State mandated school bus safety education on the teaching of bus safety education.

Abstract: The purpose of this study was to determine if mandating bus safety education increases the amount of bus safety education taught in elementary schools. Primary grade teachers in non-mandated bus safety education states were less likely to teach bus safety education and more likely to be in the relapse stage than teachers from the mandated bus safety education states. Teachers in mandated states valued teaching bus safety significantly more than those from non-mandated states. Finally, 25% of teachers in non-mandated bus safety education states claimed they desired more training compared to 19% teachers in the mandated bus safety education states.

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Unintentional injuries are the leading cause of death in the United States for people ages 1-34 (CDC, 2003; CDC, 2004). This age group includes pre-school and school-age children between the ages of 5 and 19. Unintentional injuries kill more children between the ages of 1 and 4 in the U.S. annually compared to all other childhood disease deaths combined (CDC, 2002; CDC, 2003).

Motor vehicle-related injuries are the leading cause of death among children and adolescents ages 5 to 19 years old (CDC, 2003). Since 1991, about 406,000 fatal traffic crashes have been reported (National Highway Traffic Safety Administration [NHTSA], 2002). Many of these fatalities include school buses. Each year, about 440,000 school buses travel 4 billion miles to transport 25 million children to and from school and to school-related activities (American Academy of Pediatrics [AAP], 1996; NHTSA, 2001). School buses are used for almost 10 billion student trips each year (NHTSA, 2001). It is estimated that 85% of these buses are large, carrying more than 16 passengers and are usually not equipped with lap belts (AAP, 1996).

Since 1991, 1,337 fatal traffic crashes classified as school transportation-related have been reported (NHTSA, 2002). Between 1989 and 1999, an average of 30 school-age children (ages 5 and 18) were fatally injured each year in school bus-related crashes. School bus-related pedestrian fatalities account for the highest number of school bus-related fatalities each year compared to school bus occupant fatalities (NHTSA, 2002). One study found that out of the 26 school bus related pedestrian fatalities that occur each year, two-thirds involved school buses and the remaining one-third involved other motorists illegally passing stopped school buses (NHTSA, 2000). More than half of these pedestrian fatalities were to young children between 5 and 7 years old (NHTSA, 2001). Another report by the American Academy of Pediatrics revealed that about 150 people are killed in school bus crashes each year (AAP, 1996). Out of this figure, only 8% were school-age passengers on the buses, and 30% were pedestrians. Out of the fatally injured pedestrians, 84% were school-age children (AAP, 1996).

Much can be done to prevent these bus-related injuries and deaths from occurring. Schools, teachers, parents and policy makers have roles to play in preventing school bus-related crashes and their associated injury and death. This is a public health issue that needs to be approached on multiple levels.

Elementary teachers are responsible for providing health education to primary grade students. They typically teach lessons on health topics such as nutrition, physical activity, and personal hygiene. Since unintentional injury is the leading causes of trauma death among primary grade students, it should be expected that elementary teachers teach this topic as one of their priorities.

A variety of methods can be used to reduce school bus injuries and fatalities. The National Highway Traffic Safety Administration suggests two major ways: behavioral programs and improving school bus safety standards. Behavioral programs include pupil education, driver/operator training, and educational programs to increase motorists' awareness of their role in keeping school bus passengers safe. School bus safety standards include pre-crash, crash, and post-crash standards that can be utilized to make the manufacturing of buses safer (NHTSA, 2004).

Primary grade teachers have a responsibility to teach bus safety procedures to their students. In addition, policy makers can also contribute to school bus safety by passing legislation that mandates bus safety education in schools. School bus safety instruction at the beginning of each year should teach children how to behave in and around school buses. A comprehensive review of the literature did not find any published studies that explored the impact of state mandates for providing school bus safety education on what is being taught to primary grade students.

The purposes of this study were to: 1) determine if mandating bus safety education increases the amount of bus safety education taught in schools and 2) determine what is being taught regarding bus safety education in schools from states with mandated bus safety education. Furthermore, the study assessed primary grade school teachers' confidence in teaching bus safety education programs, the stages of change of primary grade teachers experience regarding the teaching of bus safety, and the impact of mandatory bus safety education programs on the amount of bus safety instruction in primary schools.

METHOD

SUBJECTS

Subjects for the study were primary grade teachers selected from a national directory of public schools. The directory was obtained from the U.S. Department of Education and was reduced to include traditional elementary schools (K--grade 5) located within the 50 United States (Directory of Public Elementary and Secondary Education Agencies [DPESEA], 2001). This resulted in a sampling frame of 35,160 elementary schools. A two stage probability sampling technique was then applied to select the sample for the study. Specifically, a stratified sampling design was used to divide states into two non-overlapping strata: states that mandated bus safety education at the elementary school level and those which did not mandate such education.

All 50 state directors for Pupil Transportation were also used for the study to determine whether or not specific states mandated school bus safety education for primary school-aged children. Thirty-seven state directors returned their brief surveys. Of the 37 state directors that returned the survey, 17 indicated that their states had bus safety education mandated, 15 states had no mandates, and 5 were not sure if their states had the mandate or not.

After the stratification, a simple random sample was used to select 10 states from each stratum. A simple random sampling technique was again used to select 350 primary grade teachers from each of the selected states. This procedure yielded 700 primary grade teachers: 350 from states that mandated bus safety education and 350 from states that did not. The 700 primary grade teachers were selected via computer generated random numbers. The stratified sampling design and the various simple random sampling designs used in the selection of the sample ensured the removal of researcher's bias and representation of the population.

INSTRUMENT

The instrument for the primary grade teachers was developed based on the stages of change model and the self-efficacy constructs of the social cognitive theory. Components of the self-efficacy construct used in the survey development included efficacy expectations, outcome expectations, and outcome values (Montano, Kaspryzk, & Taplin, 1997). The stages of change model was used to help identify in which stages primary grade teachers were regarding the teaching of bus safety education in their schools (precontemplation, contemplation, preparation, action, maintenance, relapse; Prochaska, Redding, & Evers, 1997).

The final instrument for the primary grade teachers was a 4-page questionnaire consisting of 22 items, composed of six questions assessing schools status regarding bus safety education, two items assessing teachers' confidence in teaching bus safety education, six items assessing the importance of teaching bus safety, and eight items assessing background and demographic characteristics (sex, highest education level, experience, present teaching grade, location of school, type of school). The instrument consisted of closed-response formats (yes/no, check all that apply), and a seven point Likert-type rating scale (highly confident to confident). Some items required a fill in the blanks response (e.g.,--%).

INSTRUMENT TESTING

A cover letter explaining the purpose of the study and the behavioral models used in the instrument were sent to an expert panel (n = 6) of survey researchers and injury prevention specialists to review the initial instrument to determine the content validity. Revisions were made to the instrument based on the recommendations from the expert panel members. Stability reliability was conducted on the primary grade teachers instrument using a convenience sample (n = 35) of local primary grade teachers. The instruments, cover letters, and self-addressed envelopes were mailed to this sample after an initial contact. A second mailing was done two weeks after the first survey was completed to the same sample. Nineteen (54%) paired pilot surveys were returned. Pearson Product Moment correlation coefficient tests were used to determine the stability reliability of the primary grade teachers' responses to the self-efficacy subscales and they were: efficacy expectations (r = .76), outcome expectations (r = .71), and outcome values (r = .52). Internal reliability of the instrument was assessed for the three self-efficacy subscales on primary grade teachers' responses. Cronbach alpha was assessed for efficacy expectations (= .91), outcome expectations (= .95), and outcome values (= .78).

PROCEDURES

The final instrument, a hand signed cover letter and a self-addressed stamped envelope were mailed first class to all participants of the study. A second wave mailing was sent to those who had not responded two weeks after the first mailing and included the instrument, cover letter, and a return pre-stamped self addressed envelope. This was also mailed through first class mailing to all study participants. Two weeks after the second mailing, a reminder card was mailed to non-respondents to urge their participation (King, Pealer, & Bernard, 2001).

DATA ANALYSIS

Data from the study was analyzed using SPSS 12.0. Descriptive statistics (frequencies, percentages, means, and standard deviations) were used to describe the data from all the questions on both surveys. Analysis of variance tests were used to determine if differences existed between teachers in states with mandated bus safety education versus states that did not mandate bus safety education. Chi-square (c2) tests were used to analyze the categorical data.

RESULTS

DEMOGRAPHIC AND BACKGROUND CHARACTERISTICS

Twenty-four surveys were undeliverable, and 247 of 676 potential respondents (37%) responded; 140 from primary grade teachers in states where bus safety education was mandated and 107 from states that did not mandate such education. The majority of primary grade teachers were not sure if school bus safety education was mandated in their schools. Though 140 respondents were from states where bus safety was mandated, only 39% of primary grade teachers knew that school bus safety education was mandated in their school district.

The majority of primary grade teachers were female: 94% from states where bus safety education was mandated and 91% from states that did not mandate such education. Fifty-one percent of primary grade teachers in bus safety education mandated schools had masters' degrees compared to 42% in non-mandated bus safety education states (Table 1).

Primary grade teachers who taught bus safety were asked to indicate how much time they spent teaching bus safety education in a school year. The study revealed that teachers in mandated bus safety education states were more likely to spend more minutes teaching this safety education area (M = 109.4, SD = 105.9) than teachers in non-mandated states (M = 91.1, SD = 128.9). However, while in the expected direction, this difference was not statistically significantly different between the two groups of teachers.

STAGES OF CHANGE REGARDING THE TEACHING OF BUS SAFETY

A chi-square test was conducted to determine the relationship between state mandates for bus safety education and the stages of change model regarding the teaching of bus safety. Due to small sample sizes in some of the cells, some of the stages were combined into three groups (not teaching = precontemplation, contemplation, and preparation; and teaching = action and maintenance; and relapse) in order to be able to calculate a valid chi-square. A statistically significant relationship was found ([c.sup.2] = 24.3, df = 2, p < .001). Primary grade teachers in states without a mandate for bus safety education were over two times more likely not to be teaching bus safety education (precontemplation, contemplation and preparation stages) and were more likely to be in the relapse stage than teachers from states in which bus safety education was mandated (Table 2). Primary grade teachers in mandated bus safety education states were more likely to be in the action and maintenance stages (72%) than primary grade teachers in non-bus safety mandated states (40%; Table 2).

TOPICS TAUGHT IN BUS SAFETY EDUCATION

Teachers were requested to identify from a list of 15 items which items they included in their bus safety education curriculum. They could select all that apply. At least 50% of all the teachers taught seven areas: how to leave the bus safely (61%), how to enter the bus safely (60%), the respect for the rights of others (52%), how to cross the street after leaving the bus (51%), where to wait safely for the bus (51%), how to cross the street to board the bus (50%), and how to wait safely for the bus (50%). Primary grade teachers were least likely to teach wearing light-colored clothing to the bus stop (8%) and wearing light-colored clothing from the bus stop (8%; Table 3).

Primary grade teachers were asked to indicate the number of students who have been involved in school bus-related crashes in the past three years. Students in both groups were equally likely to be involved in school bus-related crashes (6%). Students in mandated bus safety education states were more likely to have been injured in school bus-related crashes (6%) more than students in non-mandated bus safety education states (4%). Only one student in the mandated bus safety education states died in a school bus related crash.

TEACHER SELF-EFFICACY FOR TEACHING BUS SAFETY

A series of analysis of variance tests were conducted to determine if differences existed between teachers in mandated bus safety education and non-mandated bus safety education states regarding their self-efficacy for providing bus safety education. Efficacy expectations did not differ significantly between teachers in the mandated bus safety education states (M = 41.77, SD = 11.12) versus those in the non-mandated states (M = 39.66, SD = 13.250) (F = 2.233, df = 2, 236, p = .11). In addition, outcome expectations did not differ significantly between teachers in the mandated bus safety education states (M = 40.24, SD = 10.98) versus those in the non-mandated states (M = 37.67, SD = 12.81) (F = 1.902, df = 2, 231, p = .15). However, outcome value was statistically significantly different between the two groups of teachers (F = 9.33, df = 2, 229, p < .001). Teachers in the mandated states valued teaching bus safety (M = 14.5, SD = 3.49) significantly more than those in the non-mandated states (M = 12.1, SD = 4.48).

Twenty-four percent of teachers in mandated bus safety education states reported having a bus safety curriculum which guided their teaching compared to 9% of teachers in non-mandated bus safety education states. Out of those who did not have any bus safety education curriculum, 38% of the teachers in the non-mandated bus safety education states reported they would use one if it was provided compared to 32% in the mandated bus safety education states.

TEACHER EDUCATION ON BUS SAFETY

On teachers' pre-professional training regarding safety education, 28% of teachers in the non-mandated bus safety education states reported receiving some training in injury prevention versus 22% in the mandated bus safety education states. Eight percent of teachers in the non-mandated bus safety education states indicated that their pre-professional training in injury prevention included bus safety education compared to 7% of teachers in mandated bus safety education states. When asked if they would like more training on bus safety, 25% of the teachers in the non-mandated bus safety education states indicated that they would like to receive more training compared to 19% of the teachers in the mandated bus safety education states.

Asked to select from a list of ways through which they would like to receive bus safety education information, only three ways were selected by 10% or more of the respondents. Primary grade teachers were more likely to select in-service programs by their school districts (17%), newsletters (17%), and the internet (12%; Table 5).

DISCUSSION

School bus-related injury programs in primary grade schools can reduce the number of injuries and deaths resulting from motor vehicle-related crashes. This study found that the majority of primary grade teachers in non-mandated bus safety education states were not teaching bus safety education (46%) and were more likely to be in the relapse stage (49%). Mandating bus safety education in states and the provision of more training would assist such teachers to start providing bus safety education to their students. In addition, other health education mandates in states may encourage the teaching of other valuable health education areas in primary grade schools. Primary grade teachers in mandated bus safety education states believed that it was valuable to teach bus safety education to their students. To reduce the incidence of school bus-related injury, the National Highway Transportation and Safety Administration (2001) recommends at least one bus safety education program for elementary students This recommendation was supported by the American Academy of Pediatrics (1996) who suggested that children should receive bus safety education regardless of how infrequently they ride buses.

Bus safety education should constitute an integral part of the unintentional injury curriculum during the professional preparation of primary grade teachers. This is because the majority of primary grade teachers in mandated bus safety education states reported that bus safety education was a valuable aspect of education. Pupil bus safety education should be a priority to reduce school bus-related injury and death (NHTSA, 2004).

Findings from this study also revealed that although some of the teachers were from 10 states that mandated bus safety education, only 39% of those teachers were aware of such a mandate. This shows that policy alone is not enough to encourage the teaching of bus safety education in primary grade schools. To address the issue of mandated bus safety education, primary grade teachers must be informed about their state's mandates for bus safety education. States and school districts should conduct in-service training for their teachers to equip them with teaching skills and make them aware of existing mandated policies.

This study also found that 28% of teachers in non-mandated bus safety education states reported receiving some form of pre-professional training in injury prevention compared to only 22% of teachers in the bus safety education mandated states. The curriculum of pre-professional teachers should include unintentional injury prevention training, more specifically motor-vehicle injury prevention. Such training should help equip teachers with the needed knowledge and skills to provide bus safety education to their students.

The potential limitations of this study include the response rate, response bias, the closed format nature of the questionnaire, and the monothematic nature of the questionnaire. The low response rate (37%) may have affected the findings of this study. Non-respondent primary grade teachers may have had different views from respondents regarding bus safety education. If so, this would have been a threat to the external validity of the findings. The monothematic nature of the questionnaire may have influenced some respondents. This may have introduced response bias in some responses, thereby threatening the internal validity of the study. The closed format nature of the questionnaire may have restricted the responses of some of the primary grade teachers. If so, this too would have affected the internal validity of the study. Finally, no specific analysis was conducted regarding state by state mandates to determine if specific time and content issues were mandated in the various states.

REFERENCES

American Academy of Pediatrics [AAP]: Committee on School Health and Committee on Injury and Poison Prevention (1996). School transportation safety. Pediatrics, 97, 754-757.

Centers for Disease Control and Prevention: National Center for Injury Prevention and Control. (2002). Injury fact book, 2001-2002. Retrieved November 10, 2004 from http://www. cdc.gov/ncipc/factsheets.

Centers for Disease Control and Prevention: National Center for Injury Prevention and Control. (2003). Unintentional injuries in the United States. Atlanta, GA: Author.

Centers for Disease Control and Prevention. (2004). WISQARS (web-based injury statistics & reporting system). Retrieved September 15, 2004 from http://www.cdc.gov/ncipc/ wisqars.

Directory of Public Elementary and Secondary Education Agencies. (2001). National Center for Education Statistics. Retrieved July 10, 2004 from http://www.nces.ed.gov.

King KA, Pealer LN, Bernard AL. (2001). Increasing response rates to mail questionnaire: a review of inducement strategies. American Journal of Health Education, 32, 4-15.

Montano DE, Kaspryzyk D, Taplin SH. (1997). The theory of reasoned action and the theory of planned behavior. In K. Glanz, FM Lewis, BK Rimer (Eds.), Health behavior and health education: Theory, research, and practice (pp. 85-112). San Francisco: Jossey-Bass.

National Highway Traffic Safety Administration [NHTSA]. (2001). School bus safety facts 2000. Retrieved September 12, 2004 from http://www.nhtsa.dot.gov.

National Highway Traffic Safety Administration [NHTSA]. (2001). Highway safety program: Pupil transportation safety. Retrieved September 12, 2004 from http://www.nhtsa.dot. gov.

National Highway Traffic Safety Administration [NHTSA]. (2002). Traffic safety facts 2001. Retrieved September 12, 2004 from http://www.nhtsa.dot.gov.

National Highway Traffic Safety Administration [NHTSA]. (2004). School bus safety: safe passage for America's children. Retrieved September 12, 2004 from http://nhtsa.dot.gov/people/injury/buses/schbus/schbusintro2.html.

Prochaska JO, Redding CA, Evers KE. (1997). The transtheoretical model and stages of change. In K. Glanz, FM Lewis, BK Rimer (Eds.), Health behavior and health education: Theory, research, and practice (pp. 61-84). San Francisco: Jossey-Bass.

CHES AREAS

Responsibility 1: Assessing individual and community needs for health education was addressed. Competency A, sub-competency 4: apply survey techniques to acquire health data were addressed.

Grace K. Lartey, PhD is an Assistant Professor in the Department of Public Health at Western Kentucky University. Susan K. Telljohann, HSD, CHES is a Professor of Health Education in the Department of Public Health at the University of Toledo. James H. Price, PhD, MPH is a Professor of Public Health in the Department of Public Health at the University of Toledo. Address all correspondence to Grace Lartey, Department of Public Health, Western Kentucky University, 1906 College Heights Blvd # 11082, Bowling Green, KY 42101. PHONE: [phone], FAX: [phone], E-MAIL: [e-mail].

Table 1. Demographic and Background Characteristics of Primary
Grade Teachers

                                 States With        States With
                                   Mandate            Mandate
Item                               N       (%)        N        (%)
Gender
  Female                         131     (94)        97      (91)
  Male                             8      (6)         5       (5)
Highest Level of Education
  Bachelor's degree               66     (47)        52      (49)
  Master's degree                 71     (51)        45      (42)
  Education specialist             2      (1)         4       (4)
School Location
  Suburdan                        47     (34)        40      (37)
  Urban                           58     (41)        36      (34)
  Rural                           34     (24)        25      (23)
Number of Years in Current School
  1-7                             52     (38)        46      (43)
  8-14                            36     (26)        22      (21)
  15 - 21                         22     (16)        19      (18)
  22 - 28                         15     (11)        11      (10)
  29 - 35                         13      (9)         3       (3)
Number of Years as Primary Grade Teacher
  1 - 10                          42     (30)        30      (28)
  11 - 20                         39     (28)        32      (30)
  21 - 30                         41     (29)        28      (26)
  31 - 40                         14      (9)         9       (8)

N = 140 (States with bus safety mandate)

N = 107 (States without bus safety mandate)

Table 2. Primary Grade Teachers Stages of Change Regarding the of
Teaching Bus Safety (N=237).

                                                        States with
                                                         Mandate
Item (Stage)                                           N         (%)

I have never seriously thought about teaching          23        (16)
bus safety to my students (Precontemplation)

I have been seriously thinking about teaching           3         (2)
bus safety to my students (Contemplation)

I have a plan to teach bus safety to my                 2         (1)
students next year (Preparation)

I just started teaching bus safety to my                4         (3)
students this year (Action)

I have taught bus safety to my students for            93        (66)
two or more years (Maintenance)

I used to teach bus safety to my students,             10         (7)
but I no longer do so (Relapse)

                                                   States with without
                                                        Mandate
Item (Stage)                                            N         (%)

I have never seriously thought about teaching          39        (37)
bus safety to my students (Precontemplation)

I have been seriously thinking about teaching           7         (7)
bus safety to my students (Contemplation)

I have a plan to teach bus safety to my                 2         (2)
students next year (Preparation)

I just started teaching bus safety to my                2         (2)
students this year (Action)

I have taught bus safety to my students                39        (37)
for two or more years (Maintenance)

I used to teach bus safety to my students,             13        (12)
but I no longer do so (Relapse)

Table 3. Curriculum Content of Primary Grade Teachers who Taught
Bus Safety (N=234).

Item                                                        N     (%)

How to leave bus safely                                    151      61
How to enter bus safely                                    147      60
Respect for the rights of others                           128      52
How to cross the street after leaving the bus              127      51
Where to wait safely for the bus                           125      51
How to wait safely for the bus                             124      50
How to cross the street before boarding the bus            124      50
Safe walking practices to bus stop                         122      49
Safe walking practices from bus stop                       116      47
Respect for the privileges of others                       106      43
Bullying prevention                                         72      29
What to do if bus was late                                  39      16
What to do if bus did not arrive                            38      15
Wearing light-colored clothing to bus stop                  20       8
Wearing light-colored clothing from bus stop                20       8

Table 4. Desired Types of Bus Safety Information *

                                                      States with
                                                         Mandate

Item (Topic)                                          N     (%) **

How to cross street before boarding bus               20      (14)
How to cross street after leaving bus                 19      (14)
Where to wait safely for bus                          24      (17)
Bullying prevention                                   26      (19)
How to wait safely for bus                            23      (16)
What to do if bus did not arrive                      25      (18)
Respect the rights of others                          24      (17)
Safe walking practices to bus stop                    21      (15)
Respect the privileges of others                      23      (16)
What to do if bus was late                            23      (16)
Safe walking practices from bus stop                  20      (14)
How to enter bus safely                               19      (14)
How to leave bus safely                               19      (14)
Wearing light colored clothing to bus stop            18      (13)
Wearing light-colored clothing from bus stop          18      (13)

                                                     States Without
                                                         Mandate

Item (Topic)                                          N     (%) **

How to cross street before boarding bus               32      (30)
How to cross street after leaving bus                 31      (29)
Where to wait safely for bus                          30      (28)
Bullying prevention                                   30      (28)
How to wait safely for bus                            28      (26)
What to do if bus did not arrive                      26      (24)
Respect the rights of others                          25      (23)
Safe walking practices to bus stop                    25      (23)
Respect the privileges of others                      25      (23)
What to do if bus was late                            25      (23)
Safe walking practices from bus stop                  24      (22)
How to enter bus safely                               23      (22)
How to leave bus safely                               23      (22)
Wearing light colored clothing to bus stop            13      (13)
Wearing light-colored clothing from bus stop          13      (12)

* These responses are for only those who indicated they desired more
information (N = 40 for bus safety mandated
states and N = 40 for non-mandated bus safety states).

** Percent are based on the total number of respondents in bus
safety mandated and non-mandated states.

Table 5. Ways Through Which Primary Grade Teachers Would Like
to Receive Information * (N=93)

Item                                       N       (%)

Newsletter                               42        (17)
In-Service Programs                      41        (17)
Internet                                 30        (12)
Professional Workshops/Conferences       16         (7)
Professional Journals                    11         (5)
University/College Course Credit          6         (2)

* These responses are for only those who indicated they
desired more information