title: The incidence of pedestrian distraction at urban intersections after implementation of a Streets Smarts campaign.
abstract: BACKGROUND
  Pedestrians distracted by digital devices or other activities are at a higher risk of injury as they cross streets. We sought to describe the incidence of pedestrians distracted by digital devices or other activities at two highly traveled urban intersections after the implementation of a pedestrian safety intervention at one of the intersections.
  
  
  METHODS
  This was an observational field study of two urban intersections. Two investigators were stationed at each of the four corners of the intersection. Each pair of observers included one "person counter" and one "behavior counter". The "person counter" tallied every individual who approached that corner from any of the three opposing corners. The "behavior counter" tallied every individual approaching from the three opposing corners who were exhibiting any of the following behaviors: 1) eating, 2) drinking, 3) wearing ear buds/headphones, 4) texting, 5) looking at mobile phone or reading something on mobile phone, or 6) talking on mobile phone. Every 15 min, each pair of observers rotated to the next corner of the same intersection, allowing each pair of observers to complete one 15-min observation at each of the four corners of the intersection. Intersection A had stencils at the curb cuts of each corner alerting pedestrians to put down a digital device while crossing the intersection while intersection B did not.
  
  
  RESULTS
  1362 pedestrians were observed; of those, 19 % were distracted by another activity at both intersections. Of the total, 9 % were using ear buds/headphones; 8 % were using a digital device (talking, texting, or looking down at it); and 2 % were eating or drinking. Inter-observer validity among observers (kappa) was 98 %. Of those that were distracted, 5 % were either using an assistive device (cane, walker, motorized scooter) or walking with a child (either on foot or in stroller). There were no differences in the proportion of pedestrians who were distracted at either intersection, except that more pedestrians were talking on a cell phone while crossing intersection B.
  
  
  CONCLUSIONS
  It is unclear to what degree a pedestrian safety messaging campaign is effective in decreasing distraction by digital devices. Further evaluation of the effect of posted warnings about pedestrian distraction on the safety of crossing behaviors is needed.
authors.affiliation: Injury Prevention & Research Center, Yale-New Haven Hospital, New Haven, Connecticut, USA. pina.violano@ynhh.org.|Injury Free Coalition for Kids of New Haven, Yale-New Haven Children's Hospital, 300 George St 4th Floor Room 443, New Haven, CT, 06510, USA. pina.violano@ynhh.org.
authors.forename: Pina
authors.initials: P
authors.lastname: Violano
authors.affiliation: Fairfield University School of Nursing, 1058 N Benson Road, Fairfield, Connecticut, 06824, USA.
authors.forename: Linda
authors.initials: L
authors.lastname: Roney
authors.affiliation: Injury Free Coalition for Kids of New Haven, Yale-New Haven Children's Hospital, 300 George St 4th Floor Room 443, New Haven, CT, 06510, USA.|Section of Pediatric Emergency Medicine, Yale School of Medicine, New Haven, USA.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Bechtel
keywords: Cellular phone; Distraction; Pedestrian; Pedestrian distraction; Street crossing