Using an event-triggered video intervention system to expand the supervised learning of newly licensed adolescent drivers

Factors Influencing Participation and Engagement in a Teen Safe Driving Intervention: A Qualitative Study

(1) Background: Few teen driving safety programs focus on increasing parental engagement with high-risk teen drivers, specifically those with a traffic violation. This study explored parents'/guardians' ('parents') experiences with a teen driving safety program, ProjectDRIVE, including facilitators and barriers to program engagement. (2) Methods: We conducted virtual, semi-structured interviews with parents who completed ProjectDRIVE, which included in-vehicle driving feedback technology and individualized virtual training with parents on effective parent-teen communication. (3) Results: Twenty interviews (with 17 females and three males) were transcribed verbatim and independently coded by three coders using systematic, open, and focused coding. Three major themes were identified: factors influencing a parent's initial decision to participate, factors influencing continued engagement, and perceived benefits of participation. The decision to participate was influenced by these subthemes: parental motivation to help their teen, perceived program usefulness, program endorsement, program incentives, parents' busy schedules, and lack of access to a car/internet. Subthemes impacting continued engagement included enhanced communication skills, teen willingness to engage, strong parental engagement, and teens' other priorities. Perceived benefits included greater self-efficacy in communication, improved communication patterns and frequency, and enhanced parent-teen relationships. (4) Conclusions: These findings may set the foundation for developing and implementing future court-ordered parent-based teen safe driving programs for teens with traffic citations.

ProjectDRIVE: study protocol for a randomized controlled trial to improve driving practices of high-risk teen drivers with a traffic violation

BACKGROUND

Teen drivers with a traffic violation are at increased risk for crashes and crash-related injuries; however, most parent-focused interventions target teen drivers with supervised learner's permits. Very few interventions are implemented at the probationary driver's license stage or target high-risk teen drivers, such as those with traffic violations. This paper describes the protocol of ProjectDRIVE, A Randomized Controlled Trial to Improve Driving Practices of High-Risk Teen Drivers with a Traffic Violation, which targets improving parent-teen communication about safe driving practices to reduce unsafe driving behaviors and traffic violation recidivism of teen drivers cited for traffic violation.

METHODS

Teen drivers (ages 16 or 17) cited for a moving violation and the parent/legal guardian most involved with the teen's driving are recruited from juvenile traffic courts following their required court hearing. After completing informed consent/assent, enrolled dyads are randomized into one of three groups using stratified block randomization: control, device feedback only, or device feedback plus parent communication training. Participating dyads are followed for 6 months with 3 months of active intervention. Using in-vehicle device and smartphone application technology, the study provides real-time and cumulative driving feedback to intervention teens and collects continually recorded, objectively measured driving outcome data throughout the teen's study participation. Primary outcomes include rates of risky driving events and unsafe driving behaviors per 1000 miles driven. Secondary outcomes include traffic violation recidivism up to 12 months following study completion and frequency and quality of parent-teen communication about safe driving practices.

DISCUSSION

Through partnership with the local juvenile traffic courts, this study integrates recruitment and randomization into existing court practices. Successfully completing this study will significantly impact juvenile traffic court's practices and policies by informing judges' decisions regarding the driving safety programs they refer to teens to prevent motor vehicle crashes and crash-related injuries and deaths. Trial registration The study was registered on ClinicalTrials.gov Registry (NCT04317664) on March 19, 2020, https://clinicaltrials.gov/study/NCT04317664 and updated on April 27, 2021. This protocol was developed per the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Checklist.

Developing an improved automatic preventive braking system based on safety-critical car-following events from naturalistic driving study data

In public road tests of autonomous vehicles in California, rear-end crashes have been the most common type of crash. Collision avoidance systems, such as autonomous emergency braking (AEB), have provided an effective way for autonomous vehicles to avoid collisions with the lead vehicle, but to avert false alarms, AEB tends to apply late and hard brake only if a collision becomes unavoidable. Automatic preventive braking (APB) is a new collision avoidance method used in Mobileye's Responsibility-Sensitive Safety (RSS) model that aims to reduce crashes with a milder brake and decreased impact on traffic flow, but APB's safety performance is inferior to that of AEB. This study therefore proposes three safety improvement strategies for APB, the addition of response time, safety buffer, and minimum following distance; and combines them in different ways into four improved APB systems, IP1-IP4. Simulating car-following safety-critical events (SCEs) extracted from the Shanghai Naturalistic Driving Study in MATLAB's Simulink, the safety performance, conservativeness, and driving comfort of the four systems were evaluated and compared with the original APB system, two AEB systems, and human drivers. The results show that 1) IP4, the system that integrated all three strategies, outperformed the baseline APB and IP1-IP3 and prevented all SCEs from becoming crashes; 2) IP4 was slightly more conservative than AEB, but less conservative than RSS; 3) APB's jerk-bounded braking profile improved driving comfort; and 4) higher deceleration was found in the two AEB systems (both 8.1 m/s²) than in IP4 (6.7 m/s²), but they failed to prevent all crashes. Our proposed APB system, IP4, can provide safe, efficient, and comfortable braking for AVs in car-following SCEs, and has the potential to be practically applied in vehicle collision avoidance systems.

Quantifying and recommending seat belt reminder timing using naturalistic driving video data

INTRODUCTION

To better understand the timing of when people buckle their seat belt, an analysis of a naturalistic driving study was used. The study provided a unique perspective inside of the vehicle where the entire seat belt was visible from the time the driver entered the vehicle to one minute of driving forward or 32 kph.

METHOD

Seat belt buckling behavior was identified for 30 drivers. An additional 10 drives for 13 of these drivers were identified for a seat belt sequencing, which identified the points when the vehicle was put into ignition, shifted, when vehicle movement began, and when the seat belt was buckled. The speed at belt closure was also identified. The timing from ignition to buckle and to shifting into forward gear were examined to identify the speed and appropriate timing for seat belt reminders.

RESULTS

The data show that drivers were buckled in over 92% of the 3,102 drives. In addition, in 70% of those total drives, the drivers were buckled before the vehicle began movement. Of greater interest for seat belt reminders/interlocks are those drives when drivers buckle after movement. When considering time from ignition to seat belt closure, the mean was 27.5 s. Because higher speeds are typically reached when traveling forward rather than reverse, it was important to know the time duration from shifting into drive to buckling. With this consideration, the mean to buckle dropped to 16.2 s. The mean speed at buckling when traveling forward was 15.3 kph. From the regression analysis, the input variables 'Age,' 'Sex,' 'Weight,' 'Environment,' and 'Weather' are significant contributors in predicting the log odds of a driver putting on seatbelt.

CONCLUSIONS

With the understanding that higher speeds lead to an increased risk of injury and/or death and with the results of the analysis, a recommendation of a 30 s time from forward shift and a 25 kph (6.9 m/s) threshold for reminder systems should be implemented. The regression analysis also validates that most of the predicted seat belt buckling times are within 30 s. Practical Applications: This would reduce perception of nuisance alerts and protect the driver from higher speed unbuckled crashes. The seat belt buckling time prediction model also demonstrates good potential for developing tailored buckling warning system for different drivers.

Steering Teens Safe: translation to a workplace wellness program in the USA

Parent-based teen driving interventions have been shown to increase safe teen driving but few have been translated beyond the research setting. As employers focus more on total worker health, the workplace offers a unique opportunity to implement a safe teen driving program into a workplace wellness program. The aim of this study was to adapt the evidence-based, parent-focused teen safe driving program Steering Teens Safe (STS) into workplace wellness programs, and to evaluate the implementation process and effect on parent-teen communication. The Replicating Effective Programs framework was used to modify STS to fit the workplace setting. The implementation process of the STS workplace wellness program was measured using direct observation and recordings of parent communication trainings while the effectiveness was measured by parent questionnaires. Forty-five parent employees across three businesses participated in the study. STS trainers were skilled in training parents in effective communication, including using open-ended questions and reflections. Parents reported increased success in conversations with their teens regarding safe driving through increased affection, receptivity, trust and equality in conversations. Workplaces may play a key role in assisting parents with teaching their children about safe driving.

Video feedback intervention for cognitively impaired older drivers: A randomized clinical trial

INTRODUCTION

This clinical trial aimed to determine whether in-car video feedback about unsafe driving events (UDE) to cognitively impaired older drivers and family members leads to a reduction in such driving behaviors.

METHODS

We randomized 51 cognitively impaired older drivers to receive either (1) a weekly progress report with recommendations and access to their videos, or (2) video monitoring alone without feedback over 3 months.

RESULTS

UDE frequency/1000 miles was reduced by 12% in feedback (rate ratio [RR] = 0.88, 95% confidence interval [CI] = .58-1.34), while remaining constant with only monitoring (RR = 1.01, 95% CI = .68-1.51). UDE severity/1000 miles was reduced by 37% in feedback (RR = 0.63, 95% CI = .31-1.27), but increased by 40% in monitoring (RR = 1.40, 95% CI = .68-2.90). Cognitive impairment moderated intervention effects (P = .03) on UDE frequency.

DISCUSSION

Results suggest the potential to improve driving safety among mild cognitively impaired older drivers using a behavior modification approach aimed at problem behaviors detected in their natural driving environment.

Use of theory to guide development and application of sensor technologies in Nursing

Sensor technologies for health care, research, and consumers have expanded and evolved rapidly. Many technologies developed in commercial or engineering spaces, lack theoretical grounding and scientific evidence to support their need, safety, and efficacy. Theory is a mechanism for synthesizing and guiding knowledge generation for the discipline of nursing, including the design, implementation, and evaluation of sensors and related technologies such as artificial intelligence and machine learning. In this paper, three nurse scientists summarize their presentations at the Council for the Advancement of Nursing Science 2019 Advanced Methods Conference on Expanding Science of Sensor Technology in Research discussing the theoretical underpinnings of sensor technologies development and use in nursing research and practice. Multiple theories with diverse epistemological roots guide decision-making about whether or not to apply sensors to a given use; development of, components of, and mechanisms by which sensor technologies are expected to work; and possible outcomes.

The Effect of Partial Automation on Driver Attention: A Naturalistic Driving Study

OBJECTIVE

This naturalistic driving study investigated how drivers deploy visual attention in a partially automated vehicle.

BACKGROUND

Vehicle automation is rapidly increasing across vehicle fleets. This increase in automation will likely have both positive and negative consequences as drivers learn to use the new technology. Research is needed to understand how drivers interact with partially automated vehicle systems and what impact new technology has on driver attention.

METHOD

Ten participants drove a Tesla Model S for 1 week during their daily commute on a stretch of busy interstate. Drivers were instructed to use Autopilot, a system that provides both lateral and longitudinal control, as much as they felt comfortable while driving on the interstate. Driver-facing video data were recorded and manually reduced to examine glance behavior.

RESULTS

Drivers primarily allocated their visual attention between the forward roadway (74% of glance time) and the instrument panel (13%). With partial automation engaged, drivers made longer single glances and had longer maximum total-eyes-off-road time (TEORT) associated with a glance cluster.

CONCLUSION

These results provide a window into the nature of visual attention while driving with partial vehicle automation. The results suggest that drivers may be more willing to execute long, "outlier" glances and clusters of glances to off-road locations with partial automation. The findings highlight several important human factors considerations for partially automated vehicles.

A randomized trial to test the impact of parent communication on improving in-vehicle feedback systems

This randomized controlled trial evaluated the impact of integrating Steering Teens Safe, a parent communication intervention, with feedback from an in-vehicle video recording system. In-vehicle video systems that trigger a recording when the vehicle exceeds a g-force threshold have been used to provide feedback to young drivers. Few of these programs have involved parental engagement. Parent-teen dyads were randomized to three groups and 150 dyads completed the study. All groups received an in-vehicle video system that recorded driving events. The control group received no feedback or intervention. In the first intervention group, teens received real-time feedback, and parent-teen dyads received summary feedback, based on information recorded by the in-vehicle system. The second intervention group received the same feedback, plus parents were taught strategies to improve communication with their teen about safe driving. The primary outcome variable was unsafe driving event rates per 1000 miles driven and the primary independent variable was group assignment. Generalized linear models were used to calculate effect estimates. Compared with the control group, the Event Recorder Feedback group had a rate ratio of 0.35 (95% CI = 0.24 - 0.50) and the combined intervention group (Event Recorder Feedback and parent communication) had a rate ratio of 0.21 (95% CI = 0.15 - 0.30). Furthermore, the combined intervention group had a significantly lower event rate than the Event Recorder Feedback only group (rate ratio = 0.60, 95% CI = 0.41 - 0.87). While in-vehicle feedback systems can help reduce unsafe driving events in early independent driving, teaching parents strategies for effective communication with their young driver may further improve impact.

Kinematic risky driving behavior among younger and older drivers: Differences over time by age group and sex

Objective: This research examined the incidence rates of elevated gravitational force events (kinematic risky driving, KRD) among 16- to 17-year-old drivers compared to those of 18- to 20-year-old, 21- to 25-year-old, and 35- to 55-year-old drivers over a 12-month period. Methods: Data were sampled from the Strategic Highway Research Program 2 (SHRP2) naturalistic driving study that recruited a U.S. national sample of study participants. General linear mixed models (GLIMMIX) for recurrent events were used to estimate KRD incident rates for age cohorts in 3-month periods. Results: KRD incidence rates for 16- to 17-year-old drivers were higher than the rates for older drivers at each 3-month period. Analyses of individual differences for the 12-month period indicated that incidence rates for the 16- to 17-year-old group were 1.84 times higher than the rates for 18- to 20-year-old drivers, 2.86 higher than those for 21- to 25-year-old drivers, and 4.92 times higher than those for 35- to 55-year-old drivers. The incident rate for 16- to 17-year-old males was 1.9 times higher than that for same-aged females in the first 3 months and 2.3 times higher over 12 months. Over the study period, KRD rates of 16- to 17-year-old participants declined 24.5% among females and 18.0% among males. Conclusions: KRD rates were higher among younger relative to older, more experienced drivers and did not decline over time, consistent with a protracted period of risky driving behavior. The persistently higher KRD rate among young drivers suggests the need to enhance crash prevention approaches, such as feedback about abrupt maneuvering, to young drivers and their parents.

Efficacy of intervention at traffic schools reducing impulsive action, and association with candidate gene variants

OBJECTIVE

Road traffic injuries are the leading cause of death among young people. Recognition of the contribution of impulsive behaviour may help novice drivers to behave more safely. Previously a brief intervention focusing on impulsive traffic behaviour conducted by psychologists in driving schools had been effective. The aim of this study was an independent re-evaluation of the effect of the intervention, as conducted by driving school teachers, and assessment of the potential associations with candidate genotypes.

METHODS

Driving school students (mean age 22.5, SD=7.9) were divided into intervention (n=704) and control (n=737) groups. Driving school teachers were trained to administer the intervention which consisted of a lecture and group work (1.5 h in total) on impulsivity. Traffic offences and crashes were monitored during 3 years, using police and traffic insurance fund databases. Functional polymorphisms of the dopamine transporter (DAT) and serotonin transporter genes (DAT1 VNTR and 5-HTTLPR) were assessed.

RESULTS

The intervention significantly lowered general traffic risk and prevalence of traffic accidents. DAT1 VNTR 9R carriers, particularly males, had higher general traffic risk in the whole sample. Female 5-HTTLPR s' allele carriers of the intervention group had the lowest general traffic risk. Intervention was most effective in female DAT1 VNTR 10R/10R homozygotes.

CONCLUSIONS

Brief impulsivity-centred intervention appears as a promising strategy for preventing risk-taking behaviour in novice drivers and can be fully integrated to driving school curriculum.

Learning to drive: A reconceptualization

Drivers' population-level crash rates incrementally decrease following licensure, which has led to the implicit assumption that an individual driver's crash risk also decreases incrementally after licensure as they accrue experience. However, in the aggregate data an incremental decrease in crash rate can reflect both incremental reductions in crash risk within individuals and an incremental increase in the proportion of drivers who have experienced an abrupt decrease in crash risk. Therefore, while it is true to say that the population of drivers' crash risk reduces in the months following licensure, it is not necessarily true to say that a driver's crash risk reduces in the months following licensure; that is, it cannot be assumed that individual-level changes in crash risk mirror the population-level changes in crash rates. In statistics, this is known as an ecological fallacy and in formal logic it is known as the fallacy of division, a type of category error. Using computational cognitive modeling methods we demonstrate that aggregating individual-level abrupt decreases in crash risk (i.e., non-incremental change trajectories) accurately fits population-level crash rate data from over 1 million adolescents and uniquely accounts for effects of two interventions found to reduce police-reported MVCs. Thus, we demonstrate that (1) a power-law artifact is readily observable in newly licensed drivers' aggregate crash data, which is not necessarily indicative of individual-level change processes, (2) interventions can alter crash risk trajectories by inducing immediate phase changes in crash risk into a lower risk stratum, or increasing the probability of such a change, (3) a phase transition model provides a stronger and more parsimonious account of the existing data than an incremental-accrual model.

Classifying and predicting risky driving among novice drivers: A group-based trajectory approach

INTRODUCTION

Classifying risky driving among new teenage drivers is important for efficiently targeting driving interventions. We thoroughly investigated whether novice drivers can be clustered by their driving outcome profiles over time.

METHODS

A sample of 51 newly licensed teen drivers was recruited and followed over a period of 20 weeks. An in-vehicle video recording system was used to gather data on dangerous driving events referred to as DDEs (elevated g-force, near-crash, and crash events), risky driving behaviors referred to as RDBs (e.g., running stop signs, cell phone use while driving), and miles traveled. The DDE and RDB weekly rates rate were determined by dividing the number of DDEs and RDBs in a week by the number of miles traveled in that week, respectively. Group-based trajectory modeling was used to map the clustering of DDE rate and RDB rate patterns over time and their associated covariates.

RESULTS

Two distinct DDE rate patterns were found. The first group (69.1% of the study population) had a lower DDE rate which was consistent over time. The second had a higher DDE rate pattern (30.9%) and characterized by a rising trend in DDE rate followed by a steady decrease (inverted U-shaped pattern). Two RDB rate patterns were also identified: a lower RDB rate pattern (83.4% of the study population) and a higher RDB rate pattern (16.6%). RDB and DDE rate patterns were positively related, and therefore, co-occurred. The results also showed that males were more likely than females to be in the higher DDE and RDB rate patterns.

CONCLUSION

The groups identified by trajectory models may be useful for targeting driving interventions to teens that would mostly benefit as the different trajectories may represent different crash risk levels. Practical applications: Parents using feedback devices to monitor the driving performance of their teens can use the initial weeks of independent driving to classify their teens as low or high-risk drivers. Teens making a very few DDEs during their early weeks of independent driving are likely to remain in the lower risk group over time and can be spared from monitoring and interventions. However, teens making many DDEs during their initial weeks of unsupervised driving are likely to continue to make even more DDEs and would require careful monitoring and targeted interventions.

Technology-Based Interventions, Assessments, and Solutions for Safe Driving Training for Adolescents: Rapid Review

BACKGROUND

Safe driving training for adolescents aims to prevent injury and promote their well-being. In that regard, information and communication technologies have been used to understand adolescent driving behavior and develop interventions.

OBJECTIVE

The purpose of this review is to explore and discuss existing approaches to technology-based driving interventions, driving assessments, and solutions in the literature.

METHODS

We searched the Web of Science and PubMed databases following a review protocol to collect relevant peer-reviewed journal articles. Inclusion criteria were (1) being published in the English language, (2) being published in a peer-reviewed journal, (3) testing the driving behavior of teens with technology-based intervention methods, and (4) being published between January 2000 and March 2018. We appraised the articles by reading their abstracts to select studies matching the inclusion criteria and reading the full text of articles for final refinement.

RESULTS

Initial keyword searches on technology-based solutions resulted in 828 publications that we refined further by title screening (n=131) and abstract evaluation against inclusion criteria (n=29). Finally, we selected 16 articles that met the inclusion criteria and examined them regarding the use of technology-based interventions, assessments, and solutions. Use of built-in tracking devices and installation of black box devices were widely used methods for capturing driving events. Smartphones were increasingly adapted for data collection, and use of gamification for intervention design was an emerging concept. Visual and audio feedback also were used for intervention.

CONCLUSIONS

Our findings suggest that social influence is effective in technology-based interventions; parental involvement for promoting safe driving behavior is highly effective. However, the use of smartphones and gamification needs more study regarding their implementation and sustainability. Further developments in technology for predicting teen behavior and programs for behavioral change are needed.

Behavior Change for Youth Drivers: Design and Development of a Smartphone-Based App (BackPocketDriver)

Background

The over-representation of youth in road crash injury and fatality rates is a major public health issue globally. In New Zealand, youth drivers are most vulnerable in the restricted license period when they can drive without the requirement for supervision by an experienced adult. Behavioral change interventions delivered using mobile phone technology to young drivers could serve as a useful mechanism to develop safe driving skills, but this potential remains to be fully explored.

Objective

This study aimed to apply behavioral change principles to design and develop a smartphone-based intervention with the aim of helping youth drivers to develop and hone safe driving skills.

Methods

An iterative process was used to support development of the smartphone intervention. We reviewed behavioral change literature, identifying fundamental principles and exploring use of behavior change techniques (BCTs) in other areas of public health. We engaged with key stakeholders, including young drivers, government agencies, and relevant organizations. We also took into account technology adoption considerations when designing the app.

Results

We developed BackPocketDriver (BPD), an Android smartphone app that uses in-built sensors to monitor and infer driver behavior. The app implements features that were identified during the design process and are traceable to BCTs and theory. A key feature is messaging, which is used to instruct, motivate, educate, and relay feedback to participants. In addition, messaging addresses attitudes and beliefs. Other features include journey feedback summaries, goal setting, achievements, and leaderboards.

Conclusions

BPD’s design rests on a sound foundation of theory and evidence. With explicit links between theory and features, the app aims to be an effective intervention to change and improve youth driver behavior. The next phase of this study is to run a small pilot study to assess BPD’s effectiveness.

Crash Risk and Risky Driving Behavior Among Adolescents During Learner and Independent Driving Periods

PURPOSE

Novice adolescents' crash rates are highly elevated early in licensure, despite substantial practicedriving during the learner period. The objectives of this study were to examine the variability in measures of driving risk among adolescents during the learner and early independent driving periods and evaluate how risk varies by driving experience, gender, time of day, and road surface conditions.

METHODS

Objective driving data were collected in a naturalistic cohort study of 90 adolescent drivers with learner driving permit and 131 experienced adult drivers. Participants' private vehicles were equipped with data acquisition system documenting driving kinematics, miles driven, and video recordings of the driver and the driving environment. Crash/near-crash (CNC) and kinematic risky driving (KRD) rates were calculated during the learner and early independent driving periods by gender (female/male), time of day (day/night), and road surface conditions (wet/dry) for adolescents and adults.

RESULTS

CNC and KRD rates of adolescents were similar to adult drivers during the learner period (CNC: incident rate ratio [IRR] = 1.67, confidence interval [CI] = .98-2.82 and KRD: IRR = 1.04, CI = .78-1.40, respectively), but dramatically higher in the first year of independent driving (CNC: IRR = 6.51, CI = 4.03-10.51 and KRD: IRR = 3.95, CI = 2.96-5.26, respectively), and particularly elevated the first 3months of licensure. Adolescent KRD rates were higher for males than females and invariably higher than adult rates during day and night, wet and dry conditions.

CONCLUSIONS

While the learner driving period was relatively safe for adolescents, the transition to independent driving was typified by a dramatic increase in risk among adolescents that was higher than adult rates overall and under varying driving conditions.

Talking with teens about traffic safety: Initial feasibility, acceptability, and efficacy of a parent-targeted intervention for primary care settings

INTRODUCTION

The aims of the current pilot study were to evaluate the feasibility, acceptability, and preliminary efficacy of the Talking with Teens about Traffic Safety Program. The program consists of a clinic-based health coaching session with parents of adolescents at their annual well-child visit to promote parent-teen communication about teen driver safety including: a Parent Handbook that is designed to serve as a primer on teen driver safety and facilitate parent-teen communication on a variety of teen driver topics; an interactive practice driving toolset; and an endorsement of the materials by the primary care provider.

METHOD

Fifty-four parent-teen dyads (n = 108 total) were recruited from a primary care practice. Dyads were randomized (1:1) into a treatment group or a usual care group. Implementation fidelity was assessed using checklists completed by health coaches and parent interviews. After 6 months, parents reported how often they talked with their teen about 12 safe driving topics (e.g., state graduated driver licensing laws).

RESULTS

Parents in the treatment group reported more frequent discussions than parents in the control group on 7 out of the 12 topics. Fidelity data indicate that 100% of sessions were implemented as designed and were acceptable to parents.

CONCLUSIONS

The program was feasible to administer and there was evidence for preliminary efficacy. Generally, effects were larger for more infrequently discussed topics, which is to be expected due to the potential for ceiling effects on more commonly discussed topics (e.g., distracted driving). A larger multi-site study is warranted.

PRACTICAL APPLICATIONS

The results from this pilot study provide support for implementation fidelity and establish a proof-of-concept for the Talking with Teens about Traffic Safety Program. The results provide guidance for developing partnerships with pediatricians and parents to develop parent-teen communication interventions on injury prevention topics.

Vehicle ownership and other predictors of teenagers risky driving behavior: Evidence from a naturalistic driving study

OBJECTIVE

Risky driving behavior may contribute to the high crash risk among teenage drivers. The current naturalistic driving study assessed predictors for teenagers' kinematic risky driving (KRD) behavior and the interdependencies between them.

METHOD

The private vehicles of 81 novice teenage drivers were equipped with data acquisition system that recorded driving kinematics, miles driven, and video recordings of the driver, passengers and the driving environment. Psychosocial measures were collected using questionnaires administered at licensure. Poisson regression analyses and model selection were used to assess factors associated with teens' risky driving behavior and the interactions between them.

RESULTS

Driving own vs shared vehicle, driving during the day vs at night, and driving alone vs with passengers were significantly associated with higher KRD rates (Incidence rate ratios (IRRs) of 1.60, 1.41, and 1.28, respectively). Teenagers reporting higher vs lower levels of parental trust had significantly lower KRD rates (IRR = 0.58). KRD rates were 88% higher among teenagers driving with a passenger in their own vehicle compared to teenagers driving with a passenger in a shared vehicle. Similarly, KRD rates during the day were 74% higher among teenagers driving their own vehicle compared to those driving a shared vehicle.

CONCLUSIONS

Novice teenagers' risky driving behavior varied according to driver attributes and contextual aspects of the driving environment. As such, examining teenagers' risky driving behavior should take into account multiple contributing factors and their interactions. The variability in risky driving according to the driving context can inform the development of targeted interventions to reduce the crash risk of novice teenage drivers.

Attitudes on technological, social, and behavioral economic strategies to reduce cellphone use among teens while driving

OBJECTIVE

The majority of U.S. teens admit to handheld cellphone use while driving, an increasingly common cause of crashes. Attitudes toward novel cellphone applications and settings that block use while driving are poorly understood, potentially limiting uptake. We examined teens' willingness to reduce cellphone use while driving and perceptions of potential strategies to limit this behavior.

METHODS

Teen drivers (n = 153) aged 16-17 who owned smartphones and admitted to texting while driving completed an online survey. Survey instruments measured willingness to give up cellphone use and perceptions of technological and behavioral economic strategies to reduce cellphone use while driving. We used chi-square tests to test the hypothesis that willingness to give up certain types of cellphone use while driving and the perceptions of strategies to reduce cellphone use while driving would differ by self-reported frequency of texting while driving in the past 30 days (low [1-5 days] vs. high [6 or more days]).

RESULTS

Most teens were willing or somewhat willing to give up reading texts (90%), sending texts (95%), and social media (99%) while driving. However, they were not willing to give up navigation (59%) and music applications (43%). Those who engaged in high-frequency texting while driving were more likely to say that they were not willing to give up navigation applications (73 vs. 44%, P <.001), music applications (54 vs. 32%, P <.001), and reading texts (15 vs. 4%, P =.029). Overall, the following strategies where rated as likely to be very effective for reducing texting while driving: gain-framed financial incentives (75%), loss-framed financial incentives (63%), group-based financial incentives (58%), insurance discounts (53%), automatic phone locking while driving (54%), e-mail notifications to parents (47%), automated responses to incoming texts (42%), peer concern (18%), and parental concern (15%). Those who engaged in high-frequency texting while driving were less likely to say that following strategies would be very effective: automated responses to incoming texts (33 vs. 53%, P =.016), peer concern (9 vs. 29%, P =.002), and parental concern (9 vs. 22%, P =.025). The strongest perceived benefit of cellphone blocking apps was decreasing distraction (86%). The predominant reason for not wanting to use this technology was not wanting parents to monitor their behavior (60%).

CONCLUSIONS

Promising strategies for increasing acceptance of cellphone blocking technology among teen drivers include automated screen locking and permitting hands-free navigation and music combined with behavioral economic incentives to sustain engagement.

Passive Assessment of Routine Driving with Unobtrusive Sensors: A New Approach for Identifying and Monitoring Functional Level in Normal Aging and Mild Cognitive Impairment

BACKGROUND

Driving is a key functional activity for many older adults, and changes in routine driving may be associated with emerging cognitive decline due to early neurodegenerative disease. Current methods for assessing driving such as self-report are inadequate for identifying and monitoring subtle changes in driving patterns that may be the earliest signals of functional change in developing mild cognitive impairment (MCI).

OBJECTIVE

This proof of concept study aimed to establish the feasibility of continuous driving monitoring in a sample of cognitively normal and MCI older adults for an average of 206 days using an unobtrusive driving sensor and demonstrate that derived sensor-based driving metrics could effectively discriminate between MCI and cognitively intact groups.

METHODS

Novel objective driving measures derived from 6 months of routine driving monitoring were examined in older adults with intact cognition (n = 21) and MCI (n = 7) who were enrolled in the Oregon Center for Aging and Technology (ORCATECH) longitudinal assessment program.

RESULTS

Unobtrusive continuous monitoring of older adults' routine driving using a driving sensor was feasible and well accepted. MCI participants drove fewer miles and spent less time on the highway per day than cognitively intact participants. MCI drivers showed less day-to-day fluctuations in their driving habits than cognitively intact drivers.

CONCLUSION

Sensor-based driving measures are objective, unobtrusive, and can be assessed every time a person drives his or her vehicle to identify clinically meaningful changes in daily driving. This novel methodology has the potential to be useful for the early detection and monitoring of changes in daily functioning within individuals.

Comparison of older and younger novice driver crash rates: Informing the need for extended Graduated Driver Licensing restrictions

BACKGROUND

Few previous studies have directly compared crash rates of older and younger novice drivers. To inform discussion about whether Graduated Driver Licensing (GDL) policies that are applied in the US for younger novice drivers should be applied to older novice drivers, we conducted a longitudinal study to examine overall, nighttime, and multiple passenger crash rates over the initial four years of licensure differ for novice drivers licensed at different ages.

METHODS

Using data from the New Jersey Traffic Safety Outcomes (NJ-TSO) data warehouse, we selected all NJ drivers who obtained their initial intermediate driver's license from 2006 through 2014 and had at least one month of follow-up from the date of licensure to study end or death (n=1,034,835). Novice drivers were grouped based on age at licensure: age 17; 18-20; 21-24; and 25 or older. We estimated monthly rates for overall crashes (per 10,000 licensed drivers) as well as: late night crashes (11:01 p.m.-4:59 a.m.); early night crashes (9:00 p.m.-11:00 p.m.); and multiple passenger crashes (two or more passengers). Average monthly rates were calculated for specific relevant time periods and Poisson regression models were used to compare rates: (1) between novice driver groups with the same time since licensure; (2) over the first 48 months of licensure within each novice driver group; and (3) between same-aged 21-year-old drivers with varying lengths of licensure.

RESULTS

Although initial (three months post-licensure) overall crash rates of novice NJ drivers age 21 and older were higher than rates of same-aged experienced drivers, they were substantially lower than initial rates for 17- to 20-year-old novice drivers, who are licensed under GDL policies. Moreover, older novice drivers experience much less steep crash reductions over the first year of licensure than younger novice drivers. Nighttime crash rates among the 21- to 24-year old and aged 25 and older novice driver groups were stable over the first year of licensure. For novice drivers under age 21, early night crash rates declined rapidly over the course of licensure, while changes in late night crashes were much smaller. First-year multiple passenger crash rates were highest for drivers licensed at age 18-20, and novice driver groups experienced varying amounts of reduction in multiple passenger crashes over time.

CONCLUSIONS

Study findings support NJ's current GDL policies for 17- to 20-year-old novice drivers and the potential for added benefits from beginning the nighttime restriction at 9:00 p.m. Conversely, there was a lack of compelling evidence for additional policies for drivers licensed at age 21-24 and no evidence to indicate a need for additional GDL policies for NJ novices aged 25 years and older.

Designing feedback to mitigate teen distracted driving: A social norms approach

OBJECTIVE

The purpose of this research is to investigate teens' perceived social norms and whether providing normative information can reduce distracted driving behaviors among them.

BACKGROUND

Parents are among the most important social referents for teens; they have significant influences on teens' driving behaviors, including distracted driving which significantly contributes to teens' crash risks. Social norms interventions have been successfully applied in various domains including driving; however, this approach is yet to be explored for mitigating driver distraction among teens.

METHOD

Forty teens completed a driving simulator experiment while performing a self-paced visual-manual secondary task in four between-subject conditions: a) social norms feedback that provided a report at the end of each drive on teens' distracted driving behavior, comparing their distraction engagement to their parent's, b) post-drive feedback that provided just the report on teens' distracted driving behavior without information on their parents, c) real-time feedback in the form of auditory warnings based on eyes of road-time, and d) no feedback as control. Questionnaires were administered to collect data on these teens' and their parents' self-reported engagement in driver distractions and the associated social norms.

RESULTS

Social norms and real-time feedback conditions resulted in significantly smaller average off-road glance duration, rate of long (>2s) off-road glances, and standard deviation of lane position compared to no feedback. Further, social norms feedback decreased brake response time and percentage of time not looking at the road compared to no feedback. No major effect was observed for post-drive feedback. Questionnaire results suggest that teens appeared to overestimate parental norms, but no effect of feedback was found on their perceptions.

CONCLUSION

Feedback systems that leverage social norms can help mitigate driver distraction among teens. Overall, both social norms and real-time feedback induced positive driving behaviors, with social norms feedback outperforming real-time feedback.

Performance of basic kinematic thresholds in the identification of crash and near-crash events within naturalistic driving data

Understanding causal factors for traffic safety-critical events (e.g., crashes and near-crashes) is an important step in reducing their frequency and severity. Naturalistic driving data offers unparalleled insight into these factors, but requires identification of situations where crashes are present within large volumes of data. Sensitivity and specificity of these identification approaches are key to minimizing the resources required to validate candidate crash events. This investigation used data from the Second Strategic Highway Research Program Naturalistic Driving Study (SHRP 2 NDS) and the Canada Naturalistic Driving Study (CNDS) to develop and validate different kinematic thresholds that can be used to detect crash events. Results indicate that the sensitivity of many of these approaches can be quite low, but can be improved by selecting particular threshold levels based on detection performance. Additional improvements in these approaches are possible, and may involve leveraging combinations of different detection approaches, including advanced statistical techniques and artificial intelligence approaches, additional parameter modifications, and automation of validation processes.

Video Feedback Intervention to Enhance the Safety of Older Drivers With Cognitive Impairment

OBJECTIVE

To demonstrate that g-force technology can be used to help older adults with cognitive impairment improve their driving safety as part of an in-car video feedback intervention.

METHOD

Unsafe driving events triggered g-forces leading to capture of video clips. The program included 3 mo of monitoring without intervention, 3 mo of intervention (weekly written progress reports, a DVD of unsafe driving events, and weekly telephone contacts), and 3 mo of postintervention monitoring.

RESULTS

Mean total unsafe driving events per 1,000 miles were reduced from baseline by 38% for 9 of 12 participants during the intervention and by 55% for 7 participants during postintervention monitoring. Mean total unsafe driving severity scores per 1,000 miles were reduced from baseline by 43% during the intervention and by 56% during postintervention monitoring.

CONCLUSION

Preliminary results suggest that driving safety among older drivers with cognitive impairment can be improved using a behavior modification approach aimed at problem behaviors detected in their natural driving environment.

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

PROBLEM

Roadway incidents are the leading cause of work-related death in the United States.

METHODS

The objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices.

RESULTS

Risky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj=0.61 95% CI 0.43-0.86; Holm-adjusted p=0.035) and the control group (ORadj=0.52 95% CI 0.33-0.82; Holm-adjusted p=0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj=0.86 95% CI 0.51-1.43; Holm-adjusted p>0.05).

CONCLUSIONS

The largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights.

PRACTICAL APPLICATIONS

Supervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed.

Foot placement during error and pedal applications in naturalistic driving

Data from a naturalistic driving study was used to examine foot placement during routine foot pedal movements and possible pedal misapplications. The study included four weeks of observations from 30 drivers, where pedal responses were recorded and categorized. The foot movements associated with pedal misapplications and errors were the focus of the analyses. A random forest algorithm was used to predict the pedal application types based the video observations, foot placements, drivers' characteristics, drivers' cognitive function levels and anthropometric measurements. A repeated multinomial logit model was then used to estimate the likelihood of the foot placement given various driver characteristics and driving scenarios. The findings showed that prior foot location, the drivers' seat position, and the drive sequence were all associated with incorrect foot placement during an event. The study showed that there is a potential to develop a driver assistance system that can reduce the likelihood of a pedal error.

Learning to Drive Safely: Reasonable Expectations and Future Directions for the Learner Period

The young driver problem is typified by high crash rates early in licensure that decline with experience, but are higher initially and decline more slowly for the youngest novices. Despite considerable effort, only Graduated Driver Licensing System (GDLS) policies have been shown to improve novice young driver safety outcomes. Unfortunately, GDLS policies are mostly limited to countries with a relatively young licensure age. Meanwhile, it is not entirely clear how GDLS and other young driver transportation safety efforts, including driver training and testing, supervised practice and parental management of young drivers, can best be configured. Notably, professional training can foster improvements in vehicle management skills that are necessary, but do not assure safe driving behavior. Substantial recent research has focused on training methods to improve driving skills, but the safety benefits of driver training have not been established. While prolonged practice driving increases experience and provides supervisors with opportunities to prepare novices for independent driving, the transition to independent driving challenges novices to employ, on their own, poorly-mastered skills under unfamiliar and complex driving conditions. Licensing policies and parental management practices can limit the complexity of driving conditions while novices gain needed driving experience. Nevertheless, an emerging body of literature suggests that future advances in training and supervision of novice teenage drivers might best focus on the translation of learning to independent driving by fostering safe driving attitudes and norms, judgment, dedicated attention to driving tasks and self-control at the wheel.

Supporting Safety in the Older Adult Driver: A Public Health Nursing Opportunity

The effective operation of a motor vehicle encompasses a wide range of cognitive processes that can decline due to age-related changes in neuroanatomical structures and cognitive functionality. The increasing number of older adult drivers in our rapidly aging population heightens the public safety concern of unsafe driving associated with these changes. Nurses caring for older adults in public health settings are well positioned to make a difference in the management of older patients who may be at risk of endangering themselves or others on the roadways. In this article, information is provided for increasing nurses' awareness of the cognitive factors inhibiting effective driving, recognizing older adults who may be at risk for unsafe driving, and facilitating a patient/family to seek a driving evaluation.

Testing a structural model of young driver willingness to uptake Smartphone Driver Support Systems

There is growing interest in the potential value of using phone applications that can monitor driver behaviour (Smartphone Driver Support Systems, 'SDSSs') in mitigating risky driving by young people. However, their value in this regard will only be realised if young people are willing to use this technology. This paper reports the findings of a study in which a novel structural model of willingness to use SDSSs was tested. Grounded in the driver monitoring and Technology Acceptance (TA) research literature, the model incorporates the perceived risks and gains associated with potential SDSS usage and additional social cognitive factors, including perceived usability and social influences. A total of 333 smartphone users, aged 18-24, with full Irish driving licenses completed an online questionnaire examining willingness or Behavioural Intention (BI) to uptake a SDSS. Following exploratory and confirmatory factor analyses, structural equation modelling indicated that perceived gains and social influence factors had significant direct effects on BI. Perceived risks and social influence also had significant indirect effects on BI, as mediated by perceived gains. Overall, this model accounted for 72.5% of the variance in willingness to uptake SDSSs. Multi-group structural models highlighted invariance of effects across gender, high and low risk drivers, and those likely or unlikely to adopt novel phone app technologies. These findings have implications for our understanding of the willingness of young drivers to adopt and use SDSSs, and highlight potential factors that could be targeted in behavioural change interventions seeking to improve usage rates.

Effectiveness of Parent-Focused Interventions to Increase Teen Driver Safety: A Critical Review

PURPOSE

We critically reviewed recent parent-directed teen driving interventions to summarize their success in meeting stated goals; identify promising intervention components and knowledge gaps; aid in the selection, adaptation, and dissemination of effective interventions; and guide future research efforts.

METHODS

We focused on interventions that included a direct parent component, explicitly stated outcomes related to the teen and/or their parents, were evaluated for parent or teen outcomes, targeted drivers younger than the age of 21 years, and had at least one evaluation study published since 1990 and in English. We conducted a comprehensive systematic search of 26 online databases between November 2013 and January 2014 and identified 34 articles representing 18 interventions.

RESULTS

Several interventions-in particular, those that had an active engagement component, incorporated an in-vehicle data recorder system, and had a strong conceptual approach-show promise in improving parental supervisory behaviors during the learner and early independent phases, increasing teen driver skill acquisition, and reducing teens' risky driving behaviors.

CONCLUSIONS

We identify essential characteristics of effective parent-involved teen driving interventions and their evaluation studies, propose a comprehensive and multitiered approach to intervention, and discuss several research areas and overarching issues for consideration.

The Effect of Secondary Task Engagement on Adolescents' Driving Performance and Crash Risk

PURPOSE

The purpose of this review was to synthesize the evidence of the effects of secondary task engagement on novice adolescent's driving performance and crash risk.

METHODS

Searches of multiple databases were conducted using search terms related to secondary task engagement and teenage drivers. Articles were selected for inclusion if they were: written in English, an empirical study assessing the impact of secondary task engagement on driving, and included study participants who were licensed drivers between the ages of 14 and 17 years (if research was conducted in the United States) or within 18 months licensure in other countries. Thirty-eight abstracts were reviewed.

RESULTS

Fifteen studies met the inclusion criteria. Most studies examined the effects of electronic device use as the secondary task. Effects were assessed using crash databases, simulator, instrumented vehicle, and naturalistic driving studies. Texting resulted in increased lane deviations and eyes off road time in simulated driving, whereas talking on a cell phone had little effect. Naturalistic studies, which use vehicle instrumentation to measure actual driving, found secondary tasks that required drivers to look away from the forward roadway also increased the risk of crashes and near-crashes for young novice drivers, whereas tasks that did not require eyes to be off the forward roadway (e.g., talking on cell phone) had no effect on crash risk.

CONCLUSIONS

Methodological differences in the definition and measurement of driving performance make it difficult to directly compare findings, even among the limited number of studies conducted. Despite this, results suggest that secondary tasks degrade driving performance and increase risk only when they require drivers to look away from the forward roadway. Future research needs to focus more explicitly on the ways in which secondary task engagement influences drivers' behavior (e.g., interfering with information acquisition or manual control of the vehicle). This, along with the use of standard measures across studies, would build a more useful body of literature on this topic.

Parents' and peers' contribution to risky driving of male teen drivers

The current study joins efforts devoted to understanding the associations of parents' personality, attitude, and behavior, and to evaluating the added contribution of peers to the driving behavior of young drivers during their solo driving. The study combines data gathered using in-vehicle data recorders from actual driving of parents and their male teen driver with data collected from self-report questionnaires completed by the young drivers. The sample consists of 121 families, who participated in the study for 12 months, beginning with the licensure of the teen driver. The current examination concentrates on the last 3 months of this first year of driving. The experimental design was based on a random control assignment into three treatment groups (with different forms of feedback) and a control group (with no feedback). Findings indicate that the parents' (especially the fathers') sensation seeking, anxiety, and aggression, as well as their risky driving events rate were positively associated with higher risky driving of the young driver. In addition, parents' involvement in the intervention, either by feedback or by training, led to lower risky driving events rate of young drivers compared to the control group. Finally, higher cohesion and adaptability mitigated parents' model for risky driving, and peers norms' of risky driving were associated with higher risk by the teen drivers. We conclude by claiming that there is an unequivocal need to look at a full and complex set of antecedents in parents' personality, attitudes, and behavior, together with the contribution of peers to the young drivers' reckless driving, and address the practical implications for road safety.

The contribution of parents' driving behavior, family climate for road safety, and parent-targeted intervention to young male driving behavior

One of the prominent issues in contemporary research on young drivers deals with the mechanisms underlying parents' influences on their offspring's driving behavior. The present study combines two sets of data: the first gathered from in-vehicle data recorders tracking the driving of parents and their teenage sons, and the second derived from self-report questionnaires completed by the young drivers. The aim was to evaluate the contribution of parents' driving behavior, participation in a parent-targeted intervention, and the teen drivers' perception of the family climate for road safety, to the driving behavior of young drivers during solo driving. The data was collected over the course of 12 months, beginning with the licensure of the teen driver, and examined a sample of 166 families who were randomly assigned to one of three intervention groups (receiving different forms of feedback) or a control group (with no feedback). Findings indicate that young male drivers' risky driving events rate was positively associated with that of their parents. In addition, any type of intervention led to a lower rate of risky driving events among young drivers compared to the control group. Finally, a higher perception of parents as not committed to safety and lower perceived parental monitoring were related to a higher risky driving events rate among young drivers. The results highlight the need to consider a complex set of antecedents in parents' attitudes and behavior, as well as the family's safety atmosphere, in order to better understand young drivers' risky driving. The practical implications refer to the effective use of the family as a lever in the attempt to promote safety awareness among young drivers.

Can providing feedback on driving behavior and training on parental vigilant care affect male teen drivers and their parents?

This study focuses on investigating the driving behavior of young novice male drivers during the first year of driving (three months of accompanied driving and the following nine months of solo driving). The study's objective is to examine the potential of various feedback forms on driving to affect young drivers' behavior and to mitigate the transition from accompanied to solo driving. The study examines also the utility of providing parents with guidance on how to exercise vigilant care regarding their teens' driving. Driving behavior was evaluated using data collected by In-Vehicle Data Recorders (IVDR), which document events of extreme g-forces measured in the vehicles. IVDR systems were installed in 242 cars of the families of young male drivers, however, only 217 families of young drivers aged 17-22 (M=17.5; SD=0.8) completed the one year period. The families were randomly allocated into 4 groups: (1) Family feedback: In which all the members of the family were exposed to feedback on their own driving and on that of the other family members; (2) Parental training: in which in addition to the family feedback, parents received personal guidance on ways to enhance vigilant care regarding their sons' driving; (3) Individual feedback: In which family members received feedback only on their own driving behavior (and were not exposed to the data on other family members); (4) CONTROL: Group that received no feedback at all. The feedback was provided to the different groups starting from the solo period, thus, the feedback was not provided during the supervised period. The data collected by the IVDRs was first analyzed using analysis of variance in order to compare the groups with respect to their monthly event rates. Events' rates are defined as the number of events in a trip divided by its duration. This was followed by the development and estimation of random effect negative binomial models that explain the monthly event rates of young drivers and their parents. The study showed that: (1) the Parental training group recorded significantly lower events rates (-29%) compared to the CONTROL group during the solo period; (2) although directed mainly at the novice drivers, the intervention positively affected also the behavior of parents, with both fathers and mothers in the Parental training group improving their driving (by -23% for both fathers and mothers) and mothers improving it also in the Family feedback group (by -30%). Thus, the intervention has broader impact effect beside the targeted population. It can be concluded that providing feedback on driving behavior and parental training in vigilant care significantly improves the driving behavior of young novice male drivers. Future research directions could include applying the intervention to a broader population, with larger diversity with respect to their driving records, culture, and behaviors. The challenge is to reach wide dissemination of IVDR for young drivers accompanied by parents' involvement, and to find the suitable incentives for its sustainability.

Higher crash and near-crash rates in teenaged drivers with lower cortisol response: an 18-month longitudinal, naturalistic study

IMPORTANCE

Road traffic crashes are one of the leading causes of injury and death among teenagers worldwide. Better understanding of the individual pathways to driving risk may lead to better-targeted intervention in this vulnerable group.

OBJECTIVE

To examine the relationship between cortisol, a neurobiological marker of stress regulation linked to risky behavior, and driving risk.

DESIGN, SETTING, AND PARTICIPANTS

The Naturalistic Teenage Driving Study was designed to continuously monitor the driving behavior of teenagers by instrumenting vehicles with kinematic sensors, cameras, and a global positioning system. During 2006-2008, a community sample of 42 newly licensed 16-year-old volunteer participants in the United States was recruited and driving behavior monitored. It was hypothesized in teenagers that higher cortisol response to stress is associated with (1) lower crash and near-crash (CNC) rates during their first 18 months of licensure and (2) faster reduction in CNC rates over time.

MAIN OUTCOMES AND MEASURES

Participants' cortisol response during a stress-inducing task was assessed at baseline, followed by measurement of their involvement in CNCs and driving exposure during their first 18 months of licensure. Mixed-effect Poisson longitudinal regression models were used to examine the association between baseline cortisol response and CNC rates during the follow-up period.

RESULTS

Participants with a higher baseline cortisol response had lower CNC rates during the follow-up period (exponential of the regression coefficient, 0.93; 95% CI, 0.88-0.98) and faster decrease in CNC rates over time (exponential of the regression coefficient, 0.98; 95%, CI, 0.96-0.99).

CONCLUSIONS AND RELEVANCE

Cortisol is a neurobiological marker associated with teenaged-driving risk. As in other problem-behavior fields, identification of an objective marker of teenaged-driving risk promises the development of more personalized intervention approaches.

Adolescence, attention allocation, and driving safety

Motor vehicle crashes are the leading source of morbidity and mortality in adolescents in the United States and the developed world. Inadequate allocation of attention to the driving task and to driving hazards are important sources of adolescent crashes. We review major explanations for these attention failures with particular focus on the roles that brain immaturity and lack of driving experience play in causing attention problems. The review suggests that the potential for overcoming inexperience and immaturity with training to improve attention to both the driving task and hazards is substantial. Nevertheless, there are large individual differences in both attentional abilities and risky driving tendencies that pose challenges to novice driver policies. Research that can provide evidence-based direction for such policies is urgently needed.

Distracted driver behaviors and distracting conditions among adolescent drivers: findings from a naturalistic driving study

PURPOSE

The proliferation of new communication technologies and capabilities has prompted concern about driving safety. This concern is particularly acute for inexperienced adolescent drivers. In addition to being early adopters of technology, many adolescents have not achieved the degree of automaticity in driving that characterizes experienced adults. Consequently, distractions may be more problematic in this group. Yet little is known about the nature or prevalence of distracted driving behaviors or distracting conditions among adolescent drivers.

METHOD

Vehicles of 52 high-school age drivers (N=38 beginners and N=14 more experienced) were equipped for 6 months with unobtrusive event-triggered data recorders that obtain 20-second clips of video, audio, and vehicle kinematic information when triggered. A low recording trigger threshold was set to obtain a sample of essentially random driving segments along with those indicating rough driving behaviors.

RESULTS

Electronic device use (6.7%) was the most common single type of distracted behavior, followed by adjusting vehicle controls (6.2%) and grooming (3.8%). Most distracted driver behaviors were less frequent when passengers were present. However, loud conversation and horseplay were quite common in the presence of multiple peer passengers. These conditions were associated with looking away from the road, the occurrence of serious events, and, to a lesser extent, rough driving (high g-force events).

CONCLUSIONS

Common assumptions about adolescent driver distraction are only partially borne out by in-vehicle measurement. The association of passengers with distraction appears more complex than previously realized. The relationship between distractions and serious events differed from the association with rough driving.

Special considerations in distracted driving with teens

Novice teen drivers have long been known to have an increased risk of crashing, as well as increased tendencies toward unsafe and risky driving behaviors. Teens are unique as drivers for several reasons, many of which have implications specifically in the area of distracted driving. This paper reviews several of these features, including the widespread prevalence of mobile device use by teens, their lack of driving experience, the influence of peer passengers as a source of distraction, the role of parents in influencing teens' attitudes and behaviors relevant to distracted driving and the impact of laws designed to prevent mobile device use by teen drivers. Recommendations for future research include understanding how engagement in a variety of secondary tasks by teen drivers affects their driving performance or crash risk; understanding the respective roles of parents, peers and technology in influencing teen driver behavior; and evaluating the impact of public policy on mitigating teen crash risk related to driver distraction.

Impaired-driving prevalence among US high school students: associations with substance use and risky driving behaviors

OBJECTIVES

We examined the prevalence of impaired driving among US high school students and associations with substance use and risky driving behavior.

METHODS

We assessed driving while alcohol or drug impaired (DWI) and riding with alcohol- or drug-impaired drivers (RWI) in a nationally representative sample of 11th-grade US high school students (n = 2431). We examined associations with drinking and binge drinking, illicit drug use, risky driving, and demographic factors using multivariate sequential logistic regression analysis.

RESULTS

Thirteen percent of 11th-grade students reported DWI at least 1 of the past 30 days, and 24% reported RWI at least once in the past year. Risky driving was positively associated with DWI (odds ratio [OR] = 1.25; P < .001) and RWI (OR = 1.09; P < .05), controlling for binge drinking (DWI: OR = 3.17; P < .01; RWI: OR = 6.12; P < .001) and illicit drug use (DWI: OR = 5.91; P < .001; RWI: OR = 2.29; P = .05). DWI was higher for adolescents who drove after midnight (OR = 15.7), drove while sleepy or drowsy (OR = 8.6), read text messages (OR = 11.8), sent text messages (OR = 5.0), and made cell phone calls (OR = 3.2) while driving.

CONCLUSIONS

Our findings suggest the need for comprehensive approaches to the prevention of DWI, RWI, and other risky driving behavior.

Vehicle-based studies of driving in the real world: the hard truth?

Real-world studies of driving behaviour and safety have face validity and have the distinct advantage of focussing on driving in its natural habitat. But their very naturalism can lead to problems with confounds and with noise in the data. This paper reviews the three major categories of on-road studies - controlled observation, field operational tests and naturalistic driving studies - and discusses the major applications of each study type. It also assesses some of the methodological issues that arise in one or more category of study.

The effect on teenage risky driving of feedback from a safety monitoring system: a randomized controlled trial

PURPOSE

Teenage risky driving may be due to teenagers not knowing what is risky, preferring risk, or the lack of consequences. Elevated gravitational-force (g-force) events, caused mainly by hard braking and sharp turns, provide a valid measure of risky driving and are the target of interventions using in-vehicle data recording and feedback devices. The effect of two forms of feedback about risky driving events to teenagers only or to teenagers and their parents was tested in a randomized controlled trial.

METHODS

Ninety parent-teen dyads were randomized to one of two groups: (1) immediate feedback to teens (Lights Only); or (2) immediate feedback to teens plus family access to event videos and ranking of the teen relative to other teenage drivers (Lights Plus). Participants' vehicles were instrumented with data recording devices and events exceeding .5 g were assessed for 2 weeks of baseline and 13 weeks of feedback.

RESULTS

Growth curve analysis with random slopes yielded a significant decrease in event rates for the Lights Plus group (slope = -.11, p < .01), but no change for the Lights Only group (slope = .05, p = .67) across the 15 weeks. A large effect size of 1.67 favored the Lights Plus group.

CONCLUSIONS

Provision of feedback with possible consequences associated with parents being informed reduced risky driving, whereas immediate feedback only to teenagers did not.

Graduated driver licensing research, 2010-present

This is the latest in a series of reviews of research on graduated driver licensing (GDL) published in the Journal of Safety Research, covering the period January 1, 2010-June 1, 2012 and works in progress. The intent is to keep researchers and policy makers current regarding the existing state of knowledge about GDL, and to identify information gaps and areas where clarification of research findings are needed. The recent research indicates that we continue to learn about ways to extend GDL benefits, but there remain important questions in need of further inquiry. In terms of impact on industry, the review provides guidance for the future GDL research agenda.

The effectiveness of a training method using self-modeling webcam photos for reducing musculoskeletal risk among office workers using computers

An intervention study was conducted to examine the effectiveness of an innovative self-modeling photo-training method for reducing musculoskeletal risk among office workers using computers. Sixty workers were randomly assigned to either: 1) a control group; 2) an office training group that received personal, ergonomic training and workstation adjustments or 3) a photo-training group that received both office training and an automatic frequent-feedback system that displayed on the computer screen a photo of the worker's current sitting posture together with the correct posture photo taken earlier during office training. Musculoskeletal risk was evaluated using the Rapid Upper Limb Assessment (RULA) method before, during and after the six weeks intervention. Both training methods provided effective short-term posture improvement; however, sustained improvement was only attained with the photo-training method. Both interventions had a greater effect on older workers and on workers suffering more musculoskeletal pain. The photo-training method had a greater positive effect on women than on men.

The effect of passengers and risk-taking friends on risky driving and crashes/near crashes among novice teenagers

PURPOSE

The high crash rates of novice teenage drivers are thought to be caused by inexperience and risky driving behavior, exacerbated by passengers, driving at night, and other complex driving conditions. This study examined factors associated with crash/near crash and risky driving rates among novice teenagers, including driving at night versus day, passenger presence and characteristics, and driver psychosocial factors.

METHOD

The vehicles of 42 newly licensed teenage drivers were equipped with recording systems that collected data on driving performance and occupant characteristics during their first 18 months of licensure. Survey data were collected at four measurement times. Poisson regression models with random effects were used to analyze crash/near crash and elevated gravitational force event rates (i.e., risky driving); incident rate ratios measured associations with covariates.

RESULTS

Crash/near crash rates among novice teenagers were 75% lower in the presence of adult passengers and 96% higher among those teenagers with risky friends. Teenage risky driving was 67% lower with adult passengers, 18% lower with teenage passengers; 20% lower during early night than day; and 109% higher among teens with relatively more risky friends.

CONCLUSIONS

The low rate of risky driving in the presence of adult passengers suggests that teens can drive in a less risky manner. The higher rate of risky driving among those with risky friends suggests that risky driving may be socially influenced.

Crash and risky driving involvement among novice adolescent drivers and their parents

OBJECTIVES

We compared rates of risky driving among novice adolescent and adult drivers over the first 18 months of adolescents' licensure.

METHODS

Data-recording systems installed in participants' vehicles provided information on driving performance of 42 newly licensed adolescent drivers and their parents. We analyzed crashes and near crashes and elevated g-force event rates by Poisson regression with random effects.

RESULTS

During the study period, adolescents were involved in 279 crashes or near crashes (1 involving injury); parents had 34 such accidents. The incidence rate ratio (IRR) comparing adolescent and parent crash and near-crash rates was 3.91. Among adolescent drivers, elevated rates of g-force events correlated with crashes and near crashes (r = 0.60; P < .001). The IRR comparing incident rates of risky driving among adolescents and parents was 5.08. Adolescents' rates of crashes and near crashes declined with time (with a significant uptick in the last quarter), but elevated g-force event rates did not decline.

CONCLUSIONS

Elevated g-force events among adolescents may have contributed to crash and near-crash rates that remained much higher than adult levels after 18 months of driving.

Impaired driving from medical conditions: a 70-year-old man trying to decide if he should continue driving

Some medical disorders can impair performance, increasing the risk of driving safety errors that can lead to vehicle crashes. The causal pathway often involves a concatenation of factors or events, some of which can be prevented or controlled. Effective interventions can operate before, during, or after a crash occurs at the levels of driver capacity, vehicle and road design, and public policy. A variety of systemic, neurological, psychiatric, and developmental disorders put drivers at potential increased risk of a car crash in the short or long term. Medical diagnosis and age alone are usually insufficient criteria for determining fitness to drive. Strategies are needed for determining what types and levels of reduced function provide a threshold for disqualification in drivers with medical disorders. Evidence of decreased mileage, self-restriction to driving in certain situations, collisions, moving violations, aggressive driving, sleepiness, alcohol abuse, metabolic disorders, and multiple medications may trigger considerations of driver safety. A general framework for evaluating driver fitness relies on a functional evaluation of multiple domains (cognitive, motor, perceptual, and psychiatric) that are important for safe driving and can be applied across many disorders, including conditions that have rarely been studied with respect to driving, and in patients with multiple conditions and medications. Neurocognitive tests, driving simulation, and road tests provide complementary sources of evidence to evaluate driver safety. No single test is sufficient to determine who should drive and who should not.

"The little squealer" or "the virtual guardian angel"? Young drivers' and their parents' perspective on using a driver monitoring technology and its implications for parent-young driver communication

INTRODUCTION

In-vehicle driving monitoring technologies have the potential to enable young drivers to learn from self-assessment. However, their use is largely dependent on parental involvement.

METHOD

A total of 79 interviews were conducted with young drivers and parents regarding this technology and its use. Most had the experience of having an in-vehicle data recorder installed in the vehicle driven by the young drivers. Parents and the young drivers expressed both appreciation as well as reservations about its potential as a means to enhance the driving safety of young drivers.

RESULTS

A surprising finding was that some parents did not check the feedback and said they relied on the young driver to do so. Main concerns related to privacy, parent-young driver relationship, self-esteem and confidence, constructive use of the feedback data, and the limitations of the documentation that can be done by the technology.

CONCLUSIONS

Providing parents and young drivers with a support system and tools to discuss and utilize the feedback are underscored. Challenges include addressing the invasion of young drivers' privacy and gender differences, and using the monitoring-capacity of the technology to enhance safe driving practices. Implications for programs to enhance communication and a dialogical approach between parents and young drivers are discussed.