica, Suriname, Guiana, Belize, Bahamas, Porto Rico, Santa Lúcia, República Dominicana, Haiti, São Cristóvão e Névis, Ilhas Virgens/EUA, Granada, Trinidad e Tobago, Barbados, São Vicente e Granadinas, Antígua e Barbuda, Cuba e Jamaica) apresentou aumento significativo de ambas as taxas, enquanto América Latina Andina (Equador, Bolívia e Peru) e América Latina Central (Colômbia, Costa Rica, El Salvador, Guatemala, México, Nicarágua, Panamá, Honduras e Venezuela) permaneceram estáveis. Conclusões. Os dados reforçam a importância das ações de vigilância destinadas à prevenção de acidentes motociclísticos, uma vez que os resultados de queda nas taxas ainda são insuficientes frente à morbimortalidade no trânsito como problema de saúde pública.

ABSTRACT Objective. To identify the temporal trend in mortality and years of life lost to death or disability (DALY) due to motorcycle accidents in males from Latin America and the Caribbean from 2010 to 2019, using estimates produced by the Global Burden of Disease (GBD) study. Method. In this ecological study, the time series was analyzed using a piecewise linear regression model (joinpoint) to estimate and test the annual percent change and the average annual percent change with a 95% confidence interval. Results. The super-region defined by GBD 2019 as Latin America and the Caribbean ranked first globally in mortality and DALY for male motorcyclists aged 15-49 in 2019. Rates increased significantly from 2010 to 2013, with a significant reduction in both after this period. During the analyzed decade, the Tropical Latin America sub-region (Brazil and Paraguay) had the highest mortality and DALY rates in the population of interest; nevertheless, this was the only sub-region achieving a significant reduction in these rates. The Caribbean sub-region (Bermuda, Dominica, Suriname, Guyana, Belize, Bahamas, Puerto Rico, Saint Lucia, Dominican Republic, Haiti, Saint Kitts and Nevis, U.S. Virgin Islands, Grenada, Trinidad and Tobago, Barbados, Saint Vincent and the Grenadines, Antigua and Barbuda, Cuba e Jamaica) showed a significant increase in both rates over the same period, while Andean Latin America (Ecuador, Bolivia and Peru) and Central Latin America (Colombia, Costa Rica, El Salvador, Guatemala, Mexico, Nicaragua, Panama, Honduras, and Venezuela) remained stable. Conclusions. The data underscore the importance of developing surveillance actions aimed at preventing motorcycle accidents, since the observed declining rates are still insufficient to address the morbidity and mortality associated with road accidents as a public health problem.

RESUMEN Objetivo. Determinar la tendencia temporal de la mortalidad y los años de vida perdidos por muerte o ajustados por discapacidad (AVAD) de hombres por accidentes de motocicleta en América Latina y el Caribe en el período 2010-2019, a partir de las estimaciones del estudio de la carga mundial de enfermedades (CME). Métodos. En este estudio ecológico se analizaron las series temporales mediante el modelo de regresión lineal segmentada (joinpoint), con cálculo y comprobación del cambio porcentual anual y del cambio porcentual anual promedio, con un intervalo de confianza del 95%. Resultados. La región de América Latina y el Caribe definida por el estudio de la CME ocupó el primer lugar a nivel mundial en mortalidad y AVAD de motociclistas varones de 15 a 49 años en el 2019. Las tasas tuvieron un notable aumento del 2010 al 2013, y ambas registraron una reducción importante después de ese período. En la década analizada, la subregión de América Latina Tropical (Brasil y Paraguay) presentó las mayores tasas de mortalidad y de AVAD en la población de estudio, pero fue la única con una reducción importante de las mismas. La subregión del Caribe (Antigua y Barbuda, Bahamas, Barbados, Belice, Bermudas, Cuba, Dominica, Granada, Guyana, Haití, Islas Vírgenes de Estados Unidos, Jamaica, Puerto Rico, República Dominicana, Saint Kits y Nevis, San Vicente y las Granadinas, Santa Lucía, Suriname, y Trinidad y Tabago) mostró un aumento importante de ambas tasas, mientras que América Latina Andina (Bolivia, Ecuador y Perú) y América Latina Central (Colombia, Costa Rica, El Salvador, Guatemala, Honduras, México, Nicaragua, Panamá y Venezuela) se mantuvieron estables. Conclusiones. Los datos refuerzan la importancia de las actividades de vigilancia destinadas a prevenir los accidentes de motocicleta, puesto que la reducción observada de las tasas aún es insuficiente para abordar la morbimortalidad por accidentes de tráfico como problema de salud pública.

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Introducción: En Colombia mueren anualmente alrededor de 7000 personas por accidentes de tránsito y otras resultan gravemente heridas, con más de 30 000 lesionados en 2018. Estas cifras reflejan un problema de salud pública, lo que hace necesario generar un proceso de concienciación para lograr un cambio de actitud en todos los actores viales, así como incrementar el conocimiento de las personas respecto a la movilización y las señales de tránsito. Objetivo: Determinar el impacto de un programa educativo en conocimiento vial en la adopción de actitudes seguras hacia el tránsito y la movilidad en escolares de 11 a 14 años de Barranquilla, Colombia. Materiales y métodos: La investigación está estructurada en un diseño de preprueba, posprueba con grupo de comparación con mediciones a través de dos escalas: una escala de actitudes de los estudiantes en relación con la seguridad vial y un segundo instrumento que evalúa conocimientos respecto a las normas de tránsito y la movilidad. Resultados: Se encontró que existen diferencias significativas entre los niños que tuvieron la experiencia educativa en relación con las normas y señales de tránsito. Conclusiones: La educación vial se muestra como una estrategia positiva en la formación de actitudes seguras en relación con la normativa de tránsito y movilidad.

Introduction: In Colombia, 7,000 people, in average, die every year from traffic accidents and others are seriously injured, with more than 30,000 injured in 2018. These figures reflect a public health problem, which makes it necessary to generate an awareness process to achieve change in attitude in all road actors, as well as increasing people's knowledge regarding mobilization and traffic signs. Objective: To determine the impact of an educational program on road knowledge in the adoption of safe attitudes towards traffic and mobility in schoolchildren aged 11 to 14 years from Barranquilla, Colombia. Materials and methods: This research is structured in a pre-test and post-test design with a comparison group with measurements through two scales: a scale of students' attitudes in relation to road safety, and a second instrument that assesses knowledge regarding traffic regulations and mobility. Results: It was found that there are significant differences between the children who had the educational experience in relation to traffic rules and signs. Conclusions: Road safety education is shown as a positive strategy in the formation of safe attitudes in relation to traffic and mobility regulations.

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Road traffic accidents result in injury or even death of passengers. One potential cause of these accidents is mechanical failures due to a lack of vehicle maintenance. In the quest to identify these mechanical failures, this paper aims to set up the procedure to identify the mechanical failures that contribute to traffic accidents in cities located in developing countries, including the city of Cuenca-Ecuador. For present research, a database provided by the entity responsible for the Vehicle Technical Inspection, the Empresa Pública Municipal de Movilidad, Tránsito y Transporte and for the ones responsible of managing traffic accident data, Oficina de Investigación de Accidentes de Tránsito and Sección de Investigación de Accidentes de Tránsito was used. The vehicle subcategories M1 and M3 (bus type) and N1, so named according to Ecuadorian technical standards, were considered the most relevant regarding accident rates. The database was analysed with descriptive statistics, a Pareto chart and time series with the quadratic trend. From this analysis, the most significant failures found in the VTI in all three subcategories were the alignment of the driver headlight, both horizontal and vertical, braking imbalance on the 2nd axle, insufficient tire tread and parking brake effectiveness. All these failures showed a decreasing trend over time and in the forecast at a maximum of two to three years. The most relevant causes of road accidents recorded during the period 2009-2018 related to mechanical failures were the braking system (65.5%) and the steering system (17.2%) for subcategory M1.

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