engaging the somali community in the road safety agenda: a process evaluation from the london...

ORIGINAL PAPER

Engaging the Somali Community in the Road Safety Agenda:A Process Evaluation from the London Borough of Hounslow

Nicola Christie • Judith Sleney • Fatima Ahmed •

Elisabeth Knight

Published online: 23 November 2011

� Springer Science+Business Media, LLC 2011

Abstract In the UK the most disadvantaged in society are

more likely than those more affluent to be injured or killed

in a road traffic collision and therefore it is a major cause of

health inequality. There is a strong link between ethnicity,

deprivation and injury. Whilst national road traffic injury

data does not collect ethnic origin the London accident and

analysis group does in terms of broad categories such as

‘white’, ‘black’ and ‘Asian’. Analysis of this data revealed

the over-representation of child pedestrian casualties from

a ‘black’ ethnic origin. This information led road safety

practitioners in one London borough to map child pedes-

trian casualties against census data which identified the

Somali community as being particularly at risk of being

involved in a road traffic collision. Working with the

community they sought to discuss and address road safety

issues and introduced practical evidence based approaches

such as child pedestrian training. The process evaluation of

the project used a qualitative approach and showed that

engaging with community partners and working across

organisational boundaries was a useful strategy to gain an

understanding of the Somali community. A bottom

approach provided the community with a sense of control

and involvement which appears to add value in terms of

reducing the sense of powerlessness that marginalised

communities often feel. In terms of evaluation, small pro-

jects like these, lend themselves to a qualitative process

evaluation though it has to be accepted that the strength of

this evidence may be regarded as weak. Where possible

routine injury data needs to take into account ethnicity

which is a known risk factor for road casualty involvement

which needs to be continually monitored.

Keywords Road traffic casualties � Deprivation �Ethnicity � Community engagement

Introduction

In the UK the most disadvantaged in society are more

likely than those more affluent to be injured or killed in a

road traffic collision and therefore it is a major cause of

health inequality [1, 2]. There is a strong link between

ethnicity, deprivation and injury per se. The overrepre-

sentation of Asian ethnic groups is apparent for all types

of unintentional injury. Mortality ratios for people under

the age of 15 years and over the age of 65 years are

greater in migrants from the Indian sub-continent than

those born in England and Wales [3]. There is a small but

growing body of evidence on the link between socioeco-

nomic status, ethnicity and road traffic injury. Black,

Asian and Minority Ethnic (BAME) children are at

increased risk of road traffic injury as pedestrians [4, 5].

However, one of the most difficult problems in

N. Christie (&)

Department of Civil, Environmental and Geomatic Engineering,

Centre for Transport Studies, UCL, Gower Street, London

WC1E 6BT, UK

e-mail: [email protected]

J. Sleney

Department of Sociology, University of Surrey, Guildford,

Surrey GU2 7XH, UK


F. Ahmed � E. Knight

Hounslow Council, Street Management and Public Protection,

Civic Centre, Lampton Road, Hounslow TW3 4DN, UK

F. Ahmed


E. Knight


123

J Community Health (2012) 37:814–821

DOI 10.1007/s10900-011-9515-y

understanding the high pedestrian injury risk of BAME

children is differentiating the effects of socioeconomic

status and ethnicity because many BAME residents tend to

be the most disadvantaged in society [5]. To add to this

complexity, people from BAME groups tend to cluster in

specific areas, which are often areas of multiple disad-

vantage [6, 7]. Place, as well as individual disadvantage,

may therefore adversely affect health [8, 9] with higher

population density in disadvantaged areas effecting

neighbourhood satisfaction [10].

This lack of clear evidence is partially attributable to the

fact that neither socioeconomic status nor ethnicity is coded

on national road traffic injury surveillance data bases in the

UK. Whilst there is no national data collected on the

casualty’s ethnic origin London is unique in the UK because

ethnic origin is recorded on police casualty data. Using

London data research has looked at the relationship between

road traffic casualties, deprivation and ethnicity [11]. Eth-

nicity was coded broadly as ‘White’, ‘black’ and ‘Asian’.

Casualty rates per head population were highest in the black

groups and lower in Asian groups compared to the White

group. To examine the effect of deprivation the risk of

pedestrian injury was calculated per decile of area based

deprivation following research which showed a link

between deprivation and road traffic injury in London [12].

White children in the most deprived areas were 2.5 times

more at risk of injury compared to White children in the

least deprived deciles. For Asian children, the injury rates

for the most deprived were four times higher than the least

deprived, but for black children there was no relationship

between deprivation and risk. Importantly, these relation-

ships were found for children and adults. Therefore,

deprivation did not account for all of the variation in injury

rates between ethnic groups. Exposure may account for

these differences but little is known about whether there are

differences in exposure patterns between ethnic groups.

From the report which identified the link between injury

and ethnicity in London road safety practitioners from the

London borough of Hounslow decided to look in more

depth at the relationship between child pedestrians casu-

alties and ethnicity and the over-representation of child

pedestrian casualties from a Black ethnic origin within

their borough [11]. They discovered that many of these

casualties were occurring in a specific postcode area which,

when census data were examined, revealed that there was a

large Somali community living there.

Hounslow is one of 33 boroughs in London. It has a

population of about 200, 000 of which around 35% are

from a BAME group—and whilst most are from an Asian

background the fastest growing proportion is from a Black

African background. Certain areas within Hounslow are

characterised by having over half of the population clas-

sified as from a BAME background. The proportion of

BAME in Hounslow is higher than the average for London

(29%) and much higher than for the country as a whole at

9%. Hounslow has slightly above average levels of depri-

vation compared with other London boroughs and four of

its 20 electoral wards have been identified as being in the

10% most deprived wards in the UK. With funding from

Transport for London and the Department for Transport the

borough set up a social marketing project which aimed to

• Engage with the Somali community in London borough

of Hounslow with a key focus on 0–20 year olds;

• Appoint officers from the Somali community to work

alongside community groups to engage with the

community members to explore road safety awareness,

offer evidence based road safety training (based on the

Kerbcraft model [13, 14]), and advice on child safety

seats;

• Build capacity and ensure the sustainability of the

programme after the duration of the funding.

This aim of this paper is to describe the ways in which

road safety practitioners managed to engage with the

Somali community in a social marketing project with the

objectives of improving the road safety of children and

explore the community’s response to the intervention.

The Intervention

The engagement with the Somali community was struc-

tured in four sessions each involving 15 participants who

were all women and parents of young children. Session 1

aimed to:

• Introduce the road safety practitioners and why they are

interested in engaging with the community and propose

a number of actions over the four sessions

• Explore the context and views of Somali women about

dealing with the local road system as parents

• Explore perceived differences between road systems in

Somalia and the UK

• Explore the views of Somali women on road safety,

how their children travelled, their children’s indepen-

dence, risk taking and feelings about how safe their

children were in the local environment and their views

on crossing facilities

• Discuss the potential causes of road accidents in their

community

• Explore their knowledge level about road safety issues

and the perceived safety of roads locally

• Explore what they would like to cover in road safety

training and how they think this would best be

delivered.

Session 2 was a practical session out in the road system

in Hounslow which aimed to provide family (here defined

J Community Health (2012) 37:814–821 815

123

as mothers with children) pedestrian training which aimed

to improve their perception of speed and distance, and to

discover for themselves strategies for using the roads by

encouraging learning to take place on the roads. The

training covered:

1. Finding safe places to cross

2. Crossing between parked cars

3. Crossing at junctions.

Session 3 was a practical session on in car safety which

aimed to raise awareness of travelling safely in vehicles

and increase usage of appropriate child restraints. The

training covered:

1. The law: requirements about number of people trav-

elling in car

2. The facts: accident data

3. The type of car seats according to age and weight

4. Demonstration on three types of car seats and getting

them to fit.

Session 4 was a classroom based session which aimed to

explore what they have learned and how this has changed

the way they have used the roads, what they liked and

disliked about the sessions and whether they had talked

about the sessions with family (children, spouses, in-laws,

etc.) and friends and where they would seek other infor-

mation and advice.

Method

Design

The method is a qualitative process evaluation of the pro-

ject. The evaluation had two parts. Firstly, the process

evaluation involved in-depth interviews with the two road

safety practitioners who managed the project (P1 is the

Principal Road Safety Officer and P2 a Senior Road Safety

Officer). Secondly, the evaluation involved thematic anal-

yses of transcripts from focus group sessions with the

Somali participants who attended two different community

groups within Hounslow.

Participants

The in-depth interviews involved the principal and senior

road safety practitioners. Focus groups were conducted

with the Somali participants. Overall six focus groups were

conducted; three in each of two areas in Hounslow. The

focus groups involved Somali women in a baseline group,

one conducted immediately after the training session and

another four months afterwards.

Procedures

The road safety team commissioned a local university to

provide training on qualitative evaluation methods to build

workforce capacity to enable them to conduct a qualitative

process evaluation. Topic guides were developed in col-

laboration with the university. The focus groups were

conducted in Somali by a bilingual project worker

employed to work with the community and was also

trained by the university in how to conduct a focus group.

Verbal permission was sought from the Somali partici-

pants for the discussions to be taped. The sessions were

taped and translated into English by a Somali speaking

language specialist who worked in the borough council.

Whilst the cost of translation was lower than if provided

by external services it was still expensive and whilst four

community groups were in receipt of the sessions the

borough could only afford for sessions from two of them

to be translated.

Data Analysis

The translated transcripts were thematically analysed by

university researchers. The results below contain verbatim

comments from the road safety practitioners and commu-

nity participants to illustrate points and themes which

emerged from the interviews and sessions. The first ses-

sions (referred to as Group 1 and 2) were about setting the

scene for the project and introducing the topic of road

safety and explored the road safety knowledge base of the

Somali community. The second sessions (referred to as

Groups 3 and 4) were conducted after the community had

completed the practical training on safe road crossing and

in car safety session. The last sessions (referred to as

Groups 5 and 6) were done 4 months after the practical

training sessions to explore whether the participants had

changed they way they used the roads and whether they

had communicated what they had learned to others.

This evaluation is based on a participatory action

research project conducted by the road safety practitioners.

Following University ethics committee guidelines the

University decided that this evaluation did not require a full

ethics submission.

Results

The Practitioner’s Perspective

Learning About a New Casualty Group

The data from Transport for London’s casualty report had

revealed an overrepresentation of child pedestrians from a

816 J Community Health (2012) 37:814–821

123

black origin in Hounslow in a postcode area that repre-

sented about a sixth of the borough. This was new infor-

mation to the road safety team:

P1: Prior to that we hardly did anything specifically

or recognised that it was the Somali community that

we needed to target. We were just finding out when

we were doing that piece of research thinking, we

do actually have a large Somali community in

[Borough]. I didn’t know that before…and where

they lived as well.

To understand which communities were living in these

areas the team consulted with officers responsible for

housing who they felt were extremely knowledgeable

about the ethic breakdown of the community within the

area. They had also suggested looking at the Language

Survey conducted by the borough which would reveal the

languages spoken by children attending local schools

which also showed that the Somali was a prevalent lan-

guage in the area.

During this exercise the team also discovered that

among the Somali community the use of khat, a stimulant

legal drug, was very popular, particularly among men.

This led to extending the work programme to address the

issue of driving and using khat. The team sought infor-

mation on the effects of khat, which highlighted there was

insufficient research on its effect on driving, what little

research there was concluded that the effect was small.

However, the team learned that most men had driving

jobs and the khat was being prepared whilst driving,

which led to driving with one hand and a potential

distraction.

How to Engage with the Somali Community

The road safety team also spoke to public health officers

working in the community who helped identify a Somali

community group who had set up women’s advice groups

which the road safety practitioners felt was a good model

of how to work alongside the community. Taking this

model they approached this community based service and

asked if they could form a women’s group there once a

week:

P1:….and that’s how it started up because they

themselves were interested in targeting the Somali

community because they felt that, although they had

a Somali community living in their area, they

weren’t high users of their own services, like the

library and Sure Start. So it wasn’t just our tick

boxes but the tick boxes for everybody else that

were involved in terms of the partnerships that

we’ve got here.

Gaining Trust and Acceptance

Once the group was set up the road safety team made sure

that they visited the group regularly to gain trust and

acceptance:

P2: At first, I used to go in so they’d get to know me,

maybe once a month. So they’d know me by name

and [name of person] would introduce me to people

and say, ‘This is [P2] and they’re helping us fund this

project here’ and then the ladies were really, I sup-

pose, thankful in a way that this opportunity was

being provided so when we went and delivered the

road safety training, we did the sessions, I think,

6 months later, once they had familiarised with me

and who I was and where I was coming from….…..

We weren’t coming in and saying; ‘We’re the road

safety officers and this is what…’ We got to know

them and got to know who they were as a

community.

The road safety practitioners with their further insight

into the issue of khat were able to target a number of khat

cafes within their borough. This led to a work programme

to engage with the Somali men, through the four cafes in

the borough. ‘Drop in’ advice sessions were offered in the

cafes, along with a DVD illustrating the dangers of using

khat whilst driving which was also broadcast on Somali

Satellite channels. The practitioners had to be very careful

not to be seen as advocates for banning khat in the UK, as

this was regarded as a very sensitive and much debated

subject both within and outside the community. Hence the

khat using community at first was very suspicious and

unwelcoming of the khat project. However, the road safety

unit managed to successfully work with this group and

gain their confidence, through sessions over a period of

time.

Engaging with Local Stakeholders Who Know

the Community

Talking to local stakeholders the road safety practitioners

felt that they learned a lot about the Somali community in

the borough namely that households were led by women,

that fathers tended to be ‘itinerant workers or itinerant

wanderers’, and families often had large numbers of chil-

dren. The Somali community were Muslim and the women

appeared to be active in the mosques and in their own

community. They were also a community that communi-

cated orally and rarely by the written word. Few of the

women drove a car and therefore their key interest was in

pedestrian safety and car occupant safety. The road safety

team also found out that that the Somali people had their

own TV channel which they could use to highlight local


123

road safety issues and promote the practical pedestrian

training scheme.

Addressing the Language Barrier

Practitioners felt that language was the main barrier to

engagement and funding from the Department for Trans-

port enabled the team to employ two bilingual Somali

officers to interact directly with the community which

made a big difference to the project:

P1: don’t know where it would have gone, how much

it would have got off the ground at all without them,

P2: I don’t think we could have managed without

[Somali community group], the interpreting was

there, so you had to have somebody who spoke the

language to make it a greater success.

Understanding How the Community Felt Marginalised

Engaging with the Somali community the road safety team

learned that the Somali community felt marginalised by the

local authority:

P1: I think that was another learning thing in a way –

how marginalised they felt. And I think because so

often they didn’t understand any of the council pro-

cesses, they were quite, at times, quite defensive and

a very strong sense, I felt, that they didn’t have much

control so I think doing this kind of thing was very

good for them.

The road safety team felt that working alongside rather

than ‘doing to’ was an effective way to engage the

community:

P2: I think – talking to the women in the focus groups –

it was how…what do we do when we first put the

problem to them. ……what was most effective was,

how you cross with your child as opposed to how am I

going to teach you how to cross and how are you going

to teach your child to cross the road. And we said, ‘This

is what we do when we go to school. This is how we

teach your children at school and it would be good if

you could reinforce what we’re teaching them’. So that

was sort of the method that we applied really.

Lessons for the Future

Get to know Your Community

The road safety team felt that it was important get to know

the community as far as possible in terms of their aware-

ness and understanding of risks, how they interact and

communicate not only with each other but with local ser-

vice providers and how to tailor intervention approaches to

meet their needs:

P2: Because every community receives things dif-

ferently, so we’ve now got to think about a number of

ways to make sure our messages are being received –

rather than doing one huge campaign and thinking

that one size fits all, it doesn’t, and now that we are

aware and conscious of that, we have to make sure

that road safety messages get to all our communities.

How do we go about achieving that?, by using dif-

ferent medias or different approaches. As road safety

officers, we are more aware of that and so have put

money aside to address this.

Seek out Existing Community Groups

The practitioners felt that it was important to tap into

existing services that work with the community groups

rather than trying to establish separate delivery model:

P1: I think, by far, the most useful and most pro-

ductive partnerships were with the community groups

themselves, definitely.

Focus on Smaller Groups

The practitioners also felt that the experience of working

with the Somali population would change the way they

worked in the future by focusing on smaller casualty groups:

P1:…… I think we’re probably going to approach the

rest of what we do differently as a consequence of it.

And I think what [name of other participant] said

about focusing on smaller groups of vulnerable road

users is going to be the way forward. It’s probably

going to be the way forward for everyone … because

casualty figures are really down below 2,000, well,

sorry, fatalities are really down below 2,000 for the

first time ever

How Best to Evaluate

In terms of evaluation the team felt that they should have a

Somali member of staff to conduct the evaluation or

somebody from the community, to administer one-to-one

questionnaires with them. The community’s favoured style

of communication is oral so asking them to complete

questionnaire was not going to be an effective form of

evaluation. The team therefore decided to adopt a quali-

tative process evaluation. There were also significant costs

associated with translation of the session tapes and these

need to be considered at the outset.


123

The Community’s Perspective

Lack of Understanding About the UK Road System

The sessions with the Somali participants revealed a lack of

understanding among the Somali community about how to

use traffic light controlled and zebra crossings, as these

were rare in Somalia, and difficulties crossing near buses

and coping with the volume and speed of traffic:

In Somalia, streets were not as busy as here. Road

accident can occur at any place, but the main junc-

tions and roundabouts were manned by traffic officers

in Somalia and they directed the traffic. In Mogadishu

we had traffic lights on the main roads like the one

near the presidential palace and other roads were

manned by traffic officers. Streets were not as dan-

gerous as here. Even if there were no traffic lights or

officers, for example at small roads with no signs, the

cars will stop and let you cross. (Group 1)

Fears About Road Safety Which Impact on Mobility

They also discovered how the community felt about the

UK traffic environment and their fears for their children’s

safety in the neighbourhood which was not just about road

safety:

Facilitator: Ok, do you feel you and your children to

be in danger when crossing these streets which you

have mentioned?

Participant: Yes, if there are no zebra crossings or

traffic lights. You have to wait and see if you can get

a chance and then run to cross. The cars will not stop;

they are coming from both directions (Group 2)

Parents often curtailed their children’s mobility and play

because of fears about racial abuse:

Participant: On other day, my children were playing

out when they were racially abused and told to go

back to their home country.

Facilitator: By white children?

Participant: Yes, white local children. I could not

fight them, because they were many, so I had no

choice other than to take my children home. (Group

1)

Many parents also felt that their children could easily be

abducted which they felt was a common occurrence in the

UK:

They will be in danger both from people and from

vehicles. They can be hit by a car or abducted. Either

they have to be in doors with you or you have to keep

an eye on them like animals. If your child gets lost or

something happens to him/her, you will be accused of

something and you will be asked what has happened

to them. (Group 2)

Changes as a Result of Road Safety Training

Understanding how to cross safely

Several months after the practical training sessions the

community were asked if their crossing behaviour had

changed in any way. The participant’s responses revealed a

greater understanding of how to use crossings:

I have attended all the three sessions and we learned

how to cross streets safely. For example, when

crossing at zebra crossings, we learned to wait first

and when crossing at traffic lights, we learned to

press the button and wait until we see the sign of

walking green man and also the sign of stop for cars

appears, that is when you can cross. So we learned so

many things and we hope to continue. (Group 6)

In addition it was clear that the project had engendered a

positive feeling towards the road safety team:

We were very concerned before and we had no one to

help us, but thanks God you helped us and taught us

so many things that we did not know (Group 3)

The participants also revealed that they had made

strenuous efforts to tell their families and friends about the

sessions:

Facilitator: On the previous training sessions, when

we finish the sessions did you talk to your husbands,

children and other family members about the

training?

Participant: Yes, I tell my children what I learned, I

say to them do not get close to the buses, look left and

right when crossing streets.

Facilitator: That is good.

Participant: We told the men to follow the correct

procedure, if they have been told something wrong

before, we told them the right way now. (Group 5)

Discussion

This study shows how a London Borough was alerted to a

new casualty group by ‘top line’ epidemiological data

showing an over representation of BAME casualties in

their borough and how they ‘drilled down’ to explore the

characteristics of the community at risk, worked alongside


123

them to gain trust and acceptance, understand the problems

they faced, and delivered road safety advice and training,

building in evaluation and employing many of principles of

social marketing [15].

The strengths of the study are that it used a qualitative

approach to illustrate the engagement process and provided

an insight into the road safety experience of BAME par-

ticipants and how they felt they had changed as a result of

participation on the project. A weakness of the study is that

the high cost of translation was prohibitive for the borough

and so the evaluation is based on two of four groups

covering three sessions each. Furthermore some of the

subtle nuances of the discussion may have been lost in

translation. The Somali community in Hounslow may be

very different from Somali communities elsewhere in

London or the UK so it is not appropriate to generalise to

other communities. In addition with this type of evaluation

there is no injury outcome data though casualties continue

to be monitored by ethnicity for London. With the drive for

evidence based practice qualitative evaluation is likely to

be regarded as weak evidence but a quantitative approach

seems largely inappropriate given the small number of

participants.

However, what this study does show is that unless injury

data is monitored by government in relation to ethnicity

many of smaller casualty issues related to race and culture

may slip underneath the epidemiological radar. It shows the

importance of mapping casualties and linking with census

data to understand demographic characteristics. It also

shows the importance of getting to know a community

initially by partnering with service providers who work

with them, bolting on to existing services and employing a

bottom up approach to achieve behavioural change. How-

ever, behavioural change is just one aspect of an inter-

vention approach, clearly the Somali community identified

the speed and volume of traffic as a major issue which is a

common theme among communities living in deprived

areas in the UK and need a multifaceted approach

involving education, enforcement and engineering [16].

Remarkably, the Somali population feared that their chil-

dren could be abducted as this was felt to be a common

occurrence in the UK and meant that that were not prepared

for their children to have too much independence. By

working with the community on child road safety the road

safety team were also alerted to the issue of the use of khat

and driving which some of the Somali community felt

jeopardised their safety on the roads.

The key messages for road safety practitioners are:

1. Collect injury data by ethnicity and link with census

data based on resident address of the casualty

2. Understand the nature of the BAME community

involved in casualties in terms of race and culture

3. Identify and engage with service providers (e.g.

health and children’s services) who are already

working with the community to understand more

about them and the context of their everyday lives

4. Ensure that there is a sufficient lead time in the

project (in this case 6 months) to build trust and

acceptance among the community by visiting them

regularly in settings where they gather in the

community

5. Address language barriers by employing a bilingual

project worker

6. Adopt a bottom up approach with the community,

working with them and being sensitive to their needs

7. Identify their preferred communication style (written,

oral)

8. Keep the behavioural change simple and easy to

adopt

9. Build in process evaluation from the start. For small

groups a qualitative cohort approach will show

changes from baseline, during the intervention and

several months afterwards. Seek the advice from

local universities whose social science and health

departments are likely to be able to offer advice and

training on research methods for evaluation

10. Allow sufficient budget for translation as these costs

tend to be very high

Conclusions

To provide a road safety service that embraces both the

equality and diversity of the community and tailors the

intervention to their needs requires more granular infor-

mation about the demographic and cultural characteristics

of casualties and the communities they belong to. Engaging

with community partners and working across organisa-

tional boundaries is a useful strategy to gain an under-

standing of different population groups. A bottom approach

provides the community with a sense of control and

involvement which appears to add value in terms of

reducing the sense of powerlessness that marginalised

communities often feel. In terms of evaluation, small pro-

jects like these, lend themselves to a qualitative process

evaluation though it has to be accepted that the strength of

this evidence may be regarded as weak. Where possible the

routine injury data needs to take into account ethnicity

which is a known risk factor for road casualty involvement

and needs to be monitored to explore the impact of inter-

ventions on injury incidence.

Acknowledgments This research was funded by the road safety

department from the London Borough of Hounslow.


123

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