Traffic Safety Research and Intervention in Lawa Lake ...€¦ · most motorcycle accident...
Transcript of Traffic Safety Research and Intervention in Lawa Lake ...€¦ · most motorcycle accident...
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 1
Traffic Safety Research and Intervention in Lawa Lake, Thailand: 2013
Collin Boyer, Laura Martel, Jackie Ordemann, and Sarah Wiant
Khon Kaen University; CIEE
Fall 2013
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 2
Abstract
Objective: Our objectives were to increase awareness and knowledge about road safety in the
Lawa Lake community in Lawa Lake, Thailand by improving infrastructure, increasing
knowledge, and helping to change behaviors.
Sample: Research concluded that adolescents ages 10 to 18 were most at risk. However, we
targeted all drivers and riders in the Lawa Lake community.
Methods: Research was conducted through questionnaires and observational study. The
intervention was comprised of the installation of a convex reflective mirror, delivery of
pamphlets to stakeholder, and the delivery of an educational video about road safety.
Statistical analysis: Microsoft Excel was used to analyze the results of the questionnaire and the
observational study.
Results: From our observational study, 551 motorcycles were observed. Of these motorcycles,
7.46% of riders were wearing helmets. Questionnaires were used to survey 50 participants.
Participants were asked about helmet use, speeding, drunk driving, underage driving, knowledge
of road rules, education regarding road safety, prevalence and cause of accidents, and opinions of
road safety in Lawa Lake.
Conclusion: While we believe we have sufficiently met our objectives, we recognize that gaps
still exist. We recommend that traffic safety research in Lawa Lake continues. Possible areas of
research could focus on helmet usage during different times, at different locations, or amongst
different demographics.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 3
Introduction Thailand has one of the highest rates of road accident related deaths in the world. The
country is ranked third in the world for most motor vehicle fatalities and first in the world for
most motorcycle accident fatalities (Serireongrith, 2013; Hodal, 2012). Motorcycle accidents
make up 70% of the total motor vehicle accidents in Thailand (Hodal, 2012). The high fatality
rate is related to a lack of policy enforcement on safety measures such as motorcycle helmets,
speed limits, drunk driving policies, and age requirements for driving motorcycles. Low
socioeconomic status and living in rural areas are both risk factors for motor vehicle injuries
(Suriyawongpaisal and Kanchanasut, 2003).
The people who live in Lawa Lake, a rural community in the Northeast, Isan region of
Thailand, rely mainly on motorcycles for getting around in and outside of the community. We
conducted research in the Lawa Lake community in order to understand the major issues
regarding road safety and to evaluate the need for a modest intervention. Our goal was to select
topics and target groups for our intervention, based on the research conducted. To do this
research we made a questionnaire and performed an observational study. The questionnaire
focused on helmet use, drinking and driving, underaged driving, traffic regulations, prevalence of
accidents in the community, and opinion of road safety as a problem. Fifty men and women
ranging in age from 10 to 72 participated in this survey. In our observational study we focused
on helmet use, number of riders on each motorcycle, and approximate age of the riders. In total
we observed 551 motorcycles.
In response to our research we designed an intervention composed of three separate but
interconnected parts. First, equipment needed for the installation of a convex reflective mirror at
a blind T-intersection was left with the community. Second, an educational video was created
for the school and health promoting hospital in the community. Third, a meeting was held with
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 4
political, health, and educational leaders in the community in order to gain their support and
involvement for the other two projects, in addition to handing out informational
pamphlets. Together we hope that these portions of our intervention will work to create a safer
environment on the roads of Lawa Lake.
Literature Review
Background
Worldwide, road safety is a major public health concern. Each year, 1.24 million people
die in traffic accidents (World Health Organization, 2013). Additionally, 20 to 50 million people
are injured in traffic accidents each year (World Health Organization, 2002). The majority of
fatalities occur in middle income countries with 20.1 fatalities per 100,000 people as compared
to 8.7 fatalities per 100,000 in high income countries (World Health Organization,
2013). Roughly 50% of these deaths occur amongst vulnerable road users: motorcyclists,
bicyclists, and pedestrians (World Health Organization, 2013).
In 2013, Thailand was ranked third in the world for most road accident fatalities
(Serireongrith, 2013). Road related accidents are the fifth most prevalent cause of death in
Thailand with 38.1 deaths per 100,000 people (World Health Organization, 2002). Thailand is
the worst in the world in terms of motorbike accident fatalities with 11,000 casualties per year
(Hodal, 2012). Motorbike fatalities make up 70% of Thailand’s road accident deaths (Hodal,
2012). There is a high rate of underaged and unlicensed motorcycle driving in Thailand and the
average age that people begin driving motorcycles is 12.8 (Waiyanate and Taekarthonk,
2009). Additionally, fatal accidents are the most common in rural areas, where policies are least
enforced and access to emergency medical care is least available (Suriyawongpaisal and
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 5
Kanchanasut, 2003). The population of Thailand is 66% rural; therefore, this contributes to the
prevalence of road accident morbidity and mortality (World Bank, 2012).
In Thailand, the increase in traffic accidents parallels the economic situation of the
country. The number of traffic accidents reached a record low during the economic downturn in
the 1980s, reached a record high during the subsequent bubble economy, and then dropped again
in 1997 with the economic crash (Suriyawongpaisal and Kanchanasut, 2003). This trend occurs
due to increased access to motor vehicles and gasoline during good economic
times. Furthermore, as Thailand has transitioned into a middle income country, the roads have
improved and motor vehicles have become increasingly available to Thai people
(Suriyawongpaisal and Kanchanasut, 2003). However, safety policies and enforcement have not
kept up with these strides in infrastructure. Improved roads mean that people can drive
faster. More availability of motor vehicles means increased congestion and hence increased
danger of accidents.
Risk Factors
In one study seeking to identify the main risk factors involved in motorcycle collisions in
Thailand, alcohol was proven to be the most prominent factor. The study entailed an in-depth
investigation of 969 collisions in which 1,082 riders were involved. Of these 1,082 riders, 393
were drinking at the time of impact. Of the 969 collisions, alcohol was the primary cause of
accident in three-fourths of the accidents and the only cause in one-third of the
accidents. Comparatively, when non-drinking drivers were involved in a collision, they were
considered the primary cause of less than half (43%) of the incidents. According to the
researchers, the accidents involving alcohol were distinctly different than those which did not
involve alcohol in many regards. For one, alcohol-induced accidents were more likely to occur
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 6
on the weekends and at night. Additionally, drinking drivers were more likely to lose control of
the vehicle, violate traffic regulations, and be inattentive right before the crash. Men were more
likely to be driving than women. Drivers who had been drinking were more likely to be
hospitalized and killed than non-drinking drivers. There were minimal speed differences
between drinking and nondrinking drivers (Kasantikul, Ouellet, Smith, & Panichabhongse,
2005).
Researchers Nakahara et al. investigated the temporal distribution of motorcyclist injuries
in relation to several risk factors in Khon Kaen, Thailand, a city approximately 59 km away from
Lawa Lake. The risk factors evaluated included age, helmet use, and driving while
intoxicated. Although Thailand has an aging population, 72.9% of those interviewed were
younger than 30 years old. Riding without a helmet peaked in late evening and driving under the
influence peaked around midnight. Both of these risk factors resulted in an increased severity of
the accident. The researchers conclude that in addition to increased law enforcement at night,
safety education should target specific age groups and times (Nakahara, Chadbunchachai,
Ichikawa, Tipsuntornsak, & Wakai, 2005).
Another risk factor pertaining to road traffic accidents in Thailand is socioeconomic
status. Yongchaitrakul, Juntakarn, and Prasarthritha (2012) compared socioeconomic status,
type of motor vehicle, and seating position as related to severity of injury in the greater Bangkok
area. While our research focused on the northeastern Isan region, many of the trends in Bangkok
are relevant in Isan and highlight overall national concerns. Few studies have focused on seating
position on the motorcycle of those injured. This is relevant because it is typical to see many
family members on one motorcycle, often without helmets. The study found that the middle seat
had a greater likelihood (16%) of being injured when compared with the rear seat (1%). The
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 7
conclusions of the study additionally indicated that patients with a lower education level
accounted for the largest number of cases.
Road Safety Policies
The WHO outlined Thailand road safety policies in their 2012 report. The country has a
maximum national speed limit of 80 kmh on urban highways. There is also a law prohibiting
driving with a blood alcohol level of greater than 0.05 g/dl. There is a motorcycle helmet law in
place, although enforcement is sporadic. Only 53% of motorcycle drivers and 19% of
passengers wear helmets, according to one study. There is also a seatbelt law requiring all front
seat riders to wear a belt. Only 61% of drivers and 42% of front seat riders wear
seatbelts. There is also a mobile phone law in place that prohibits use of handheld devices while
driving (World Health Organization, 2012).
A study conducted by Suriyawongpaisal, Hyder, and Juul uses Thailand as a case study in
evaluating road safety policies in developing countries (2007). This case study focused on how
policies have been formed in Thailand to promote a decrease in road traffic injuries. Policies
that have been formed have focused on increased helmet use, seat belt use, and the use of
daytime headlights on motorbikes (Suriyawongpaisal et al., 2007). Throughout Thailand, there
was also a ban on alcohol advertising in media sources in efforts of reducing the number of
drunk driving incidents and increasing the public’s awareness of the ill effects of alcohol. The
three main components that ensured the enforcement of the new policies were advertising,
advocating, and lobbying (Suriyawongpaisal et al., 2007).
Convex Mirror
Convex mirrors have the ability to remedy visibility issues when other solutions will not
work. They are considered an economic option in comparison to more expensive ones, like
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 8
restructuring existing roads. In particular, convex mirrors can be particularly useful at obscured
T-junctions, concealed driveways, bends in a road, and parking areas. In order for the mirror to
be effective and long-lasting, the mirror must be durable, low maintenance, and made from
weather-resistant material (DuraVision Mirror Systems, 2012).
Traffic safety education
An important means of reducing the incidence of road traffic accidents and injuries is to
educate the community about the dangers associated with driving and riding motor vehicles. A
recommendation that was presented in one study states that road traffic safety education should
be administered in primary school (Yongchaitrakul, Juntakarn, & Prasartritha,
2012). Researchers have recognized the need for a holistic approach in order to fully influence
the behaviors of a community. Drivers and riders learn mostly through practical application on
the road, but it is important for traffic safety education to provide a foundation for experiential
learning (Joubert, Fraser, & Sentsho, 2012).
The Thailand Road Safety Master Plan included began in May of 2000 and had nine
different components. Educating children was one of the nine components and it was found that
educating children as early in childhood as possible helped reduce the number of road traffic
injuries later in their lives (Klein, 2001). The education instruments were implemented in the
school curriculum at local and community levels and tried to incorporate students, teachers,
police officers, and government agencies as well as other community members. To ensure
children were receiving uniform information, there were standard training manuals that were
used by the people who were involved in training other people and children (Klein, 2001).
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 9
Research rationale
Our reasoning for conducting research on road safety in the Lawa Lake community is
because of the quantity and severity of road-related injuries in Thailand. Based on previous
research, there are multiple established risk factors for these deaths, including a lack of helmet
and seatbelt usage, drunk driving, speeding, and underaged driving. Additionally, rural
communities in Thailand like Lawa Lake are the most affected by road-related
injuries. Although there are some policies regarding road safety in Thailand, there are less
people to enforce these in rural communities. Also, when there is a road-related injury in a rural
community, it is more difficult for emergency medical services to reach them. Lawa Lake is a
rural community in Thailand that has expressed to previous CIEE students a need for
improvements in road safety (CIEE, 2013). Therefore, we conducted research in order to
evaluate the severity of traffic safety in Lawa Lake and to guide our intervention.
Intervention objectives and purpose
The overarching goal of our modest intervention is to improve the road safety conditions
in Lawa Lake. We understand that in order to most successfully combat a public health problem
it must be approached from many different angles; therefore, we addressed the community’s
infrastructure, knowledge, and behaviors separately within our intervention. We hoped to
successfully install a convex mirror to reduce the number of accidents at the dangerous T-
intersection. Additionally, we wanted to increase awareness and safe driving habits among
youth now and in the future by leaving an educational video with the local school and with the
health promoting hospital. By creating pamphlets, we hoped to reach households to provide tips
for safer driving, as not everyone will have access to the video in schools. Finally, by holding a
meeting with the headman, village health volunteers, and school teachers we hoped to increase
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 10
the sustainability of our intervention by including them in the implementation of our convex
mirror and video projects in their community and emphasizing the importance of road safety by
passing on our collected data. Most importantly, we hoped to foster good relations with the
Lawa Lake community. As the first CIEE student group to visit Lawa Lake, it is necessary that
we continue to develop a strong relationship with the community in order to ensure the
sustainability of our project.
Methods
Measurements
Road safety questionnaire. We distributed 50 surveys in order to gauge the Lawa Lake
community members knowledge about road safety practices. Stratified convenience sampling
was used in order to gain an even number of participants older than 30 years old and 30 years old
and younger. There were two versions of the questionnaire, dependent on whether or not the
participant was a driver or non-driver. Community members were chosen based on availability
and administered in an interview format. The survey questions pertained to helmet use,
speeding, drunk driving, underaged driving, knowledge of road rules, education regarding road
safety, prevalence and cause of accidents, and opinions of road safety in Lawa Lake (see
Appendix A & B).
Motorcycle observation. In addition to the road safety survey, our group spent four
hours observing motorbikes that passed by a busy intersection in the village. We each took a one
hour shift at the intersection and observed the number of people per each motorbike, if the
passengers or drivers were wearing a helmet, and if the person driving was a child or
teenager. Since it was after school hours, we defined a child or teenager as someone who was
wearing a school uniform.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 11
Sample Population
Since road safety is a problem that everyone is susceptible to, we wanted to create an
intervention to target all populations. Therefore, there were 4 different components to our
intervention. We targeted community leaders by creating a data sheet with all of our research
results to present to them at a stakeholders meeting. We targeted households and all drivers by
creating pamphlets about road safety to be given out by village health volunteers and by
installing a convex reflective mirror at a dangerous T intersection in Moo 10. Lastly, we targeted
children and teenagers ages 10 to 18 years by filming an educational video to be shown in
schools to teach about road safety.
Intervention
Convex reflective mirror. During our questionnaires, we were notified by community
members and a police officer of a dangerous intersection within the Lawa Lake community, in
Moo 10, where there have been numerous accidents. The police officer recommended that we
install a convex reflective mirror. The belief is that installing a convex reflective mirror would
be a better idea than a stop sign, or other road signs, because drivers may be more inclined to run
the stop sign compared to stopping if they saw another vehicle in the mirror. We found a bucket,
sand, and gravel and purchased a convex reflective mirror, a metal pole, and concrete to stabilize
the mirror. Before going into the community, we mixed the sand, gravel, and concrete together
and put it in the bucket surrounding the metal pole. We let it set for four days before going into
the community. Once we got into the community, we showed the community leaders, including
the headwomen, where we felt that the mirror should be placed. We left the materials at the
health promoting hospital so that the community members could install it at a later date.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 12
Educational traffic safety video. An educational traffic safety video was filmed with
children and teenagers in the Lawa Lake community between the ages of 10 and 15. The video
was intended to highlight problems that we observed regarding road safety in the Lawa Lake
community throughout our research. These problems included helmet use, speed, and drunk
driving. After filming the children and teenagers, the video was edited and a translator narrated
the video in Thai. We made ten copies so that some could be given to the school and some could
be left at the health promoting hospital. The video will be given to the director of the health
promoting hospital by next semesters’ CIEE students and he will then distribute it to the primary
school in the community.
Pamphlets. Based on the information we gathered during our research, we created
pamphlets highlighting the most important road safety information that the Lawa Lake
community should be aware of. We included statistical information that we gathered about
Lawa Lake, information about road safety in Thailand, precautions that people can take in order
to drive or ride more safely, and the importance of wearing a helmet. We sent the pamphlet to a
translator so that it could be translated into Thai and then we printed out 200 copies for village
health volunteers to give to each house that they take care of. We also plan to give the health
promoting hospital an electronic version of the pamphlet on a USB so that they could print more
when they need them.
Stakeholder meeting. At the stakeholders meeting, we presented the hospital director,
Village Health Volunteers, a police officer, a primary school teachers, a director from at the
regional hospital, and other community leaders with data sheets that we created about the
research that we gathered. We explained to them the purpose of the convex reflective mirror,
educational traffic safety video, and pamphlets. We also emphasized the importance of proper
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 13
road safety behaviors and the possible outcomes if certain safety measures are not followed. We
stressed the importance of showing the educational traffic video to school-aged children and
impressed upon them the importance of wearing helmets, reducing speeds, not drunk driving,
and not driving underaged. Through this meeting, we hoped to gain the support of the
stakeholders so that they continue to monitor the success of road safety in the Lawa Lake village
in the future.
Budget.
Item Cost
Mirror 950 B
Pole 526 B
Cement 130 B
Refreshments 555 B
10 Blank DVDs and cases 138 B
200 Pamphlets and other printing 1,068 B
1 Translator 500 B
Transportation 2,165 B
Gifts 1,140 B
Lunch 400 B
Total 7,572 B
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 14
Timeline 2013.
Sunday Monday Tuesday Wednesday Thursday Friday Saturday
Nov 17 Nov 18 Nov 19 Nov 20 Research
Proposal
Presentation
Nov 21 Nov 22 Research
Day
Nov 23 Research
Day
Nov 24 Calculated
Statistics
from
Research
Day
Nov 25 Nov 26
Nov 27 Nov 28 Intervention
Proposal
Presentation
Nov 29 Nov 30
Dec 1 Dec 2 Dec 3 Collect
Materials;
Cement
Pole
Dec 4 Collect
Materials
Dec 5 Collect
Materials
Dec 6 Intervention
Run-
through;
Pamphlets
Dec 7 Intervention
Day
Intervention Day: 9:30 Arrive at Lawa Lake
9:30 - 1:20 Re-visit location for pole installation; Begin filming; Attend diabetes session
1:30 - 2:15 Stakeholder meeting
2:15 - 3:30 Showing community leaders where to put the pole; End filming
3:30 Leave Lawa Lake
Data Analysis
Pre-Intervention. Following our research, we used Microsoft Excel to calculate
different statistics pertaining to age, sex, helmet usage, speeding, drunk driving, and underaged
driving.
Post-Intervention evaluation. Due to the nature of our intervention, there is no
quantitative way for us to evaluate the success immediately. Qualitatively, we evaluated our
success by listening to the comments that community leaders had at the stakeholder meeting and
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 15
by noticing their level of enthusiasm about our different intervention components. However,
students next semester could evaluate our intervention by conducting observations at the same
intersection that we originally observed at. They can check to make sure that the convex
reflective mirror was installed and they could also survey the community, especially Moo 10, to
see if there were less accidents in that intersection.
Ethics
Research. With any research or intervention that deals with human participants, ethical
procedures need to be followed. Before conducting any research we told participants who we
were and what we were researching. We made sure to gain their approval before moving
forward with any questions we had for them.
Intervention. When implementing our intervention, we made sure to receive consent by
the community by conducting a stakeholders meeting with community leaders and respected
their wishes when they asked us to leave the convex reflective mirror for them to install instead
of us installing it ourselves. We continually made sure that we were respectful of the Lawa Lake
community.
Results
Research Results
The results of both our questionnaire and our roadside observation in Lawa Lake showed
road safety to be a significant issue in the Lawa Lake community. Helmet use, speeding and
reckless driving, drinking and driving, underage driving, infrastructure problems, and crowded
roads were all raised as problems in the community.
Questionnaire. The goal of our survey was to determine an appropriate target group and
specific topic for a road safety intervention by gauging the current level of road safety in the
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 16
community and by determining the desires of the community. The survey was centered on issues
such as: helmet use, drunk driving, underage driving, knowledge of road rules, prevalence and
cause of accidents, and opinions of road safety in Lawa Lake. Fifty villagers were surveyed. In
this population 40% were male and 60% were female. The age of participants ranged from 10 to
72 years and the average age was 34.5 years. Of those surveyed 78% drive motorcycles while
22% only ride as a passenger. Pertaining to helmet usage, 16% of community members said that
they always wear a helmet, 58% said that they wear a helmet more than half of the time, and
26% said that they wear a helmet less than half of the time (Fig. 1). The data suggests that non-
drivers are statistically more likely to wear a helmet than drivers with 42% of non-drivers always
wearing a helmet and 8% of drivers always wearing a helmet (p=0.015). Additionally, people
over age 30 were found to be statistically more likely than people younger than 30 to wear a
helmet with 23% of those over 30 and 4% of those younger than 30 wearing helmets
(p=0.007). Finally, it is appropriate to note that many of the drivers who rarely wear helmets
claim to always wear a helmet when driving long distances, outside of Lawa Lake.
Fig. 1 Reported helmet use (L-R) among all surveyed participants, among drivers, and among
drivers younger than 30.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 17
Drunk driving also poses a serious problem in the Lawa Lake community; 29% of
participants in our survey reported having driven a motorcycle under the influence of alcohol at
least once in their lifetime. Males were far more likely than females to drive under the influence
of alcohol than females with 53% of males and 12% of females having done so (p<0.001).
In order to gauge the level of underaged driving in the community, each participant was
asked at what age they began driving a motorcycle. The ages given ranged from 10 to 60 with a
median age of 13.5 years (Fig. 2). Amongst motorcycle drivers, 53% said that they started
driving before the legal age of 15. In our survey population, 20% of participants were below age
15. These riders are statistically the least likely to wear a helmet when driving with every
participant in this age group saying that they wear a helmet less than half of the time
(p<0.001). Additionally, these riders are statistically more likely to ride with more people on a
motorcycle than those older than 15 with an average of 3.9 people per motorcycle as compared
to 2.6 people per motorcycle for people older than 15 (p<0.001).
Fig. 2 Reported age when participating drivers first started to drive a motorcycle.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 18
Knowledge of road rules was gauged by asking participants whether there was a speed
limit in Lawa Lake or not. It was clear that people in Lawa Lake were generally uneducated
whether or not there is a speed limit and what it is. Of respondents, 27% said that they think
there is a speed limit in Lawa Lake. When asked what the speed limit is, their answers ranged
from 30 to 80 km/hr (Fig. 3). A policeman we interviewed told us that in actuality there is no
speed limit in Lawa Lake.
Fig. 3 Reported speed limits given by the 13 participants who said there is a speed limit in Lawa
Lake.
In order to gauge the prevalence of accidents in the Lawa Lake community, participants
were asked if any family member had ever been in a motor vehicle accident. Of those
interviewed, 67% of participants said that a family member had been in an
accident. Furthermore, 67% of these accidents occurred within the Lawa Lake
community. Participants were asked what the cause of their family member’s accident was (Fig.
4). The top answer, at 38%, was speeding. Hitting animals on the road was second with
17%. Drunk driving was the third most prevalent answer at 12%. Other answers including
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 19
driving in the wrong lane, falling asleep while driving, vehicle malfunctions, and bad weather
made up the remaining 33% of answers.
Fig. 4 The most common causes of motorcycle accidents in the Lawa Lake community.
Finally, in order to gauge opinion of road safety as a problem in Lawa Lake, each person
surveyed was asked whether they thought road safety to be a problem in the
community. Participants who believed road safety to be a problem made up 63% of those who
took the survey. These participants were then prompted to explain why road safety is a problem
(Fig. 5). Teenagers seemed to be of the greatest concern. Their tendency to speed, drive
recklessly, and do wheelies was the most important road safety problem to 48% of the
population. Another 15% said that the roads are overcrowded due to too many drivers and
animals in the road. Driving while intoxicated was cited by 11% and another 11% said that there
is a lack of speed limit and regulations. Lastly, many spoke of infrastructural hazards being the
greatest issue as 8% referenced a blind spot in the village where many accidents occur, and 7%
talked about holes in the road as a safety issue.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 20
Fig. 5 Reasons given by participants in the questionnaire for road safety problems in the Lawa
Lake community.
Observation. Researchers observed 551 motorcycles with 724 riders pass by the
intersection near the temple in the Lawa Lake community. Of these riders, only 7.5% were
observed to wear a helmet. Drivers were wearing helmets 8.7% of the time while riders were
observed to wear helmets only 3.49% of the time. Solo riders made up 73.3% of those observed,
22.1% had two riders, 4.2% had three riders, and 0.4% had four riders. Teen and child drivers,
defined as riders wearing school uniforms, made up 16.9% of the drivers. Only 9.7% of teen
drivers were wearing helmets. This is contrary to the information given by teens who were
surveyed. We speculate that this could be due to school rules regarding helmet use since most of
the teens seen were driving home from school.
Intervention Results
We arrived in Lawa Lake at approximately 9:30AM on December 7th, 2013. Upon
arrival, the other group’s diabetes workshop occurred. We participated in this, in addition to
revisiting the location of the convex mirror and beginning to obtain footage for our video. We
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 21
spoke with some village health volunteers to assist us in gathering the stakeholders whom we
wished to speak with.
As we were waiting for everyone to show up for the stakeholders’ meeting, we
approached several teenage boys at the health promoting hospital and asked if they would like to
be filmed for our movie. They agreed and Collin went with them to shoot footage. Jackie,
Laura, and Sarah were to lead the stakeholders’ meeting. At 1:30PM, we began the
meeting. There were 14 community members present: the vice head-woman of Moo 10, a
volunteer policeman, the director of family planning from the Ban Phie Hospital, the director of
Moo 10 village health volunteers, the director of the Lawa Lake health promoting hospital, a
road safety teacher from the neighboring school, and several village health volunteers. At the
meeting, we handed out data sheets that we had prepared which graphically displayed the results
of our research. We explained each statistic on the sheet. The road safety teacher took notes on
his copy. The director of family planning made several comments and asked questions
throughout the presentation. Following, we opened it up for discussion and asked if any of them
found the results surprising or believed the statistics were indicative of the community’s
practices. The director of family planning articulated that he believed the results were accurate
and that similar studies done previously yielded similar results. During this, one student noticed
a village health volunteer making a Facebook status about the statistics on our sheet.
We then explained the three components of our intervention: the mirror, the educational
video, and the pamphlet. When we brought up the mirror, they asked us if after the meeting we
would take them to the location. We presented the pamphlets and recommended that they are
distributed by village health volunteers. The road safety teacher and the health promoting
hospital additionally took some pamphlets.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 22
Following the meeting, we took the stakeholders to the location of the mirror as shown to
us by a policeman while researching. Several of the attendees of the stakeholders’ meeting
already knew which intersection we were referencing. We met the head woman there and
presented her with our mirror. We returned to the health promoting hospital. The director of the
hospital asked us for our email addresses so he could send us pictures of the mirror once
installed. Around 3PM, we left to return to Khon Kaen.
Discussion
Interpretation of Results
Research. The results of our research strongly guided our intervention and supported the
need for one. As secondary research indicated, helmet usage in Lawa Lake was strikingly low,
even lower than the national averages. In questionnaires, 16% of the population reported always
wearing a helmet, but only 7.46% of motorcycle riders observed wore their helmets. The
questionnaires indicated that many Lawa Lake residents will only wear a helmet when they leave
the community. Of the participants, 67% had had at least one member of their household
involved in a motor vehicle accident. Of these accidents, 67% occurred within the community
limits. Due to the prevalence of accidents within Lawa Lake, helmet usage even when riding a
short distance needs to be increased.
As 29% of participants reported having driven after drinking alcohol and several
respondents indicated drunk driving as a cause of accidents, it was deemed a significant risk
factor of Lawa Lake traffic accidents. Secondary research supported that drunk driving is a
major risk factor of traffic accidents globally and therefore, it will be addressed in the
educational video in addition to the pamphlet.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 23
The median age that respondents began driving was 13.5, despite the legal driving age of
15. Additionally, this demographic is less likely to wear a helmet and more likely to drive with
more people than those above the age of 15. These statistics influenced the target group choice
for our intervention. Because of their lack of driving experience and increased risky behavior,
they are at a greater risk for accidents and injuries.
The lack of knowledge about the existence of a speed limit proved that institutional
regulations were not clear. It was confirmed by a policeman that there is not a speed limit in
Lawa Lake. However, the fact that many respondents answered, “I don’t know” confirmed the
need for community-wide conversations concerning Lawa Lake’s current status and desired
future traffic safety status.
Finally, 63% of the participants expressed that road safety was a concern within their
community. Almost half of those participants cited teenagers’ reckless driving as the main cause
of the problem, once again reiterating that the target group that the intervention needed to focus
on is teenagers between the ages of 10 and 18 years.
Intervention. The stakeholders are a crucial component to our intervention as they will
ensure that the project is sustainable. We were pleased by the turnout at the meeting as we had
community leaders from several different sectors. Many leaders are now involved and invested
in the installation of the convex mirror which will aid in its success. During the stakeholders’
meeting, attendees appeared engaged and interested. The road safety teacher was taking notes
and one village health volunteer even appeared to have made a Facebook status about the
statistics on the data sheet we prepared. We interpret this as awareness that traffic safety is a
community concern. Prior to our departure, the director of the health promoting hospital asked
for our personal email addresses so that he could send us pictures when the mirror is
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 24
installed. We interpreted this as a good sign because since they sought us out to ask for the
information instead of the other way around, it shows their level of excitement about the
project. The community appears to be invested in the project and eager to mobilize and make
changes in Lawa Lake. Since community engagement is such a crucial component of successful
public health interventions, it was exciting that the stakeholders and the community as a whole
appeared to be interested in both our research and our intervention.
When we passed out our pamphlets, the plan was to leave all of the pamphlets at the
health promoting hospital for the village health volunteers to distribute. However, when we
attempted to do this, the director of the health promoting hospital also handed a stack to the road
safety teacher to distribute within the school. This was positive because it demonstrated that he
saw methods of disseminating traffic safety knowledge further than what we initially
intended. The community’s initiative gives hope to the sustainability of the project.
The educational video provides a unique opportunity to integrate community health
concerns into the local school. By filming local village children as opposed to ourselves, we
hoped to make the video more personal and relevant to the kids’ lives. Additionally, the kids
who are featured in the film hopefully become excited about traffic safety and may think about it
in a new light. It will hopefully be exciting for them to see themselves and their friends on
screen during school. While in some ways it is unfortunate that the video will not be delivered to
the community prior to our departure, this will only increase the sustainability of the project. We
have already made contact with the road safety teacher at the local school and he is aware that
the video will be arriving. Future CIEE students may feel ownership over the video and continue
to research traffic safety and work with Lawa Lake to improve their attitudes and behaviors.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 25
Expected Outcomes
It is expected that once installed, the convex mirror will increase visibility at the T-
intersection and therefore decrease the amount of accidents that occur there. Drivers of
motorcycles and cars alike will be able to see oncoming traffic prior to turning onto the main
road. Hopefully, the installation of the mirror will prompt conversations within the community
about the current traffic safety situation and further actions that can be taken to continue
infrastructural improvement.
In addition, it is expected that the finished educational video will be sent to health
promoting hospital next February with future CIEE students. The director of the health
promoting hospital will then deliver copies of the neighboring school. The teacher whom we
talked to during the stakeholders meeting will use the video when teaching about road
safety. Based on our own research and others’, we expect that adolescents within the community
will improve their driving and riding behaviors. This includes, but is not limited to: wearing a
helmet more frequently, driving with less people on the vehicle, not driving after drinking, and
not driving as recklessly.
In regards to the pamphlet, it is our belief that this will increase awareness and concern
amongst the general population of Lawa Lake. We have recommended that village health
volunteers bring them to the houses they visit and have a conversation with the villagers about
why traffic safety is important. The pamphlets provide not only Lawa Lake-specific data, but
also national statistics in order to convey the necessity for reform on a local and national
scale. By reaching this demographic, we hope that adults will adopt better driving and riding
habits, similar to our expected outcomes for adolescents. Additionally, we hope that adults will
begin encouraging their children and peers to drive and ride more safely.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 26
Problems Faced During Intervention
It was our goal to remain flexible during the intervention process as problems are bound
to arise. When we arrived at the health promoting hospital in Lawa Lake we were told that not
that many people were around because there was a festival nearby. Fortunately, we were able to
find the right people for our stakeholders’ meeting and in addition to children for filming.
Despite offering several date choices prior to landing on the one we did, there was still an
unforeseen schedule change.
Our initial plan was to spend the morning of intervention day installing the convex
mirror. However, the night prior, we received an email stating that we would be leaving the
mirror with the head-woman of Moo 10 and she would complete the installation at a later
date. Once we arrived in Lawa Lake and this was further explained to us, we felt comfortable
leaving it with her and were confident that it would be properly installed. We ended up leaving
the bucket and pole at the health promoting hospital and the mirror with its attachments with the
head woman.
Additionally, there was a miscommunication and the translators we used for our research
were unable to attend the intervention day. We had to adjust our plans and were unable to use a
translator when filming the village children for the movie. This provided minor setbacks and
increased language barriers at some point, but we were able to obtain the footage needed
regardless.
Conclusion
Summary of Findings
Our research informed us that road safety is indeed a problem in the Lawa Lake
community. Through our observations, we learned that only 7.5% of riders wear a helmet and
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 27
9.7% of drivers were school aged children and teenagers. It is because of this information that
we decided to aim our intervention at all community members in the Lawa Lake
community. However, we decided to have a specific component of our intervention targeted
towards children and teenagers.
Although we do not have a quantitative way to measure the level of impact, we
qualitatively determined our level of success. The level of enthusiasm from the community
leaders in our stakeholder meeting stressed the importance of our planned interventions. They
were enthusiastic about our convex reflective mirror and asked us for our email address so they
could send us a picture to show us when it was done. The primary school road safety teacher
also agreed to show the educational traffic safety video to his students.
Strengths and Limitations
Our group encountered several limitations while preparing and implementing our
intervention. First of all, we underestimate the process of cementing our pole into the
bucket. We did not know how extensive of a project that was going to be and therefore we were
very lucky that Na Am was willing to help us. We experienced other limitations when we got
into the Lawa Lake community. We were unaware that there was a festival going on that day
and therefore many community members were not around. We planned on doing our
intervention in the morning while the Lawa Lake diabetes group was supposed to go in the
afternoon. However, this was switched because when we arrived the people for the diabetes
intervention were already at the health promoting hospital. Another limitation that occurred on
that day was that our translator never came. Ajaan Toon did a wonderful job translating for us;
however, we were planning on having a translator for the whole day and not just for a few
hours. This meant that when one group member was filming the video, while the other group
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 28
members were conducting the stakeholders meeting, the person filming the video did not have a
translator to communicate with the children. Lastly, we were unable to install our convex
reflective mirror in the community that day because the community did not want us to.
The strengths of our intervention mostly revolve around the fact that our group really
played to individual strengths and we worked really well together. When we had complications
in the Lawa community, we were able to successfully cope with it and be flexible in order to
have a successful intervention.
Recommendation for Future Research
For future research, we recommend that there are more observations at different times of
the day or at different locations. It would be interesting to observe at the mouth of the
community to see the statistics of who is wearing a helmet when they leave the
community. Observations could happen every month and the information could be compared to
previously collected statistics in order to note a possible improvement. It would also be
important to study the conditional usage of helmets with farmers and with the people who said
they only wear a helmet when they leave the community.
Recommendation for Future Interventions
We recommend that next semesters CIEE students can follow up with the community
about the installation of the mirror. Our last recommendation for an intervention would be to
have more contact with the school. Although we would call our stakeholders meeting a success,
it would be very beneficial if more teachers attended so that all teachers would understand the
importance of teaching road safety information to students.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 29
References CIEE. (2013, October).
DuraVision Mirror Systems. (2012, September 9). Do convex mirrors work? Retrieved
December 6, 2013, from http://www.duravision.net/duravision/news/do-convex-mirrors-
work
Hodal, K. (2012, May 15). Thailand's government seeks to get a head start on improving road
safety. The Guardian . Retrieved from: http://www.theguardian.com/global-development
/2012/may/15/thailand-head-start-road-safety
Joubert, I. J., Fraser, W. J., & Sentsho, M. L. (2012). Road safety education: A paradoxical state
for children in a rural primary school in South Africa. Journal of Asian and African
Studies, 48(2), 209-228. http://dx.doi.org/10.1177/0021909612449125
Kasantikul, V., Ouellet, J. V., Smith, T., & Panichabhongse, V. (2005). The role of alcohol in
Thailand motorcycle crashes. Accident Analysis and Prevention, 37(2), 357-366.
Retrieved from: http://dx.doi.org/10.1016/j.aap.2004.07.006
Klein, R., (2001). Road & Transport Research.Thailand road safety education, 10(4), 54-67.
Nakahara, S., Chadbunchachai, W., Ichikawa, M., Tipsuntornsak, N., & Wakai, S. (2005).
Temporal Distribution of Motorcyclist Injuries and Risk of Fatalities in Relation to Age,
Helmet Use, and Riding while Intoxicated in Khon Kaen, Thailand. Accident Analysis
and Prevention, 37(5), 833-842. http://dx.doi.org/10.1016/j.aap.2005.04.001.
Serireongrith, P. R. (2013, November 15). Thailand Ranked World’s No.3 in Road Fatalities.
National News Bureau of Thailand. Retrieved from: http://thainews.prd.go.th/centerweb/
newsen/NewsDetail?NT01_NewsID=WNSOC5611150010001.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 30
Suriyawongpaisal, P., Hyder, A. A., & Juul, N. H. (2007). Filling Know-do Gaps In Road Safety
Policy In Developing Countries: A Case Study Of Thailand.International Journal of
Injury Control and Safety Promotion, 14(2), 128-130.
Suriyawongpaisal, P. and Kanchanasut, S. (2003). Road Traffic Injuries in Thailand: Trends,
Selected Underlying Determinants, and Status of Intervention. Injury Control and Safety
Promotion. 10 (1-2), 95-104.
Waiyanate, N. and Taekarthonk, T. (2009). The New Trend of Risky Groups on All Roads in
Thailand, 2009. Injury Prevention. 16, A13.
World Bank. (2012). Rural Population. Retrieved from: http://data.worldbank.org/indicator/SP.
RUR.TOTL.ZS/countries.
World Health Organization. (2002). Magnitude and Impact of Road Traffic Injuries. Retrieved
from: http://www.who.int/violence_injury_prevention/road_traffic/activities/roadsafety_
training_manual_unit_1.pdf.
World Health Organization. (2013). Global Status Report on Road Safety: Supporting a Decade
of Action. Retrieved from: http://www.who.int/gho/road_safety/en/index.html.
Yongchaitrakul, T., Juntakarn, C., & Prasartritha, T. (2012). Socioeconomic inequality and road
traffic accidents in Thailand: Comparing cases treated in government hospitals inside and
outside of Bangkok. Southeast Asian Journal of Tropical Medicine and Public
Health, 43(3), 785-794.
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 31
Appendix A
Questionnaire used to evaluate road safety attitudes and behaviors of motorbike drivers.
1. How old are you?
. years old
2. Do you drive a motorbike?
Yes No
3. How old were you when you first started driving?
. years old
4. How often do you wear a helmet?
100% of the time >50% of the time (or in certain circumstances) <50% of the
time
5. What is the maximum number of people who ride on your motorbike at one time?
. People
6. Is there a speed limit in Lawa Lake?
Yes No
If yes, what is the speed limit? km/hr
What is the average speed you drive? km/hr
7. Have you ever driven after drinking alcohol?
Yes No
8. Have any of your friends or family members been in a motor vehicle accident?
Yes No
If yes, were they: Driving Riding Walking Other
Please explain: (Did it happen in the Lawa Lake community?)
9. Do you feel that road safety is a problem in Lawa Lake?
Yes No
Please explain:
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 32
Appendix B
Questionnaire used to evaluate road safety attitudes and behaviors of non-motorbike drivers.
1. How old are you?
. years old
2. Do you drive a motorbike?
Yes No
3. Do you ride on a motorbike?
Yes No
4. How often do you wear a helmet?
100% of the time >50% of the time (or in certain circumstances) <50% of the
time
5. What is the maximum number of people who ride on a motorbike at one time?
. People
6. Is there a speed limit in Lawa Lake?
Yes No
If yes, what is the speed limit? km/hr
7. Have you ever ridden on a motorbike with someone after they have been drinking
alcohol?
Yes No
8. Have any of your friends or family members been in a motor vehicle accident?
Yes No
If yes, were they: Driving Riding Walking Other
Please explain: (Did it happen in the Lawa Lake community?)
9. Do you feel that road safety is a problem in Lawa Lake?
Yes No
Please explain:
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 33
Appendix C
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 34
Appendix D
RUNNING HEAD: TRAFFIC SAFETY IN LAWA 35
Acknowledgement The Lawa Lake road safety research team would like to acknowledge the support given to
us by the Khon Kaen University faculty of Public Health. We would like to give a special thank
you to Ajaan Pattara, Ajaan Toon, and Ajaan Nai for providing useful feedback and guidance
throughout our research and intervention process. Also, to Ajaan Toon and Ajaan Nai for
helping arrange meeting times within the communities and for logistical support and for Ajaan
Toon translating during our intervention on short notice. We want to thank CIEE, and more
specifically Ajaan Jen and Sam, for answering unresolved questions and providing support when
needed throughout our research and intervention process. We would also like to thank Na-Am
for teaching and assisting us with the installation of the convex reflective mirror. Lastly, we
would like to acknowledge the people in the Lawa Lake Community, specifically the
headwoman of Moo 10, the director and staff of the health promoting hospital, village health
volunteers, the members of our stakeholder meeting, and the children of the community. They
allowed us to into their community to gain an educational experience while collecting data,
presenting the convex reflective mirror, and teaching them about road safety in their
community. We would like to offer a special thank you to the children who allowed us to film
them for our final project.