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.

尽管有分级驾驶执照 (GDL)，机动车辆碰撞事故仍然是导致死亡和死亡的主要原因 美国青少年受伤。 GDL 通常适用于 18 岁以下的人，并将初始驾驶体验限制为较低 风险状况；然而，这些 18 岁以下的驾驶员在获得驾照时准备不足，并且发生事故的比例最高 费率。来自 R21 的新证据表明，事故率下降与人员伤亡之间存在关联。 俄亥俄州 GDL 中的驾驶员教育和培训已经过时，但很少有州需要此类培训。 在俄亥俄州，需要在 18 岁之前接受 GDL 和专业驾驶 (BTW) 培训才能获得执照（那些 >18 岁，免 GDL 和培训），那些获得许可的 <18 岁的人表现出较低的事故率，更高的许可 考试通过率以及经过验证的虚拟驾驶评估 (VDA) 的表现比获得许可的更安全 18岁。相比之下，宾夕法尼亚州和大多数其他州对年轻人没有专业培训要求 驱动因素，这在很大程度上可归因于一项随机对照试验（RCT）的负面结果 1983 年在迪卡尔布进行执照培训。自迪卡尔布以来我们在俄亥俄州取得的成果和重大安全进步（GDL、 更严格的国家驾驶员培训标准，以及解决新手驾驶员错误的在线培训）动机 批准了我们提出的培训随机对照试验（三十年来的第一次随机对照试验）。我们提出了一项 III 期 3 臂随机对照试验，涉及： 调查了 1000 名青少年新手司机，年龄介于 16 至 18 岁之间。以 PA (GDL) 的常规护理作为对照，我们 将测试 2 项培训干预措施：第 2 组、ACCEL、危险预期/响应和注意力在线培训 化维护和第 3 组，8 小时最先进的 BTW 培训。我们将检查 3 个结果：(1) 从干预期开始到获得许可后 6 个月期间的智能手机监控驾驶，(2) PA 许可 考试成绩； (3) 获得许可时的 VDA 表现。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的实践地点（2 个城市、2 个郊区、1 个农村）。所有参与者都将经历 驾驶表现 (VDA) 以及神经认知和个性电池的基线评估。目标 1：去- 终止 ACCEL 或 BTW 训练与常规护理对驾驶碰撞风险的影响（例如，硬制动发生率） ing）在获得许可后的前 6 个月内。假设：(1) ACCEL 和 BTW 都会减少早期许可 崩溃风险。 (2) ACCEL 将比 BTW 训练更大程度地降低碰撞风险，因为 ACCEL 的目标是 降低碰撞风险的技能。目标 2：确定 ACCEL 或 BTW 培训与常规护理对技能的影响 获得。假设：(1) ACCEL 和 BTW 都会改善技能获取。 (2) ACCEL将减少产量 顺便说一句，VDA 技能衡量标准存在错误；但是，顺便说一句，执照考试成绩可能会更好 （例如，平行停车）。目标 3：确定与年龄相关的、难以接受训练的碰撞风险因素。假设- eses：ACCEL 和 BTW 会降低认知技能，但对于冲动/个性差异来说不太成功。 与危险驾驶行为相关的问题。 R01的预期结果将直接为政策提供信息并提供指导 为今后的临床实践提供帮助。