Review of Walk-With-Care: An education and advocacy program for older pedestrians
Monash University Accident Research Centre - Report #109 - 1997
Authors: S. Kent & B. Fildes
Full report in .pdf format [560KB]
Walk-With-Care is a VicRoads initiative developed between 1990-92 to identify and reduce the dangers to older pedestrians through a combination of educational and engineering countermeasures. The program has relied on strong local government involvement and targeted municipalities with a high incidence of older pedestrian accidents. It was timely to review the administrative structure and the content and format of the educational sessions, given recent changes within the authority and local government. The review process comprised the examination of the available literature on older pedestrian safety, attendance at one of the educational sessions and extensive discussions with Walk-With-Care administrators, experts in the field of disability studies, and a road safety educational consultant. The review highlighted a number of problems with the way the program is currently staffed and implemented and barriers to achieving the objectives of the educational sessions. It also identified new messages for inclusion in the program and simpler and more effective ways to convey the existing ones. Recommendations include changes in staffing, implementation, promotion, resources, messages, format and evaluation. The basic thrusts of the changes proposed will ensure that the program reflects current road crash statistics and research, that the issue of older pedestrian safety is raised to a higher level in the community consciousness, and that the program is implemented with maximum efficiency, accountability and quality control.
Crash statistics indicate that people aged 60 years and over are over-represented in fatal and serious injury pedestrian accidents per head of population compared to younger adults. Their increased risk stems from a number of factors, such as declines in their vision, hearing, mobility and cognitive functioning. Behavioural factors, too, seem to play a part in their crashes, especially while crossing the roadway.
A program to counteract the over-involvement of older people in pedestrian accidents was first introduced in 1991 by VicRoads. The program, Walk-With-Care, aims to identify and reduce dangers to older people through a combination of promotional, educational and engineering countermeasures. The program has involved strong local government participation and has typically been run in municipalities with a high incidence of older pedestrian accidents. The key features of the program are a public awareness campaign, interactive sessions among small groups of the elderly community involving discussion of local pedestrian issues, and engineering improvements to local problem sites.
PROJECT OBJECTIVES AND TASKS
No formal full evaluation of the Walk-With-Care program has been conducted since its inception. In addition, many of the messages contained in the program need to be updated in the light of more recent knowledge and infrastructure changes. The aim of the current study, therefore, was to review the structure, content and format of the program and to develop a set of recommendations for change.
The review incorporated three main tasks. First, a review was undertaken of Australian and overseas literature on older pedestrians as a basis for reviewing the existing messages of the program and for suggesting new messages. Second, the various components of the program were reviewed involving discussions with relevant implementation personnel, a small evaluation of a single Walk-With-Care discussion session, a series of meetings with a panel of specialists in education and ageing, and consultations with a Road Safety Educational Consultant. Written reports pertaining to the program were also gathered and reviewed. The final task was to incorporate the information from all the above sources into a final report with recommendations for changes and suggestions for future evaluation of the program.
REVIEW OF STRUCTURE AND PROCESS
This component of the review examined the administrative structure and process for implementing the Walk-With-Care program within Victoria. The main issues identified related to restructuring, staffing, and evaluation.
A number of infrastructure changes within VicRoads and local government have all impacted on the Walk-With-Care process. These include administration restructuring, compulsory competitive tendering and the trend toward outsourcing so that it no longer dovetails neatly with the current modes of operation. These changes have also reduced the time and resources available to implement Walk-With-Care.
Other problems were identified such as the changing role of the program leader, a council employee responsible for guiding and monitoring implementation of the program at the local level, and the discussion group leader (a volunteer older person drawn from the local community). Program leaders today invariably have other tasks within council with less time and resources to devote to promoting or implementing the Walk-With-Care program as intended. Problems with the discussion group leaders related to reliability, commitment and group presentation skills. It was evident that recruiting, training and maintaining the enthusiasm of older people to act as group leaders was hampered by health problems, frequent vacations and the voluntary nature of the work.
The review also highlighted the lack of a formalised mechanism for ongoing evaluation of personnel, process and outcomes resulting in sparse or incomplete records of activities, and educational discussion sessions of mixed quality.
Recommendations arising from this component of the review included:
- retaining strong links with local government as the key vehicle for program implementation to ensure that local issues of concern are identified and addressed;
- maintaining the existing program phases, namely Planning, Education and Advocacy;
- outsourcing the roles of Program Leader and Discussion Group Leaders as contract positions to ensure higher levels of commitment, knowledge and technical expertise (it was recommended that Discussion Group Leaders still be sourced from the older age category);
- instituting regionally based Management Facilitators at VicRoads to assess problem areas, identify a need for the program, and monitor its implementation via liaison with the Program Leader;
- instituting thorough, professional training and routine evaluation of all contract staff,
- setting up a mechanism for future evaluation of behavioural outcomes once the revised program is in place and operating smoothly;
- developing a more extensive and structured promotional campaign with the aim of raising the general level of community consciousness of pedestrian safety issues pertaining to the elderly and generating greater interest and demand for the educational group discussion sessions among the elderly community.
REVIEW OF CONTENT
The content of the Walk-With-Care program was reviewed using the most recent research on ageing and pedestrian behaviour to determine if the messages were still appropriate and relevant. This included an examination of the wording and format of the messages to ensure they are communicated effectively to the target audience.
The material examined identified a need to provide a greater focus on strategies for crossing the road in complex situations (e.g., undivided roads and roundabouts); strategies for anticipating unexpected events; and knowledge of confusing road situations (e.g., light cycles, traffic management devices).
The way that messages are presented also needs to be sensitive to a number of relevant issues for older people. These include avoiding trite, obvious or offensive messages and stereotypes of the elderly; stressing the benefits of pedestrian mobility for health and independence while downplaying the emphasis on ageing and crash involvement; couching messages and rationales in positive terms; avoiding jargon or overly technical terms, and providing explanatory diagrams wherever possible.
A basic framework for the messages of the Walk-With-Care program was proposed which included:
- presenting "The Facts" (simple up-to-date crash statistics presented in a non-threatening way);
- how to make road crossing easier & safer;
- reducing time on the road;
- making pedestrians more visible (day and night);
- anticipating unexpected events; and
- understanding right-of-way at confusing traffic situations.
Important messages within each of the above categories were identified along with a subset of key messages for use in annotated promotional material such as brochures or posters (these are detailed in Table 4.1 and Appendix 3).
It was also apparent that the educational video, used in the discussion sessions to reinforce the key messages was a little outdated, especially in terms of its style and content. A revised version would allow for the inclusion of current messages and presentation techniques. Market testing would be required to help determine its acceptance and impact among the older community.
REVIEW OF FORMAT
This component of the review examined the format of the educational group discussion sessions to determine if they are an effective vehicle for conveying the messages of the program. The format of the program's promotional campaign was also included in this stage in order to determine its effectiveness in raising awareness and as a means of recruitment for the discussion sessions.
Main problems identified with the current discussion group format included large group sizes (up to 50 in some instances); the lack of appropriate group presentation and facilitation skills on the part of the Discussion Group Leaders; too much information dissemination and not enough interactive discussion or role plays; or lack of features which adequately capture the interest or imagination of the older audience.
Interactive Workshops. Findings embraced the concept of interactive workshops involving small groups of between 10 and 12 people as prescribed in the existing guidelines, and suggested ways of achieving this in practice, for example:
- preface the interactive small group component with a brief information session designed to act as a stimulus for discussion (this session could be conducted with a larger group if necessary and could incorporate a slide presentation and the video screening);
- schedule the interactive discussion session in small groups immediately after the information session (with multiple facilitators) or as a follow-up activity at a later date (single facilitator);
- use professional presenters, trained in group dynamics and with an adequate knowledge of road safety issues, to facilitate the information and interactive sessions.
Other suggestions were made to enhance the effectiveness of the interactive session in exploring relevant issues, such as increased use of role plays or demonstrations in simulated environments to convey key issues such as speed/distance judgements or walking speed; an interactive format which is flexible enough to allow group members to raise relevant issues and share personal experiences; and follow-on group activities such as route trialing and local pedestrian safety audits to enthuse and empower group participants and to identify issues for the advocacy phase.
Promotional Support. The review of the format of the current promotional campaign highlighted the need for methods which are more effective at raising the general level of public awareness of the issues and at generating demand and interest for the workshop sessions among the elderly community. Suggested modifications to the format of the promotional campaign included:
- extension of the media campaign to include mass media widely utilised by the elderly (e.g., daily newspapers, women's magazines, and lifestyle-centred television programs);
- targeting the elderly community through direct means like rates notices or in-situ at places such as shopping centres or churches;
- targeting the elderly indirectly through fwnily or carers who are influential in directing health-related attitudes or behaviours;
- utilising the police to endorse the program and its messages through community consultation committees or safe living programs such as Confident Living or Neighbourhood Watch.
A revision of the current Walk-With-Care program would seem warranted given the findings of this review. While the review concluded that the workshop approach generally is still a relevant and suitable medium for delivering the program, a number of critical format, content and presentation changes have been highlighted for inclusion in the revised program. In addition, the infrastructure for delivery of the program, too, needs to be revised in line with current VicRoads and local government methods of operation.
Three recommendations for additional research and/or development were identified during the review and these are listed below.
1. The current Walk-With-Care video, "Gabby Gets It Right" is now seven years old and would benefit from being upgraded. In developing a new version, market research is required to determine its acceptance and impact among the older community.
2. The proposed interactive workshop needs to be trialed to demonstrate its likely effectiveness and any associated problems or difficulties with its format or presentation style.
3. A full evaluation be undertaken of any revised Walk-With-Care program to ensure that it meets the needs of the program participants, is optimal in terms of getting critical messages across and, to the degree that is possible, maximise its road safety benefits.
Sponsoring Organisation: Baseline Research Program - Department of Justice, Transport Accident Commission, Royal Automobile Club of Victoria (RACV) Ltd, VicRoads