| Evidence-based pedestrian safety programs are needed to combat rising pedestrian fatality incidence in the US. Research is lacking on the nature of pedestrian injury data sources and intervention development, delivery, and effectiveness. The dissertation aims were to: 1) evaluate how available data sources capture pedestrian injury and how determinants of pedestrian injuries differ across sources, 2) describe the Watch for Me NC intervention---a multifaceted pedestrian safety program involving public engagement, law enforcement, and engineering---and assess program delivery to identify implementation successes and challenges, and 3) estimate enforcement/engineering component effects on driver yielding. We used statewide North Carolina data sources (police reports, hospital emergency department visits, and death certificates) to analyze temporal and demographic pedestrian injury distributions. Comparison of injury data sources showed similar pedestrian injury distributions in relation to sex and temporal factors. Emergency data captured 20 percent of actual pedestrian fatalities and police data underrepresented pedestrian injury incidence, particularly among very young and old pedestrians. We used administrative records from ten cities to describe Watch for Me NC program delivery. Funding, partnerships, and training for law enforcement were instrumental in intervention implementation, and key challenges included limited resources (particularly law enforcement) to effectively engage large populations. To assess program effectiveness, we used a pre-post design with a control group, comparing locations receiving enforcement and engineering treatments with untreated locations to examine changes in driver yielding over a six-month period. Despite the intervention delivery limitations, driver yielding rates improved (between four and seven percentage points on average) at locations enhanced by enforcement and engineering, while remaining unchanged at untreated sites. This dissertation provides recommendations for making relevant comparisons between police, emergency, and death certificate data, and provides a better understanding of the discrepancies that exist between these data sources. It proposes process measures to increase the consistency and comparability of program delivery, and provides evidence that enhanced enforcement/engineering, as a part of a broader program, can increase driver yielding to pedestrians in marked crosswalks. These results can guide researchers and decision-makers in developing and evaluating pedestrian safety interventions. |
