RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

A STUDY TO ASSESS THE EFFECTIVENESS OF STRUCTURED TEACHING

PROGRAMME ON PREVENTION OF ROAD TRAFFIC ACCIDENTS

AMONG HIGH SCHOOL CHILDREN IN SELECTED

SCHOOL AT KOLAR DISTRICT, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS

FORDISSERTATION

MS. P. RAJANI
A.E&C.S PAVAN COLLEGE OF NURSING, KOLAR

RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION.

NAME OF THE
CANDIDATE:

MS. P. RAJANI
1ST YEAR M.Sc. NURSING
A.E & C.S PAVAN COLLEGE OF NURSING,
BANGALORE CHENNAI BYE- PASS
ROAD, KOLAR- 563101

NAME OFTHE
INSTITUTION:

A.E&C.S PAVAN COLLEGE OF NURSING,

COURSE OF THE STUDY M Sc. NURSING

AND SUBJECT:
CHILD HEALTH NURSING

DATE OF ADMISSION:

04-06-2008

TITLE OF THE TOPIC:

A STUDY TO ASSESS THE EFFECTIVENESS

OF STRUCTURED TEACHING PROGRAME
ON PREVENTION OF ROAD TRAFFIC
ACCIDENTS AMONG HIGH
SCHOOLCHILDREN IN A SELECTED
SCHOOL AT KOLAR DISTRICT, KARNATAKA

6. BRIEF RESUME OF INTENDED WORK:INTRODUCTION:

Children are the wealth of tomorrow.
Take care of them, if u wishes to have a strong India,
Every day to meet various challenges
----Jawaharlal Nehru

School age children are successful learners. School age children represent about 25% of
total population. The very size of the population suggests that health care of the school
children can contribute to the over all health status of the country. The health and well
being of the school children has become high profile issue, lying at the heart of numerous
government initiatives and policies. Receiving considerable public attention. (1)
Todays children are the tomorrows citizens. So its very much important to protect the
life of the children and to provide safer environment. As the country develops, traffic had
become the burning problem.
For a city with an estimated population of between 5.5 minion and 6 million, the number
of fatal Road accidents is considered alarming. A high level committee dealing with the
cities traffic and transport needs recently mooted are idea of reducing congestion on roads
through plans such as a parallel elevated drive way on main thorough fares. With work
soon to start on the metro rail project, these proposals are on the back burner (2)
The large number of vehicles on roads engineered for a much smaller number is
bound to increase the accident rate. Other factors include the lack of facilities for
pedestrian, drunken driving during weekends and many one way roads through which
drivers tend to drive speedily.

(2)

A part from the accident rate, other traffic violations such as jumping red lights at
intersections have increased. Affecting road safety. (3)
Pedestrian road traffic injuries among children and adolescents are most important
cause of death and disability. The simple reflective discard rectangle dangled from the
pocket or shoulder of the pedestrian on a piece of string serves as a very efficient method
of warning drivers at night of the presence of pedestrian from a distance, and using cycle
reflectors. Childrens should have their bicycle equipped with the latest colour and style
of projecting reflector. Which sticks out as a side arm on the side of the over taking
traffic thus causing drivers to give lee way to the other wise insignificant cyclist. (3)
Enforcement of traffic regulations must be strict, and those exceeding the speed
limit (50 k.m/hr. in the town and 80 k.m / hr. in open road) must expect a heavy on the
spot fine. (3)
If the children are met with the accidents, it will affect the childrens life in many
ways such as, loss of limbs, psychological depression, psychological disturbances, etc.
So, Its important to protect the childrens from the road traffic accidents.
6.1 NEED FOR THE STUDY:
Teach children how they should live, they will remember it all their lives.
-- Good news bible
Its very much important to bring - up the children in safer environment for their
proper mental and physical growth and development. Now a days almost every
school going child is handling a bi-cycle an motor cycle and the incidence of road
traffic accidents are also increasing year by year. There all various factors which are
influencing road traffic accidents.

They are, congested road ways, absent lane

demarcations, high vehicle speed, high street vendor density and so on.

If we take the world wide statistics of road traffic accidents, in 2003, the incidence
in Germany was 354,534. Greece 15,751, Hungary 19976, Iceland 807, Norway 8,266, Poland-51078, Nigeria 5,517, and in Scotland -22. (23)
In India, according to National survey on road traffic accidents, in 2007, 6,113
people were reported in collisions, on the roads in survey, 589 people were killed and
seriously injured. 37 children under the age of 16 were killed or seriously injured. 5,524
people were slightly injured. If we take the previous statistics in 2001,668, in 2002-783,
in 2003-834, in 2004-875, in 2005-73, and in 2006-776, were the children under the age
group of 17 years. (2)
In Karnataka, the incidence of road traffic accidents in 2005 was, children between
5-9 years fatality rate was 448, and 10-14 yrs was 40. Seriously injured rate was 30%
among them 69.4% were males and 30.6% were female children and 44% of accidents
are due to wheeler crashes. 36% due to falls, median incidence is estimated that, 137.5
falls injuries / 1,00,000 in children are occurring. (2)
A Study was conducted on pedestrian road traffic injuries in urban perurian
children and adolescents. They have found that, factors associated with increased risk of
child pedestrian road traffic injuries included, high vehicle volume (Or 7.88, 95% CI,
1.97 31.52), absent lane demarcations (OR 6.59, 95%, CI.1.65 26.26), high vehicle
speed (OR 5.35, 95% CI 1.55 -18.54), high street vendor density (OR 1.25 -95% ; CI
1.00 1.56), Reducing traffic volumes and speeds, limiting the number of street venders
on a given stretch of road, and improving lane demarcations should be evaluated as
components of child pedestrian Road traffic injuries interventions in poorer countries. (20)
A Study was conducted to examine associations among individual, social and
environmental barriers and childrens walking or cycling to school. Sample was parents
of school aged children (N=720). And they have concluded that working with parents,
schools and local authorities to improve pedestrian skills and environments may help to
over came barriers. (4)
5

A Study was conducted which state that, most well evaluated effective
interventions dont directly focus on efforts to protect vulnerable road users, such as
motor cyclists and pedestrians. Yet these groups comprise the majority of road traffic
victims in low income and middle income countries and consequently, the majority of the
road traffic victims globally. Appropriately responding to these disparities in available
evidence and prevention efforts is necessary if we are to comprehensively address this
global health dilemma. (20)
I have first hand knowledge following the death of a 14-year old nephew
was knocked from his bicycle. We must not be complacent, or any lesson, that can be
learnt from other countries.
As the mortality rate increases due to road traffic accidents, researcher
select this problem to create awareness regarding causes of road traffic accidents. So that,
children can be protected from road traffic accidents.
6.2. Review of literature:Review of literature involves the systematic identification, location, and
scrutinizing summary of written material that contain information on the research
problem. (Polit. 1991).
The present study is to evaluate the effectiveness of structured teaching
programme (STP) regarding prevention of road traffic accidents among school children.
The researcher presents their review under the following headings.
a) Review related to incidence of road traffic accidents.
b) Review related to knowledge on road traffic accidents.
c) Review related to importance of prevention of road traffic accidents.
d) Review related to factors influencing road traffic accidents.
e) Review related to effects of RTA.
a) Review related to incidence of road traffic accidents

A Conducted study among children 1-14 years. In Tirana, during 2000-2005. 31(17.5%)
were fatal events. Prevalence was much among children aged 1-4 years/compared. There
was no difference in fatality rates with respect to childrens sex (18.7% in boys ;14.1% in
girls; p 0.645). So immediate actions must be undertaken in order to enforce current
legislation about mandatory use of child restraint and bicycle helmets .(5)
A conducted study in 2005, said that road traffic injuries resulted in the death of an
estimated 110,000 persons, 2.5 million hospitalizations, 8-9 million minor injuries. If
present, trend continues, India will witness the deaths of 150,000 persons.

Health

professionals can contribute in numerous ways and should take a lead role in reducing the
burden of road traffic injuries in India.(20)
A conducted study on using red light cameras are increasingly used to promote
compliance with traffic signals their selection criteria was randomized or quasi controlled
trails and controlled before after studies of red light cameras. The results are one
study found that 0.53% has done red light violations. So red light cameras are effective
in reducing total casualty crashes (20).
b) Review related to knowledge on road traffic accidents: A study on child
pedestrian safety said that, Sweden and Newzeland performed less well. Countries with
higher cycling levels like the Nether lands perform better than those with low levels like
the UK and Newzeland. So, exposure based fatality rates can help us to understand
whether policies reduce exposure or whether they increase safety (6)
A case control studies suggest that, cycle helmets offer their wearers protection
from injury in the event of an accidents. It can be confirmed that, head injuries are falling
faster among cyclists than pedestrians. Although case control studies suggest cycle
helmets are not effective in reducing over all injuries. (7)
A conducted study said that, registered nurses Transport sick children in
ambulances and other road vehicles every day in the United Kingdom safely restraining
the child, the equipment and the accompanying adults is a matter which should be
7

addressed by all departments who transport children and concluded that, default standard
when transporting a child in a road vehicle under any circumstances. Recent research also
indicates that young infants must never be allowed so sleep in car seats on the ward
because of the increased risk of obstructive sleep apnea. (20)
A Study was conducted and reported that, motor vehicle crashes remain elevated
among novice teen drivers for at least several years after licensure. Recent research has
shown that that, parent management of the early independent driving experience of
novice teens improves safety out comes, and other research has shown that, its possible
to increase parent management practices. (20)
A Study reported that, drivers aged 17- 21 years make up 7% of license holders;
but 13% of drivers involved in road traffic crashes resulting in injury in U.K. 3 trails
conducted between 1982-1984. Met the inclusion criteria (n= 17,965). 2 Trails examined
the effect of driver education on licensing. In the trail by stock (USA) 87% of students in
the driver education group obtained their driving license as compared to 84.3%. In the
control group (R.R. 1.04-95% CI. 1.02 to 1.05). They provide no evidence that driver
education reduces road crash involvement and suggest that it may lead to a modest but
potentially important increase in the proportion of teenagers involved in traffic crashes.
(20)

C. Review related to importance of prevention at road traffic accidents:

A Study reports that, Birmingham city councils streets ahead on safety project which
aims to improve road safety and quality of life in an area of multiple deprivation when
87000 people from largely Asian. A third of residents are under 16 years old and 58% self
define their religion as Muslim. The area has a poor traffic accident record leading to high
levels of killed or seriously injured children engineers and road safety officers to provide
local going people with opportunities to participate in decision making in the belief that
the active engagement of young service users would lead to more effective and
sustainable solutions to accident preventions(8)
A Study reported that several study have shown that, road traffic injuries
are major cause of death and disability globally With a disproportionate number
occurring in developing countries. A total of 757 road traffic victims were reported which
accounted for 6.66% of all the cases attending the emergency. 49.93% cases belonged to
21-40 years age group. The most common victim group comprised the pedestrians
(56.54%) , with motor cycle ( 55.09% ), the lower limbs (42.0%) were accounting for the
most common injury pattern followed by soft tissue injuries. Most accidents occur in
April June trimester. (9)
A Study reported that the enhancement of Kuwaits seat belt law in January
1994 to examine the impact of seat belt use in road accident fatalities and injury types in
this affluent Persian Gulf Nation. Non users of belts experienced higher frequencies of
head, face, abdominal and limb injuries. Users of the belts on the other hand . (10)

A Study was conducted to examine the preventive effect of bicycle helmets on

head injuries in youngsters aged 0-15 years. Treated after road traffic accidents. The
result was among 3215 person, 2109 had injuries to the head or brain and 2876 had
9

injuries to other body regions. The conclusion was helmets after bicyclists aged 0-15
years protection against head injury. The effect could not be shown in accidents involving
a motor vehicle as the counter part. (11)
D. Review related to factors influencing road traffic accidents.
A Study reported that, in India where boys as young as 8 years. Ride motor cycles.
It attempts to find out the behavioral and non-behavioral factors leading to motor cycles
use and the pre disposition to accidents among male school children aged between 10 and
16 years. The implication of child motor cycle riders up on children themselves. And on
the society are discussed for a greater discourse on road safety motor cycle riding policy
and to high light the behavior and non behavioral factors that are associated with traffic
accidents. (12)
A Study report the Risk factors of a severe outcome for children severely injured
in a road accident. Among under 14 years children. The result was annual incidence of
injury severely scare of lot was 7.7/100 children. Among the 126 severely injured
children included in this study. The mechanisms of the injury an injury pattern involving
the head in a young age were associated with a severe outcome following a road accident.
A majority of children severely injured were not referred to in patient rehabilitation. (13)
Conducted a study on usage of occupational light vehicle. Occupational light
vehicle use in the leading cause of work related traumatic deaths in westernized
countries. This model provides a frame work for understanding the theory of occupational
light vehicle use. OHS & guidance far urgently needed intervention research policy &
practice. (20)

E. Review related to effects of Road Traffic Accidents:

A Conducted study reported that accidents are the main cause of death &
disability in children & adolescents aged 1-15 years and cause more than one 6 th of all
10

infant admissions to hospital. In the cause of the years was observed in both study period.
However, quadral reduction in admission is evident. Comparison of these date with those
collected 20 years earlier revealed a general reduction in the number of hospital
admissions. (15)
A Study Reported that, the impact of road traffic accidents on the physical health
of the children is well recognized. Prospective cohort study was conducted of 8 to 10
years. Old children in adolescents who were involved in Road Traffic Accidents. 3
months after the accident 25% of the children reported persistence of the Post Traumatic
Stress Disorder symptoms. After every day road traffic accidents psychological
consequences are common. Special attention should be paid to the common occurrence of
subsyndromal psychological disturbances and more complex syndromes. (16)
A Study was conducted and assessed the prevalence, course, and predictors
of post traumatic stress symptoms, in children after road traffic accidents. 68 children
were interviewed 4-6 months and 12 months after road traffic accidents. There is a need
for careful psychological assessment of children and their parents after an road traffic
accidents. The impact of fathers post traumatic stress symptoms an child post traumatic
stress symptoms suggest that fathers ought to be actively involved in family based
prevention and treatment, interventions of childrens post treatment stress symptoms after
road traffic accidents. (17)
A Study reported that, post traumatic stress disorder can occur following road
traffic accidents. And concluded that, presence of mild TBI. Didnt influence the likely
hood of experiencing post traumatic stress disorder symptomatology following a traffic
accident. There is a dear need for provision of systematic assessment and, where
appropriate, the implementation of intervention strategies to treat children. (18)
A Conducted study reported that, knee injuries represent an important category
of road traffic injuries among children. And they are heterogeneous in their etiology.
Injury percentage was 97.5/100. And they have concluded that car passengers with out
11

seat belt have high injury rate. Frequently tourists were at high risk of knee injuries while
using motor cycles and bicycles. (19)

Problem statement:

12

A study to assess the effectiveness of structured teaching programme on

prevention of road traffic accidents among High School children, in a selected school at
Kolar district.
6.3 Objectives of the study:
To assess the existing knowledge on prevention of road traffic accidents
among High school children.
To determine the effectiveness of structured teaching programme on
prevention of road traffic accidents.
To find out the association between post test knowledge scores with
selected demographic variables.
6.4 Operational definitions:
Assess: In refers to the statistical measurements of knowledge scores of school children
with regard to prevention of road traffic accidents by using closed ended questionnaire.
Effectiveness: Its the statistical difference between per and post test knowledge scores
regarding road traffic accidents.
Structured Teaching programme: It is the planned series of events in order to provide
instruction.
High School Children: Children in the age group of 13-15years
Prevention: Measures taken by the High school children to avoid the road traffic
accidents.
Accidents: UN expected event. An event which takes place without persons knowledge
Road traffic accidents: Events which takes place on the road with out persons
knowledge, like, motor cycle crashes,bi-cycle hits, car crashes etc.
6.5 Hypothesis:
13

H0: There will be no significant Relationship between pre and post test knowledge scores
of children regarding prevention of road traffic accidents.
6.6 Delimitations:

Study will be limited to the children in the age group of 13-15 years
Who will be willing to participate in the study
The study will be limited so the sample size of 100
Study will be limited to a period of 6 weeks

6.7 Variables under the study

6.7.1 Independent Variable:
Structured teaching programme
6.7.2 Dependent variable:
Knowledge of children
6.7.3 Attribute variable:
Related to child: Age, education, sex, mode of transportation to the school,
source of health information.
Related to family: Type of family, parents education, total family income.

7. Materials and methods:

14

7.1 Source of data:

High school children from a school at Kolar.
7.2 Methods of data collection:
Closed ended questionnaire
7.2.1 Research design:
Quasi experimental design will be used.(pre and post test with out control
group)
7.2.2 Setting of the study:
Study will be conducted in a school at Kolar district.
7.2.3 Population:
Population for the present study will be all the children in the age group of
13-15years.
7.2.4 Sample:
High school children between the age group of 13-15 years will be taken as
sample.
7.2.5 Sample size:
Sample will consist of 100 High school children.
7.2.6 Sampling technique:
Systematic random sampling technique will be used for the study.

7.2.7 Sampling criteria:

15

Inclusion criteria:
High school children in between the age group of 13-15 years
Children who are willing to participate in the study.
Children who can understand and write English.

Exclusion criteria:
Children who are not in the age group of 13-15 years.
Children who are not willing to participate in the study.
Children who cant understand write English.

7.2.8 Tools of research:

structured questionnaire
Structured teaching programme will be used to assess the knowledge
regarding prevention of road traffic accidents among school age children.

7.2.9 Description of Tools:

This questionnaire consists of 2 sections.
Section A:
Demographic data: It consists of demographic variables like age, education, sex, type of
family, total family income, mode of transportation to the school, parents education.
Section B:
Knowledge and prevention: It consists of questionnaire regarding prevention of road
traffic accidents, which includes,

Meaning of road traffic accidents

Causes of road traffic accidents
Prevention of road traffic accidents
Road traffic rules, symbols etc
16

 Effects of road traffic accidents

7.3 Methods of data collection:

The researcher will use closed ended questionnaire to asses the knowledge
regarding road traffic accidents.
7.4 Data analysis and interpretation:
The researcher will use descriptive and inferential statistics like frequency,
percentage, paired t-test, chi square, and present the data in the form of tables and
diagrams.
7.5 Does the study require any intervention to be conducted on patients and other
children or animals?
NO
7.6 Ethical clearance been obtained from concerned authorities:
Prior to the study, permission will be obtained from the concerned authority of the
school, to conduct the study on the school children at Kolar. And also from research
committee of Pavan College of Nursing Kolar.
Consent will be taken from the school children. The purpose of the study will be
explained to the school children. Scientific objectives of the study will be maintained
with honesty and impartiality.

8. List of References.
1) Kerala Nursing Forum journal. Vol.2, No.1. Jan-March. (2007). P.32.
2) www.hindu.com
3) British medical journal, volume. 285.2 October 1982. P.9763
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4)

Salamon.J, Salmon.L, etal,individual,social,and environmental barriers and

childrens walking or cycling to school, American journals of Health promotion.

2007. nov-dec,22(2),p13-107
5) Qiviako. G, Burazeri. G, Hysa.G, Hysa. B, Roshi. E, magnitude of fatality
fromroad accidents among children in Tirana, Albania. Medical journal of arh
2008-62 (12). P.1.100.
6) Christic. N, Cairnsi.S, Towner. E, ward. H, how exposure information can
enhace our understanding of child traffic death leaques, Injury prevention
2007. Apr 13(2), P.9-128.
7) Hew son. P.J. Investigating population level trends in head injuries amongst
child cyclists in the UK, Accident annual preview. 2005 Sep. 37(5). P. 15-807.
8) Kimberlee. R, young peoples participation in decion making to address the
European road injury epidemic, Health social care community. 2008. May
16(3), P. 8-322.
9) Bantia. P, Koivala. B, ravnivar, A, Chandary. D, Kharel. T, Kadka. S.B,An
epidemiological study of road traffic accident cases attending emergency
department of teaching hospital, JNMA.
Journal of Nepal Medical association 2006. Apr Jun. 45(162); p.45-238.
10) Koushki. PA, Bnotan. MA, Karlam.N, Impact of safety belt use on road
accident injury and injury type in Kuwait, Accident annual preview. 2003. Mar.
35 (2). P.41-237.
11) Larsen. LB ,Uqeskr,Laeqer,Importance of the use of bicycle helmets for head
injuries among injured bicyclists aged 0-15 yrs,2002oct,28,164(44)P5115-9
12) Rathinam.C nair. N, Gupta. A, Joshi.S, Bansal.S,Self reported motor cycle
riding behaviour among school children in India, Accident annual preview.
2007. March. 39 (2). P. 9-334.
13) Javahey. E. Amorus. E, Hadclak. M. Ndiave. A. flaret. D, Chivon. M. Severe
outcome of children followingtrauma resulting from road accidents
Europeoan jonrnal of paediatrics. 2006. Aug 15(8) p 25-519.

18

14) Treacy.PJ, Jores.K, Mansilield.C, Flipped out of control; single vehicle roll
over accidents in the northern territory, Medical journal of Austrelice. 2002.
March. 18.176 (6). P.3-260
15)

Falesi, Berni.S, Strambi. M, causes of accidents in paediatic patients;

what has changed through ages, Minerva Paediatics. 2008 Apr. 60(2);
P.76.169.
16) Schnfer.I, Barkmann.C, Reideser.P.post traumatic syndromes in children and
adolescents after road traffic accidents, Journal of psycho pathology. 2006.
39(4),p 64-159.
17) Landolt. MA, Vollarath. M, Predicting post traumatic stress symtoms in
children after road traffic accidents, Journal of American acad. Child
18)

adolescent. Psychiatry. 2005, Dec 44 (12), P.83-1276.

Mather. FJ, Tate. R.L, Hannan. TJ, Post- traumatic stress disorder in children
following road traffic accidents; acomparision of those with and with out

mild traumatic brain injury; Brain injury, 2003. Dec. 17 (12). P. 871077.
19) Ikovakis I, Dessypris. N, Dalamaga. M, Pertidol.E, A cluster analysis of
road traffic related child hood knee injuries, child health care
Development. 2003. Jul 2 (4,) P. 301-297.
20)

www.pubmed.com

21 ) www.google.com
22) www.surveycc.com

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9.

SIGNATURE OF THE
CANDIDATE:

10.

REMARKS OF THE GUIDE:

11.

NAME AND THE

DESIGNATION OF:
11.1. GUIDE

20

11.2. SIGNATURE

11.3. CO-GUIDE

11.4. SIGNATURE

11.5. HEAD OF THE

DEPARTMENT

11.6. SIGNATURE

12.

REMARKS OF THE
PRINCIPAL:

12.1. SIGNATURE

21