PT  - JOURNAL ARTICLE
AU  - Cárdenas-Cárdenas, Luz Mery
AU  - Barrientos Gutiérrez, Tonatiuh
AU  - Quistberg, D Alex
AU  - Chias-Becerril, Luis
AU  - Martínez-Santiago, Armando
AU  - Reséndiz Lopez, Héctor
AU  - Perez Ferrer, Carolina
TI  - One-year impact of a multicomponent, street-level design intervention in Mexico City on pedestrian crashes: a quasi-experimental study
AID  - 10.1136/jech-2022-219335
DP  - 2022 Dec 19
TA  - Journal of Epidemiology and Community Health
PG  - jech-2022-219335
4099  - http://jech.bmj.com/content/early/2022/12/18/jech-2022-219335.short
4100  - http://jech.bmj.com/content/early/2022/12/18/jech-2022-219335.full
AB  - Background Mexico City implemented the Pasos Seguros 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 Pasos Seguros 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 Pasos Seguros 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 Pasos Seguros programme successfully decreased total and injury pedestrian crashes. Similar interventions may improve walking safety in other LMIC cities.Data are available in a public, open access repository. Data are available upon reasonable request. [dataset] [19] Instituto Nacional de Estadística y Geografía. Censo de Población y Vivienda 2010 [Internet]. INEGI. INEGI; 2016 [cited 2022 September 26]. Available from: https://www.inegi.org.mx/programas/ccpv/2010/%23Datos_abiertosdataset] [20] Instituto Nacional de Estadística y Geografía. Directorio Estadístico Nacional de Unidades Económicas [Internet]. [cited 2022 September 26]. Available from: https://www.inegi.org.mx/app/descarga/?ti=6[dataset] [21] Gobierno de la Ciudad de México. Ubicación de líneas y estaciones del Sistema de Transporte Colectivo Metro [Internet]. [cited 2022 September 26]. Available from: https://datos.cdmx.gob.mx/dataset/lineas-y-estaciones-del-metro[dataset] [22] Gobierno del Estado de México. Incidentes viales reportados por C5 [Internet]. [cited 2020 March 30]. Available from: https://datos.cdmx.gob.mx/explore/dataset/incidentes-viales-c5/table/?disjunctive.incidente_c4The location and characteristics of the intersections can be requested from the authors.