[Effectiveness of school-based interventions to prevent traffic accidents: an overview of secondary literature].

INTRODUCTION: traffic accidents are the eighth cause of death worldwide and the first among subjects aged 15-29 years. The Italian National Road Safety Plan recommends school-based interventions to prevent traffic accidents. Presently, there is no document gathering evidence on the effectiveness of such interventions in relation to the Italian context. OBJECTIVES: to summarize and discuss the existing evidence on the effectiveness of school-based interventions in reducing traffic accidents. METHODS: guidelines and systematic reviews were searched, using the following criteria: target population including both males and females younger than 25; road safety school-based interventions; effects on primary outcome indicators such as reduction in the number of traffic accidents, refraining from driving under the influence of alcohol and/or from accepting lifts from drivers who are under the influence of alcohol; effects on secondary outcome indicators such as knowledge and skills regarding driving behaviour. CONCLUSIONS: two systematic reviews were identified. Road safety programmes in schools show no evidence of effectiveness in reducing traffic accidents (relative risk: 1.03; 95% CI 0.98-1.08). More specific educational programmes lead to results that are only partially convincing, as they regard the adoption of a safer driving behaviour such as refraining from driving under the influence of alcohol and from accepting lifts from drivers who are under the influence of alcohol. DISCUSSION: no school-based programme emerged as effective in reducing car accidents and its risk factors. While waiting for new studies on this topic, it seems appropriate to promote the implementation of multi-component school-based and community-based interventions for which there is some evidence of effectiveness.