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Methodological proposal for implementing an intervention to prevent pedestrian injuries, a multidisciplinary approach: the case of Cuernavaca, Morelos, Mexico
  1. Jorge M Rodríguez1,2,
  2. Martha Híjar Medina1,
  3. Julio César Campuzano1,
  4. Shrikant I Bangdiwala3,4,
  5. Andrés Villaveces5
  1. 1National Institute of Public Health of Mexico—Center for Health Systems Research, Cuernavaca, Morelos, México
  2. 2Centro de Proyectos Para el Desarrollo (Cendex), Universidad Javeriana, Bogotá, Capital District, Colombia
  3. 3UNC Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  4. 4Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
  5. 5Cisalva Institute, Universidad del Valle, Cali, Velle, Colombia
  1. Correspondence to Dr Andrés Villaveces, Cisalva Institute, Oficina 114, Universidad del Valle, San Fernando Calle 4B # 36-00 Cali, Valle 25360 Colombia; avillavec{at}


Objective To describe the process for implementing an intervention to prevent pedestrian injuries in Cuernavaca, Mexico, using a multidisciplinary and evidence-based approach.

Methodology This study included two phases with several stages. The first was an overall assessment of pedestrian mortality in Cuernavaca that included a comparison of pedestrian mortality between Cuernavaca and the rest of Morelos State (1998–2007), an analysis and geocoding of pedestrian injuries (2008–2009), and a description of techniques for selecting and analysing clustered events using road audits. The second phase focused on selecting an intervention through a review of the literature seeking the ‘best evidence’ adaptable to the local context and a methodological evaluation for implementation including techniques for cluster randomisation and for the evaluation of possible effects of the intervention.

Results Between 2008 and 2009, in Cuernavaca there were 620 pedestrian injury events: 59.4% were men, the mean age was 36.3 years, 70% occurred during daylight hours, 55% had mild severity and there were no differences by sex (p>0.05). We generated evidence, that when combined with the results from a systematic search of the literature, provided sufficient information for the implementation of a pedestrian injury prevention intervention.

Conclusions A combination of strategies and disciplines makes it possible to comprehensively address this public health problem, allowing interventions to strengthen aspects of pedestrian safety while accounting for characteristics of the local context; the promotion of local measures, of low cost and high impact, with modifications to the road infrastructure, are more effective in addressing pedestrian vulnerabilities.

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