A Contemporary Look at Driver Training and Its Role In Reducing Crash Risk in Novice Adolescent Drivers.

对驾驶员培训及其在降低青少年新手驾驶员碰撞风险中的作用的当代看法。

• 批准号: 10582905
• 负责人: DANIEL ROMER
• 金额: $ 79.09万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-07 至 2027-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10582905
• 关键词: 18 year old; Address; Adolescent; Age; Area; Attention; Automobile Driving; California; Caring; Cause of Death; Cellular Phone; Certification; Clinic; Cognitive; Degree requirements; Detection; Development; Education; Educational Intervention; Effectiveness; Enrollment; Esthesia; Future; Goals; Hour; Impulsivity; Injury; Intervention; Laws; Licensing; Licensure; Maintenance; Measurement; Measures; Medical; Modernization; Monitor; Neurocognitive; Neuropsychology; Ohio; Outcome; Participant; Pennsylvania; Performance; Personality; Personality Traits; Phase; Philadelphia; Placebos; Policies; Preparation; Randomized, Controlled Trials; Recommendation; Research; Research Design; Resistance; Risk; Risk Behaviors; Risk Factors; Role; Rural; Safety; Sampling; Short-Term Memory; Site; Testing; Time; Training; Training and Education; Vehicle crash; Young driver; age effect; age related; arm; clinical practice; cognitive skill; design; driving behavior; driving skills; experience; hazard; improved; male; online delivery; point of care; preservation; recruit; response; risky driving; skill acquisition; skills; skills training; smartphone application; suburb; sustained attention; treatment as usual; virtual

Despite Graduated Driver Licensing (GDL), motor vehicle crashes remain a leading cause of death and injury for US adolescents. GDL typically applies to those <18 and restricts initial driving experience to lower risk conditions; however, these drivers <18 years enter licensure underprepared and have the highest crash rates. New evidence from our R21 showed an association between decreased crash rates and man- dated driver education and training in the context of GDL in Ohio, but few states require such training. In Ohio, which requires GDL and professional behind-the-wheel (BTW) training for licensure before 18 (those >18, exempt from GDL and training), those licensed <18 years demonstrate lower crash rates, higher licensing exam pass rates, and safer performance on a validated virtual driving assessment (VDA) than those licensed at 18. By contrast, Pennsylvania and most other states have no professional training requirements for young drivers, which can largely be attributed to the negative results of a randomized controlled trial (RCT) of pre- licensure training in DeKalb in 1983. Our Ohio results and major safety advances since DeKalb (GDL, stronger national driver training standards, and online training to address novice driver errors) moti- vated our proposed RCT of training (the 1st RCT in 3 decades). We propose a Phase III 3-arm RCT involv- ing 1000 adolescent novice drivers balanced by ages 16-18 years. With usual care in PA (GDL) as control, we will test 2 training interventions: Arm 2, ACCEL, an online training in hazard anticipation/response and atten- tion maintenance and Arm 3, 8 hours of state-of-the-art BTW training. We will examine 3 outcomes: (1) Smartphone-monitored driving from start of intervention period through 6 months post-licensure, (2) PA license exam result; and (3) VDA performance at licensure. Participants will be recruited from 5 Philadelphia-area practice sites (2 urban, 2 suburban, 1 rural) as part of routine adolescent care. All participants will undergo baseline assessment of driving performance (VDA) and a neurocognitive and personality battery. Aim 1: De- termine the effect of ACCEL or BTW training versus usual care on driving crash risk (e.g., rates of hard brak- ing) during the first 6 months post-licensure. Hypotheses: (1) Both ACCEL and BTW will reduce early licensure crash risk. (2) ACCEL will produce greater reduction in crash risk than BTW training because ACCEL targets skills that reduce crash risk. Aim 2: Determine the effect of ACCEL or BTW training versus usual care on skill acquisition. Hypotheses: (1) Both ACCEL and BTW will improve skill acquisition. (2) ACCEL will produce fewer errors on the VDA measure of skills than BTW; however, BTW may produce better license exam performance (e.g., parallel parking). Aim 3: Identify age-related risk factors for crashes that are resistant to training. Hypoth- eses: ACCEL and BTW will mitigate cognitive skills but will be less successful for impulse/personality differ- ences related to risky driving practices. The expected R01 results will directly inform policy and provide guid- ance for future clinical practice.

尽管毕业驾驶许可（GDL），但汽车撞车仍然是死亡的主要原因， 美国青少年受伤。 GDL通常适用于<18 风险条件；但是，这些驾驶员<18年的驾驶执照不足，撞车事故最高 费率。我们R21的新证据表明，撞车率降低与人体之间的关联 在俄亥俄州GDL的背景下，驾驶员的教育和培训过时，但很少有州需要这种培训。 在俄亥俄 > 18，免于GDL和培训），这些许可<18岁的崩溃率较低，许可较高 考试率率和经过验证的虚拟驾驶评估（VDA）的性能比获得许可 相比之下，第18岁，宾夕法尼亚州和其他大多数州没有针对年轻的专业培训要求 驱动因素很大程度上归因于预先进行的随机对照试验（RCT）的负面结果 自1983年在Dekalb举行的许可培训。自DeKalb以来，我们的俄亥俄州业绩和重大安全进展（GDL， 更强大的国家驾驶员培训标准和在线培训以解决新手驾驶错误） VED我们提议的培训RCT（三十年来的第一个RCT）。我们提出了III期3臂RCT的参与 1000名青少年新手驾驶员以16-18岁的年龄平衡。在PA（GDL）控制中通常的护理作为控制，我们 将测试2个培训干预措施：ARM 2，ACCEL，危险预期/响应的在线培训以及 维护和手臂3，8小时的最先进的BTW培训。我们将检查3个结果：（1） 从干预期开始到许可后6个月，（2）PA许可证智能手机监控 考试结果； （3）许可的VDA绩效。参与者将从5个费城地区招募 作为常规青少年护理的一部分，练习场所（2个城市，2个郊区，1个农村）。所有参与者都会经历 驾驶性能（VDA）和神经认知和个性电池的基线评估。目标1：de- 终止加速或BTW培训的影响与通常的护理对驾驶坠机风险的影响（例如，硬勇气的比率 ）在许可后的头六个月中。假设：（1）加速和BTW都会减少早期许可 崩溃风险。 （2）与BTW培训相比，加速的崩溃风险会更大，因为加速目标 降低崩溃风险的技能。目标2：确定加速或BTW培训的影响与通常的护理对技能 获得。假设：（1）加速和BTW都将提高技能的获取。 （2）加速会产生较少的 与BTW相比，VDA衡量技能的错误；但是，顺便说一句，可能会产生更好的许可考试表现 （例如，平行停车）。 AIM 3：确定与年龄相关的危险因素，以抗训练的崩溃。假设 ESE：ACCEL和BTW将降低认知能力，但对于冲动/个性不同而取得的成功较低 - 与风险驾驶实践有关的加密。预期的R01结果将直接为政策提供信息，并提供指南 未来的临床实践。