Trial of Training to Reduce Driver Inattention in Teens with ADHD.

BACKGROUND: Teens with attention deficit-hyperactivity disorder (ADHD) are at increased risk for motor vehicle collisions. A computerized skills-training program to reduce long glances away from the roadway, a contributor to collision risk, may ameliorate driving risks among teens with ADHD. METHODS: We evaluated a computerized skills-training program designed to reduce long glances (lasting ≥2 seconds) away from the roadway in drivers 16 to 19 years of age with ADHD. Participants were randomly assigned in a 1:1 ratio to undergo either enhanced Focused Concentration and Attention Learning, a program that targets reduction in the number of long glances (intervention) or enhanced conventional driver's education (control). The primary outcomes were the number of long glances away from the roadway and the standard deviation of lane position, a measure of lateral movements away from the center of the lane, during two 15-minute simulated drives at baseline and at 1 month and 6 months after training. Secondary outcomes were the rates of long glances and collisions or near-collisions involving abrupt changes in vehicle momentum (g-force event), as assessed with in-vehicle recordings over the 1-year period after training. RESULTS: During simulated driving after training, participants in the intervention group had a mean of 16.5 long glances per drive at 1 month and 15.7 long glances per drive at 6 months, as compared with 28.0 and 27.0 long glances, respectively, in the control group (incidence rate ratio at 1 month, 0.64; 95% confidence interval [CI], 0.52 to 0.76; P<0.001; incidence rate ratio at 6 months, 0.64; 95% CI, 0.52 to 0.76; P<0.001). The standard deviation of lane position (in feet) was 0.98 SD at 1 month and 0.98 SD at 6 months in the intervention group, as compared with 1.20 SD and 1.20 SD, respectively, in the control group (difference at 1 month, -0.21 SD; 95% CI, -0.29 to -0.13; difference at 6 months, -0.22 SD; 95% CI, -0.31 to -0.13; P<0.001 for interaction for both comparisons). During real-world driving over the year after training, the rate of long glances per g-force event was 18.3% in the intervention group and 23.9% in the control group (relative risk, 0.76; 95% CI, 0.61 to 0.92); the rate of collision or near-collision per g-force event was 3.4% and 5.6%, respectively (relative risk, 0.60, 95% CI, 0.41 to 0.89). CONCLUSIONS: In teens with ADHD, a specially designed computerized simulated-driving program with feedback to reduce long glances away from the roadway reduced the frequency of long glances and lessened variation in lane position as compared with a control program. During real-world driving in the year after training, the rate of collisions and near-collisions was lower in the intervention group. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT02848092.).

Applying the multiphase optimization strategy to evaluate the feasibility and effectiveness of an online road safety education intervention for children and parents: a pilot study.

BACKGROUND: Reports of children's engagement in active transportation outline low participation rates in many countries despite many associated mental, physical, and social health benefits. One of the main contributors to this phenomenon is a cited lack of education and knowledge among children regarding active travel (AT), specifically road safety. To address this issue, the aim of this study was to evaluate the feasibility and effectiveness of an online road safety education intervention to promote AT among children and their parents. METHODS: Applying the Multiphase Optimization Strategy (MOST) for intervention development, implementation, and evaluation, we designed and assessed a four-module online road safety education intervention with a sample of 57 parent-child dyads using a 23 factorial design featuring both qualitative and quantitative analyses. RESULTS: Main intervention feasibility findings include positive and critical feedback on the program's content and design, and moderate participant engagement as reflected by program retention and completion rates. With respect to the preliminary intervention effectiveness on children, a significant improvement in road safety knowledge scores was observed for groups that feature the "wheeling safety and skills" module. Slight improvements in AT knowledge scores across all the intervention groups were observed, but were not of significance. Preliminary intervention effectiveness on select parental AT practices and perceptions saw significant improvements in some groups. Groups that featured the 'wheeling safety and skills' module exhibited significantly higher guided choice scores upon completion of the program than those who did not receive this component. CONCLUSION: The MOST framework allowed us to design and evaluate the feasibility and preliminary effectiveness of an online road safety education intervention. The developed intervention has demonstrated that it has the potential to improve children's road safety knowledge and some areas of parental AT practices and perceptions, to which improvements may be attributed to the inclusion of the "wheeling safety and skills" module, suggesting that the targeted focus on cycling skills is a prioritized area. AT programming and practice implications are discussed. Future research is encouraged to refine modules to better reflect the priorities of children and parents and to test these refined components among larger samples. WORD COUNT: 9,391 (excludes abstract, tables, figures, abbreviations, and references).

Building a Campaign to Increase Older Driver Safety.

With aging, physical and cognitive changes can affect driving safety. Emergency nurses can provide education for seniors that can create awareness of these changes and ways to mitigate the changes, allowing the older driver to remain independent and a safer driver.

Mobility management to prevent, reduce, or delay driving a car in teenagers.

BACKGROUND: Rates of injury and death caused by car crashes with teenage drivers remain high in most high-income countries. In addition to injury and death, car use includes other non-traffic risks; these may be health-related, such as physical inactivity or respiratory disease caused by air pollution, or have global significance, such as the environmental impact of car use. Research demonstrates that reducing the amount of time driving reduces the risk of injury, and it is expected that it would also reduce other risks that are unrelated to traffic. Mobility management interventions aim to increase mobility awareness and encourage a shift from private car use to active (walking, cycling, skateboarding), and public (bus, tram, train), transportation. 'Soft' mobility management interventions include the application of strategies and policies to reduce travel demand and may be instigated locally or more widely, to target a specific or a non-specific population group; 'hard' mobility management interventions include changes to the built environment or transport infrastructure and are not the focus of this review. Between the ages of 15 to 19 years, young people enter a development stage known as the 'transition teens' in which they are likely to make long-lasting lifestyle changes. It is possible that using this specific time point to introduce mobility management interventions may influence a person's long-term mobility behaviour. OBJECTIVES: To assess whether 'soft' mobility management interventions prevent, reduce, or delay car driving in teenagers aged 15 to 19 years, and to assess whether these mobility management interventions also reduce crashes caused by teenage drivers. SEARCH METHODS: We searched the Cochrane Injuries Group Specialised Register, CENTRAL, MEDLINE, Embase, Web of Science, and Social Policy and Practice on 16 August 2019. We searched clinical trials registers, relevant conference proceedings, and online media sources of transport organisations, and conducted backward- and forward-citation searching of relevant articles. SELECTION CRITERIA: We included randomised controlled trials (RCTs) or controlled before-after studies (CBAs) evaluating mobility management interventions in teenagers aged 15 to 19 years. We included informational, educational, or behavioural interventions that aimed to prevent, reduce, or delay car driving in this age group, and we compared these interventions with no intervention or with standard practice. We excluded studies that evaluated graduated drivers licensing (GDL) programmes, separate components of GDL, or interventions that act in conjunction with, or as an extension of, GDL. Such programmes aim to increase driving experience and skills through stages of supervised and unsupervised exposure, but assume that all participants will drive; they do not attempt to encourage people to drive less in the long term or promote alternatives to driving. We also excluded studies which evaluated school-based safe-driving initiatives. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed studies for inclusion, extracted data, and assessed risks of bias. We assessed the certainty of evidence with GRADE. MAIN RESULTS: We included one RCT with 178 participants and one CBA with 860 participants. The RCT allocated university students, with a mean age of 18 years, who had not yet acquired a driving licence, to one of four interventions that provided educational information about negative aspects of car use, or to a fifth group in which no information was given. Types of educational information about car use related to cost, risk, or stress, or all three types of educational information combined. In the CBA, 860 school students, aged 17 to 18 years taking a driving theory course, had an additional interactive lesson about active transport (walking or cycling), and some were invited to join a relevant Facebook group with posts targeting awareness and habit. We did not conduct meta-analyses because we had insufficient studies. We could not be certain whether educational interventions versus no information affected people's decision to obtain a driving licence 18 months after receiving the intervention (risk ratio 0.62, 95% confidence interval 0.45 to 0.85; very low-certainty evidence). We noted that fewer participants who were given information obtained a driving licence (42.6%) compared to those who did not receive information (69%), but we had very little confidence in the effect estimate; the study had high or unclear risks of bias and the evidence was from one small study and was therefore imprecise. We could not be certain whether interventions about active transport, given during a driving theory course, could influence behavioural predictors of car use. Study authors noted: - an increased intention to use active transport after obtaining a driving licence between postintervention and an eight-week follow-up in students who were given an active transport lesson and a Facebook invitation compared to those given only the active transport lesson; and - a decrease in intention between pre- and postintervention in those given an active transport lesson and Facebook invitation compared to those given the active transport lesson only. There were high risks of bias in this CBA study design, a large amount of missing data (very few participants accepted the Facebook invitation), and data came from a single study only, so we judged the evidence to be of very low certainty. These studies did not measure our primary outcome (driving frequency), or other secondary outcomes (driving distance, driving hours, use of alternative modes of transport, or car crashes). AUTHORS' CONCLUSIONS: We found only two small studies, and could not determine whether mobility management interventions were effective to prevent, reduce, or delay car driving in teenagers. The lack of evidence in this review raises two points. First, more foundational research is needed to discover how and why young people make decisions surrounding their personal transport, in order to find out what might encourage them to delay licensing and driving. Second, we need longitudinal studies with a robust study design - such as RCTs - and with large sample sizes that incorporate different socioeconomic groups in order to evaluate the feasibility and effectiveness of relevant interventions. Ideally, evaluations will include an assessment of how attitudes and beliefs evolve in teenagers during these transition years, and the potential effect of these on the design of a mobility management intervention for this age group.

Effectiveness of a collaborative, student-run campaign to increase safety belt use among adolescents.

BACKGROUND: MVCs are the leading cause of death among adolescents. Seat belts have been shown to decrease MVC-related death. The purpose of this retrospective cohort study was to evaluate the effectiveness of a community-supported, student-run campaign to increase safety belt use among adolescents in Southwest Florida. METHODS: We reviewed results of campaigns at 14 high schools from 2012 to 2018. The primary outcome was change in rates of student-driver seat belt use over the course of each campaign. Secondary outcomes included trends in seat belt use and MVC-related fatalities over the study period. Wilcoxon signed-rank test was used to compare rates of seat belt use before and after each intervention and over the course of the study period. Multivariate logistic regression was used to estimate the independent effects of demographic covariates on outcomes. RESULTS: Altogether, 85 campaigns were reviewed. A total of 8500 preintervention and 8500 postintervention observations of student seat belt use were assessed. The median rate of seat belt use increased from 82% prior to the intervention to 87% following the intervention (p<0.001). We did not detect a sustained trend in seat belt use or MVC-related fatalities over the study period. On multivariate analysis, schools with a higher proportion of minority students were less likely to experience a substantial increase in seat belt use following the intervention (OR=0.17, 95% CI 0.03 to 0.84, p=0.030). CONCLUSION: This collaborative campaign resulted in a modest, short-term increase in seat belt use among high school students. Future studies should evaluate which interventions are most effective and how short-term increases in seat belt use can be sustained.

Are interventions effective at improving driving in older drivers?: A systematic review.

BACKGROUND: With the aging of the population, the number of older drivers is on the rise. This poses significant challenges for public health initiatives, as older drivers have a relatively higher risk for collisions. While many studies focus on developing screening tools to identify medically at-risk drivers, little research has been done to develop training programs or interventions to promote, maintain or enhance driving-related abilities among healthy individuals. The purpose of this systematic review is to synopsize the current literature on interventions that are tailored to improve driving in older healthy individuals by working on components of safe driving such as: self-awareness, knowledge, behaviour, skills and/or reducing crash/collision rates in healthy older drivers. METHODS: Relevant databases such as Scopus and PubMed databases were selected and searched for primary articles published in between January 2007 and December 2017. Articles were identified using MeSH search terms: ("safety" OR "education" OR "training" OR "driving" OR "simulator" OR "program" OR "countermeasures") AND ("older drivers" OR "senior drivers" OR "aged drivers" OR "elderly drivers"). All retrieved abstracts were reviewed, and full texts printed if deemed relevant. RESULTS: Twenty-five (25) articles were classified according to: 1) Classroom settings; 2) Computer-based training for cognitive or visual processing; 3) Physical training; 4) In-simulator training; 5) On-road training; and 6) Mixed interventions. Results show that different types of approaches have been successful in improving specific driving skills and/or behaviours. However, there are clear discrepancies on how driving performance/behaviours are evaluated between studies, both in terms of methods or dependent variables, it is therefore difficult to make direct comparisons between these studies. CONCLUSIONS: This review identified strong study projects, effective at improving older drivers' performance and thus allowed to highlight potential interventions that can be used to maintain or improve older drivers' safety behind the wheel. There is a need to further test these interventions by combining them and determining their effectiveness at improving driving performance.

Developing a national road traffic safety education program in Iran.

BACKGROUND: Education is a pivot included Decade of Action for Road Safety initiative, which has reduced deaths caused by accidents in developed countries. Given the circumstances of each country, a proper education program is necessary. Thus, the aim of this study was to develop the National Road Traffic Safety Education Program (NRTSEP) and reduce Road Traffic Injuries (RTIs). METHODS: This study used a qualitative approach and was conducted in Iran. Data were obtained through sixteen semi-structured in-depth interviews from indifferent road safety and health promotion field experts as well as eleven focus group discussion (FGD) sessions conducted with participants from general population. Inductive qualitative content analysis was used to converge and compare themes through data. The initial pattern of the program was developed and subsequently, the designed program was validated and finalized by two-step Delphi method for the consensus of expert opinion. RESULTS: The following six main themes emerged from the analysis: target groups, program content, educational methods, instructors, resources and evaluation. The target group consisted of children, youth, parents, teachers, elderly, motorcyclists, cyclists, pedestrians, drivers, driver license applicants, instructors and administrators of driving schools, and specific groups such as the disabled, managers at different levels, and policymakers. The content of the program consisted of 27 items, including traffic laws and regulations, first aid, and medical emergencies. Educational practices and authorities were determined based on the target group and educational content. The most important resources of the program were human force and other cases, which can be managed in case of a lead agency. In the evaluation dimension, the cases such as mortality rate, hospitalization, behavioral changes, and other cases can be considered. CONCLUSIONS: The designed program should be implemented for all target groups for road safety promotion. The proper content was provided with proper educational methods and instructors for the target groups. A lead agency is needed to provide the resources and funding to run the program.

'Just Drive': An Employee-Based Intervention to Reduce Distracted Driving.

Distracted driving is a major danger on today's roadways. Employers play a critical role in developing distracted driving policies and promoting a culture of workplace driving safety. The purpose of this study was to evaluate the effectiveness of an in-person work-based class to reduce distracted driving in participating employees. The "Just Drive-Take Action Against Distraction" class was designed by the UC San Diego Training, Research and Education for Driving Safety (TREDS) program to increase awareness of the dangers of distracted driving and to encourage employees to be safe and responsible drivers, both on and off the job. Participants completed pre- and post-anonymous surveys and, in a subset of attendees, volunteers were contacted via email 3 months post-intervention to complete a driving-behavior survey on Surveymonkey.com. 115 classes for 6896 employees were delivered at 54 agencies in Southern California. A total of 4928 participants completed the pre- and post-survey; 2014 n = 2263 and 2015 n = 2665. The course was found useful (85%) and engaging (85.6%). For non-commercial drivers, 55.6% of participants reported an increase of 80-100% in awareness of the dangers of distracted driving, and 67.2% reported an increase of 80-100% in their motivation to change. For commercial drivers, 71.3% reported a motivation increase of 80-100%. There were significant increases in knowledge for both groups. In the three-month follow-up survey, participants identified multiple positive changes in distracted driving behavior. This 1-h employer-supported intervention demonstrated positive changes in short-term intention and medium-term behaviors.

Increasing Organ Donor Designation Rates in Adolescents: A Cluster Randomized Trial.

Objectives. To evaluate the effectiveness of video messaging on adolescent organ donor designation rates.Methods. We randomized adolescent driver education classes in Massachusetts, between July 2015 and February 2018, to receive 1 of 3 organ donation video messaging interventions (informational, testimonial, or blended). Adolescents completed questionnaires before and after the intervention and at 1-week follow-up; we compared their registration status at time of obtaining driver's license with that of a regionally matched historical comparison group.Results. Donor designation rates were higher for those exposed to video messaging than for the historical comparison group (60% vs 50%; P < .001). Testimonial (64%) and blended messaging (65%) yielded higher donor designation rates than informational messaging (51%; P = .013). There was a statistically significant messaging × time interaction effect for donation knowledge (P = .03), with blended and informational messaging showing more gains in knowledge from before to after the intervention (P < .001; d = 0.69 and P < .001; d = 0.45, respectively), compared with testimonial messaging (d = 0.09; P = .22).Conclusions. Testimonial messaging is most effective in producing a verifiable and demonstrable impact on donor designation rates among adolescents, and driver education classes are an efficient venue for disseminating organ donation messaging to youths.Trial Registration. ClinicalTrials.gov; identifier: NCT03013816.

Recommendations for current and future countermeasures against sleep disorders and sleep loss to improve road safety in Australia.

The Australian National Road Safety Strategy 2011-2020 framed a 19-point action plan targeting a 30% reduction in road deaths by 2020. In achieving a 9% reduction to date, it is likely to fail this target. Sleep disorders and sleep loss did not feature prominently in this strategy, despite their high prevalence and effect on drowsiness and crashes. This article gathers sleep experts to provide recommendations addressing driver education and legislation to assist the response to this public health problem. Developments in drowsiness detection and sleep disorders management are also presented that offer innovative countermeasures that could enhance road safety beyond 2020.

The impact of a crash prevention program in a large law enforcement agency.

BACKGROUND: Motor vehicle crashes (MVCs) remain a leading cause of death for US law enforcement officers. One large agency implemented a crash prevention program with standard operating policy changes, increased training, and a marketing campaign. This was a scientific evaluation of that crash prevention program. METHODS: MVC and motor vehicle injury (MVI) data for law enforcement officers were compared using an autoregressive integrated moving average (ARIMA) model. Two law enforcement agencies who had not implemented a crash prevention program were controls. RESULTS: After program implementation, overall, MVC rates significantly decreased 14% from 2.2 MVCs per 100 000 miles driven to 1.9 (P = .008). MVC rates did not decrease in the control agencies. Overall, MVI rates significantly decreased 31% from 3.4 per 100 officers to 2.1 (P = .0002). MVC rates did not decrease in the control agencies. MVC rates for patrol officers significantly decreased 21% from 3.1 per 100 000 miles to 2.4. MVI rates for patrol officers significantly decreased 48% from 3.2 per 100 officers to 1.6 (P < .0001). CONCLUSIONS: Crash and injury rates can be reduced after implementation of a crash prevention program and the largest impacts were seen in patrol officers.

Switched On: How the Timing of Aversive Content in Traffic Safety Videos Impact Psychophysiological Indicators of Message Processing.

This study investigates how timing of the introduction of unpleasant emotional tone in a traffic safety video impacts the intensity of the viewer's emotional experience. Traffic safety advertising is a multi-million-dollar business in the United States. In many instances, 30-60 s ads are produced to raise awareness of the consequences of unsafe behaviors with the expectation that simply providing information will motivate safer behaviors. Producing videos intended to generate behavior change requires a complex understanding of what motivates behavior. Behavior change theory, neuroscience, and psychophysiology all provide guidance to improve the persuasive power of traffic safety videos. This study consisted of a 3 (message tone) × 3 (video) × 4 (order) repeated measures within subjects designed experiment. Participants (N = 75) were 20-30-year-old men who were shown nine traffic safety videos. Arousal intensity, attention, and negative emotion were tracked with the psychophysiological measures of skin conductance (measuring intensity of arousal), heart rate (measuring attention paid during the video), and corrugator muscle activation (measuring the negative emotional experience). Videos with three different aversive tones were used, low, high, and videos in which the tone switched from low to high aversive. Aversive tone is defined as stimuli that motivate a desire to escape or avoid something like death or pain. All videos were designed to prevent motor vehicle crashes. The results obtained from this study indicate that when attempting to persuade males aged 20-30 to practice safer driving behaviors, switched message tone appears to be the most effective message design in terms the intensity of emotional arousal and maintenance of attention.

Multidisciplinary attentive treatment for patients with chronic disorders of consciousness following severe traumatic brain injury in the NASVA of Japan.

Primary Objective: The aim of this study was to demonstrate the clinical outcomes of long-term multidisciplinary attentive treatment (MAT) in patients with chronic disorders of consciousness (DOC) due to severe traumatic brain injury (TBI) following automotive accidents.Research Design: Five hundred and ten patients (mean age: 40.4 years) were enrolled in this retrospective study.Methods and Procedures: Patients were provided MAT for one to several years in the eight medical facilities of the National Agency for Automotive Safety and Victims' Aid (NASVA) in Japan. Clinical status for consciousness, communication, and activities of daily living were evaluated using the NASVA grading system.Outcomes and results: Following MAT, NASVA scores at discharge were significantly improved compared to those at admission in every patient subgroup including sex, age, NASVA score, and association with/without hypoxic encephalopathy at admission. Younger age, shorter interval between injury and admission, and better neurocognitive function at admission were found to be significant and independent factors for a good prognosis.Conclusions: MAT can partially improve the cognitive and physical abilities of patients with chronic DOC. From the perspective of not only restoring a patient's daily life, but also reducing the caregiver's burden, this type of treatment program warrants more public attention.

Teen Driving Education in a Pediatric Emergency Department: Effectiveness of a Toolkit.

OBJECTIVES: In the United States, the leading cause of death for adolescents aged 16 to 24 years is motor vehicle crashes, with Alabama ranked as the second-worst state in the nation for teen driving deaths. We sought to determine the efficacy of teenage driving education within the setting of the pediatric emergency department and to assess the driving habits of teenagers and their parents and their understanding of the Alabama Graduated Driver's License (GDL) law. METHODS: Surveys were administered to noncritically ill teenagers aged 13 to 19 years and their parents who presented to the children's emergency department. Participation was voluntary and anonymous. Presurveys were administered to assess driving habits and knowledge. Intervention was then given in the form of a "safe driving toolkit," followed by postsurveys to measure educational outcomes. Pre- and postsurvey data were then analyzed and compared using Epistat. RESULTS: A total of 41 parents, 2 grandparents, and 45 teenagers were enrolled in this study. An additional 47 teenagers answered a single curfew question at a teen driving event. Of all of the participants, 63% had never heard of the Alabama GDL law, and of that 63%, 37% had been enrolled in a driver's education course. A χ2 analysis revealed no significant difference between parents and teenagers having taken a driver's education course. Of the participants, 22% responded that they knew the specifics of the Alabama GDL law, with only 1 correct on all 3 counts. The most common item missed was the curfew for teenagers, with 4 believing it to be 8 pm, 14 believing it to be 9 pm, 23 believing it to be 10 pm, and 7 believing it to be 11 pm. Sixty-nine percent of the respondents correctly answered that there was to be no cellular telephone use while driving for teenagers with a GDL. More than 97.2% of participants, both parents and teens, reported learning new information from this study. CONCLUSIONS: The majority of participants enrolled were not aware of the Alabama GDL law, which has been in place since 2002. More than 97% of those surveyed were given new information during the education session. There is a strong need for further public education regarding the law and safe driving habits. Sixty-one percent of respondents believe that the teen curfew is earlier than the present curfew. The authors believe that this shows support for revising the curfew in the present law to an earlier time. Nighttime driving restrictions starting at 10 pm or earlier have been shown to result in greater reductions in motor vehicle crashes involving teenagers. Our study affirmed that teen driving education within the pediatric emergency department setting is efficacious.

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.

Safe Drive Stay Alive: exploring effectiveness of a real-world driving intervention for predrivers and the utility of the health action process approach.

Young drivers are greatly over-represented in road traffic collisions (RTCs) worldwide. Interventions attempt to change driving-related behaviours to reduce injuries and deaths from RTCs. The current study evaluated the effectiveness of the well-established Fife Safe Drive Stay Alive (SDSA) practice-based intervention on determinants of driving behaviour using the health action process approach (HAPA) model. Adolescent participants (predominantly predrivers) attending the SDSA intervention from schools and colleges in Fife, Scotland, were invited to complete an evaluation at baseline and at 3 months exploring motivational determinants of driving behaviour (eg, risk perception). Intervention content was examined for behaviour change techniques (BCTs). Eighty-seven participants completed both baseline and follow-up evaluations. The motivational HAPA model variables predicted driving intentions. There was no significant overall effect of the SDSA intervention between baseline and 3-month follow-up. Seven negatively framed BCTs were used in the intervention. The effectiveness of SDSA is questioned; however, the study supports the use of the HAPA model in explaining driving intentions, and therefore, may usefully inform driving interventions.

A call to improve sampling methodology and reporting in young novice driver research.

Young drivers continue to be over-represented in road crash fatalities despite a multitude of research, communication and intervention. Evidence-based improvement depends to a great extent upon research methodology quality and its reporting, with known limitations in the peer-review process. The aim of the current research was to review the scope of research methodologies applied in 'young driver' and 'teen driver' research and their reporting in four peer-review journals in the field between January 2006 and December 2013. In total, 806 articles were identified and assessed. Reporting omissions included participant gender (11% of papers), response rates (49%), retention rates (39%) and information regarding incentives (44%). Greater breadth and specific improvements in study designs and reporting are thereby identified as a means to further advance the field.

Playing Action Video Games Improves Visuomotor Control.

Can playing action video games improve visuomotor control? If so, can these games be used in training people to perform daily visuomotor-control tasks, such as driving? We found that action gamers have better lane-keeping and visuomotor-control skills than do non-action gamers. We then trained non-action gamers with action or nonaction video games. After they played a driving or first-person-shooter video game for 5 or 10 hr, their visuomotor control improved significantly. In contrast, non-action gamers showed no such improvement after they played a nonaction video game. Our model-driven analysis revealed that although different action video games have different effects on the sensorimotor system underlying visuomotor control, action gaming in general improves the responsiveness of the sensorimotor system to input error signals. The findings support a causal link between action gaming (for as little as 5 hr) and enhancement in visuomotor control, and suggest that action video games can be beneficial training tools for driving.

Efficacy of Driving Simulator Training for Novice Teen Drivers.

The objective of this study was to determine if driving simulator training lowers motor vehicle crash (MVC) rates for novice teen drivers. We enrolled 215 high school students, and randomly assigned 89 to the control group, and 126 to the intervention group. Twelve months after the intervention, participants completed a survey asking about crash history and driving infractions. Nearly two-thirds (n = 137, 63%) of participants completed the presimulator survey, follow-up survey, and obtained a license. Nearly one-third of the intervention group (n = 42, 33%) completed some of the 12 simulator training modules: 2-5 modules (n = 8, 19%), 6-11 modules (n = 7, 17%), and all 12 modules (n = 27, 64%). Postsimulator training involvement in a MVC (intervention = 19.0% vs control = 12.0%, P > .05) and driving infractions (intervention = 7.1% vs control = 18.0%, P > .05) did not differ significantly. Simulator training did not produce a measurable reduction in self-reported driving infractions and MVCs. Future evaluation of driving simulator training should include approaches that ensure higher completion rates.

Characteristics of on-road driving by persons with central vision loss: Learning to drive with a bioptic telescope.

There is limited research on the driving performance and safety of bioptic drivers and even less regarding the driving skills that are most challenging for those learning to drive with bioptic telescopes. This research consisted of case studies of five trainee bioptic drivers whose driving skills were compared with those of a group of licensed bioptic drivers (n = 23) while they drove along city, suburban, and controlled-access highways in an instrumented dual-brake vehicle. A certified driver rehabilitation specialist was positioned in the front passenger seat to monitor safety and two backseat evaluators independently rated driving using a standardized scoring system. Other aspects of performance were assessed through vehicle instrumentation and video recordings. Results demonstrate that while sign recognition, lane keeping, steering steadiness, gap judgments, and speed choices were significantly worse in trainees, some driving behaviors and skills, including pedestrian detection and traffic light recognition were not significantly different from those of the licensed drivers. These data provide useful insights into the skill challenges encountered by a small sample of trainee bioptic drivers which, while not generalizable because of the small sample size, provide valuable insights beyond that of previous studies and can be used as a basis to guide training strategies.