Hagel, BrentAucoin, Janet2024-10-302024-10-302024-10-28Aucoin, J. (2024). Bicycling injuries in children: the role of the built environment (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.https://hdl.handle.net/1880/120025Background: Bicycling has many health benefits for children but can result in injuries, some severe. Additionally, children’s perceptions of injury risk decrease participation. The built environment is associated with the risk of bicycling injury in adults, yet less is known about risks for children who have different bicycling behaviours and locations than adults. This dissertation improves understanding of child bicyclist injury risk factors and perceptions in Canada, with an emphasis on the role of the built environment. Methods: We recruited 333 injured child bicyclists (ages 5-17) who presented to pediatric emergency departments in Vancouver, Calgary, and Toronto from May 2018 - October 2021. Using data from participant interviews and in-person site audits of injury/control locations from the injured child’s route, Chapter 3 used a case-crossover study design to examine associations between built environment characteristics and child bicyclist injuries. Chapter 4 used data from the case-crossover study to explore injury circumstances and examine risk factors associated with severe child bicyclist injuries. In 2021, 40 participants also completed a qualitative interview to explore injured child bicyclists’ perceptions of risk factors and safety (Chapter 5). Results: The results in Chapter 3 provided evidence that unpaved off road locations, presence of debris, poor surface quality, surface grade, and construction were risk factors for child bicyclist injuries. In Chapter 4, motor vehicle involvement and intersections were associated with higher odds of severe injury in child bicyclists. In Chapter 5, child bicyclists shared that some of the factors that contribute to perceptions of safety included sharing spaces with motor vehicles, road design, debris, surface quality, and surface grade. Conclusions: This study adds to evidence suggesting built environment supports are important for increasing bicycling safety for Canadian children. There is a critical need to provide child bicyclists with safe spaces where they are physically separated from motor vehicles and to ensure that routes used by child bicyclists are properly maintained.enUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.Epidemiologydoctoral thesis