Rationale
Pedestrian injuries and deaths should be considered as a growing public health problem [
1‐
3]. Pedestrians are amongst the most vulnerable road users globally, accounting for 23% of the world’s road accident deaths in 2018 [
4]. Unsafe road crossing behavior exposes them to risk of trauma and death and imposes a heavy burden on the health care system [
5,
6]. The United Nations (UN) recommends governments to pay more attention to vulnerable road users such as pedestrians, by making proper policies and practices for pedestrian safety [
7]. The high rate of pedestrian injury and mortality highlights the importance of an urgent call for evidence-based health education and safety promotion programs [
8]. Nevertheless, research and interventions to improve pedestrian safety are still unsatisfactory [
4,
9,
10].
Ensuring appropriate targets for intervention [
9], the theory-driven interventions are more effective than interventions lacking theory [
10‐
12]. The theory of planned behavior (TPB) developed by Ajzen [
13] is one of the most frequently applied social-psychological models and helps health professionals to identify key beliefs to develop appropriate health behavior change intervention [
11,
14,
15]. A number of researchers have used the TPB to predict pedestrians’ intention to cross the road in a potentially hazardous situation [
16‐
24]. The TPB renders an authoritative framework for conceptualization, measurement, and identifying issues affecting behavior [
11]. The TPB argues that behavioral intention and perceived behavioral control (PBC) are proximal predictors of actual behavior and is determined by its three basic constructs, including attitude toward the behavior, subjective norms, and PBC [
14,
22]. In order to measure intention, it is necessary to measure its predictors. These predictors are latent variables and should be measured indirectly through a questionnaire response [
14].
Development of a valid and reliable questionnaire as a measurement instrument is a very critical point, particularly in social-psychological and health-related behavior research. Due to some confusing issue and diverse views about the operationalization of the TPB, particularly for non-psychologist researchers[
14], Ajzen [
25], Francis et al. [
26], Fishbein and Ajzen [
27],
Conner and
Norman [
28], and Godin and Kok [
29] proposed some sort of guidelines for constructing the TPB-based questionnaire to help the researchers in developing a valid and reliable tool. In developing a TPB-based questionnaire, initial qualitative study, the wording of questions, response formats, and scoring should be considered as essential steps [
14]. Different questionnaires based on the TPB have been used to measure pedestrians’ road crossing intention/behavior worldwide [
16‐
24,
30]. To what extent these questionnaires enjoy satisfactory measurement properties (MPs) is unknown. COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments) initiative, is an international multidisciplinary team of researchers which has provided a new updated modular tool for conducting a systematic review of patient-reported outcome measures (PROMs) and evaluating the outcome measurement instruments [
31]. COSMIN methodology uses the word patient but, the target population could be not the patient. In this study, the target population is pedestrian, and the outcome measure is the pedestrians’ road crossing behavior. So, here the capital letter P in the PROMs represents pedestrian instead of patient or in general let us say, participant. Systematic reviews of PROMs provide an overall understanding of the MPs of PROMs to select the most suitable PROM for a certain objective [
31]. An initial search conducted within the Cochrane Database of Systematic Reviews, PubMed\MEDLINE, and PROSPERO indicates that the only systematic review for evaluating the quality of TPB-based questionnaires and their development processes has been conducted by Oluka et al. in 2014, regardless of concentration on a specific subject like pedestrian behavior [
32]. Since there are no current or underway systematic reviews on the topic, a systematic review is needed and reasonable to identify, appraise, summarize, and compare the quality of MPs of available self-reported TPB-based questionnaires predicting pedestrians’ road crossing intention or behavior.
So the aim of the proposed systematic review is to evaluate the quality of MPs of the questionnaires constructed based on the theory of planned behavior (TPB) to predict pedestrians’ road crossing intention/behavior by using the updated COSMIN methodology. The following specific objectives will be achieved by the proposed systematic review.
1.
To identify the existing TPB-based questionnaires predicting pedestrians’ road crossing intention or behavior
2.
To evaluate the methodological quality of the included studies
3.
To assess the quality of MPs
4.
To grade the overall quality of evidence
5.
To provide recommendation on the most suitable questionnaires