Impact of road safety education programs: a critical review of current evidence

Traffic accidents remain a persistent global public health issue, particularly among vulnerable populations. As a preventive strategy, road safety education programs have been promoted to enhance knowledge, modify attitudes, and reduce risky behaviors in public spaces. This study presents a critical review of empirical evidence published between 2015 and 2025 on the effectiveness of these programs, with emphasis on their impact on knowledge, attitudes, risky behaviors, and crash incidence. Twenty empirical studies were selected based on thematic relevance and methodological diversity. The studies were classified by geographic context, target group, type of intervention, variables assessed and reported behavioral impact. Among the studies included in this review, improvements in knowledge (n = 12) and attitudes (n = 8) were more frequently reported than behavioral or crash-related outcomes. However, these findings represent patterns within the selected evidence base and should not be interpreted as general trends across all road safety education programs. The majority of the studies used quasi-experimental or cross-sectional designs and focused on populations from developed or developing countries, with no studies from underdeveloped contexts. While the reviewed evidence suggests that road safety education can improve cognitive outcomes, its demonstrated effects on behavior and crash incidence remain less frequently evaluated. There is a need for more sustained, participatory, and culturally adapted interventions, along with longitudinal studies incorporating real-world impact indicators.

The World Health Organization (World Health Organization, 2004) defines road traffic injuries as those that may or may not be fatal, that result from collisions or incidents occurring on public roads involving at least one moving vehicle. Road traffic accidents are among the leading causes of death worldwide, accounting for the loss of over one million human lives each year (World Health Organization, 2019). Despite advancements in safety technologies and improvements in road infrastructure, mortality rates from these incidents remain high, establishing traffic accidents as a serious global public health issue. In this context, traffic-related fatalities are recognized as the outcome of a complex interplay of factors involving people, vehicles, roadways, and the surrounding environment (Wang et al., 2019; Wang et al., 2019).

A particularly concerning statistic is that approximately 90% of global road traffic fatalities occur in low and middle income countries, even though these nations account for only about 60% of the world’s registered vehicles (Chou et al.,. 2022). More specifically, children and adolescents constitute the most vulnerable segments to such accidents, with a significantly higher mortality rate within this age group (World Health Organization, 2004; Zare et al., 2019) indicate that road traffic accident rate among children aged 6 to 10 is four times higher than that of adults, making it one of the leading causes of death among youth. In Western countries, these account for 35%–40% of injury-related fatalities in adolescents and young adults (Assailly, 2017; Ibrahim et al., 2012). In high-income countries, 5%–10% of road traffic injuries involving children are pedestrian-related, whereas in low- and middle-income countries, this figure rises to between 30% and 40% (Toroyan and Peden, 2007).

This scenario reflects that, despite technological advancements in vehicles and road infrastructure, the human factor remains the leading cause of road traffic accidents. Road safety knowledge is a crucial element in accident prevention, as individuals with limited understanding of traffic regulations and a tendency toward risky behaviors are more likely to be involved in such incidents (Buics et al., 2024). In this context, road safety education has become one of the fundamental pillars for reducing traffic accidents, as effective training in traffic rules can enhance knowledge, promote positive attitudes toward safe driving, and reduce risks associated with unsafe road behavior (Buics et al., 2024; Alonso et al., 2021).

Road safety education goes beyond conveying traffic regulations; it encompasses the promotion of behaviors and attitudes that must be adopted by all road users: pedestrians, drivers, and passengers within a broader social context. This comprehensive perspective positions road safety education as a fundamental tool for accident prevention. Furthermore, when combined with enforcement measures and improvements in road infrastructure, educational initiatives become even more effective, not only by increasing safety-related knowledge but also by influencing road users’ behaviors in a positive and lasting way (Buics et al., 2024; Mary et al., 2016; Swami et al., 2006).

The implementation of road safety education programs varies widely, with most relying on informational manuals and the use of technology to promote road safety. However, responsible attitudes and attentiveness among all road users can be more effectively fostered through comprehensive educational strategies that incorporate tools such as driving simulations, collaborative learning, interactive lessons, and awareness campaigns on social norms (Assailly, 2017; Weber, 2005). Moreover, inappropriate driving behaviors such as speeding, alcohol consumption, and mobile phone use remain the leading causes of accidents, endangering not only the driver’s life but also that of other road users (Mesken et al., 2002; Zhang et al., 2022).

Several studies have shown that driver characteristics and behaviors are key factors in predicting road traffic accidents (Özkan et al., 2006). In this regard, well-structured road safety education programs have shown significant potential to influence the social cognitive and behavioral factors of road users, thereby contributing meaningfully to accident prevention (Cuenen et al., 2016). These findings underscore the importance of designing road safety education programs that go beyond information dissemination, incorporating behavioral change strategies and intentional planning to maximize their effectiveness.

Although various methods exist for implementing road safety education programs, many still rely on traditional approaches that do not always address the current challenges of traffic environments (Alonso et al., 2018; Bucsuházy et al., 2020; Alonso et al., 2018; Bucsuházy et al., 2020). While many of these programs have proven effective in increasing knowledge, few have directly evaluated changes in risky behaviors or reductions in crash incidence (Zainafree et al., 2022). This represents a significant methodological challenge, as intermediate indicators such as knowledge do not necessarily guarantee improvements in actual road safety.

Furthermore, outdated teaching methods and the lack of road safety awareness among drivers remain significant barriers to program success. Low rates of voluntary compliance with traffic regulations and limited awareness of the risks associated with unsafe driving behaviors further hinder efforts to improve safety. Therefore, educational programs must evolve by incorporating modern and evidence-based approaches while also encouraging stricter adherence to road safety regulations (Chou et al.,. 2022).

This article aims to critically review the most recent evidence on road safety education programs, analyzing their methodological approaches and assessing their impact on modifying risky behaviors and reducing crash incidence. The objective is to identify best practices and methodologies to enhance the effectiveness of road safety education across different contexts, ultimately contributing to the reduction of deaths and injuries caused by road traffic accidents worldwide.

The analysis by Chou et al. (2022) highlights methodological shortcomings in studies on road safety education, such as the lack of crash incidence measurement and the limited focus on behavioral change. This critical review applies the PRISMA-ScR methodology to address these gaps by providing a detailed and systematic classification of the studies, considering intervention type, socioeconomic context, and variables assessed. Furthermore, it focuses on studies that directly assess changes in behavior and crash incidence, which will help identify more effective practices and improve educational approaches. Thus, this work contributes to overcoming methodological gaps and enhancing the global effectiveness of road safety education programs.

While road safety education has been widely studied, existing reviews predominantly focus on pedagogical effectiveness or knowledge acquisition, often treating educational outcomes as proxies for safety improvement. The added value of the present review lies in its critical and comparative examination of how road safety education effectiveness is evaluated, rather than whether education is beneficial in general. By systematically distinguishing between cognitive outcomes, behavioral change, and crash incidence, and by comparing results across different socioeconomic and institutional contexts, this study provides a structured assessment of the gap between educational intent and real-world safety impact. This perspective enables the identification of methodological and contextual limitations that constrain the practical effectiveness of road safety education programs and offers evidence-based guidance for improving future intervention design and evaluation.

Accordingly, the objective of this study is not merely to summarize existing road safety education initiatives, but to apply a structured scoping review methodology to critically examine how the effectiveness of such programs has been evaluated in the literature. By applying the PRISMA-ScR framework, this review aims to (i) classify educational interventions according to their methodological design and socioeconomic context, (ii) distinguish between cognitive outcomes, behavioral change, and crash-related indicators, and (iii) identify systematic gaps that limit the translation of educational efforts into measurable road safety improvements. This approach provides a methodological basis for interpreting why educational programs frequently report positive learning outcomes but have limited real world impact.

The methodological approach adopted in this study was selected to support a critical and comparative analysis of how road safety education effectiveness is currently assessed in the literature, rather than to estimate pooled effects or intervention efficacy.

A critical review was conducted following the methodology outlined in The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) by Tricco et al. (Tricco et al., 2018). This methodology includes essential reporting items that should be considered in a scoping review. The reference management tool Rayyan (Ouzzani et al., 2016) was used to assist the screening of titles and abstracts. During this process, articles that did not meet the eligibility criteria or were identified as duplicates were excluded.

Research question and objective

What does the current evidence reveal about the methodological approaches and educational strategies used in road safety programs?

To achieve the objective and address the research question, this review presents an explanatory framework and theoretical foundations regarding the benefits of road safety education, as well as the impact of specific evaluated tools, in relation to the evidence found in the selected publications.

Data sources and search strategy

For the development of this critical review, the databases Web of Science and ScienceDirect were used, selected for their broad coverage in the fields of science and engineering, and for providing specialized, high quality, peer reviewed literature aligned with the objective of this study. The literature search was conducted in January 2026, covering publications from January 2015 to December 2025. The same search strategy and eligibility criteria were independently applied by two reviewers during the screening process to improve consistency, transparency, and reproducibility of the study selection. During the search and analysis process, only one document was identified that explicitly addressed the evaluation of the effectiveness of road safety education programs in reducing traffic accidents, with a focus limited to adolescent populations. In contrast, this review expands the scope by including multiple age groups and geographical contexts, and by comparing different types of interventions and evaluated variables. This broader approach offers an inclusive and more comparative understanding of the current state of evidence regarding road safety education.

The database searches were organized into two thematic blocks: (1) road safety education, safety culture, safe roads; and (2) risk factors, hazard identification. These terms were combined to construct the following search strings using Boolean operators (AND and OR), and eligibility and exclusion criteria were applied through database filters. Ultimately, a total of three generic search strings were identified. (“traffic safety education”) AND (“road” OR “highway”)

(“Highways”) AND (“road safety” OR “risk factors” OR “road infrastructure” OR “traffic safety culture’)

(“road safety” OR “traffic safety”) AND (“risk factors” OR “hazard identification”) AND (“driver education” OR “road safety education”)

Eligibility and exclusion criteria

For this critical review, the inclusion criteria comprised peer-reviewed indexed journal articles, indexed book chapters, and case reports or experimental studies related to the implementation of road safety education guidelines. Eligible publications were required to be open access, published within the last 10 years (2015–2025), and written in either English or Spanish. Conversely, the exclusion criteria encompassed conference proceedings, theses, essays, popular science magazines, and opinion articles.

To select the publications for analysis, Table 1 outlines the eligibility and exclusion criteria, structured according to the Population, Concept, and Context (PPC) framework recommended by the Joanna Briggs Institute (JBI) methodological guidance (Peters et al., 2020). This framework supports the assessment of reliability, relevance, and outcomes of scoping reviews.

Article selection

The selection strategy was divided into four stages. The first stage involved identifying peer-reviewed indexed journal articles, indexed book chapters, and individual case reports or experimental studies related to the implementation of road safety education guidelines, published within the last 10 years (2015–2025), and available in open access in either English or Spanish. An initial limited search was conducted in the Web of Science and ScienceDirect databases to identify commonly used keywords in titles and abstracts. The second stage, referred to as the “screening” phase, involved removing duplicate publications retrieved from both databases and selecting eligible studies based on a review of titles and abstracts, using the Rayyan software tool for scoping review management. In the third stage, called the “eligibility” phase, the full texts of the selected publications were reviewed to exclude those that did not meet the inclusion criteria. Finally, in the “inclusion” stage, data were analyzed and extracted from the publications that met all eligibility requirements.

Figure 1 presents the search results reported through a flow diagram, following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) framework. The extracted data include specific details regarding the factors and relevant findings reported in each publication, which contribute to addressing the research question. Additional details regarding the research context, participants involved, and methods employed are also presented.

Data extraction

Two reviewers independently extracted data from the selected studies. A standardized Excel spreadsheet was used for data extraction. The recorded variables included title, authors, year, country, target group, type of study, and impact on risky behaviors. The same researchers who participated in the study selection phase also carried out the data extraction process to ensure consistency.

Analytical dimensions and methodological enhancements

Although this review follows the PRISMA-ScR framework, the methodological approach was extended beyond standard reporting guidelines by incorporating additional analytical dimensions aimed at improving interpretability and differentiation from previous reviews on road safety education. Rather than focusing solely on study identification and classification, the review applied a structured comparative framework based on three complementary dimensions: (i) the socioeconomic context of implementation (developed versus developing countries), (ii) the type of educational intervention (school-based, community-based, technology-based, or awareness campaigns), and (iii) the level of outcome evaluation, distinguishing between cognitive outcomes (knowledge and attitudes), behavioral outcomes, and objective safety indicators such as crash incidence.

This multidimensional classification allowed the identification of systematic gaps in the literature, particularly the limited translation of knowledge gains into sustained behavioral change and measurable reductions in traffic crashes. Unlike previous reviews that emphasize effectiveness in terms of knowledge acquisition, the present study explicitly prioritizes the analytical separation between intermediate and real-world impact indicators, thereby providing a more critical assessment of educational effectiveness.

Regarding methodological quality and risk of bias assessment, a structured qualitative appraisal was incorporated to account for the heterogeneity of the included study designs. Since the reviewed publications included quasi-experimental, cross-sectional, descriptive, qualitative, observational, and educational material development studies, a single quantitative risk of bias scoring system was not appropriate for all cases. Therefore, studies were assessed using a set of methodological quality criteria adapted to the objectives of this scoping review, including: (i) clarity of study objectives and intervention description, (ii) appropriateness of study design, (iii) presence of pre and post intervention measurements or comparison groups when applicable, (iv) type and reliability of outcome measurements, (v) use of objective indicators instead of exclusively self reported data, and (vi) follow up assessment.

This appraisal was not used to exclude studies, consistent with the exploratory purpose of scoping reviews, but to support the interpretation of the strength of the reported evidence. Studies with stronger methodological characteristics, particularly those incorporating longitudinal evaluation, behavioral measurements, or crash-related indicators, were considered to provide more robust evidence than studies limited to short-term knowledge or attitude assessment.

These analytical enhancements contribute to a more differentiated and context sensitive synthesis of the literature, positioning this review not only as a mapping exercise, but as a critical methodological assessment of how road safety education outcomes are currently evaluated.

This section presents the results derived from the scoping review process and their interpretation. First, a descriptive characterization of the selected studies is provided to contextualize the evidence base. This is followed by a comparative analysis of road safety education programs, aimed at identifying methodological patterns, contextual differences, and factors associated with their reported effectiveness.

Descriptive characteristics of the selected studies

The results of this review are first presented through a descriptive characterization of the selected studies, which provides the empirical basis for the subsequent comparative and interpretative analysis. This descriptive stage summarizes publication trends, geographic distribution, and study characteristics derived directly from the systematic screening process and constitutes an essential step in scoping reviews for contextualizing the evidence base.

A total of 1,990 publications were identified through database searches, and two additional publications were included from other sources. After removing 13 duplicates, 1,979 unique records remained. Titles and abstracts were screened, leading to the exclusion of 1,791 publications for the following reasons: out of scope (n = 336), not meeting eligibility criteria (n = 1,450), or lacking information or access to the document, marked as error (n = 5).

The remaining 188 publications underwent full-text evaluation. Of these, 51 were excluded due to irrelevance (n = 34) or because the full text could not be retrieved (n = 17), resulting in a total of 137 publications. The remaining 117 publications were not included in the comparative synthesis because they did not provide an explicit evaluation of road safety education interventions with measurable outcomes related to knowledge, attitudes, behaviors, or crash-related indicators. Ultimately, 20 studies met all criteria and were included for comparative analysis to address the main objective of this critical review. Figure 2 shows the temporal distribution of the 20 studies included in this review, highlighting an increase in publications from 2021 onward, which coincides with renewed international efforts to improve road safety outcomes. This descriptive analysis establishes the empirical foundation for the subsequent comparative and interpretative assessment.

Study characteristics

A notable increase in the number of publications is observed from 2021 onward, reaching a peak in 2022 with six studies. This pattern suggests growing attention to road safety, coinciding with the proclamation of the Decade of Action for Road Safety 2021–2030 by the United Nations General Assembly. This global plan aims to reduce road traffic deaths and serious injuries by at least 50% by 2030 (World Health Organization, 2023; Beesten and Bresges, 2025).

The increase in scientific output reflects a strengthened international commitment to road safety and the implementation of evidence-based public policies. It also highlights the importance of improving data collection and the evaluation of educational programs to effectively reduce crash incidence.

To further contextualize the evidence base, the selected studies were analyzed according to their geographic distribution, target populations, and general study characteristics. Figure 3 presents the distribution of publications by country, revealing a higher concentration of studies conducted in developing countries, particularly in Asia, compared to developed regions. In addition, the reviewed studies encompass diverse target groups, including children, adolescents, young adults, adults, and older adults, and employ a range of study designs such as descriptive, cross-sectional, quasi-experimental, and observational approaches. This contextual overview provides essential background for understanding the variability in reported outcomes and supports the need for structured comparative analysis.

Figure 3 presents the geographical distribution of the 20 selected studies. A higher concentration of research is observed in developing countries. India, with three publications, is the country with the greatest number of studies, followed by China, Vietnam, and Greece with two each. These countries are primarily located in Asia, particularly in South and Southeast Asia, where road safety issues have become an increasing concern.

On the other hand, developed countries such as Germany, South Korea, Slovenia, Spain, and France each account for only one publication, reflecting a lower concentration of studies compared to developing countries. This distribution pattern is partly due to the limited number of studies selected for this analysis (n = 20), which constrains the representation of countries with higher overall research output in road safety. Nevertheless, the chart highlights a clear concentration of studies in Asia, particularly in countries where road safety challenges are more pronounced.

Comparative analysis of road safety education programs

Building on the descriptive results, a systematic comparative analysis was conducted to examine how road safety education programs differ in terms of intervention type, methodological design, evaluated outcomes, and reported impact. Rather than treating the reviewed studies as isolated cases, this analysis seeks to identify recurring patterns and contrasts across socioeconomic contexts and educational approaches. The comparison focuses specifically on distinguishing between cognitive outcomes (knowledge and attitudes), behavioral change, and objective safety indicators such as crash incidence, in order to assess the practical effectiveness of educational interventions.

Recognizing the importance of guidelines and methodologies in the field of road safety, explicit standards for data extraction and classification were established. Therefore, this review focused on analyzing and identifying methodological approaches reported in peer-reviewed and indexed publications that present results from interventions aimed at improving road safety across populations of all ages.

The data extracted from each study included: country, target group, method used, duration of the intervention, type of study, evaluated variables (knowledge, attitudes, behaviors, accident rates), main outcomes, type of publication, and the socioeconomic context of the country. All data were systematically coded using predefined categories and peer-reviewed among researchers. Priority was given to collecting information directly related to changes in road safety, which served as the main criterion for comparative analysis.

From a scholarly perspective, the comparative analysis identifies several relevant patterns within the reviewed studies. First, the findings suggest that reported outcomes are influenced by methodological design, with studies incorporating stronger evaluation approaches being more capable of assessing behavioral or crash-related outcomes. Second, differences observed across socioeconomic contexts should be interpreted cautiously, as they may reflect variations in institutional support, study design, and evaluation methods rather than differences in intervention effectiveness alone. Third, experiential and multi component approaches appear to provide more opportunities for behavioral reinforcement compared with purely informational programs.

Analytical framework and classification criteria

A fundamental part of the analysis involved classifying each publication according to its context, categorizing them into developed countries such as Germany, South Korea, Slovenia, Spain, France, Greece, Japan, Norway, and the Czech Republic and developing countries such as Qatar, China, India, Indonesia, Pakistan, and Vietnam.

The World Health Organizationreports that low and middle income countries account for the majority of road traffic deaths globally. Moreover, road safety education strategies vary considerably depending on cultural, institutional, and regulatory contexts, which complicates the standardization of intervention models. This diversity underscores the need for adaptable approaches that integrate cultural, social, and educational factors in order to achieve meaningful behavioral change in road users across different regions.

To facilitate comparative analysis and explore variations in program effectiveness based on participants’ developmental stages, an age group classification commonly used in public health and educational psychology literature was adopted. Children were defined as participants up to 12 years old, adolescents as those between 13 and 17 years, and young adults as individuals aged 18 to 25 mostly comprising university students or novice drivers. Adults were defined as individuals between 26 and 64, while those aged 65 and over were classified as older adults. This categorization allows the identification of age-specific trends in knowledge acquisition, attitudes, road behaviors, and responsiveness to educational interventions.

For a structured analysis of the reviewed road safety education courses, a classification was established based on the educational methodology of each strategy. The programs were grouped into four categories: (1) school-based programs, implemented within formal educational institutions at the primary, secondary, or higher education levels; (2) community-based programs, conducted outside of formal education settings and aimed at the general population through workshops, community activities, or programs led by social organizations; (3) technology-based programs, which included interventions using serious games, virtual platforms, traffic simulators, or mobile applications as the primary teaching tool; and (4) awareness campaigns, encompassing strategies focused on the mass dissemination of road safety messages through traditional media or social networks, generally short in duration and aimed at influencing attitudes in the short term. This classification enables the comparison of approaches and the assessment of their impact when evaluated on crash incidence.

For this critical review, studies were also classified according to their methodological design, following conventional standards in social and health sciences research. Quasi-experimental studies evaluated changes attributable to an educational intervention, with or without a control group and without strict random assignment. Cross-sectional correlational studies collected data at a single point in time to analyze associations between variables such as attitudes, beliefs, and road behaviors. Descriptive studies characterized levels of knowledge or perceptions without establishing causal relationships, while qualitative studies explored perceptions, barriers, or experiences through interviews or focus groups. Additionally, one educational material development study and one observational study based on empirical accident analysis were identified.

In addition to classifying study designs, a methodological quality appraisal was incorporated to support the interpretation of the reported outcomes. The purpose of this assessment was not to exclude studies, but to differentiate the strength of evidence provided by each methodological approach. Studies including experimental designs, objective outcome indicators, and follow up measurements were considered to provide stronger evidence regarding program effectiveness, whereas studies relying only on cross-sectional data or self-reported cognitive outcomes were interpreted with greater caution.

This classification enabled a systematic comparison of the results based on the scope of the methodological designs employed. Such methodological systematization provides a clear framework for interpreting the reviewed studies’ findings, allowing for a comparative analysis of the effectiveness of road safety education programs in relation to their approaches and research designs (see Table 2).

The methodological quality appraisal showed that only a small proportion of the reviewed studies provided high-quality evidence based on behavioral or crash-related outcomes, reinforcing the existence of a methodological gap between educational objectives and real-world safety evaluation. Studies with stronger methodological characteristics, particularly those incorporating quasi-experimental designs, objective indicators, or follow-up assessments, provided more robust evidence regarding program effectiveness, whereas studies relying primarily on descriptive or cross-sectional approaches offered more limited evidence. This indicates that methodological rigor influences the type and strength of impact that can be evaluated and reported.

Comparative analysis across socioeconomic contexts showed differences in the type of outcomes reported among the reviewed studies. However, these differences should not be interpreted as evidence that interventions implemented in developed countries are inherently more effective than those in developing countries. Given the limited number of studies and the heterogeneity in intervention intensity, sample size, study design, follow up duration, and outcome measurement methods, socioeconomic context should be considered as one of several factors that may influence how road safety education outcomes are evaluated and reported.

Interventions combining school-based education with technology or experiential components tend to demonstrate more consistent behavioral effects than purely informational or awareness-based approaches. In contrast, short-term campaigns and community-based interventions without follow-up mechanisms show limited evidence of sustained impact.

The joint analysis of the twenty studies included in this review reveals important findings regarding the type of educational interventions, socioeconomic contexts, target populations, and evaluated variables. Most studies focus on increasing knowledge on road safety, while significantly fewer assess the impact on risky behaviors or on crash-related indicators.

Of the twenty studies analyzed, only seven report results demonstrate a change in participants’ road behaviors. These studies are predominantly from developed contexts such as Germany, France, Greece, Norway, and employ quasi-experimental designs with integrated educational methods, such as the use of technology, testimonials, or immersive strategies. This contrasts with studies that do not report behavioral impact, most of which focus on knowledge or attitudes and utilize descriptive or correlational designs, thereby limiting their capacity for causal inference.

Interventions targeting young adults tend to show greater effectiveness in behavior change, likely due to their increased autonomy to apply acquired knowledge in real-world driving contexts. In contrast, interventions aimed at children and adolescents primarily focus on knowledge and risk perception, without subsequent behavioral follow-up. This may be attributed to both methodological limitations and ethical considerations when evaluating behaviors in minors.

From the perspective of intervention type, school-based strategies combined with technology or awareness campaigns tend to be more effective than purely informational approaches. Programming that integrate simulators or serious games appear to facilitate meaningful learning and the internalization of traffic rules. In contrast, exclusively community-based approaches or those relying solely on teacher perceptions did not demonstrate a direct behavioral impact.

The findings also reveal notable differences according to the development level of the country where the road safety education programs were implemented. In developed countries, studies included in this review reported a higher proportion of behavioral and crash-related outcomes. However, these findings may reflect differences in study design, institutional support, evaluation methods, and availability of objective indicators rather than greater effectiveness of educational interventions alone. For example, studies conducted in Norway (Simsekoglu and Suzen, 2021), France (Alonso et al., 2018), and Greece reported positive outcomes; however, these results cannot be attributed exclusively to socioeconomic context. These outcomes may be partially associated with the presence of consolidated institutional infrastructure, systematic public policies on road safety, and the cross-cutting integration of the topic into educational systems. In addition, these countries have the technical and human resources needed to implement multimodal interventions that combine school-based components, technology, and awareness campaigns.

In contrast, several studies conducted in developing countries within the reviewed sample reported limited or partial outcomes. For example, in India (Jagnoor et al., 2020), Indonesia (Zainafree et al., 2022), and Vietnam (Gounaridou et al., 2021), interventions tend to be limited to improving knowledge, with no clear evidence of impact on attitudes or road practices. Even in quasi-experimental designs, such as the study in Pakistan (Nawaz et al., 2024), although improvements are reported, these are typically constrained to specific contexts and show limited replicability. This gap may be explained by budgetary constraints, lack of institutional support, and weak alignment between educational programs and national mobility policies. Furthermore, many interventions lack systematic evaluation protocols and cultural adaptation, which limits their overall effectiveness.

These differences between both contexts reflect not only structural inequalities but also divergences in implementation capacity, monitoring systems, and political prioritization. The findings highlight the need for context-sensitive strategies with longitudinal evaluation mechanisms and community participation, particularly in settings with limited institutional capacity.

This gap limits the ability to draw robust conclusions about the practical effectiveness of road safety education interventions, particularly regarding their actual impact on accident reduction. Among the studies analyzed, only one observational study conducted in India (Masilamani et al., 2022) and one quasi-experimental study in Norway (Simsekoglu and Suzen, 2021), explicitly included crash incidence as an outcome variable. This highlights the insufficient incorporation of objective and relevant indicators for road safety. The widespread absence of such measurements hinders the evaluation of whether improvements in knowledge or attitudes effectively translate into a reduction in road incidents, thereby limiting the external validity of the findings.

The limited evidence regarding behavioral change and crash incidence reduction should not be interpreted solely as a failure of educational content, but rather as a reflection of broader institutional and contextual constraints. Differences between developed and developing countries in terms of enforcement capacity, regulatory consistency, infrastructure quality, and integration of road safety policies play a critical role in mediating the effectiveness of education-based interventions. In contexts where traffic laws are weakly enforced or where institutional coordination between education, transport authorities, and law enforcement agencies is limited, educational gains are less likely to translate into sustained behavioral change. This may partially explain why, within the reviewed studies, some publications from developed countries reported behavioral or crash-related impacts, while several studies from developing contexts mainly reported knowledge-based outcomes.

Beyond identifying these comparative patterns, the reviewed evidence also allows a deeper theoretical interpretation of why certain educational approaches demonstrate greater effectiveness than others. Programs that report behavioral or crash-related impacts typically extend beyond information delivery and incorporate experiential learning, repeated exposure, and reinforcement mechanisms. From a theoretical perspective, these features facilitate the translation of cognitive gains into behavior change by engaging habit formation processes, risk perception calibration, and feedback driven learning.

In contrast, purely informational or short-term awareness interventions tend to produce improvements limited to knowledge or attitudes, as they do not sufficiently address habitual or socially mediated risk behaviors. Without reinforcement through enforcement, social norms, or institutional feedback, newly acquired knowledge is unlikely to persist as sustained behavioral change. This theoretical mismatch helps explain the frequently observed gap between educational outcomes and real-world safety indicators.

Furthermore, the effectiveness of road safety education appears to be strongly moderated by institutional context. Educational interventions embedded within supportive regulatory and enforcement environments are more likely to influence behavior, as the perceived consequences of unsafe actions reinforce educational messages. In settings where institutional capacity or enforcement consistency is limited, educational gains remain largely cognitive, reinforcing the need to conceptualize road safety education as one component of a broader behavioral and institutional system.

Based on these theoretical considerations, the findings of this review suggest the need for theoretically grounded, multicomponent intervention designs. Educational initiatives should be conceived as part of an integrated system that combines cognitive learning with behavioral reinforcement, regulatory enforcement, and contextual adaptation. Programs incorporating experiential learning, repeated exposure, and real-world feedback—particularly when aligned with institutional enforcement and infrastructure conditions—are more likely to produce sustained behavioral effects. From a theoretical standpoint, this implies shifting from information-based models toward behavior-oriented frameworks that explicitly address motivation, habit formation, and institutional support as core determinants of road safety outcomes.

Given the heterogeneity of study designs, intervention formats, and outcome measures across the reviewed literature, a formal meta-analysis was not methodologically appropriate. Instead, to strengthen the synthesis beyond a purely narrative interpretation, a quantitative descriptive comparison was conducted. This approach summarizes the frequency with which different levels of outcomes—cognitive, behavioral, and crash-related were reported across intervention types and study contexts. The resulting quantitative summary provides a structured basis for comparison while remaining consistent with the exploratory objectives of a PRISMA-ScR review. Table 3 summarizes the frequency of knowledge, behavioral, and crash-related outcomes reported across the different intervention types included in this review.

This quantitative summary reinforces the patterns identified in the comparative analysis, showing that the majority of reviewed interventions report outcomes primarily at the cognitive level, while fewer studies demonstrate behavioral change and only a limited number assess crash-related indicators. The distribution of outcomes across intervention types further highlights the methodological and contextual constraints discussed above, supporting the conclusion that reported effectiveness is strongly influenced by how and where outcomes are evaluated rather than by educational content alone. These findings strengthen the interpretation of the reviewed evidence and provide a coherent transition toward the concluding discussion.

Taken together, these findings underscore the need to strengthen methodological designs in future studies. This includes the incorporation of objective measurements such as crash records, number of traffic violations, or direct observation of safety device usage, as well as longitudinal measurements, understood as those that track participants over an extended period to observe sustained behavioral changes (Peden et al., 2004; Ivers et al., 2009). Moreover, several studies recommend the use of multimodal approaches that combine school-based, technological, and community interventions, adapted to the local context, in order to facilitate effective knowledge transfer and foster lasting behavioral changes in road users (Toroyan and Peden, 2007; Elvik et al., 2009).

Figure 4 summarizes the conceptual relationships identified from the reviewed literature regarding factors associated with road safety education effectiveness. Rather than representing a quantitative causal model, the figure provides an evidence-informed synthesis of the main dimensions discussed in the selected studies. This comprehensive approach encompasses not only knowledge of traffic regulations, but also the responsible attitudes and behaviors expected from different road users, including drivers, pedestrians, and cyclists. The figure illustrates how the integration of education with enforcement measures and infrastructure improvements may contribute to safer behaviors by reinforcing the interaction between knowledge acquisition, behavioral change, and supportive road safety systems.

Limitations of the review

This review has several limitations that should be considered when interpreting the findings. First, the heterogeneity of study designs, intervention formats, outcome definitions, and evaluation methods limited the possibility of conducting a meta-analysis or estimating pooled effects. As a result, the synthesis relied on qualitative and descriptive quantitative comparisons rather than statistical aggregation.

Second, most of the reviewed studies focused on short-term outcomes and predominantly assessed cognitive or attitudinal variables using self-reported instruments, which may introduce reporting bias and limit the ability to infer sustained behavioral change or real-world safety impact. The scarcity of longitudinal designs and objective outcome measures, such as crash incidence or observational behavioral data, further constrains the strength of the conclusions.

An additional limitation of this review relates to the size and temporal scope of the final corpus. Although the initial search yielded a large number of records, only 20 studies met all predefined eligibility criteria, reflecting the limited availability of empirical evaluations that explicitly assess the effectiveness of road safety education programs. Furthermore, the restriction to publications from 2015 to 2025 was intentionally adopted to capture contemporary educational approaches, evaluation methods, and institutional contexts. Earlier studies, while relevant from a historical perspective, often rely on outdated pedagogical models or evaluation frameworks that differ substantially from current road safety practices.

An additional limitation concerns the geographic distribution of the reviewed studies. In many cases, only a single study was identified per country, and several countries with well-established road safety systems, such as Sweden and the Netherlands, as well as English-speaking developed countries (e.g., Australia, the United Kingdom, and the United States), were not represented in the final corpus. This uneven distribution reflects the limited availability of recent empirical evaluations explicitly focused on road safety education effectiveness within the selected databases and time frame.

Consequently, quantitative summaries reported in this review (e.g., the number of studies reporting improvements in knowledge or attitudes) should be interpreted as descriptive patterns within the reviewed evidence rather than as generalizable global trends. The findings therefore highlight gaps in the geographic and institutional coverage of current research rather than providing a comprehensive representation of best-performing road safety systems. This limitation is particularly relevant when interpreting cross-country comparisons, as countries with advanced road safety performance are underrepresented or absent from the reviewed literature.

Additionally, comparisons between developed and developing countries should be interpreted cautiously. The heterogeneity of intervention characteristics, sample sizes, methodological quality, duration of follow-up, and outcome measurement approaches prevent attributing differences in reported effectiveness solely to socioeconomic context. Future comparative studies with standardized methodologies are needed to better understand the influence of contextual factors on intervention effectiveness.

A key contribution of this review is its analytical examination of the gap between educational intent and real-world road safety outcomes. Rather than reiterating the general importance of road safety education, the study provides a critical synthesis of how effectiveness is currently evaluated and why evidence remains inconsistent across the reviewed literature. By systematically considering methodological design, contextual factors, and outcome selection, the findings identify relevant patterns that may inform the design, evaluation, and policy integration of future road safety education initiatives.

More specifically, this review does not aim to confirm that road safety education improves knowledge or attitudes, which is already well documented, but rather to identify a persistent disconnection. Between educational outcomes and measurable safety indicators such as behavior and crash incidence. By explicitly analyzing this gap across intervention types and socioeconomic contexts, the study highlights why many education-based initiatives fail to produce sustained real-world impact and underscores the need for integrated, institutionally supported, and behavior-oriented approaches. This contribution provides a clearer basis for decision-makers, educators, and researchers to design and evaluate road safety education programs with a stronger focus on practical effectiveness.

From an empirical standpoint, this scoping review examined 20 road safety education studies published between 2015 and 2025. The findings indicate that while most interventions report positive effects on knowledge and attitudes, only a limited number of studies provide evidence of behavioral change, and even fewer assess crash-related outcomes. Studies reporting behavioral effects predominantly employ quasi-experimental designs and incorporate practical or technology-based components.

Methodologically, the review highlights a persistent gap between stated educational objectives and the evaluation of real-world safety outcomes. The analysis suggests that differences in reported effectiveness are associated with study design, outcome selection, and institutional context. However, variations in methodological quality, intervention characteristics, sample size, follow-up duration, and evaluation approaches limit direct comparisons across studies.

From a practical perspective, the findings of this review suggest that road safety education programs should evolve toward longer-term, participatory, and culturally adapted interventions. It is also recommended that road safety education be integrated into multisectoral frameworks that include regulatory reforms, infrastructure improvements, and community engagement.

Future research directions

Looking ahead, research on road safety education should prioritize the direct assessment of behavioral and crash-related outcomes to better capture the real-world impact of educational interventions. In particular, the use of longitudinal designs is essential to evaluate the sustainability of behavioral changes over time.

Beyond outcome measurement, future studies should examine the interaction between road safety education, regulatory enforcement, and infrastructure conditions, treating these elements as interconnected components of broader road safety systems rather than as isolated variables. Comparative research across different socioeconomic and institutional contexts would further contribute to identifying the conditions under which educational interventions are most effective.

At a methodological level, the development of standardized evaluation frameworks and outcome indicators would enable more robust comparisons across studies and facilitate evidence synthesis in future systematic reviews and meta-analyses.