Effectiveness and implementation of interventions to increase commuter cycling to school: a quasi-experimental study

BACKGROUND Active transportation to school has been positively associated with various health parameters whereas only sparse evidence exists on risk of injury while commuting to school. This study investigated the overall effectiveness of cycling promotion combined with structural changes on cycling to school. METHODS Interventions at public schools in three different regions in Denmark were based on planned infrastructural changes near schools (e.g. road surface and traffic regulation) and school-motivation for promoting commuter cycling. Participants were pupils from control schools (n = 12) or intervention schools (n = 13). All children (n = 2415) from the 4(th) and 5(th) grade were measured at baseline during spring 2010 and at follow-up one year later. RESULTS No significant differences in commuter cycling were detected in the adjusted analyses comparing the intervention with the control group neither when assessed as changes in short term (beta: 0.15 trips/week, p = 0.463) nor when assessed as changes in long term school cycling (beta: -0.02 units, p = 0.485). No differences were observed neither in the incidence of traffic injuries nor in the characteristics of injuries when comparing the control group and the intervention group. Approximately 50 % of all traffic injuries occurred during school transport with most injuries categorized as solo injuries. The only significant predictor of future traffic injuries was previous school transport injuries. CONCLUSION This multifaceted school cycling promotion programme did not affect school cycling behaviour or the health parameters assessed. Implementation issues relevant in the planning of future school cycling interventions are discussed in the article. The one year incidence of being involved in a traffic injury was approximately 25 % with almost 50 % of all traffic injuries occurred during school transport. Previous school transport injury predicted future school traffic injuries.