games for health: ace's adventure game
TRANSCRIPT
ACE’S ADVENTURE GAME
AN INNOVATIVE APPROACH TO PEDESTRIAN SAFETY FOR CHILDREN
M. Margaret Knudson MDProfessor of Surgery, UC-San Francisco
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
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