Accident prevention. Presentation of a model placing emphasis on human, structural and cultural factors

This paper presents a model of how three groups of accident prevention measures: modification of attitudes, behaviour, and structural conditions, are influencing two broad categories of risk factors: (a) behaviour, and (b) physical and organisational environment; and two process factors: (c) attitudes and beliefs, and (d) social norms and culture. Some of the hypothesised paths in the model seem to be weak: Attitude modification→Attitude→Behaviour→Accidents and injuries (the KAP-model), while others seem strong: Structural modification→Physical and organisational environment→Behaviour→Accidents and injuries. When various preventive measures are used in combination, and to the extent that they influence social norms and cultural factors, they are probably more effective than interventions affecting individuals (modifying factors such as attitudes and beliefs) only. Although attitude change measures seem to have little direct impact on behaviour, they may still have an important role in accident prevention. Important challenges remain to develop interventions that influence social norms and safety-related aspects of culture and to identify optimal combinations of preventive measures.