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Promoting Pedestrian and Bicyclist Safety to Hispanic Audiences

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Appendix A. Steps Taken To Develop The Marketing Plan

An outline, developed as part of the Educación de seguridad en el tránsito/Education in Traffic Safety (EST) project, was referenced and used to guide the development of this marketing plan. The EST is a 2-year project to study existing traffic safety educational materials for Latinos and to create guidelines for the development of new culturally appropriate materials (5). The guidelines developed by EST could be used to develop brochures, posters, videos, and booklets designed to promote safe driving, riding, walking, and biking. Therefore, these guidelines are important to consider in developing any outreach campaign for Hispanic communities. While the guidelines will not be available until summer 2005, the following is an outline of the guidelines under development (27):

Research and Planning

  1. Identify the audience.
  2. Identify key partners.
  3. Understand the traffic safety topic.
  4. Understand the audience.
  5. Understand health communication.
  6. Review existing materials.
Creating Materials
  1. Develop your message and content.
  2. Use accurate, simple, and appropriate language.
  3. Use culturally appropriate format and graphics.
  4. Solicit feedback from the target audience and your partners.
Dissemination and Evaluation
  1. Effectively disseminate.
  2. Evaluate and review.

The research team for this FHWA/NHTSA project used this outline to identify critical steps towards the development of this marketing plan. These critical steps were defined as:

A.1 Develop Key Questions About Audience And Communicating With Them

In order to accomplish many of the items listed in the above outline, (e.g., identify and understand the audience, identify key partners, understand the traffic safety topic and the audience, understand effective principles of health/safety communication, use a format and graphics that are culturally appropriate, use accurate and appropriate language, disseminate in an effective way), the research team developed a list of key questions to be answered under each of these critical steps. These questions included:

The remaining critical steps in the outline (not listed above with questions) will be addressed through the tasks in the Statement of Work for this project. For example, "review Spanish language materials" was addressed in the information gathering stage (Task 2-see Section A.2.3); while "solicit feedback from community partners on the content, format and graphics, and language" and "evaluate and review your material" will be addressed through focus groups conducted in Task 3, which will be written as an addendum to this marketing plan.

A.2 Identify Means Of Gathering Information To Answer Key Questions

Next, several means of gathering information to answer the key questions were identified, including: a literature search, focus groups with Hispanic pedestrian and bicyclists, and a review of Hispanic outreach materials created for other safety campaigns. Each method for gathering information is discussed in more detail in the following subsections.

A.2.1 Literature Search

The objective of the literature search was to develop a marketing plan of the most effective methods of promoting bicycle and pedestrian safety to Hispanic audiences. The extent of the task was delineated in the Work Plan submitted to FHWA/NHTSA in November 2004. It stated that:
The SAIC team, principally Sprinkle, will review the FHWA's "Determining the Extent of the Highway Safety Problem as it Relates to Hispanic Populations in the United States" (when completed), NHTSA's "Highway Safety Needs of U.S. Hispanic Communities: Issues and Strategies," and other documents as deemed appropriate. SAIC staff will meet with members of the MWCOG's [Metropolitan Washington Council of Governments] Street Smart Program to review their Hispanic outreach materials and learn about their market research performed to date. SAIC staff will also review any other relevant materials developed for Hispanic audiences, such as material that helps develop a full understanding of the general issues faced by Hispanic immigrants to the U.S. (e.g., language barriers); staff members have collected informative materials developed for Hispanic audiences by the Pan American Health Organization (PAHO).

Sources referenced in the literature search include:

The results of the literature review are summarized in Section A.3.

A.2.2 Focus Groups

Focus groups related to Hispanics' perceptions, knowledge, and attitudes concerning pedestrian and bicycle safety were conducted as part of this research study. The purpose of these groups was to better understand what information Hispanics need about this topic. As discussed, this information will inform the development of the marketing campaign.

A.2.2.1 Locations for focus groups

Colorado Springs, CO, and the Washington, DC, areas were selected as locations to conduct the two focus groups. Both these locations were selected as areas that have a large number of recent immigrants from many different countries of origin. In addition, the geographic spread between the two locations will help ensure that the findings are not specific to Hispanics from one country of origin (i.e., Colorado Springs has a larger number of immigrants from Mexico than the Washington, DC, area, while the Washington, DC, area has a larger number of immigrants from Puerto Rico than Colorado Springs).

A.2.2.2 Participant recruitment

The Media Network (TMN), in conjunction with Springs Research of Colorado Springs, CO, recruited participants to attend the focus group sessions. Eligible participants had to meet the following criteria: Hispanics over the age of 18 who have less than a college education and walk or ride a bicycle regularly (at least 2 times a week). Additionally, participants needed to be a member of a group at higher risk for pedestrian and bicycle accidents (i.e., seniors, young males, parents of young children, recent immigrants, or being of Mexican origin). The goal was to create diverse groups of respondents in each city. TMN designed a customized recruiting screener with input from FHWA/NHTSA to ensure that participants in the focus groups fit the profile of respondents the research team sought. Potential participants were contacted by telephone and screened to verify their eligibility.

Eligible participants were invited to participate in the groups and were assured of the personal confidentiality and research-oriented purpose of the groups. Participants were not informed of the sponsor of this project. Confirmation letters with the time and location of the group were sent to all participants, as well as directions to the facilities where the groups were being held. Participants were called the day before the sessions to remind and encourage them to attend.

A.2.2.3 Focus group methodology

The focus groups were held in February 2005 in Colorado Springs, CO and Silver Spring, MD. A professional bilingual focus group moderator led each group. The groups lasted about 2 hours and were conducted in Spanish. Each participant signed an agreement to acknowledge that the session was being recorded (audio only); the agreement informed them that their personal information would be kept confidential. Participants were provided with a light meal as well as a cash stipend for their participation.

At the beginning of the discussion, participants were encouraged to share their ideas and were told that there were no wrong answers to the questions being asked. Participants were advised of "ground rules" for the discussion that included the role of the moderator and what constitutes appropriate participant behavior. They were then reminded that they were being audio recorded.

To begin the discussion, participants introduced themselves to one another and to the moderator. They were then led through the research questions in the moderator's guide, which focused on issues such as general knowledge of pedestrian and bicycle safety issues, key content areas for potential messages, participants' preferences for types and kinds of information on this topic, and participants' preferences for how to receive information on this topic.

The results of the focus groups are summarized in Section A.2.3.

A.2.3 Review Hispanic Outreach Materials

Hispanic outreach materials recommended for review by FHWA and NHTSA, as well as those found in the literature search were gathered and reviewed. A summary of these documents is shown in Table A-1.

Table A-1. Summary of Spanish Language Materials Reviewed.
Outreach Material Source Brief Description
Manual del Ciclista (Bicyclist Manual) State of Oregon 15-page bi-fold manual covering bicycle maintenance, traffic laws for cyclists, basic safety principles, and what to do in case of an accident.
Cómo Ajustar y Usar un Casco Para Ciclistas (How to adjust and use a Bicycle Helmet) Asociación de Daño Cerebral de la Florida, Inc. Tri-fold brochure1 - 5-step instructions with picture illustration and written instructions for adjusting and using a bicycle helmet.
Proteja la Cabeza de su Niño (Protect your child's head) State of California Department of Health Services 2-page (8.5" X 11") color handout with large photograph and brief textual description on properly fitting a bicycle helmet (presented in Spanish and English) 2
Los Chicos y la Bicicleta En Illinois (Children and bicycles in Illinois) State of Illinois 10-page bi-fold manual with "how to" drawings and text descriptions on the following bicycle-related topics: ride in the street and in the sidewalk, look behind you, navigate intersections, and adjust the bicycle and helmet for a proper fit (for parents)3
Comparta el Camino: Guia Para Ciclistas y Motoristas (Share the Road: Guide for Cyclists and Drivers) City of Tucson Dept. of Transportation,
Pima Association of Governments,
Pima County Dept. of Transportation
45-page guide with "how to" drawings and text on numerous bicycle-related topics: pass parked cars, open car doors if cyclists are close by, detailed Arizona laws, etc.4
Medidas de seguridad para montar en bicicleta (Safety measures for mounting bicycles) Kaiser Permanente 3-page flyer/handout on how to properly mount a bicycle (i.e., good locations to do so, use a helmet)5
Mira Izquierda Derecha Izquierda (Look Left Right Left) Florida Department of Transportation 4-page pamphlet6 - explains the meaning of the pedestrian signal indications.
Street Smart (multiple Spanish-language materials) Metropolitan Washington Council of Governments Multimedia campaign materials include TV spots (signal explanation for pedestrians); brochures, bus transit shelters and cards, and posters (cross safely); and handouts (use the crosswalks).
¡Yo camino - yo cuento! (multiple Spanish-language materials) North Central Texas Council of Governments Campaign materials include brochures and bookmarks (reasons to walk, suggestions on destinations, safety tips, walking gear tips, steps to fitness walking, and walking goals).
1 www.dot.state.fl.us/safety/ped_bike/brochures/ped_bike_brochures_bicycle.htm
2 www.dhs.ca.gov/ps/cdic/epic/bike/documents/BikeHelmetSPAN01.pdf
3 www.dot.state.il.us/bikemap/kidsonbikesspanish/kidsbikespanish.pdf
4 www.dot.pima.gov/tpcbac/comparte1.pdf
5 www.permanente.net/kaiser/pdf/7341.pdf
6 www.cure.fau.edu/pedcenter/downloads/spanishcard.pdf

In addition, Pedestrian-Bicycle Coordinators in all 50 States, the District of Columbia, Guam, and Puerto Rico were contacted via email to determine what, if any, Spanish language materials they had used. Finally, several organizations and agencies suggested by NHTSA were also contacted. These agencies included:

The following questions were asked of the State Pedestrian-Bicycle Coordinators and the organizations/agencies:

  1. Has your office put out any Spanish-language materials on bicycle or pedestrian safety?
  2. If yes, how are you distributing these materials or reaching the target audience? What have you found to be the best way(s) to reach the audience?
  3. Have the materials themselves and the outreach mechanisms been effective?

As of March 4, 2005, responses had been received from 18 of the States, the District of Columbia, and 4 of the 7 organizations. These responses from the states are summarized in Table A-2. Summary of Responses from Pedestrian-Bicycle Coordinators, and the responses from the organizations are summarized in Table A-3. Summary of Responses from Organizations. Any state or organization from which no information was received in not listed in the table; however, as information is received, it will be considered in the development of the marketing materials.

Table A-2. Summary of Responses from Pedestrian-Bicycle Coordinators
State/Organization Response
California California Highway Patrol produces brochures on various traffic safety topics, including Patinetas y Patines (Skateboards, Rollerblades & Scooters)
District of Columbia ¡Proteja la cabeza de su niño! (Protect Your Child's Head)-California Department of Health Services
Florida Cómo ajustar un casco para ciclistas (How to Fit a Cyclist's Helmet) (brochure). Mira Izquierda Derecha Izquierda (Look Left Right Left) - produced by Florida DOT.
Idaho The Bicycle/Pedestrian Coordinator distributes Safe Ride News publications and fact sheets through county driver's license offices, schools upon request, and others.
Illinois Los chicos y las bicicletas en Illinois (Kids on Bikes in Illinois) (primary target audience of this booklet is children ages 9 to 11). These brochures are available to anyone requesting them in hard copy. In the past, they have been sent to schools with Hispanic students and have been distributed at Bike Shows and conferences around the state. It is difficult to evaluate the effectiveness, but they are in continual demand and there have been several reprintings.
New Mexico Currently translating a bicycle awareness brochure into Spanish
Oregon Oregon DOT sent multiple copies of its Manual del Ciclista (Bicycle Manual). It is not available online.
Rhode Island The Rhode Island Department of Health has not produced its own materials. Instead, the department has distributed Spanish-language National SAFE KIDS and AAA materials at school and community events and health fairs:
  • Pedestrian Safety (SAFE KIDS)
  • Walkability Checklist (SAFE KIDS)
  • Safe Walking Tips (AAA)
The department has not distributed any Spanish-language materials on bicycle safety.
Arizona, Georgia, Indiana, Massachusetts, Michigan, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Tennessee, Vermont Nothing in Spanish.
Phone responses: Massachusetts, Minnesota, Tennessee.
Other States responded by e-mail.

Table A-3. Summary of Responses from Pedestrian-Bicycle Coordinators
Organization Response
Children's Safety Network "Educación de seguridad en el tránsito" (EST) (5).
Thunderhead Alliance This is a national alliance of state and local bicycle coalitions. The Executive Director suggested the Chicagoland Bicycle Federation (www.biketraffic.org), LA County Bicycle Coalition (www.labikecoalition.org), Florida Bicycle Association (www.floridabicycle.org), and Texas Bicycle Coalition (www.biketexas.org).
American Academy of Pediatrics E-mail response: "The AAP has not put out any Spanish-language materials on bicycle or pedestrian safety."
National Bicycle Dealers Association E-mail response: "Sounds like an excellent project, but we have nothing in Spanish."
Centers for Disease Control Phone response: Suggested two organizations - www.safekids.org and www.iwalktoschool.org.
Florida Bicycle Association The FBA has English and Spanish PSAs on "Go with the Flow" and "Get Out and Ride." The PSAs are available online at www.floridabicycle.org.
Los Angeles County Bicycle Coalition The Los Angeles County Bicycle Coalition prepared a report called Enhanced Public Outreach Project for Metro's Bicycle Transportation Strategic Plan. Data collection included both English and Spanish surveys of bicyclists.
The Coalition distributes Spanish and bilingual English/Spanish materials produced by the Los Angeles DOT, Metro, and other area agencies.
Chicagoland Bicycle Federation The Chicagoland Bicycle Federation created a series of pamphlets in Spanish: Ciclistas: ¿Desean respeto?
Ciclistas: ¡No viajen por la acera!
Ciclismo seguro en Chicago
Cómo asegurar su bicicleta
Cómo usar el carril para bicicletas
Consejos para los motoristas
Los chicos y la bicicleta en Chicago
The Chicago Bicycle Federation also produced a bilingual coloring book, Kids on Foot in Chicago / Niños caminando en Chicago.
Texas Bicycle Coalition The Texas Bicycle Coalition is working with universities to get student teachers certified to teach a course, SuperCycle, to 4th and 5th graders.

The review of the materials demonstrated that a variety of different types of materials on a variety of different topics have been produced for Hispanic audiences. There was no overall theme identified in the materials and not necessarily any connectivity between any of the documents. The print documents do provide an idea of the visual layouts that have been used and, in some cases, illustrate what may work and what may not (i.e., some are more graphics oriented, while others rely more heavily on textual descriptions). This visual aspect will be considered when developing the marketing materials for this project.

A.3 Analyze And Synthesize Information

Once all the information was gathered, the information from all sources was analyzed and synthesized. This section presents a synthesis of the results in terms of the EST outline and the key questions developed to address the items in the outline. The results are first shown for the literature, followed by the results of the focus groups.

A.3.1 Identify the Audience

In order to develop an effective outreach campaign, it was important to identify the audience. In other words, who exactly is the target of the campaign? Who relates to age and sex of the audience, culture, and how long they have been in the United States.

A.3.1.1 Which Hispanic groups should be targeted?

FHWA and NHTSA sponsored a research project in 2004 related to Hispanic pedestrian and bicycle safety. As part of this research, crash data from 1999 through 2003 were analyzed. Pedestrian and bicycle fatalities were examined by ethnicity, gender, age, and alcohol involvement. (1) In addition, 8 focus groups were conducted with 62 Hispanic men and women who walked or rode a bicycle regularly. (6) Focus group participants mentioned that new immigrants and those less informed about the laws as being at increased risk of a crash.

In particular, the participants reported that Hispanics who are recent immigrants, low in acculturation, or possess limited English language skills are those who are most confused about the U.S. traffic safety system.

A.3.1.2 Should different cultural groups be targeted?

Focus group participants in the 2004 FHWA/NHTSA-sponsored study did not think that any one Hispanic cultural group was more at risk. Moreover, participants agreed that, while each Hispanic culture is unique, the differences among Hispanic cultures as they pertain to pedestrian and bicycle safety are relatively minor. (6) However, based on the crash statistics, Hispanics of Mexican origin account for roughly two-thirds of all fatalities among Hispanic pedestrians and bicyclists. Among all Hispanics, about 67 percent of pedestrian fatalities and 89 percent of bicyclist fatalities occurred to males. (27)

A.3.1.3 What age groups should be targeted?

Focus group participants in the 2004 FHWA/NHTSA sponsored study reported that children were most likely to be in a crash, but that seniors were also at increased risk. (6) Crash statistics showed that there was a higher percentage of fatalities among Hispanic pedestrians and bicyclists aged 21-29, compared to non-Hispanic pedestrians and bicyclists in the same age group. (37)

In 2001, a child passenger safety campaign was developed in partnership between NHTSA, the National Latino Children's Institute (NLCI), and Nationwide Insurance. (4) The results showed that:

A.3.2 Understand the Audience and the Safety Topic

After the target audience has been identified, it is important to develop an understanding of the audience and how the safety topic relates to them.

A.3.2.1 In what pedestrian and bicycle safety-related areas is communication with Hispanic audiences most needed?

Focus group participants in the 2004 FHWA/NHTSA study had a general awareness of traffic signs and regulations; they were familiar with some aspects of the U.S. traffic system, including signs, signals, and laws. However, their knowledge was somewhat vague. For example, some pedestrians were unsure of what the blinking hand meant at a crosswalk. Several bicyclists questioned whether biking rules existed. In addition, traffic signs in English confused some participants. Participants reported that there is a lack of basic information on pedestrian and bicycle safety. The main sources of knowledge were their peers and taking their driver's exam. Pedestrian focus group participants suggested that more education be provided on these pedestrian safety-related areas:

Bicycle focus group participants were interested in information on laws, precautions, risks, and positive and negative things about being a bicyclist. They also thought that educating drivers on bicycle safety was critical. (6)

According to crash data analyzed as part of the same study, pedestrian and bicyclist fatalities among Hispanics were more likely to occur in urban areas than pedestrian fatalities among Non-Hispanic Whites or Non-Hispanic Blacks. Bicyclist fatalities among Hispanics were more likely to occur at or near an intersection than bicyclist fatalities among non-Hispanic Whites or Non-Hispanic Blacks. (1) The authors point out that about one-fifth of fatal pedestrian crashes are intersection or intersection-related. About 9 percent of fatal pedestrian crashes occur at a signalized intersection. These numbers are applicable to both Hispanic and non-Hispanic pedestrian fatalities. According to the authors, intersections on multi-lane roadways are a potential topic for educational programs that target Hispanic bicyclists. The authors also recommend that (1) campaigns should focus on the need to obey traffic laws, how to use crosswalks, and pedestrian/bicyclist rights and responsibilities; and (2) local programs should focus on the specific pedestrian/bicyclist problems in each community.

Focus group participants for this study reported that Hispanics, as a cultural group, have limited knowledge about U.S. traffic safety laws. This lack of knowledge is driven by cultural differences (i.e., differences between Latin American countries and the U.S. in traffic behaviors), as well as by language barriers. The result is that specific features of the U.S. traffic safety system are consistently confusing to Hispanics who are recent immigrants, low in acculturation, or possess limited English language skills. These include general differences in how traffic laws are enforced, differences in signs, the importance of crossing only in marked areas, how to read walk/don't walk signs, and how to push the button to call for a walk signal on a crosswalk. This result shows the importance of using more than just materials to change behaviors.

Participants readily self-reported that they would like to know more about U.S. traffic safety laws. There was a consensus among group members that Hispanics needed additional general information on traffic safety issues. They reported that Hispanics need to know more about:

In the focus groups, participants were told that Hispanics were especially at risk for accidents, and this was viewed as important information that should be included in educational materials.

A.3.3 Understand Effective Principles of Health/Safety Communication

One of the most significant references found in the literature review was the Corazón de mi vida campaign. (4) The Corazón de mi vida campaign is a child passenger safety campaign developed in partnership between NHTSA, the National Latino Children's Institute (NLCI), and Nationwide Insurance. Corazón de mi vida reaches the Latino community using appealing culture-based materials combined with four unique community activities, including: (1) parent pláticas, gatherings at Head Start and childcare centers, churches, clinics, and community centers to discuss child passenger safety and common attitudes; (2) press conferences where communities are encouraged to use special days to promote media coverage for child passenger safety; (3) safety seat "blessings," moving spiritual ceremonies that result in personal commitments to protect children; and (4) safety seat clinics to encourage families to drive up to checkpoints to test the installation of their safety seats. The materials include a variety of hangers, tags, bumper stickers, lotería games, and a video.

Twelve community-based organizations were invited to participate in the development and pilot testing of the Corazón de mi vida materials and strategies. Additional pilot tests were conducted in El Paso and Del Rio. Each program participated in a training session and received a video on how to organize a Corazón de mi vida plática, press conference, blessing, and safety seat clinic.

Findings from the pilot test indicated that although the Corazón de mi vida materials provide information in an easy-to-use manner and offer innovative reminders, the materials alone were not enough to change behavior. Parents and family members indicated that commitment to passenger safety practices was more likely to occur when the materials were used in combination with at least one of the community outreach activities. The greatest improvement in Latino safety behavior occurred when all four activities were held within the community, and when respected leaders of the community as well as family members reinforced the messages.

The messages and activities of the Corazón de mi vida program connect personally with each participant. They work because:

A.3.3.1 What types of messages are most likely to have the most impact?

In 1995, NHTSA sponsored a study to identify the highway safety needs of Hispanic communities within the United States. (7) Interviews with representatives of public and other agencies actively involved with Hispanic communities and focus groups with members of Hispanic communities were used to gather information. The results of the study showed that, in promoting health and safety, community members recommended developing themes that have some relationship to their lives and agreed that the family is one of the most powerful symbols in the Hispanic community. The organizational representatives emphasized the importance of personal contact and establishing relationships within the community. Effective strategies include:

Strategies to be avoided include:

Specifically, focus group participants called for graphic and explicit descriptions of motor vehicle crashes and the impact on families.

In 2002, Mecklenburg County, NC, developed a Safe Communities Program by producing culturally sensitive materials to reduce drinking and driving among Latinos in the county. From focus groups, they learned that the materials should focus consequences to the family, a genre popular among Latinos. (8) One of the RadioNovelas involves a woman being informed by a police officer that her husband has died in an impaired driving crash. The woman is concerned about taking care of the family and how they will manage without her husband. Another RadioNovela involves a man who has been injured in a drunk driving crash. A physician informs him that he was unable to save his leg during an emergency operation. The man is then concerned about how he will be able to take care of his family.

A bilingual video developed by El Pueblo, Inc., in North Carolina covers topics such as how to get a driver's license, the importance of using safety belts and child passenger seats, and the possible impacts of actions, such as driving under the influence, on the family. (27)

Street Smart is a pedestrian and bicycle safety and public awareness program in the Washington, DC, metropolitan area with the goal of educating the public on pedestrian and bicycle safety issues and laws. Street Smart started in 2002, and the most recent implementation took place in April 2004. The campaign is not targeted solely at Hispanics. Campaign materials urge drivers to "Imagine the Impact" of a crash on the lives and families of pedestrians, cyclists, and drivers. (9)

A study to design effective multi-media campaigns to reduce motor vehicle crashes in communities of recent Latino immigrants employed focus groups with Latino immigrants in three U.S. Cities. Results showed that many newly arrived Latino immigrants need to be informed about traffic safety laws. Focus group participants preferred that messages reflect real life or real stories, and be delivered by real people as opposed to celebrities. In three focus groups with Latino immigrants in three U.S. cities, results showed that, because of low literacy among many Latinos, effective messages must be clear, consistent, and free of jargon. In addition, messages should go beyond slogans like "Don't Drink and Drive" and preaching, and instead allow recipients to make their own conclusions. (10)

Participants in the focus groups conducted for this study generally did not like the idea of humorous messages, although reaction was inconsistent. While they are attention-getting, the topic of traffic safety is not a humorous subject and they would therefore be in bad taste. Participants' reactions to messages with shock value were more consistent. Overall, participants thought such messages could get their attention and cause them to think about the importance of traffic safety. In fact, this was one of two favorite types of messages discussed in the groups. There was a sense among participants, however, that messages should not be too shocking or scary, as this may have a negative impact.

The other favorite message type among participants focused on the importance of being safe because you love your family. They liked the idea of materials that focused on family and community, and thought such materials would resonate well with Hispanic cultural values. As with messages on acting out of family love, messages on sparing your family the trauma of loss were likewise reacted to favorably. This is, of course, closely related to being safe because you love your family; however, sparing your family the trauma of loss messages were slightly less preferred than being safe because you love your family messages. If messages on avoidance of trauma were used, participants thought they should focus on true stories of family trauma.

Participants had a favorable reaction to messages focused on general information. For example, such messages showed and explained traffic signs or encouraged people to use crosswalks. Participants appreciated the clarity of these messages, although their slight preference was for messages with more emotional content. Participants also did not like general information messages that contained too much textual information or that were overly simplistic and thus condescending.

A.3.3.2 What format and graphics are culturally appropriate?

Focus group participants from the 2004 FHWA/NHTSA study said materials should include graphics and other visuals and not rely too heavily on text. (6) Likewise, focus group participants in the 2002 Mecklenburg County Safe Communities Program recommended the use of photos and verbal information, as opposed to a large amount of text, was important. (8)

The EST project suggested that messages for parents that emphasize the value of family and that messages be written in a positive way (such as "Protect Yourself - Drive Sober" instead of "Don't Drink and Drive"). (27) Regarding graphics, the EST project suggested the use of faces that look like the target population, faces of people that the target audience knows and respects (such as community and religious leaders), popular celebrities, and photographs rather than illustrations. (27)

Participants in the focus groups conducted for this study reported that all materials should be relatively concise: participants were willing to listen to a commercial for up to a minute, and were willing to spend 2-3 minutes reading a flyer, advertisement, or brochure. All print materials should be written at a very low literacy level and should rely on images as well as text to convey their message. What are the best media for getting the messages across?

Focus group participants from the 2004 FHWA/NHTSA study suggested that information be distributed via television, radio, newspaper, commercials, soap operas, public service announcements, word-of-mouth advertising campaigns, posters, flyers, bumper stickers, and manuals/maps for bicyclists. (6)

Focus group participants from the 1995 NHTSA study, particularly from urban areas, viewed television as the medium with the most potential for disseminating traffic safety information to the Hispanic population. (7) The report also notes that the most effective medium may differ by location.

Focus group participants in the 2002 Mecklenburg County Safe Communities Program thought that the messages should be seen and heard in a variety of places. (8)

Recommendations from the Corazón de mi vida pilot test include: (4)

The ¡Yo cuento! campaign is intended to encourage people who currently walk for purposeful trips to continue to do so, and to encourage those who currently drive, even for short trips, to choose to make at least some of those trips by foot. Billboards depicting the family of Baldo™ comic strip characters, with the slogan "Una Familia Activa Vive Mejor ¡Camina!" (An Active Family Lives Better. Walk!) are being placed at strategic locations around the district, and hundreds of "¡Éntrale!" (Come in, or join us!) door decals featuring the campaign logo are being installed on every public entrance made available to the program, to demonstrate unified support from area businesses. (11) The North Central Texas Council of Governments is now looking at ways to gauge success. (12)

The Mecklenburg County Safe Communities Program found the most effective means of communication was through "fotonovelas" (i.e., photographic storytelling brochures) and "radionovelas" (i.e., soap opera-style segments) focusing on the pertinent educational points. (8)

Street Smart utilized multiple resources and media: TV and radio spots, print ads, outdoor media including transit shelters and bus backs, posters, handouts, and more. Enforcement activities (i.e., pedestrian stings) were also conducted. Spanish media included Telemundo (TV), El Tiempo Latino (a newspaper), and some transit shelter signs. (9) The Metropolitan Washington Council of Governments (MWCOG) received some comments about grammatical mistakes in the Spanish-language posters. MWCOG also had some positive comments on how the radio ads played in Spanish. No focus groups were held to obtain feedback. (13)

Madrina-Padrino Public Safety Project was a 1-year pilot educational program on traffic and public safety that ended on December 31, 2004. Through its culturally competent approach, this project relied upon community-based organizations to serve as madrinas (godmothers) and padrinos (godfathers), or trusted friends, who pledge to ensure the community's safety and wellbeing and to counsel, advocate for, and strengthen families in the pursuit of greater public safety. This project published feature stories in Hispanic newspapers to create interest and built trust between the Hispanic community and law enforcement, used Hispanic newspapers and radio to promote the education and training to be offered by community-based organizations, and secured TV news coverage of training. (14)

The results of NHTSA-sponsored focus groups in 2001 with Latinos in three cities showed that television appears to be the preferred medium, as focus group participants spent more time watching television (especially telenovelas on weekdays and sports programs on weekends) than listening to the radio. Fotonovelas were also suggested as a way to transmit messages, and can be distributed in some areas as newspaper inserts. Newspapers seem to have limited impact, in light of limited educational levels among many Latinos. Also, many U.S.-educated Latinos do not read Spanish print media. (10)

In August 2003, Cheskin, a consulting and strategic market research firm, reported that Hispanic print constitutes an up-and-coming set of media in the U.S. Examples of successful print media in the U.S. Hispanic market include dailies such as: La Opinion, El Nuevo Herald, and El Diario La Prensa; and magazines such as: Healthy Kids en Español, Ser Padres, People en Español, Latina, and Selecciones del Reader's Digest. All these magazines have listened to the consumer and have created and reinforced the content Hispanics appreciate. (15)

In October 2003, an in-school publication developed through a partnership with the Kid Guardian Foundation, Los Angeles County Sheriff's Department, Los Angeles Unified School District (LAUSD) School Safe Traffic Zone and La Opinion newspaper was distributed. A total of 353,000 handbooks went to K-3 students from the Los Angeles Unified School District and S.T.A.R. (Success Through Awareness and Resistance) Unit participating schools and as an insert in the Sunday edition of La Opinion newspaper reaching more than 100,000 families throughout Los Angeles. The handbook provided parents and children with written stories on the subject and included lesson ideas for teachers to develop and carry out in the classroom. (16)

In August 2000, the Lincoln-Lancaster County (Nebraska) Health Department Traffic Safety Program, the School Traffic Education and Enforcement Program, and Lincoln-Lancaster County Safe Communities came together to reduce the number of pedestrian injuries among the county's rapidly growing Hispanic population. Three elementary schools with a significant proportion of Hispanic students conducted observational surveys on pedestrian safety in the neighborhoods around the schools. Interventions based on the data gathered in these surveys included multilingual educational materials for parents, peer education activities, and the creation of pedestrian safety videos in both English and Spanish. Pedestrian safety resource packets were distributed to all 50 public and parochial schools in the county. The program also developed a website that allows the public to report unsafe behaviors of students or motorists around schools, as well as traffic safety assessments to evaluate the safety habits of both young pedestrians and motorists in the vicinity of the schools. (17)

The use of pictures or photographs of familiar scenes and activities is another effective strategy. For example, images of soccer (which is popular in Latin America) may be more appealing than images of American football. (27)

The EST project also advises that graphics should be respectful (do not reinforce negative stereotypes) and inclusive (if the whole family is being targeted, include grandparents because many Hispanics live in extended family situations). (27)

Participants in the focus groups conducted for this study expressed an interest in information from a variety of media. They were interested in television, radio, newspaper, and magazine advertisements, as well as in brochures, posters, and information for students. Among these options, television advertisements are most preferred, followed by posters and information distributed at schools. Print materials were seen as most useful because participants were interested in taking them home and looking at them on their own time. Participants were not interested in fotonovelas, radionovelas, buttons, calendars, or bumper stickers as a means to distribute information.

A.3.4 Use Accurate and Appropriate Language

Rather than just assuming that the materials should all be in Spanish, it was important to determine how the audience wants to receive information and what has worked well in past outreach campaigns.

A.3.4.1 Should materials be presented in just Spanish, or in English and Portuguese as well?

Focus group participants in the 2004 FHWA/NHTSA-sponsored study said that materials should be bilingual in Spanish and English. (6)

Agency representatives interviewed in the 1995 NHTSA study said that bilingual materials are generally preferred, but that English only may sometimes be appropriate. (7) A common mistake noted by some agency representatives is the assumption that all Hispanics want to speak Spanish, which can be patronizing and a turn-off. The preferred language depends on age and acculturation.

Street Smart conveyed information in both English and Spanish. (9) The Spanish materials were translations of the English materials. (13)

According to the EST project, material should be written as if it were for Spanish speakers initially. A word-for-word translation from English to Spanish will not capture the meaning of all essential points and may come across as an "afterthought." (27) The EST project cites the example of an informational card, developed in Indiana, about child passenger safety. The English side of the card has a law enforcement message: "Buckle Me Up Properly: That's the Law." The Spanish side has different photographs and a different message, with a focus on safety instead of law enforcement. The message is roughly translated as "A mother's arms are not always the safest place." (27)

In a January 2005 article, according to collective experience at Cheskin, bilingual marketing documents are appropriate for various reasons. Those Hispanics who prefer Spanish as their dominant language do so because they feel that they are being taken into account when they receive marketing material that includes information in Spanish. They also like the English language material as it helps them learn English, especially the technical terms. In addition, Hispanics believe that the English language makes the document more legitimate. The legitimacy brings with it an emotional benefit, namely, respondents describe a feeling as being part of the U.S. (18)

A.3.4.2 How should multiple languages be presented in the documents?

If materials are to be presented in two or more languages, what is the best way to accomplish this? Should materials be translated line by line? Should the materials be presented with one side in Spanish and the other side in English (or front to back)? Or should two separate documents be produced? According to Cheskin's intercultural team, it is best to offer bilingual documents with pages side-by-side or front-to-back. This option allows people to understand one concept at a time and to learn the technical distinctions as full concepts. (18)

A.3.5 Disseminate in an Effective Way

A.3.5.1 Who are the key partners in the outreach effort?

Partnerships can be critical in helping spread the word, especially in certain communities. One common theme throughout the literature and past outreach campaigns is the importance of family in Hispanic communities, as well as the effectiveness of using trusted leaders in the community in promoting the safety messages.

One of the key findings of focus groups of participants at the Latino Traffic Safety Summit in Wisconsin was the necessity of building trust between the Latino community and law-enforcement agencies. (19)

As an example of building trust between the Latino community and law-enforcement, the Florida Highway Patrol (FHP) created the Salvando Vidas (Saving Lives). This program, created in 2004, was designed to promote traffic safety among Northeast Florida's Hispanic population. By partnering with civic, religious, government, and non-profit organizations, the FHP sought to serve this unique community and promote general traffic safety, vehicle safety, seatbelt use, child restraint use, and driving under the influence (DUI) awareness among this target population.

Some key goals of the program are to:

The Salvando Vidas outreach program allows FHP Troopers, who are either of Hispanic ancestry or are bilingual and/or bicultural, to be designated as Salvando Vidas Coordinators. These coordinators work within the Hispanic community to organize community safety events, provide traffic safety education presentations, and serve as role models in the community. In addition, FHP has established a telephone voice mailbox for callers in the Jacksonville area, which offers a message in Spanish with information about the program. (20)

Since 1987, the California Highway Patrol (CHP) has been proactively involved in a traffic safety outreach program, El Protector, directed at the Hispanic community. It places special emphasis on educating through dialogue with the community, instead of focusing on enforcement measures. The goal of the El Protector Program is to reduce the disproportionate number of Hispanic drivers and victims involved in traffic related collisions. Activities are designed to educate and encourage positive traffic safety behavior and to build better community relations between the community and law enforcement agencies. Such community opportunities arise at local neighborhood/town hall meetings, educational functions, media, and at other community related forums. The driving force and focus of this program is the use of a CHP officer of Hispanic ancestry or officers that are bilingual and bicultural; such an officer is known as an El Protector Program Coordinator. The coordinator organizes community events, provides traffic safety education presentations, and serves as a Hispanic role model. (21)

In February 2004, the New Jersey Department of Community Affairs Center for Hispanic Policy, Research, and Development, in partnership with the Department of Law and Public Safety's Division of Highway Traffic Safety, awarded $270,000 in funding to support Hispanic nonprofit organizations participating in a "Partnering for Traffic Safety" program. The funding went to assist nine Hispanic organizations to develop public education programs geared toward raising child seatbelt and car seat awareness in the Hispanic community. "Nonprofit, community-based programs are a great untapped resource in our effort to educate the public about traffic safety," said Roberto Rodriquez, Director of the Division of Highway Traffic Safety. "I am excited about this new partnership that will, for the first time, allow our finding to be channeled directly to these local agencies that work closely with members of the Hispanic community." (22)

One recommendation from the Corazón de mi vida pilot test was that large institutions and State and city governments need to be encouraged to create

partnerships with Latino community-based organizations and to make funds available to them for costs associated with safety activities. Small organizations cannot join partnerships if their overhead costs are not covered. (4) During 2004, Corazón de mi vida was launched in Kansas City, MO, and Santa Ana, CA. The local partners in Kansas City were the Guadalupe Center and El Centro, Inc. The local partner in Santa Ana was Latino Health Access. (23, 24)

To develop the ¡Yo cuento! campaign, a group of key stakeholders formed a committee to help guide the campaign to reach the widest audience possible. This ¡Yo cuento! committee is working with support from the Greater Dallas Hispanic Chamber, the Oak Cliff Chamber, the Cooper Institute, and others to maximize saturation throughout the mile-square district. The committee is providing input and direction on potential strategies (i.e., what would work best), as well as messages and graphic images for the campaign. The campaign was publicized through news articles in Spanish-language newspapers and through outreach at community events for Hispanics. (11, 12)

The EST guidelines 27) state that "If materials are to influence attitudes and change behavior, they must consider cultural and linguistic factors, contain correct traffic safety information, and utilize principles of effective health communication." Therefore, the guidelines encourage the reader to find partners who can contribute expertise in these areas. Examples include national and local organizations that serve the Latino community, traffic safety organizations, and agencies that specialize in health education. During the development of the materials, feedback should be solicited from both professionals and community residents with regard to whether the messages are clear and relevant, whether the language is appropriate, and whether the graphics and design are appealing. (27)

A.3.5.2 Who should help distribute and promote the safety information within the community?

In the Corazón de mi vida campaign, information is relayed through trusted community organizations, as well as family members and friends. (4) A recommendation from the Corazón de mi vida campaign was to have information presented by a relative, trusted friend, a service provider with which they have a relationship, or through an event sponsored by an organization they trust. (4)

Focus group participants from the National Program to Design Effective Multi-Media Campaigns to Reduce Motor Vehicles Crashes in Communities of Recent Latino Immigrants preferred that messages reflect real life or real stories, and be delivered by real people as opposed to celebrities. (10)

In 2001, NHTSA selected Hispanic communities in Boston and surrounding areas to introduce the NHTSA mission of reducing the number of motor vehicle injuries and deaths among Hispanics in the area. They began by sending letters of introduction requesting a meeting, along with packets of information and sample materials to eight public and non-profit grassroots organizations in Massachusetts. NHTSA met face-to-face with four of the agencies in an effort. As a direct result of these meetings, each agency now understands that traffic safety is a worthy topic and now knows how and where to access educational materials and programs to begin to address concerns. While these grassroots organizations need a fair amount of TLC, they have credibility in their communities and have the direct contact with the populations in need of this information. (25)

Participants in the focus groups recently conducted for this ongoing FHWA/NHTSA marketing study thought that they had a role to play in distributing such information via conversations with friends and family members. In addition, information spread via word-of-mouth (e.g., through a network of Hispanics trained to educate others on this topic) would also be appreciated.

A.3.5.3 Where should the materials be distributed?

The focus group participants in the 2004 FHWA/NHTSA study suggested that information be distributed at soccer games, public transit stations and bus shelters, churches, schools, supermarkets, doctor's offices, community centers, libraries, motor vehicle offices, and bike stores. (6)

The Corazón de mi vida campaign works because it holds safety events at the local Head Start center, clinics, multiservice centers, neighborhood stores, or parks, rather than across town at large institutions such as hospitals. Family gatherings, special events, holidays, and cultural celebrations are also considered as key outreach opportunities. El Día de los Niños, birthdays, El Día de los Muertos, and Mother's Day are recommended for special events. (4)

In the 1995 NHTSA-sponsored study to identify the highway safety needs of Hispanic communities, the results suggested message delivery through schools, churches, and community-based organizations as effective strategies. (7)

University of Illinois, Chicago/Illinois Hispanic Safe Communities (UIC/IHSC) is a statewide coalition focusing on Hispanic communities in Illinois. UIC/IHSC conducted a study to define the Hispanic traffic injury problem using local data. Department of Public Health data indicated that Hispanics were killed in traffic collisions at a rate double that of their representation in the population. The project staff decided to use focus groups in order to understand better what was going on in a particular Hispanic community. These focus groups revealed that while Hispanics in Illinois were concerned with traffic safety, the issue was often overshadowed by concerns with gangs and violence. The research also revealed that few of the participants had any formal driver education and that a substantial number were actually driving without a license. Following the focus groups, UIC/IHSC and its local partners reached out to Hispanics in a number of ways. They found that youth soccer events were effective venues for reaching Hispanics. Also, an effective educational event was held in conjunction with a "Scoop the Loop" antique car rally. UIC/IHSC and its partners provided traffic education activities for the entire family. For example, police officers walked adults wearing "Fatal Vision" goggles, which simulate various blood alcohol levels, while community volunteers helped children draw pictures with traffic safety themes. (26)

Materials can be distributed through programs used by members of the target audience, for example, English classes, Head Start, child care agencies, prenatal classes, etc. (27)

Participants in the focus groups recently conducted for this ongoing FHWA/NHTSA marketing study listed a variety of possible locations. The most popular were schools, supermarkets, other stores (Wal-Mart and 7-Eleven were noted by name), and churches. There was also some interest in getting information through community centers or at doctors' offices. A few participants mentioned public transit stations or motor vehicle offices as possible locations to distribute information. There was little to no interest in getting information at soccer games (they go to games for entertainment purposes), libraries (few Hispanics visit libraries because most information is in English), or bicycle shops (too expensive).

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