Protocol of a cluster-randomised trial to improve adolescent bicycling safety education programme efficacy.

Introduction: Second to motor vehicles, bicycles contribute to more childhood injuries than any other consumer product. Youth bicycling safety education programmes are one avenue of prevention, but despite a plethora of programmes, little is known about their impact on bicycling safety behaviour. This paper summarises a cluster-randomised trial to evaluate the impact of a bicycle safety education programme for young adolescents. Methods and analysis: Adolescents aged 9-12 years old who bike at least two times per week and a parent/guardian are recruited via email listservs, flyers and word of mouth. Participants are screened for eligibility before they are consented/assented into the study. Adolescent-parent dyads are randomised to one of the three study arms (Control, Bike Club, Bike Club Plus) based on the school they attend. The Bike Club intervention arm evaluates the bicycle safety club programme and the Bike Club Plus intervention arm evaluates the addition of an active parent engagement component. Control group participants receive no intervention, but they are told that other participants in the study will receive the education intervention so that they understand why they are asked to record their bicycling trips for two separate weeks. The intervention involves 12 hours of classroom and on-bike lessons covering a variety of bike safety skills for independent riding in mixed traffic. Adolescents record their bike rides using a Global Positioning System (GPS)/video camera system for 2 weeks, 1 week before and 1 week after the education programme for participants in the intervention arms and approximately 1 month between data collection weeks for participants in the control group. All participants complete baseline and follow-up surveys. Primary outcomes include rates safety-relevant events (eg, crashes, near crashes) and safety behaviours (eg, helmet use, traffic law violations, hazard avoidance) per 100 miles/min ridden, and the proportion of positive and negative behaviours relative to the overall number of instances of a given event behaviour. Secondary outcomes include differences in knowledge test scores, mean ratings of perceptions, mean ratings of self-efficacy, and identification and recall of cues to action related to bicycling safety. Ethics and dissemination: This study has ethical approval from the University of Iowa Institutional Review Board (IRB# 202105148). Study results will be disseminated through presentations at national and international scientific conferences, peer-reviewed manuscripts, outreach to stakeholders and digital media outlets. Trial registration number: NCT05265689.