and Injury Outcomes
As noted in Chapter 5, the relationship between behavioral measures (such as driver yielding) and pedestrian crashes has not yet been described in the literature and may well be complex. There is no guarantee that improvements in driver yielding automatically translate into tangible reductions in pedestrian crashes. Future studies are needed to examine changes in pedestrian crash rates taking in communities participating in the Watch for Me NC program to monitor the longer-term safety impacts that can be associated with multifaceted interventions. Additionally, from Chapter 5, it is clear that there are multiple strong predictors of driver yielding (including environmental features of the roadway and crossway) and these may moderate the effect of pedestrian safety programs (such as Watch for Me NC) on pedestrian crashes as well.
Initial evidence from Durham, NC—an early Watch for Me NC adopter—based on preliminary crash data available through the Traffic Engineering Accident Analysis System (TEAAS) shows a decline in pedestrian and bicycle crash rates since 2012. From 2012 to 2014, the pedestrian crashes per 10,000 residents decreased by 5 percent, and bicycle crashes per 10,000 residents decreased by 48 percent. Similarly, Asheville, NC, a new community participating in 2015, reported that the number of pedestrian and bicycle crashes in Fall 2015 was 37 percent lower than that of the same time period in 2014 (Barb Mee, personal
communication, Dec 2015). The city’s 2015 crash figures were 20 percent lower than the previous 5-year average (2010-2014). While promising, these reported trends are in need of a more rigorous analysis, including use of appropriate comparison groups and adjustment for
Until recently, a crash-based assessment of the Watch for Me NC program was not feasible due to the small number of communities implementing the program over a long period of time. The Watch for Me NC program officially began in 2012 in only four pilot
communities—where there were not sufficient crash volumes to support a rigorous analysis— and police-reported crash data were not available beyond 2012. In 2013, the program added an additional six municipalities in the same region as the pilot communities. In 2014 and 2015, the program was made available to communities across the state and it currently has been adopted by 18 communities in 16 counties and NCDOT plans to continue expanding on a yearly basis
(Figure 6.3). Many communities have now been delivering the Watch for Me NC program for multiple years and have established partnerships in place for more effective delivery than in their initial year of involvement. Additionally, in 2016, HSRC will complete the process of crash- typing and geo-coding statewide pedestrian crash data for 2013 and 2014. These geocoded crash data will be available to researchers seeking to further evaluate the Watch for Me NC program. Finally, some of the partner communities, such as Charlotte, have their own system in place for generating geo-coded police-reported crash data in real time (or close to real time), which could be used in future research.
Given the above, the opportunity exists to conduct a study with the aim of estimating the association between the Watch for Me NC intervention and police-reported pedestrian crash incidence rate per 100,000 population. Ideally, such as study should use site-based pre-post design (using several years of crash data before and after the Watch for Me NC program was implemented), and one or more comparison groups, similar to the design of Chapter 5 study (Aim 2.3). The hypothesis is that pedestrian crash rates per capita will decrease throughout the duration of the pedestrian safety intervention, and crash rates will decrease at a faster rate in Watch for Me NC regions in comparison to non-participating communities.
Multiple comparison groups may be used to help control for any pre-existing crash trends that could mistakenly be attributed to the intervention. Potential comparison groups include: 1) all of NC, 2) urban regions comparable to current Watch for Me NC communities that are currently not participating and are in separate media markets (such as Fayetteville, Winston- Salem, and others), or 3) selected regions closely matched to the intervention regions on a variety of socio-demographic criteria. The use of multiple comparison groups is an approach taken in other studies (Zegeer et al. 2008) to accommodate the fact that there is no single community that would be comparable in all dimensions or pedestrian crash experiences to the treatment communities. Since many macro-trends (such as the economy and transportation policies occurring at the state-level) may also be affecting walking and driving rates and crash rates and may confound the intervention effects, the state is also considered an appropriate comparison group.
The study would also benefit from the use of crash data linked with ED data, as discussed in prior sections. With linked data, we could further explore changes in the nature of injuries in
accurate cost-benefit analysis, using actual injury treatment expenditures from hospital data sources.
As reported in Chapter 4, the Watch for Me NC program cost NCDOT roughly $254,000 in 2013. This included the cost of media purchases, materials, and staff time to support program administration, but did not include the cost of NCDOT personnel or the in-kind contributions of the participating communities. The total of $254,000 is a small investment in comparison to the estimated $4.6 million average economic cost of a single motor-vehicle related fatality (NSC 2015). As more communities join the program over time and additional funds are required to support program delivery across the state, program costs are expected to rise. More evidence on program impacts related to pedestrian crashes, injuries, and potential benefits of participation (such as lowered health care expenditures associated with treating pedestrian injuries) will be useful to decision-makers who must consider funding for pedestrian safety programs in relation to other initiatives. Such a study would provide an estimate of crash-based outcomes associated with the Watch for Me NC intervention that will build upon work developed in this dissertation and provide timely information to decision-makers responsible for pedestrian injury prevention programs.