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Original Article
Study of knowledge and behavioural patterns with regard to road safety among high school
children in a rural community in Tamil Nadu, India
C K Priyanka Raj, Shib Sekhar Datta, Jayanthi V, Zile Singh, Senthilvel V
Dept of Community Medicine, Pondicherry Institute of Medical Sciences, Kalapet, Pondicherry–605014. India.
Dr. C.K. Priyanka Raj, Assistant Professor, Dept of Community Medicine, Pondicherry Institute of Medical Sciences,
Kalapet, Pondicherry–605014. India. Fax- 0413-2656068
Email: pri_man@rediffmail.com, dr.priyankaraj.30@gmail.com
Corresponding Author:
Received: 15-06-2011| Accepted: 29-07-2011 | Published Online: 24-08-2011
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (creativecommons.org/licenses/by/3.0)
Conflict of interest: None declared Source of funding: Nil
[4]. Pondicherry Institute of Medical Sciences which
is situated on the border of Puducherry and Tamil
Nadu state caters to populations from either side of
the border. Puducherry has the second highest
number of road accidents after Delhi among the
union territories while Tamil Nadu accounts for
14.5% of total road accident cases in the country [5].
Bringing about behavioural change among young
adults with regard to road safety starting from their
schooling years would go a long way in bringing
down morbidity and mortality due to road
accidents. Literature search revealed very few
studies conducted, especially from India in the area
of road safety among school children. The starting
point for any intervention aiming to bring about a
greater sense of responsibility and safety among the
Introduction
Globally, 1.2 million people die and another 20-50
million sustain injuries from road accidents every
th
year. Road accidents are 9 leading cause of deaths
th
and are estimated to become the 5 leading cause of
death by 2020 [1]. Globally road traffic injuries are
the leading cause of death among young people
aged 15-19 years and second leading cause among 5-
14 year olds [2]. 90% of world's road traffic fatalities
occur in developing countries. It is in this
background that the UN General Assembly has
declared 2011 to 2020 as the "Decade of Action for
Road Safety” which seeks to halt the increasing
trends in road traffic deaths and injuries worldwide
[3]. India has the dubious distinction of the country
with the highest number of road accident fatalities
Abstract
Background : Globally road traffic injuries are the leading cause of death among young people aged 15-19
years and second leading cause among 5-14 year olds. The UN General Assembly has declared 2011 to 2020 as
the "Decade of Action for Road Safety” which seeks to halt the increasing trends in road traffic deaths and
injuries worldwide. The starting point for any interventions aimed at achieving the UN declaration especially
with regard to young people would be to first know their understanding and behaviour patterns with respect
to road safety.
Methods: A school based cross-sectional questionnaire-based study was conducted among 485 high school
students in Anaichikuppam area of Villupuram district in Tamil Nadu.
Results: Majority of study population (n=277, 57.1%) were girls and 34.6% of the students were aware of the
legal age for driving but 55% were unable to identify even one of the five given mandatory road signs. 98.1% of
the children were aware of the risks of drunken driving. Only 33 (20.88%) students were using helmets while
riding motorised two-wheelers and 55 (11.34%) school children had been involved in road-related accidents in
the past 1 year.
Conclusions: Study revealed poor knowledge of traffic rules and unsafe traffic behaviour among the school
children.
Traffic accidents; accident prevention; adolescents.Key words:
Indian Journal of Medical Specialities, Vol. 2, No.2, Jul - Dec 2011
110
INDIAN JOURNAL OF MEDICAL SPECIALITIES 2011;2(2):110-113
precious but restless young generation would be to
first know about their current level of knowledge
and behaviour regarding road safety and build on it,
hence this study was undertaken to assess the
knowledge and behaviour regarding road safety,
traffic rules and risk factors associated with road
accidents among high school students. Based on the
results of the study, behavioural change
communication programmes on road safety will be
considered.
Methods
The present study is a cross-sectional study
conducted in the field practice area of rural health
centre of Pondicherry Institute of Medical Sciences.
The health centre caters to rural communities of
Anaichikuppam area in Villupuram district of Tamil
Nadu. The study was conducted from November
2010 to January 2011.The study covered high school
students from all four high schools in the field
practice area, which included two government and
two private schools. The total number of high school
students enrolled in the four schools was 541 out of
which students who were present and willing to
participate were 485 (89.64%). After getting
necessary permissions from the school authorities,
these students were interviewed using a pre-
designed pre-tested questionnaire.
The questionnaire included questions on
demographic characteristics, traffic behaviour, risk
factors associated with road accidents and traffic
rules. With regard to traffic lights, the students
were asked to explain the significance of the red,
yellow and green lights, responses were considered
correct if they implied red was stop, yellow was wait
and green was go. The questionnaire also included
pictures of 5 road signs (school zone, no parking, 50
kilometers speed limit, no entry and no overtaking)
from the group of mandatory road signs, which the
students were asked to identify. Data was entered
and analysed using SPSS version 16.0. To compare
between proportions, Chi-square test was used and
p < 0.05 was considered statistically significant.
Subsequently road safety awareness programme
was conducted in all the schools incorporating the
findings of the study.
Results
The mean age of the study population was 14.07 ±
1.042 (range 12-18) years. Majority of the
respondents, 277(57.1%) were girls. Table 1 outlines
the knowledge regarding traffic rules and the
awareness about risk factors. Boys had significantly
better knowledge than girls in most aspects. Nearly
half of the students (n=236, 48.45%) were able to
explain all three traffic lights correctly.
None of the students were able to identify correctly
all five traffic signs while only 7 (1.44%) of the
students could identify 4 of the signs correctly with
boys doing better than the girls (table 2). 46
(58.97%) students from private schools, were able
to identify at least one of the traffic signs correctly
as compared to 172 (42.26%) government school
students and the findings were statistically
significant (table 2).
When asked about their driving behaviour, 383
(78.96%) students said that they were using bicycles
but none of the students wore a helmet. 158
(32.57%) students had ridden motorised two-
wheelers while only four among them had valid
license. Only 33 (20.88%) of the students used
helmets while riding motorised two-wheelers. Five
students had even driven a four-wheeler though
they were ineligible. It was also revealed that 55
(11.34%) school children had been involved in road-
related accidents in the past one year.
With regard to the source of information regarding
road safety, the schools (n=369, 76%) played a major
role in making students aware followed by family
members (n=47, 9.69%), textbooks (n=38, 7.83%),
television (n=3, 6.39%) and newsprint (n=9,1.85%);
while 66 (13.6%) students gave no response.
Discussion
The present study revealed 34% of the students were
aware of the legal age for driving geared vehicles
compared to 53.1 % reported from Chandigarh [6]. In
the same study knowledge regarding traffic lights
among the students was 59%, while the present
study revealed a knowledge level of 48.4%. The
higher level of awareness regarding legal age for
driving and knowledge regarding traffic lights in a
Chandigarh study and present study could be due to
urban and rural study populations, as urban
population has generally higher literacy rate and
better exposure to the media.
Boys had better knowledge when compared to girls
with respect to risk factors and road signs probably
Indian Journal of Medical Specialities, Vol. 2, No.2, Jul - Dec 2011
111
Road safety among high school children
because boys have more exposure to media and the
outside world than girls who are confined to homes
although overall none of the students could identify
all five road signs correctly.
A study conducted in Hyderabad revealed that 70% of
the two-wheeler (motorised) riders were not using
helmets [7]; in the present study 79% of the students
who were driving motorised two-wheelers did not
wear helmets. A study from Texas, USA showed that
only 13.5% of children were using helmets while
riding a bicycle [8]. In the present study the practice
of wearing helmet among student cyclists was non-
existent as it is not mandatory in this state for
cyclists to wear helmets.
The study further revealed that 11% of the students
had been involved in road-related accident in the
past 1 year which was comparable to 10.8% among
school children in China [9].
Overall the study revealed poor knowledge
regarding traffic rules and road signs among the
school children, whereas knowledge regarding risk
factors associated with road accidents was found to
be adequate. Mere knowledge does not necessarily
translate into improved traffic behaviour as was
seen in this study with majority of the students who
had driven a motorised two-wheeler did not have a
valid license and did not wear a helmet. Improving
road safety is a multi-dimensional task requiring
efforts and coordination from various stake holders
i.e. students, parents, teachers, law enforcement
agencies and policy makers through various means.
An attempt was made, by following up the study
with road safety awareness programmes in the
affected schools with a view to bring about
attitudinal and behavioural change in the school
children.
Boys (208) Girls (277) Total (485) Chi square
N (%) N (%) N (%) (p value)
Knowledge regarding traffic rules
Before crossing the road
Look right-left-right 11 (5.28) 4 (1.44) 15 (3.09) 3.27 (0.07)
Look right-left 132 (63.46) 166 (59.93) 298 (61.44) 3.88 (0.04)
Others * 65 (31.25) 107 (38.63) 172 (35.47) 10.26 (0.001)
Legal age for driving
Gearless vehicles(≤ 50 cc) 30 (14.42) 27 (9.74) 57 (11.75) 0.15 (0.69)
Geared vehicles (> 50 cc) 99 (47.59) 69 (24.9) 168 (34.63) 5.36 (0.02)
Knowledge of 117 (56.25) 119 (42.96) 236 (48.45) 0.02 (0.9)
Considered driving
Aware of risk of
Driving without helmet 184 (88.46) 236 (85.19) 420 (86.59) 6.44 (0.01)
Drunken driving 206 (99.03) 270 (97.74) 476 (98.14) 8.61 (0.003)
Using mobile phones while driving 192 (92.30) 248 (89.53) 440 (90.72) 7.13 (0.008)
traffic lights
without
offence 199 (95.67) 245 (88.44) 444 (91.54) 4.77 (0.03)license as an
* Others included those who said look left-right, right only, left only and don’t know
Number of traffic Boys* Girls* Private Government Total
None 97(46.63) 170(61.37) 32(41.03) 235(57.74) 267(55.05)
Any One 62(29.81) 69(24.91) 21(26.92) 110(27.03) 131(27.01)
Any Two 23(11.06) 31(11.19) 14(17.95) 40(9.83) 54(11.13)
Any Three 19(9.13) 7(2.53) 9(11.54) 17(4.17) 26(5.36)
Any Four 7(3.37) 0(0) 2(2.56) 5(1.23) 7(1.44)
All Five 0(0) 0(0) 0 0 0 (0)
Total 208(100) 277(100) 78(100) 407(100) 485(100)
signs identified correctly school** school**
N(%) N(%) N(%) N(%) N(%)
2 2
* X =20.93, df =4, p = 0.0003 (with Yates’ correction); ** X = 14.625, df=4 and p=0.006
Table 1- Knowledge regarding traffic rules and awareness about risk factors associated with road
accidents among the school children
Table 2- Knowledge regarding traffic signs among school children-differences according to sex and
type of school
Indian Journal of Medical Specialities, Vol. 2, No.2, Jul - Dec 2011
112
C K Priyanka Raj and others
1. World Health Organization. Global status
report on road safety. Geneva (CH): WHO
press(CH);2009.http://www.un.org/ar/roa
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Accessed on November 15, 2010.
2. World Health Organization. World report on
child injury prevention. Geneva (CH): WHO
press (CH); 2008 [cited on 2010 November
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http://www.whqlibdoc.who.int/publicatio
ns/2008/9789241563574_eng.pdf Accessed
on November 26, 2010.
References
Key Points
• 55 % of the students were unable to identify
even one of the five given mandatory road
signs.
Overall the study revealed poor knowledge
regarding traffic rules and road signs among
the school children, whereas students had
good knowledge regarding risk factors
associated with road accidents.
Mere knowledge does not necessarily
translate into improved traffic behaviour as
was seen in this study with majority of the
students who had driven a motorised two-
wheeler did not have a valid license and did
not wear a helmet.
•
•
3. World Health Organization. United Nations
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W H O p r e s s ( C H ) ; 2 0 1 0 .
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Road safety among high school children
