Why Are Older Adults More at Risk as Pedestrians? A Systematic Review

OBJECTIVE

To explore factors that could explain why older adults are more at risk at the roadside.

BACKGROUND

The physical and psychological health benefits of walking have been well-established, leading to the widespread promotion of walking amongst older adults. However, walking can result in an increased risk of injury as a pedestrian at the roadside, which is a greater risk for older adults who are overrepresented in pedestrian casualty figures.

METHOD

Relevant databases were searched up to January 2020. All peer-reviewed journals that presented data on healthy older adults and some aspect of road crossing or roadside behavior were included. A total of 142 papers were assessed and 60 met the inclusion criteria.

RESULTS

Identified papers could be grouped into three areas: crossing at a designated crossing place; crossing with no designated crossing place; perceptions or behaviors.

CONCLUSION

Multiple individual (attitudes, perceived behavioral control, walking time, time-to-arrival judgments, waiting endurance, cognitive ability), task (vehicle size, vehicle speed, traffic volume), and environmental (road layout, time of day, weather) constraints influence road crossing in older adulthood.

APPLICATION

Accessibility of designated crossing areas needs to be addressed by ensuring sufficient time to cross and nonrestrictive waiting times. Signalized crossings need to be simplified and visibility increased. Where there is no designated crossing place, a reduction in speed limit alongside the provision of pedestrian islands to provide "pause" places are needed. Educational-based programs may also help ensure safety of older adults where there is no designated crossing place.

Design, Implementation and Experimental Investigation of a Pedestrian Street Crossing Assistance System Based on Visible Light Communications

In urban areas, pedestrians are the road users category that is the most exposed to road accident fatalities. In this context, the present article proposes a totally new architecture, which aims to increase the safety of pedestrians on the crosswalk. The first component of the design is a pedestrian detection system, which identifies the user's presence in the region of the crosswalk and determines the future street crossing action possibility or the presence of a pedestrian engaged in street crossing. The second component of the system is the visible light communications part, which is used to transmit this information toward the approaching vehicles. The proposed architecture has been implemented at a regular scale and experimentally evaluated in outdoor conditions. The experimental results showed a 100% overall pedestrian detection rate. On the other hand, the VLC system showed a communication distance between 5 and 40 m when using a standard LED light crosswalk sign as a VLC emitter, while maintaining a bit error ratio between 10^-7 and 10^-5. These results demonstrate the fact that the VLC technology is now able to be used in real applications, making the transition from a high potential technology to a confirmed technology. As far as we know, this is the first article presenting such a pedestrian street crossing assistance system.

Road Use Pattern and Street Crossing Habits of Schoolchildren in India

Road traffic accidents (RTAs) contribute significant DALYs in the global burden of diseases. Vulnerable groups particularly pedestrians and children are at an increased risk. Road use pattern, street crossing habits, and road safety awareness are important determinants of RTAs. The present study was carried out to assess the road use pattern and street crossing habits of schoolchildren. This cross-sectional study included 497 schoolchildren of 12–15 years. The interview technique was used as a tool for data collection on a predesigned questionnaire. A total of 40.4% of schoolchildren did not like to go to school alone and wanted somebody from the family to drop them to school. About one quarter of the students were afraid of traffic and expressed their inability to deal with traffic on the road. A total of 10.7% reported crossing the street in groups, and 1.4% reported running while crossing the street. Only 80.9% of students received some form of road safety training, and the parents and schools were the major source of information for such safety training. Age <14 years and a lower level of mother's education were found to be significant contributors for poor road crossing habit in univariate as well as multivariate analysis. The study suggests that the knowledge regarding safe road use and street crossing was lacking among study participants albeit in a small proportion only. Safety aspects can be partly strengthened by imparting practical knowledge about road use pattern, street crossing habits, and road safety procedures.

Distracted Behavior of Pedestrians While Crossing Street: A Case Study in China

Pedestrians are the most vulnerable road users in the traffic system and thousands of pedestrians are injured or killed globally as a result of traffic crashes every year. With their popularity and enriched functions, mobile phones are playing an increasingly important role in people's lives, and records of vehicle crashes involving pedestrians have shown the hazards caused by distraction of mobile phone use, especially in the context of crossing the street. The present study employed the theory of planned behavior (TPB) to investigate the behavior of using a mobile phone while crossing the street in China. An online questionnaire based on the TPB framework was developed to collect data, and 387 eligible samples were retained after inspection. Mobile phone use while crossing the street is prevalent in China (i.e., 53%). The results show that three standard TPB constructs (i.e., attitudes, intention and perceived behavioral control) emerged as significant predictors of the behavior of using mobile phone while crossing, and two extended constructs (i.e., situation, mobile phone involvement) also significantly predicted the behavior. In addition, for this population, intention was the strongest predictor of the behavior among these significant constructs. Moreover, the results were discussed and compared with some existing studies and safety interventions were also provided.

Pedestrians Accept Shorter Distances to Light Vehicles Than Dark Ones When Crossing the Street

Does the brightness of an approaching vehicle affect a pedestrian's crossing decision? Thirty participants indicated their street-crossing intentions when facing approaching light or dark vehicles. The experiment was conducted in a real daylight environment and, additionally, in a corresponding virtual one. A real road with actual cars provides high face validity, while a virtual environment ensures the scenario's precise reproducibility and repeatability for each participant. In both settings, participants judged dark vehicles to be a more imminent threat-either closer or moving faster-when compared with light ones. Secondary results showed that participants accepted a significantly shorter time-to-contact when crossing the street in the virtual setting than on the real road.

Cognitive-Motor Interference in an Ecologically Valid Street Crossing Scenario

Laboratory-based research revealed that gait involves higher cognitive processes, leading to performance impairments when executed with a concurrent loading task. Deficits are especially pronounced in older adults. Theoretical approaches like the multiple resource model highlight the role of task similarity and associated attention distribution problems. It has been shown that in cases where these distribution problems are perceived relevant to participant's risk of falls, older adults prioritize gait and posture over the concurrent loading task. Here we investigate whether findings on task similarity and task prioritization can be transferred to an ecologically valid scenario. Sixty-three younger adults (20–30 years of age) and 61 older adults (65–75 years of age) participated in a virtual street crossing simulation. The participants' task was to identify suitable gaps that would allow them to cross a simulated two way street safely. Therefore, participants walked on a manual treadmill that transferred their forward motion to forward displacements in a virtual city. The task was presented as a single task (crossing only) and as a multitask. In the multitask condition participants were asked, among others, to type in three digit numbers that were presented either visually or auditorily. We found that for both age groups, street crossing as well as typing performance suffered under multitasking conditions. Impairments were especially pronounced for older adults (e.g., longer crossing initiation phase, more missed opportunities). However, younger and older adults did not differ in the speed and success rate of crossing. Further, deficits were stronger in the visual compared to the auditory task modality for most parameters. Our findings conform to earlier studies that found an age-related decline in multitasking performance in less realistic scenarios. However, task similarity effects were inconsistent and question the validity of the multiple resource model within ecologically valid scenarios.

An Evolution of Virtual Reality Training Designs for Children With Autism and Fetal Alcohol Spectrum Disorders

This article describes an evolution of training programs to use first-person interaction in virtual reality (VR) situations to teach safety skills to children with autism spectrum disorder (ASD) and fetal alcohol spectrum disorder (FASD). Multiple VR programs for children aged 2 to 9 were built and tested between 1992 and 2007. Based on these results, a learning design evolved that uses practice in virtual space with guidance and correction by an animated character, strategic limitations on allowed actions to force correct patterning, and customization of worlds and responses to simplify user controls. This article describes program evolution by comparing design details and results as variations in behavioral responses between disorders, differences in skill set complexity between different safety skills being taught, and improved technology required changes in the virtual training methodology. A series of research projects are summarized in which the VR programs proved effective for teaching children with ASD and FASD new skills in the virtual space and, where measured, most children generalized the actions to the real world.