I've got a squeeze-horn, designed for a kid's bike, that some teens from the youth group at my church bought for me because they know I don't have a car. It's labeled "for ages 3-5" and "adult assembly required." Nevertheless, I was able to install it on my handlebars and it's very effective for warning pedestrians, much moreso than a bell in my experience and usage. Plus, the pedestrians think it sounds really funny, so they're not annoyed that I'm basically telling them to get out of my way... It's comparably effective to yelling, but people take it better. Probably wouldn't work in NYC noise, though.
And yes, I know that my handlebar ain't perfectly straight with the front wheel in this picture.