1. Wuhou District Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China; 2. Jingyang District Center for Disease Control and Prevention, Deyang, Sichuan 618000, China; 3. Sichuan Provincial Center for Disease Control and Prevention, Chengdu, Sichuan 610041, China
Abstract：Objective To evaluate the intervention effects of comprehensive interventions on the incidence of road traffic injuries and road traffic behaviors among middle school students, so as to provide evidence for optimizing the prevention and control strategies of road traffic injuries in this population. Methods A community-based trial design was adopted, with Wuhou District of Chengdu City as the intervention area and Jingyang District of Deyang City as the control area. Using stratified cluster random sampling, students from 6 middle schools in the intervention area and 5 middle schools in the control area were randomly enrolled as research subjects. In June 2024, questionnaires were used to collect the demographic information, incidence of road traffic injuries in the past 12 months and road traffic behaviors, including cycling, riding and walking. Routine traffic safety education was implemented in the control group, while a comprehensive intervention including multi-department collaboration, participatory safety education and improvement of the traffic environment around campuses was carried out in the intervention group from September 2024 to August 2025. A terminal survey was performed in September 2025. The difference-in-differences (DID) model was used to evaluate the intervention effect. Results A total of 7 917 middle school students were included in the baseline survey, with 5 267 students in the intervention group and 2 650 students in the control group. A total of 9 171 students were enrolled in the terminal survey, including 4 908 students in the intervention group and 4 263 students in the control group. DID analysis showed that the incidence of road traffic injuries decreased from 2.28% to 2.18% in the intervention group, while it increased from 2.42% to 4.55% in the control group, and the group-time interaction effect was statistically significant (DID=-0.021, P<0.05). In terms of cycling behaviors, significant group-time interaction effects were observed in riding vehicles without safety devices (DID=-0.045, P<0.05), wearing helmets when riding electric bicycles (DID=0.075, P<0.05), failing to keep a safe distance from large trucks (DID=-0.056, P<0.05), and failing to slow down when turning (DID=-0.049, P<0.05). For riding behaviors, wearing helmets when riding electric bicycles or motorcycles (DID=0.117) and wearing seat belts (DID=0.048) had statistically significant group-time interaction effects (both P<0.05). In terms of walking behaviors, jaywalking without observing traffic lights (DID=-0.024) and traveling at night without wearing reflective equipment (DID=-0.040) showed significant group-time interaction effects (both P<0.05). Conclusion Comprehensive interventions were effective in reducing the incidence of road traffic injuries and decreasing risky traffic behaviors related to cycling, riding in vehicles, and walking, while also promoting safe traffic behaviors among middle school students.
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