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Update on the Monitoring and Evaluation of RS-10 Brazil/Vida no Trânsito JH-IIRU: Jeffrey C. Lunnen and Adnan A. Hyder UFMG: Waleska Teixeria Caiaffa PUC-PR:

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Presentation on theme: "Update on the Monitoring and Evaluation of RS-10 Brazil/Vida no Trânsito JH-IIRU: Jeffrey C. Lunnen and Adnan A. Hyder UFMG: Waleska Teixeria Caiaffa PUC-PR:"— Presentation transcript:

1 Update on the Monitoring and Evaluation of RS-10 Brazil/Vida no Trânsito JH-IIRU: Jeffrey C. Lunnen and Adnan A. Hyder UFMG: Waleska Teixeria Caiaffa PUC-PR: Samuel Moyses and Sandra Ulinksi Aguilera UFRGS: Flavio Pechansky and Tanara Sousa

2 Outline JH-IIRU’s approach to M&E Background information on 5 RS-10/VnT intervention cities Summary of data sources Secondary data Primary data (by intervention city and risk factor) Discussion Challenges/Barriers/Opportunities Future plans

3 JH-IIRU’s approach to M&E M&E to be conducted by partners independent from implementing agencies – Design of the global consortium – Enhances credibility of an evaluation M&E must not depend only on routinely collected information – Nor can we wait…

4 JH-IIRU’s role in RS-10 Brazil/VnT Defining baseline impact of RTI in selected sites – Based on secondary and primary data Monitoring trends in selected indicators over a period of four years – Using repeated (serial) observations Assess the impact of interventions in changing health outcomes – Crashes, injuries and deaths

5 Background: RS-10/VnT Teresina Palmas Belo Horizonte Campo Grande Curitiba Targeted Risk Factors  Drinking & Driving  Speeding JH-IIRU’s role  M&E via collaborations with:  UFMG (Belo Horizonte & Campo Grande)  PUC-PR (Curitiba)  UFRGS (Palmas & Teresina) Interventions  Social Marketing  Enhanced enforcement (blitz)  Engineering

6 Background: RS-10/VnT Intervention Cities SiteRegion Population (2010) Death per 100,000 population (2010) Motor vehicle per 1,000 Population (2010) Fleet; % motos) (2012) Fleet Growth (2010-2012) place of occurrence place of residence Brazil191,481,04522,5339.8 76,137,191 (25.5%) 17.5% Belo Horizonte Southeast2,375,15126.319.3564.2 1,519,438 (13.4%) 13.4% Campo Grande Midwest786,79728.928.5498.4 453,531 (29.2%) 15.7% CuritibaSouth1,751,90722.917.7712.4 1,371,431 (10.9%) 9.9% PalmasNorth228,33245.131.5474.1 132,537 (37.4%) 22.4% TeresinaNortheast814,23057.831.7246.6 348,120 (39.0%) 23.4% Source: IBGE/Ministry of Health/DENATRAN Source: MoH; IBGE; DENATRAN

7 Data Sources for ongoing M&E Secondary data: – Publically available sources: Police data Ministry of Health: – Available only by cooperative effort [with risk factor data]: Enforcement blitz & infraction data from police Primary data: – Drinking & driving: Traffic agents/police roadblocks Results from breathalyzer testing Roadside surveys – Speeding: observations by handheld speed camera/radar

8 Secondary Data: Overview

9 Outcomes: Rate of crashes with victims, 2008- 2012 Sources: DETRAN-MG; DETRAN-MS; DETRAN-PR; DETRAN-PI; Transit Secretariat of Palmas

10 Outcomes: Rate of non-fatal hospitalized RTIs, 2002 – 2012 Source: MoH; SIH

11 Outcomes: Non-fatal RTI rate 2002 – 2012 Sources: DETRAN-MG; DETRAN-MS; DETRAN-PR; DETRAN-PI; Transit Secretariat of Palmas

12 Outcomes: RTI mortality rate 2002 – 2010 Source: MoH; SIM

13 Primary Data: Overview

14 Primary data collection: Summary of rounds conducted to date Belo Horizonte Campo Grande CuritibaPalmasTeresina Drinking & Driving Obsr --344 RSS --344 Speeding Obsr 1* 322 Obsr=Roadside Observational Study; RSS=Roadside Surveys *Raw data pending

15 Primary Data: Belo Horizonte and Campo Grande UFMG

16 Primary Data: Curitiba PUC-PR

17 Risk factor: Drinking & driving Methods 35 (military) police officers Data collection – 08:00pm to 01:00am Sites and participants randomly selected Staff: 11 researchers Police conduct checkpoint procedures

18 Risk Factor: Drinking & driving After Round 2 we utilized tablets for data collection

19 Drinking & driving Roadside observations (2012) March 2012September 2012November 2012 DescriptionN% (95% CI)N N Breathalyzer Offered15779% (74, 85)21263% (58, 68)2963% (49, 77) Breathalyzed7246% (39, 54)9947% (40, 53)1138% (20, 56) Breathalyzer test >046% (0, 11)0000 Reported any alcohol consumption in last 6 hours 148.9% (4, 13)125,7 (2, 8)29% (-8, 26)

20 Drinking & driving Roadside observations

21 Round 1Round 2Round 3P-value MonthMarch 2012JulyNovember - Sample Size (n.)15721230 - Male (%)7181,684,80.00 Age (20 to 29 years)%46.447.348.30.53 High School or + (%)65.686.880.00.00 Resides in Curitiba (%)85,374,590,00.00 Has a License (%)97.599,196,70,43 Drinking and Driving Roadside survey Socio-Demographic Data

22 Round 1Round 2Round 3P-value MonthMarchJulyNovember Sample Size (n.)15721230- Speeding26.815.624.10.02 Red light8.38.06.90.96 Drinking & driving0.01.96.90.16 Mobile phone use8.96.613.80.35 Restraint device6.44.700.35 Drinking and driving Roadside Survey Self-reported having been ticketed

23 Descriptionn=33% χ² p Value Gender Male2987,93,80,15 Female412,1 Vehicle Car2371,90,70,69 Motorcycle928,1 Licence Without licence39,118,90,04 Less than 1 year26,1 1 to 2 years39,1 2 to 5 years824,2 5 to 10 years515,2 More than 10 years1236,4 Origin Home721,294,40 Friend’s house39,1 Work515,2 Bar/restaurant927,3 University412,1 Others515,2 Risk Factor: Drink and driving

24 Descriptionn=33% χ² p Value Reason for travel Work39,160,50.00 Pleasure2472,7 Studies412,1 Outher26,1 Frequency of alcohol consumption 5 or more times a week 721,2133,20.00 1 - 4 times a week824,2 1 - 3 times a week1545,5 Less than 1 time a month 39,1 Alcoholic beverages consumed 0,5 – 2824,293,30.00 3 - 5618,2 6 – 101339,4 More than 11618,2 Alcoholic beverage consumed Beer1854,5367,50.00 Beer and liquor/spirits 13 Liquor/spirits39,1 Wine39,1 Risk Factor: Drink and driving

25 Methods – Selected roads with a high rate of speed-related infractions and or crashes in 2011 – Excluded crosswalks, sites with poor visibility – Special assurances to ensure observer safety and parking – Observations: 09:00-11:00am and 02:00-04:00pm – Sites and days of week for observation were selected at random Risk Factor: Speeding

26 Speeding Roadside observations (2012) March 2012September 2012October 2012 Sample% speeding (95% CI)Sample% speeding (95% CI)Sample% speeding (95% CI) Car156411.8% (1.6, 2.0)1709014% (13.6, 14.6)1460531% (30.5, 32) Motorcycle17829.1% (8, 10)132034% (32, 37)116153% (50, 56) Bus4270.5% (0, 1)2556% (3, 8)2176% (3, 9) Truck5480.6% (0, 1)105612% (10, 14)75313% (11, 16) Total186982.4% (2.3, 2.5)1972115% (14.7, 15.7)1673632% (30, 32.3)

27 Primary Data: Palmas and Teresina UFRGS

28 Risk factor: Drinking & driving Method – Sample size: based in fleet/population size and estimated prevalence – Site selection: roadblocks locations, dates and times were chosen with the police and traffic agents. – Roadblocks location: selected based on the traffic crash occurrence in 2010/11. – Process Traffic agents/police stop cars & motorcycles Standard roadblock procedures Invited the drivers to participated on the study (interview) Offer breathalyzer

29 Risk factor: Speeding Method – Hand-held static radars with attached camera – 7 sites randomly selected from a composite list of 30 sites with high frequencies of accidents in 2011 Data collected in five 1-hour intervals for seven days a week, from 8:00AM to 6:00PM Site selection considered the absence of fixed radars, general traffic flow and safety of data collectors

30 Results from Palmas

31 Drinking & driving Roadside observations (2011-2013) Round 1 (Aug 2011) Round 2 (Jan 2012) Round 3 (Jun 2012) Round 4 (Apr 2013) DescriptionN%N%N%N% Flow5356-4244-6064-2526- Invited to participate in study 2113.92886.84146.728511.3 Agreed to participate 14769220743508522981 Breathalyzer Offered 11856189662756418477.6 Breathalyzed9580.513873.023485.117394.0 Breathalyzer Test >0 1111.6118 177.3105.8

32 Drinking and Driving Roadside survey Socio-Demographic Data Round 1Round 2Round 3Round 4P-value MonthAug-11Jan-12Jun-12Apr-13- Sample Size (n.)147220350229- Male (%)80.387.384.080.30.00 Age (mean)30.531.730.930.80.92 High School or + (%)78.989.588.893.00.00 Resides in Palmas(%)100.095.096.595.60.07 Has a License (%)-96.891.698.70.00

33 Drinking and driving Roadside Survey Alcohol use in the last 6 hours Consumo de álcool nas últimas 6 horas P-value = 0.00

34 Drinking and driving Roadside Survey Ability to drive compromise by alcohol consumption? Habilidade para dirigir está comprometida por este consumo de álcool? P-value = 0.05

35 Drinking and driving Roadside Survey Drinking and driving in the last year Dirigiu após beber, no último ano

36 Drinking and driving Roadside Survey Knowledge of the legal alcohol limit, by Law Conhecimento do limite para beber e dirigir (pela legislação ) P-value = 0.00

37 Drinking and driving Roadside Survey In the last year was a passenger of driver under the influence Usou carona de condutor que bebeu, no último ano P-value = 0.95

38 Drinking and driving Roadside Survey Have had at least 1 alcohol associated crash (driver) Teve pelo menos um acidente causado por álcool enquanto era condutor, na vida P-value = 0.07

39 Drinking and driving Roadside Survey In the last year was stopped at at least one blitz Foi parado em pelo menos uma blitz nesta cidade, no último ano P-value = 0.78

40 Drinking and driving Roadside Survey I invited to take a breathalyzer test Foi convidado a fazer teste do etilômetro P-value = 0.35

41 Speeding Roadside observations (2012-2013) *Second Round in March/2013 June 2012March 2013 Sample% speeding (97% CI)Sample% speeding (97% CI) Car800950% (48, 51)713549% (47, 50) Motorcycle221530% (28, 32)241541% (39, 43) Bus21728% (22, 34)28114% (10, 18) Truck26932% (27, 40)31837% (31, 50) Total1071045% (44, 46)1014946% (45, 47)

42 Speeding (2012-2013) *Second Round in March/2013 14% 18% 56% 55% 6% 7% 19% 16% 5%3%

43 Speeding (2012-2013) *Second Round in March/2013

44 Speeding Roadside Survey Have had at least 1 ticket for speeding in the last year Teve pelo menos multa por excesso de velocidade, no último ano P-value = 0.56

45

46 Drinking & driving, Roadside observations (2011-2013) Round 1 (Aug 2011) Round 2 (Feb 2012) Round 3 (Aug 2012) Round 4 (Feb 2013) DescriptionN%N%N%N% Flow 3958-5429-3098-2676- Invited to participate in study 2867.22494.62146.81415.3 Agreed to participate 23682.520981.118782.212689.4 Breathalyzer Offered 19768.811245.013261.712085.1 Breathalyzed 15377.71109812594.711595.9 Breathalyzer Test >0 64.076.41310.443.5

47 Results from Teresina

48 Drinking and Driving Roadside survey Socio-Demographic Data Dados Socio-demográficos Round 1Round 2Round 3Round 4P-value MonthAug 11Feb 12Aug 12Feb 13- Sample Size (n.)236209187126- Male (%)80.989.785.083.30.03 Age (mean)35.235.935.435.90.72 High School or +(%)83.975.776.588.90.00 Resides in Teresina(%) 100.077.281.269.80.07 Has a License (%)-95.595.297.60.53

49 Drinking and driving Roadside Survey Alcohol use in the last 6 hours Consumo de álcool nas últimas 6 horas P-value = 0.00

50 Drinking and driving Roadside Survey Ability to drive compromise by alcohol consumption? Habilidade para dirigir está comprometida por este consumo de álcool? P-value = 0.00

51 Drinking and driving Roadside Survey Drinking and driving in the last year Dirigiu após beber, no último ano

52 Drinking and driving Roadside Survey Knowledge of the legal alcohol limit, by Law Conhecimento do limite para beber e dirigir (pela legislação) P-value = 0.00

53 Drinking and driving Roadside Survey In the last year was a passenger of driver under the influence Usou carona de condutor que bebeu, no último ano P-value = 0.12

54 Drinking and driving Roadside Survey Have had at least 1 alcohol associated crash (driver) Teve pelo menos um acidente causado por álcool enquanto era condutor, na vida P-value = 0.43

55 Drinking and driving Roadside Survey In the last year was stopped at at least one blitz Foi parado em pelo menos uma blitz nesta cidade, no último ano P-value = 0.05

56 Drinking and driving Roadside Survey I invited to take a breathalyzer test Foi convidado a fazer teste do etilômetro P-value = 0.05

57 Speeding, Roadside observations (2012-2013) *Second Round in March/2013 August 2012February 2013 Sample % speeding (95% CI) Sample % speeding (95% CI) Car1175610.6% (10, 11)813412% (10.8, 12.2) Motorcycle51538.1% (7, 9)38626.9% (6.1, 7.7) Bus53610% (8, 13)4329.4% (7, 12) Truck5267% (5, 8)7264.4% (3, 6) Total170179.7% (9.3, 10.2)133349.6% (9. 10)

58 Speeding Roadside Survey Have had at least 1 ticket for speeding in the last year Teve pelo menos multa por excesso de velocidade, no último ano P-value = 0.76

59

60 Challenges/Barriers/Opportunities

61 Discussion Drinking & Driving – Observations conducted in absence of reliable data – Breathalyzers increasingly offered and accepted, but drivers can refuse – Small samples due largely to low cooperation from police + pre-defined days for data collection in some cities

62 Discussion Speed – Teresina: low prevalence compared to other cities Poor street quality; cars do not reach the speed limit – Palmas: High prevalence Drivers do not respect crosswalks – Curitiba: 3 waves using 3 different methods Changes in radar types, street locations – Belo Horizonte & Campo Grande: Different method as well

63 Challenges & Barriers: In general Uniqueness of cities – Size – Infrastructure Changing municipal leadership and institutional policies – Inhibits access to secondary data – Delays primary data collection

64 Challenges & Barriers Data collection did not begin until 2011 Alcohol data particularly difficult to obtain due to: – Refusals + inconsistent cooperation from police in some cities Methodological differences

65 Opportunities Tougher “Lei Seca” – Every driver will be fined/jailed for refusal to take a Breathalyzer test – Police empowered! Standardize methods across 5 RS-10 Brazil/VnT intervention cities Increase the number of rounds of data collection

66 Future Plans Improve quality/frequency of data collection – Insert training component for police officers – Make linkages with National Highway Patrol Department – Insert specific social marketing messages into KAP survey to determine reach Bebida no trânsito mata. E nem sempre só você. Gather additional secondary information

67 ACKNOWLEDGEMENTS Dr. Aruna Chandran International Consortium Partners National Commission VnT Local VnT partners Secretariats of Health and Transportation/Transit Military Police Highway Patrol

68 OBRIGADO! THANK YOU!


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