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


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.


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


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


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


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


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


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).


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


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.


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.


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


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


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;

Print

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


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


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.


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.


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


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.


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


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.


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.


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


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.


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.


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


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


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.


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.


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.

http://www.bibme.org/




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:


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:


Appendix C


Appendix D


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.

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