Reducing accidents and promoting safety behaviours

1
Reducing accidents and promoting safety
behaviours

• Health Psychology

2
Road Safety

• Where young children are concerned, it is usually
  adults who have to take responsibility for
  promoting safe behaviours and preventing
  accidents. It is therefore adults who are
  targeted in health promotion and accident
  prevention campaigns rather than children. There
  are some messages that can be conveyed to
  children such as road safety - for example, the
  Green Cross Code in the 1970s. More messages are
  being taught in schools through Personal, Social
  and Health Education (PSE).

3
Wortel et al (1994)

• Wortel et al (1994) describe four safety
  behaviours that parents can engage in that
  prevent accidents among pre-school children
• 1.      Educating the child about risks
• 2.      Supervision of the child
• 3.      Making sure that the child's
  environment is safe
• 4.      Giving first aid when an accident has
  happened.

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Commentary

• It is difficult to make a child understand the
  nature of risk. It is almost impossible to ensure
  constant supervision, and also does not allow the
  child to explore the environment and learn from
  its mistakes. Making the environment safe is the
  best choice.

5
Langley and Silva (1982)

• Langley and Silva (1982) found that only 39 of
  parents whose child had had an accident in the
  pre-school period changed their behaviour to
  prevent further accidents. Most of the parents
  who did not change their behaviour did not feel
  that it was possible to prevent the accident.

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Commentary

• The problem with an approach that focuses on the
  role of the parent is that it lays blame on these
  parents, instead of recognizing the need for a
  safe environment to be provided for everyone.

7
Commentary

• For example, if we recognize that children who
  grow up in deprived homes are more likely to have
  accidents than those who do not, then we often
  lay the blame for that statistic on negligent
  parents, rather than looking at the environment
  in which these parents are forced to bring up
  their children - in high-rise flats or on housing
  estates near main roads, for example.

8
Laws

• The promotion of safe behaviours can be more
  effective if laws are passed.

9
learning theory approach

• Oborne (1982) (cited in Pitts, 1996) uses a
  learning theory approach to understanding safety.
  He argues that often safety routines and
  practices take a lot of time, and that these
  behaviours are less likely to be reinforced than
  behaviours that are often quicker and easier,
  although more risky.

10
Pitts (1996)

• Pitts (1996) lists the following accident
  prevention actions as the most important
•         To eliminate the hazards from the
  workplace
•         To remove the individual from exposure
  
•         To isolate the hazard
•         Workers can be issued with personal
  protection - such as protective clothing.
• The emphasis in this model is that the
  management, rather than the individual should
  take the action.

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The use of cycle helmets

• In Maryland (USA), the use of cycle helmets was
  compared in three counties
• one in which a law had been passed in 1990 making
  it mandatory for everyone under the age of 16 to
  wear an approved helmet
• one in which publicity about proposed legislation
  was widespread,
• and one in which there were no laws or publicity.
  

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The use of cycle helmets

• Using self-report measures, the increase in
  helmet use rose from 11.4 to 37.5, 8.4 to
  12.6 and 6.7 to 11.1 respectively.

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The use of cycle helmets
14
The use of cycle helmets

• Observations of the use of cycle helmets in the
  three counties found slightly different
  increases from 4 to 47, 8 to 19, and in the
  county with no laws or publicity, there was a
  decrease during the period of survey.

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The use of cycle helmets

• In one state in Australia, after the wearing of
  cycle helmets was made compulsory there was an
  immediate increase in helmet use from 31 in
  March 1990 to 75 a year later. The number of
  cyclists killed from head injuries decreased by
  48 in the first year, and by 70 in the second
  year.

16
motor vehicle accidents

• The death rates for motor vehicle accidents
  increase dramatically during adolescence, as
  depicted in the graph, and males between 15 and 9
  years of age are about 2½ times more likely to
  die in traffic mishaps than females in the same
  age range (Matarazzo, 1984).

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motor vehicle accidents
18
Safe-driving programs

• Because of the high rates of traffic fatalities
  in adolescence, special safe-driving programs
  have been directed toward teenagers. One approach
  has involved providing driver training in high
  schools, and early quasi-experimental research
  showed that students who take driver education
  courses subsequently have fewer accidents than
  those who do not.

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Safe-driving programs

• But later studies revealed that the course itself
  was not the cause of this relationship for some
  reason, students who elect to take driver
  education simply drive less than those who do not
  (Robertson, 1986). Similarly, driver education
  for adults-for example, as a condition for
  employment or in response to traffic
  violations---also seems to have little effect on
  accidents.

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Perception and reaction

• Other ways to reduce traffic accidents have been
  more effective than driver training. One approach
  capitalizes on research findings regarding
  drivers' perceptual and reaction abilities, with
  the goal of reducing their errors and enhancing
  their reaction time. Public health researcher
  Leon Robertson has described two examples

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Perception and reaction

• (1)   An extra brake light mounted in the centre
  of the vehicle above the trunk resulted in a 50
  reduction in rear-end collisions when the front
  vehicle was braking, compared to randomly
  assigned control cars in the same fleets.

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Perception and reaction

• (2)   Stripes across a road at an exponentially
  decreasing distance creates the illusion of
  acceleration when crossing at a constant speed .
  . . Installation of such stripes at high-speed
  approaches to roundabouts in England resulted in
  an average 66 reduction in crashes at such
  sites. (1986, pp. 22-23)

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Perception and reaction

• Another approach that is quite effective involves
  raising the legal driving age (Robertson, 1986).

24
SLEEPY DRIVERS

• As mentioned above, there is a problem in the UK
  with sleep-related vehicle accidents (SRVAs).
  There has been extensive research into this issue
  (Reyner and Horn, 1998) which shows that the
  methods suggested to prevent this by motoring
  organisations, such as opening the window or
  turning up the radio, only have small and
  short-term benefits (about 15 minutes). The best
  advice is to take a break and maybe have a nap.

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SLEEPY DRIVERS

• It has been found that naps of between 4 and 20
  minutes can have a positive effect on performance
  and reduce sleepiness. In fact, 15-minute naps
  taken every 6 hours during a period of 35 hours
  of no sleep have been found to be effective in
  maintaining a good level of performance.

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SLEEPY DRIVERS

• The common technique of having some coffee is
  also a good one, and laboratory tests have shown
  that low doses of caffeine (100200 mg, or about
  two cups of coffee) improve alertness in sleepy
  people. The answer is fairly clear. To reduce
  road SRVAs we need to encourage drivers to stop
  driving when sleepy, and to take a nap or drink
  some coffee (for a review see Horne and Reyner,
  1999).

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MOBILE PHONES

• There is concern about the use of mobile phones
  by drivers. A review of research by RoSPA
  (R0SPA, 2001 b) about the effects of using mobile
  phones on driving found that when the driver is
  using a hand-held or hands-free phone they (a)
  vary their road speed and (b) wander in their
  lane. The driver appears to lose touch with
  driving conditions and become distracted. They
  concluded that using a mobile phone when driving
  increases the risk of having an accident.

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MOBILE PHONES

• Interestingly, not all research paints such a
  negative picture of the phone user. For example
  Alm (1998) tested the idea that the more
  demanding the driving task, the greater would be
  the effect on using a mobile phone. The study did
  not support the hypothesis and showed, in fact,
  that drivers under pressure of a demanding road
  will reduce the level of difficulty by, for
  example slowing down, when they are using a
  mobile phone.

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MOBILE PHONES

• This suggests that we are able to successfully
  multi-task and adjust our behaviour to match the
  actions we are required to do.

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MOBILE PHONES

• The health promotion strategy to reduce accidents
  in drivers who are using mobile phones is carried
  out though driver education, through legislation
  (drivers must be in proper control of their
  vehicles at all times and holding a mobile phone
  whilst driving is now banned in the UK), and
  through employer education (so that they do not
  require their drivers to be available on the
  phone at all times).

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Protective equipment

• Injuries and deaths can also he prevented if
  drivers and passengers will use protective
  equipment, such as seat belts in cars and helmets
  when riding motorcycles (Latimer Lave, 1987
  Robertson. 1986 Waller, 1987). But after seat
  belts were installed as standard equipment in
  cars, few people opted to use then. As a result,
  researchers began to try a wide variety of
  methods to promote the use of protective
  equipment in cars.

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Protective equipment

• Some of these studies were conducted to improve
  car safety for children by providing instruction
  and information to parents through hospitals and
  paediatricians. These programs have had mixed
  success (Cataldo et al, 1986 Christophersen,
  1984, 1989).

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Protective equipment

• Some programs to increase seat belt use have been
  directed at the child, rather than the parent.
  One study presented a 2-week passenger safety
  curriculum to children in several preschools,
  using a theme character called Bucklebear'
  (Chang, Dillman, Leonard, English, 1985). Two
  of the curriculum's main messages were that
  buckling up for every ride is a good thing for
  everyone to do and that the best seat in the car
  is the back seat.

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Protective equipment
35
Protective equipment

• Some of the parents also took part in activities
  to promote seat belt, use. The children in
  several other preschools served as a control
  group who were matched to the experimental
  subjects for their prior seat belt use. Follow-up
  observations in the preschool parking lots 3
  weeks after the program was completed revealed
  that over 44 of the "Bucklebear' children and
  only about 22 of the control children were using
  seat belts.

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ACCIDENT REDUCTION AT WORK

• Health promotion can be used at work to reduce
  accidents. The most frequently cited methods for
  reducing accidents at work are stress reduction
  programmes. For example, Kunz (1987) describes
  how a stress intervention programme reduced
  medical costs and accident claims in a hospital.
  The programme more than paid for itself with the
  savings from reduction in accidents.

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ACCIDENT REDUCTION AT WORK

• Stress reduction programmes have also been shown
  to reduce absenteeism (Murphy and Sorenson,
  1988).
• Another way of reducing accidents is through
  incentive programmes. Fox et al. (1987) looked at
  the effects of a token economy programme at open
  cast pits.

38
ACCIDENT REDUCTION AT WORK

• Employees earned stamps for working without time
  lost for injuries, for being in work groups in
  which none of the workers had lost time through
  injury, for not being involved in equipment
  damaging accidents, for making safety
  suggestions, and for behaviour that prevented
  injury or accident. They lost stamps for
  equipment damage, injuries to their work group
  and failure to report accidents and injuries.

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ACCIDENT REDUCTION AT WORK

• The token economy produced a dramatic reduction
  in days lost through injury and reduced the costs
  of accidents and injuries. These improvements
  were maintained over a number of years.
• A relatively simple intervention to reduce
  fatigue and accidents in logging workers involved
  encouraging them to take regular fluids.

40
ACCIDENT REDUCTION AT WORK

• Sports science has shown that the use of regular
  fluid intake is one way to reduce the sense of
  strain in a task and delay the onset of physical
  and mental fatigue. A study of loggers in New
  Zealand (Paterson et al., 1998) looked at the
  normal performance of the loggers and compared it
  with performance when they were taking a sports
  drink every 15 minutes.

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ACCIDENT REDUCTION AT WORK

• In the normal condition, the loggers lost on
  average about 1 per cent of their body weight
  during the working day, but in the fluid
  condition they maintained or increased their body
  weight. Also in the fluid condition, the heart
  rate was lower, and the loggers reported feeling
  fresher, stronger, more alert and more vigorous.
  Reducing fatigue and strain can reduce errors so
  it is a useful intervention to keep a worker
  properly hydrated.

42
MEDIA CAMPAIGNS

• Public information films on television often tell
  us to do very sensible things like dip our
  headlights or fit smoke alarms. They might well
  affect our attitudes to these procedures and
  products but do they affect our behaviour? In the
  field of accidents it is possible to estimate
  changes in behaviour by comparing accident rates
  before and after an advertising campaign.

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MEDIA CAMPAIGNS

• This discrepancy between attitude (what we think)
  and behaviour (what we do) is illustrated in a
  report by Cowpe (1989). This report looked at the
  effectiveness of a series of advertisements about
  the dangers of chip pan fires. Before the
  advertisements, people were asked about this
  hazard and most of them claimed that they always
  adopted safe practices.

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MEDIA CAMPAIGNS

• However, the statistics from fire brigades about
  the frequency of chip pan fires and the
  descriptions by people of what they should do
  suggested that their behaviour was not as safe as
  they thought. A television advertising campaign
  was developed and broadcast showing dramatic
  images of exactly how these fires develop, and
  how people should deal with them.

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MEDIA CAMPAIGNS

• The adverts ended with a simple statement, such
  as Of course, if you dont overfill your chip
  pan in the first place, you wont have to do any
  of this.

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MEDIA CAMPAIGNS

• By comparing fire brigade statistics for the
  areas which received the advertisements, and
  those for the areas which did not, the
  advertisers found that the advertisements had
  produced a 25 per cent reduction in the number of
  chip pan fires in some areas, with a 12 per cent
  reduction overall. Surveys taken after the series
  of advertisements showed that people had more
  accurate knowledge about what they should do in
  the event of a chip pan fire than before.

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PREVENTING SLIPS, TRIPS AND FALLS

• Slips, trips and falls make up around a third of
  injuries leading to absence from work (HSE,
  1999). Older people are especially susceptible to
  health-damaging falls, with approximately 30 per
  cent of people over 65 who live in the community
  falling each year and about 50 per cent of the
  over 80s (D0H, 2000).

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PREVENTING SLIPS, TRIPS AND FALLS

• The consequences of falling can be
•  
• physical injury such as fractures
• psychological impacts such as increased fear
  of falling
• reduced mobility
• needing to be cared for in an institution
• death.

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PREVENTING SLIPS, TRIPS AND FALLS

• There have been many programmes aimed at reducing
  damaging falls in older people. Studies that have
  targeted high-risk groups and offered programmes
  of exercise aimed at increasing mobility and
  strength have been relatively ineffective in
  reducing the number of falls.

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PREVENTING SLIPS, TRIPS AND FALLS

• Programmes which have the greatest success
  combine a number of interventions such as a
  review of the medication the older person is
  taking, a safety review of their house and taking
  moderate exercise (for a review see D0H, 2000).
  For people at particular risk, there have been
  some interventions using hip protection so that
  falls are cushioned and less damaging. The
  problem with such interventions is that the
  compliance rate for wearing the devices is
  relatively low.

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PREVENTING SLIPS, TRIPS AND FALLS
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UNDERSTANDING MEDICAL INSTRUCTIONS

• We live in a world full of icons and signs.
  Diagrams of stick people with crosses through
  them appear all over our everyday environment.
  What is the stick figure doing? Does everybody
  understand the same message from these signs?
  Research into signs can help us adjust them so
  that more people can understand what is required
  and make fewer errors in medication.

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UNDERSTANDING MEDICAL INSTRUCTIONS

• For example, a study by Dowse and Ehlers (1998)
  on the different perceptions of signs by black
  and white people in South Africa, was able to
  devise signs that could be better recognised by
  the black community. Literacy in the black
  community is still very low in South Africa
  (estimated 45 per cent illiterate and 25 per cent
  semi-literate), so the use of icons and pictures
  is important in medical instructions.

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UNDERSTANDING MEDICAL INSTRUCTIONS

• A set of international symbols was published in
  1991 in the United States Pharmacopoeia, but the
  researchers believed that many of these symbols
  would be poorly understood by black South
  Africans.

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UNDERSTANDING MEDICAL INSTRUCTIONS

• Following interviews with black students they
  devised some Africanised versions of the symbols.
  When they tested them with members of their
  target group (black South Africans with low
  levels of literacy), they found that the
  Africanised symbols were either equally well or
  better recognised than the US symbols.

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UNDERSTANDING MEDICAL INSTRUCTIONS
57
Homework

• a) Outline one study that shows how accidents can
  be reduced. (6)
• b) Discuss the difficulties in reducing accidents
  and promoting safety behaviours. (10)

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The End