DESCRIPTION (provided by applicant): Child pedestrian injury represents a significant public health problem in China and many other LMICs. Although automatic for most adults, safe street-crossing requires complex cognitive-perceptual skills that children must develop. Research in developed nations suggests children can learn those skills through repeated practice, including within interactive virtual reality (VR) pedestrian environments. Therefore, we propose development of an interactive VR pedestrian environment that simulates the Chinese traffic/street environment and can be delivered via the internet to the tablet platform for wide us in China and beyond. The system will be built using Unity 3D software and will run over a standard internet connection to tablets, phones, and computers. This work builds on our development of VR to train US children in pedestrian safety and our investigations of other child injury risks (drowning, dog bites) among Chinese children. Along with development of the VR system, we propose an evaluation study. We will implement a pre- post research design and use multiple behavioral and observational assessments of pedestrian skill prior to and after training a sample of about 300 Chinese schoolchildren in pedestrian safety with the newly-developed tablet-based VR system. Assessment strategies pre- and post-training will include self-report, individualized behavioral observation of pedestrian safety in the VR and at street side locations, and observation of children's street-crossing after school dismissal. Primary data analyses will assess changes within individual from pre- to post-training. Attention will be paid to development of research capacity and ensuring further evaluation and sustainability of the program if it proves successful in the efficacy trial.

PUBLIC HEALTH RELEVANCE: Pedestrian injuries are a leading cause of pediatric mortality for children in China, the US, and many other countries. This project will study the efficacy of an internet-based virtual reality system that can be delivered by tablet platform to train Chinese children in safe pedestrian behavior. Results will have significant direct implications for child pedestrian injury prevention in China and indirect implications globally.