Abstract
BACKGROUND: Child pedestrian injuries in China result from crashes not just with cars. We considered how Chinese youth and young adults perceive pedestrian risk from four vehicle types-bicycles, electric bicycles, cars, buses-evaluating perceptions for two factors that may influence pedestrian behavior and risk-taking, perception of road environment risk and responsibility to avoid crashes. Understanding how pedestrians perceive risk, and how these perceptions change as children grow older, could guide prevention efforts. METHODS: 383 children (grades 3-4, 5-6, 8) and university students completed self-report surveys. We analyzed overall responses, plus age/gender differences in risk perception and responsibility attribution, across vehicle types and number of vehicles approaching, using multivariate analysis of variance (MANOVA) and generalized estimating equation (GEE) models. RESULTS: Overall, larger vehicles were perceived as riskier (p less than .001). Compared to children, university students perceived bicycles and electric bicycles as less risky (Mean=2.66 vs. 3.69, 3.34 vs. 3.62, respectively, p less than .05). Cars and buses were perceived as equally risky across age groups. Across all vehicle types and number of vehicles traversing the road, both children and young adults perceived more pedestrian responsibility to avoid collisions relative to drivers (p less than .001). Children attributed less personal responsibility to avoid pedestrian-vehicle crashes than university students (e.g., buses odds ratio (OR)=0.20, p less than .001; OR=0.26, p less than .01; OR=0.28, p less than .01 for third/fourth, fifth/sixth, eighth graders, respectively). University students and fifth/sixth graders also identified greater pedestrian responsibility to avoid collisions with multiple vs. one vehicle approaching (e.g., university students/cars OR=4.17, p less than .001). CONCLUSIONS: We discuss cognitive and perceptual development factors in childhood, adolescence, and young adulthood that may contribute to differences in risk perception and responsibility attribution among Chinese pedestrians and suggest future research should explore those processes and subsequently develop evidence-based interventions to reduce pedestrian injury risk.