Longitudinal study of adverse driving outcomes among adolescents with ADHD

多动症青少年不良驾驶结果的纵向研究

• 批准号: 8931012
• 负责人: Allison Elizabeth Curry
• 金额: $ 40.91万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-22 至 2017-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8931012
• 关键词: Acute; Address; Adolescence; Adolescent; Adolescent and Young Adult; Affect; Age; Anxiety Disorders; Attention deficit hyperactivity disorder; Autistic Disorder; Automobile Driving; Behavioral; Brain Concussion; Cause of Death; Child; Childhood; Clinic; Data Sources; Databases; Development; Devices; Diagnosis; Disease; Disruptive Behavior Disorder; Electronic Health Record; Electronics; Ensure; Event; Exposure to; Foundations; Future; Gender; General Population; Goals; Hand; Health; High Prevalence; Hyperactive behavior; Impulsivity; Intervention; Knowledge; Learning; Length; Licensing; Licensure; Link; Literature; Long-Term Effects; Longitudinal Studies; Medical; Medical Records; Mental Health; Methods; Mood Disorders; New Jersey; Observational Study; Outcome; Parents; Patients; Pediatric Hospitals; Pharmaceutical Preparations; Phase; Philadelphia; Police; Policies; Population; Prevalence; Primary Health Care; Process; Recording of previous events; Relative (related person); Reporting; Research; Risk; Role; Safety; Sampling; Seat Belts; Sleep; Specificity; Speed; Symptoms; System; Teenagers; Time; Vehicle crash; Young driver; base; cohort; community setting; design; disability; distraction; driving behavior; evidence base; experience; inattention; male; novel; older driver; trafficking; young adult

DESCRIPTION (provided by applicant): The proposed study will be the largest and first truly longitudinal study focused on examining the risk of adverse driving outcomes throughout adolescence and young adulthood (age 16-25) among a general population of children diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). ADHD is one of the most common childhood disorders. For the majority of affected children, the defining symptoms of ADHD- inattention, hyperactivity, and impulsivity-persist into adolescence, a time at which many likely get licensed to drive. Motor vehicle crashes are the leading cause of death and disability among adolescents with inattention/distraction and unsafe driving behaviors major causes-creating the potential for heightened adverse health risk for adolescents with ADHD. Small studies among more severely-affected adolescents and young adults suggest an increased risk of adverse driving outcomes. However, these studies have significant methodological limitations and were mostly conducted prior to the year 2000, when distractions from electronic devices were less prevalent and before Graduated Driver Licensing systems-which restrict novice young drivers' exposure to hazardous conditions-were widely implemented. We still know little about when adolescents with ADHD get licensed, whether they engage in unsafe driving behaviors (e.g., speeding, reckless driving, seat belt nonuse) more often than other adolescents, and the specific mechanisms by which ADHD influences crash risk. This crucial study will provide the evidence base needed to inform medical, behavioral, technological, and policy interventions targeted to novice drivers with ADHD. The study aims to: compare licensing trajectories of adolescents with and without ADHD; examine the effect of ADHD on the risk of citations and crashes, and further determine the role of inattention/distraction and unsafe driving behaviors in these crashes; and determine whether the effect of ADHD varies by gender, age, driving experience, and diagnosis with a comorbid mental health condition (i.e., disruptive behavior, anxiety, or mood disorder). Further, it will be the first observational study to examine the association between long-term ADHD medication use and driving outcomes among adolescents with ADHD. Two unique and rich data sources will be combined: (1) electronic health record information for over 1,600 children with ADHD and 10,000 children without ADHD who were born between 1987-1995 and who were patients of The Children's Hospital of Philadelphia's New Jersey (NJ) primary care network; and (2) a linked database that contains the full licensing, citation, and crash history of every NJ driver through December 2013. The study will support our long-term goal of developing interventions that tailor the licensing and learning-to-drive process to, and ensure safe driving behaviors among, teens with ADHD. It will also be the first study to link children's medical records to their future outcomes as young drivers-a methodological advancement in the field of young driver research that will provide a novel method to investigate the effect of other medical conditions/events on traffic outcomes.

描述（由申请人提供）：拟议的研究将是一项最大的，首次真正的纵向研究，重点是研究整个青春期和年轻成年期不良驾驶结果的风险（16-25岁），其中一般诊断为注意力缺陷/多动障碍的儿童（ADHD）。多动症是最常见的儿童疾病之一。对于大多数受影响的儿童来说，多动症不集中的症状，多动症和冲动性的症状进入青春期，这是许多人可能被许可驾驶的时期。汽车撞车是注意力不集中/分心和不安全驾驶行为的青少年死亡和残疾的主要原因，这是主要原因的原因，这可能会增加患有多动症青少年的不良健康风险。对受影响更严重的青少年和年轻人的小型研究表明，不良驾驶结果的风险增加。但是，这些研究具有重大的方法论局限性，并且主要是在2000年之前进行的，当时电子设备的分心较少，并且在毕业的驾驶许可系统之前，限制了新手年轻驾驶员对危险条件的暴露，并且在广泛实施的情况下。我们仍然对ADHD的青少年获得许可，他们是否比其他青少年更频繁地进行驾驶行为（例如，超速，鲁ck驾驶，不使用安全带）的驾驶行为以及ADHD会影响崩溃风险的特定机制。这项至关重要的研究将为针对ADHD的新手驱动因素提供信息，为医学，行为，技术和政策干预提供信息所需的证据基础。该研究的目的是：比较有或没有多动症的青少年的许可轨迹；检查多动症对引用和崩溃风险的影响，并进一步确定这些崩溃中注意力不集中/分心和不安全行为的作用；并确定ADHD的影响是否因性别，年龄，驾驶经验和诊断而变化，并具有合并症的心理健康状况（即颠覆性行为，焦虑或情绪障碍）。此外，这将是首次研究ADHD青少年的长期多动症药物使用与驱动结果之间的关联的观察性研究。将结合两个独特而丰富的数据来源：（1）1,600多名多动症儿童和10,000名没有多动症儿童的电子健康记录信息，他们出生于1987 - 1995年之间，并且是费城新泽西州儿童医院（NJ）初级保健网络的患者； （2）一个链接的数据库，其中包含每个NJ驱动程序的完整许可，引用和崩溃历史。该研究将支持我们的长期目标，即制定干预措施，以量身定制许可和学习驱动过程，并确保与ADHD的青少年之间的安全驾驶行为。这也将是将儿童病历与他们的未来结果联系起来的第一项研究，因为年轻的驾驶员在年轻驾驶员研究领域的方法论进步将提供一种新颖的方法来研究其他医疗状况/事件对交通结果的影响。