An Intervention Study On Bicycle Injuries Of Middle School Students In Rural China

ObjectiveThrough the investigation and analysis of bicycle injuries of students in rural areas of Chaoshan, China, the study aimed to investigate the epidemiological characteristics of bicycle injuries in the region and the related risk factors for the issue. By implementation and evaluation of targeted interventions on the students in the region, the research intended to find out appropriate and effective intervention strategy.Methods1 Developing specialized students bicycle injury questionnaire, conduct the investigation with the unified approach. Statistics analysis likeχ2 test,rank sum test and multivariate analysis were used to analyze data obtained.2 Combined with qualitative analysis, focus group discussions were conducted to interview three people groups, including the students, parents and teachers.3 According to the results of preliminary investigation, intervention schools and control schools selected to compare the effect of the implementation of intervention measures and evaluation.Results1. Epidemiological characteristics of bicycle injuries among middle school students1.1 The bicycle injury of middle school studentsThe incidence rate of bicycle injury of Fuyang County was 11.0% and Liangying County was 17.0%, there was statistically significant difference in the incidence rate of injuries between the two counties. The proportion of students riding bicycles to school were 84.5% and 87.5 % respectively; the incidence rate of injuries of boys were significantly higher than girls, which in Fuyang county, the incidence rate of bicycle injury for men and women were 13.7% and 8.1% and in Liangying county were 20.0% and 13.8%; There were significant differences between different schools in the incidence rate of bicycle injury.1.2 The bicycle injury of left-behind childrenFuyang County investigated a total of 590 left behind children and 2396 non-left behind children. The proportion of left behind children was 19.8%; The incidence rate of bicycle injury for left behind children and non-left behind children, were 18.3% and 10.7% respectively (χ2=20.572, P<0.01). There were a total of 573 left behind children, 1978 non-left behind children. The proportion of left behind children was 22.4%. The incidence rate of bicycle injury for left behind children and non-left behind children were 20.5% and 16.0% (χ2=5.6822, P<0.05).1.3 The risk factors for bicycle injury among middle school studentsIt showed that the risk factors for bicycle injuries affecting Fuyang County and Liangying County differently. After multivariate logistic regression analysis, town, school, age, gender, accommodation, riding bicycles, walking, chase each other when cycling, cycling in reversed direction variables. The risk factors for Fuyang schools, male, riding a motorcycle, riding other vehicles, ride a bicycle to hook other vehicles, passenger of a bicycle hooked to other vehicles variables.2 Focus groups discussions results2.1 Students, parents and teachers groups reflected that the road conditions of the two area were poor, committed there was a great risk of occurrence of bicycle injuries and bicycle also aware of the existence of great impact on students'learning and living. However, the participants rarely suggested preventive measures or make specific recommendations for improvement the situation. Parents and teachers recognized that the main causes of poor road conditions due to poor local economic conditions and lack of government management.2.2 By verification by the rank sum test, there were not significantly different on the ranking relative importance of 10 the causes of bicycle injury among the students, parents, teachers, students groups. The top three most important reasons are: non-compliance with traffic rules, negligence of risk of road users and the fast speed when cycling were the main reasons for school children bicycle injury.3 Intervention assessment3.1 The incidence rate of bicycle injury: In low incidence rate of bicycle injury group, the incidence of bicycle injuries of the intervention group decreased, 11.8% before intervention, after intervention was 7.4%(χ2=7.891,P=0.005). The incidence of bicycle injuries in the control group showed no significant change. In high incidence rate of bicycle injury group, there was no statistically significant difference between intervention group and control group. The results showed that the difference between intervention group and control group was significantly(χ2=5.893, P=0.015)in . high incidence rate of bicycle injury group but not in low incidence rate of bicycle injury group.3.2 The cognition of bicycle injury prevention of middle schools students: Before and after intervention the road safety knowledge, attitudes and behavior of students in Fuyang County, After the intervention, 64.1% of the students know that less than 12 year-old children can not ride a bike on roads (P<0.01); the command to learn the knowledge of students to prevent traffic accidents decreased, from 86.3% to the 77.8% (P<0.001) one year after. Knowledge degree of related traffic signs inexpertly lower (66.1%) than before intervention (71.6%). Before and after intervention the road safety knowledge, attitudes and behavior of students in Fuyang County, there was a significant difference for the behavior not walking crosswalk after one year in the control schools. The number of students knowing traffic accident injuries had decreased. The rate knowing the traffic rules that less than 12 years of age children can not ride a bicycle on roads increased from 35.6% to 41.5%. And the number of students who want to learn the knowledge to prevent traffic rose.Conclusion1 Middle school students ride bicycles to school in large number in rural China, with high incidence rate of bicycle injuries. More risk behavior found in students of the area students when riding a bike. The different risk factor affected in different aspects suggested that to reduce the incidence of traffic injuries in children targeted measures should be taken.2 The awareness of different groups on children road safety in rural China generally low. The need to raise awareness of road safety in different populations is urgent.3 Propaganda and education interventions have some short-term results, but long-term intervention effects have not yet proved. The effects of interventions may be affected by a variety of interference factors, including the school's own education strategy on students.