• Using research to improve safe teen driving.

    Readers of the blog know that I like to drive home the point that accidents are the number one killer of children. Motor vehicle accidents are the number one cause of death in teens in the United States. What do do?

    Effect of the Teen Driving Plan on the Driving Performance of Teenagers Before Licensure: A Randomized Clinical Trial“:

    Importance: Many studies have failed to show an effect of parent-supervised practice driving on the driving performance of teenagers; nevertheless, most Graduated Driver Licensing programs have provisions that require supervised practice.

    Objective: To determine whether a web-based intervention, the Teen Driving Plan (TDP), can improve the driving performance of teenagers before licensure as measured by the Teen On-road Driving Assessment (tODA).

    Design, Setting, and Participants: Randomized, single-blind, clinical trial among 217 dyads (1 parent: 1 teenaged learner’s-permit holder) to test TDP effectiveness on increasing the quantity and diversity of supervised practice and improving the teenagers’ prelicensed driving performance. The study was conducted from December 2011 through January 2013 in Southeastern Pennsylvania.

    Interventions: Dyads were randomized (3:2) to receive the TDP or the Pennsylvania driver’s manual (control group). The TDP is a psychoeducational intervention designed to increase the quantity and diversity of parent-supervised practice. Materials are grouped by the following driving environments: empty parking lots, suburban residential streets, intermediate (1- or 2-lane) roads, highways, rural roads with curves and elevation changes, and commercial districts.

    Main Outcomes and Measures: The main outcomes were self-reported practice driving across 6 environments and 2 conditions and driving performance as measured by the teenagers’ completion of the standardized and validated tODA 24 weeks after enrollment. Certified professional driving evaluators blinded to randomization status terminated the tODA if they determined that the teenager could not safely complete it. We examined mean differences in the quantity of supervised practice, differences in the overall proportion of teenagers in each group that had assessments terminated for unsafe driving, and the point of termination during the assessment.

    Researchers took 217 pairs of teens and parents and randomized them to get a web-based intervention to improve their driving performance before testing. The main outcomes were teens’ completion of the Teen On-road Driving Assessment, graded by a certified evaluator who was blinded to the teen’s study group. Differences in quantity of supervised practice, failed tests, and how far students got before failing were also measured.

    Students who received the web-based intervention reported more practice in most environments compared to controls. Only 6% of teens in the intervention failed the driving assessment, compared to 15% of controls. Those who got the intervention had a hazard ration of 0.35 compared to those who did not.

    The authors clearly identify the difficulties that will likely be faced taking this from efficacy to effectiveness. But this is an easily disseminated intervention. It also used objective measures to show its results. That’s awesome.

    Too often I complain here on the blog about how we’re attacking the wrong problems with bad solutions. This is the right problem, and this solution appears to be a step in the right direction.

    @aaronecarroll

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