ACE’S ADVENTURE GAME

AN INNOVATIVE APPROACH TO PEDESTRIAN SAFETY FOR CHILDREN

M. Margaret Knudson MDProfessor of Surgery, UC-San Francisco

William Seaman; Minneapolis Star Tribune

Pulitzer Prize Winner 1959

Wheels of Death

THE BURDEN OF INJURY IN CHILDREN

• Unintentional injury: #1 cause of death

• 9,000 deaths/year in U.S. children from injury

• > 150 school buses loaded with children

• 25 deaths/day: unintentional injury

• >225,000 hospitalizations

• > 9 million emergency department visits

• USA: 2x rate other countries

FINANCIAL BURDEN: CHILDHOOD INJURIES

MECHANISM NO. DEATHS MEDICAL COSTS LOST WORK COST

Motor Vehicle 6781 $56 M $8.2 B

Drowning 1120 $5.7M $1.2 B

Suffocation 1047 $5.4M $987M

Poisoning 729 $3.4M $924M

Fire/Burns 529 $7.1M $547M

TOTAL 10,206 $77.6M $11.9 B

ANNUAL TOTAL MEDICAL AND

QUALITY OF LIFE COSTS: $200B

PEDIATRIC PEDESTRIAN INJURIES

• 501 Deaths in 2010 (0-18 year olds)

• For every death=4.5 injuries

• Children: 4x higher rate than adults

• Highest pedestrian group: 5-9 year olds

-4,509 injured pedestrians in 2010

-70 pedestrian deaths

EARLY ELEMENTARY SCHOOL

• 40-70%: walk alone to school or play near/on streets

• 60% of injuries in this age group: “dart outs”

• Children < 9 years:

-small size/not easily seen

-poor perception of traffic speed

-poor attention focus

-can’t interpret traffic signs

BEHAVIORAL SCIENCE: PEDESTRIAN SAFETY FOR YOUNG CHILDREN

• Behavioral programs: developmentally appropriate

• Modeling and training by an adult

• Didactic teaching/rote learning: ineffective

• Interactive/immediate feedback

• Practice in simulation and real-world

Classroom Teaching

• 650 Primary Grade School Teachers

• 54% responded to survey

• 85%: important to teach pedestrian safety

• 40%: taught in some format

• 16%: was a requirement in their school

• Barriers: Not enough time

Not part of their curriculum

ACE’S ADVENTURE GAME

Dave Warhol ,

Founder Realtime

Associates

PEDESTRIAN SAFETY GAME

• Child walking to school (boy or girl); timed

• Picking up homework along the way

• Series of instructions (English or Spanish)

• Several mini-games:

-crossing the street

-cars backing up

-exiting a car

-signaling a driver

-altering someone “darting out”

HOW DO YOU TEST A SAFETY GAME?

• Observational studies: biased

• Written tests: unreliable in K-2 grade

• Children’s Hospital Los Angeles:

Richie’s Neighborhood/Street Smarts

STUDY DESIGN

• 348 Children: 14 schools: LA District

• 2nd/3rd Grade classrooms

• Randomized: Didactic teaching vs. Game

• Pre and Post Written Test

• Both groups tested on Simulated Street

STUDY RESULTS: J Trauma 2014

• Didactic group: higher mean score on writtentest (perfect score-6; 1.01, p<0.0001)

• Game group: scored significantly better on street:

-exiting a parked car

-signaling to a car at intersection

-signaling to a car backing up

-crossing the street

NEXT STEPS FOR OUR RESEARCH

• Creation of an all-hazards game

• In-car safety; bike safety; fire/burns; drowning

Creation of a Game App