title: The advocacy for pedestrian safety study: cluster randomised trial evaluating a political advocacy approach to reduce pedestrian injuries in deprived communities.
abstract: OBJECTIVE
  To determine whether advocacy targeted at local politicians leads to action to reduce the risk of pedestrian injury in deprived areas.
  
  
  METHODS
  Cluster randomised controlled trial.
  
  
  METHODS
  239 electoral wards in 57 local authorities in England and Wales.
  
  
  METHODS
  617 elected local politicians.
  
  
  METHODS
  Intervention group politicians were provided with tailored information packs, including maps of casualty sites, numbers injured and a synopsis of effective interventions.
  
  
  METHODS
  25-30 months post intervention, primary outcomes included: electoral ward level: percentage of road traffic calmed; proportion with new interventions; school level: percentage with 20 mph zones, Safe Routes to School, pedestrian training or road safety education; politician level: percentage lobbying for safety measures. Secondary outcomes included politicians' interest and involvement in injury prevention, and facilitators and barriers to implementation.
  
  
  RESULTS
  PRIMARY OUTCOMES DID NOT SIGNIFICANTLY DIFFER: % difference in traffic calming (0.07, 95%CI: -0.07 to 0.20); proportion of schools with 20 mph zones (RR 1.47, 95%CI: 0.93 to 2.32), Safe Routes to School (RR 1.34, 95%CI: 0.83 to 2.17), pedestrian training (RR 1.23, 95%CI: 0.95 to 1.61) or other safety education (RR 1.16, 95%CI: 0.97 to 1.39). Intervention group politicians reported greater interest in child injury prevention (RR 1.09, 95%CI 1.03 to 1.16), belief in potential to help prevent injuries (RR 1.36, 95%CI 1.16 to 1.61), particularly pedestrian safety (RR 1.55, 95%CI 1.19 to 2.03). 63% of intervention politicians reported supporting new pedestrian safety schemes. The majority found the advocacy information surprising, interesting, effectively presented, and could identify suitable local interventions.
  
  
  CONCLUSIONS
  This study demonstrates the feasibility of an innovative approach to translational public health by targeting local politicians in a randomised controlled trial. The intervention package was positively viewed and raised interest but changes in interventions were not statistically significance. Longer term supported advocacy may be needed.
  
  
  BACKGROUND
  Current Controlled Trials ISRCTN91381117.
authors.affiliation: Swansea University, Swansea, Wales, England. r.a.lyons@swansea.ac.uk
authors.forename: Ronan A
authors.initials: RA
authors.lastname: Lyons
authors.forename: Denise
authors.initials: D
authors.lastname: Kendrick
authors.forename: Elizabeth M L
authors.initials: EM
authors.lastname: Towner
authors.forename: Carol
authors.initials: C
authors.lastname: Coupland
authors.forename: Mike
authors.initials: M
authors.lastname: Hayes
authors.forename: Nicola
authors.initials: N
authors.lastname: Christie
authors.forename: Judith
authors.initials: J
authors.lastname: Sleney
authors.forename: Sarah
authors.initials: S
authors.lastname: Jones
authors.forename: Richard
authors.initials: R
authors.lastname: Kimberlee
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Rodgers
authors.forename: Samantha
authors.initials: S
authors.lastname: Turner
authors.forename: Mariana
authors.initials: M
authors.lastname: Brussoni
authors.forename: Yana
authors.initials: Y
authors.lastname: Vinogradova
authors.forename: Tinnu
authors.initials: T
authors.lastname: Sarvotham
authors.forename: Steven
authors.initials: S
authors.lastname: Macey
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003254:Consumer Advocacy / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D011057:Politics; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012306:Risk; D012449:Safety / Q000706:statistics & numerical data*; D012923:Social Class; D016138:Walking