Advancing Young Driver Safety by pnx67864

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									    Advancing Young Driver Safety:
The perceptions and experiences of teen drivers


            Dennis Durbin, MD,MSCE
               Associate Professor of
             Pediatrics and Epidemiology
Goals for presentation
• Gain insight on factors contributing to
  teen crashes
  – The leading cause of death for teens and
    young adults
  – Understand perspectives of your patients
• Appreciate the role you can play in
  ensuring the safety of your patients
  – Prevention advocate
 Driver fatality rates by age
 2005

          4             3.8


          3
# Driver
fatalities
(per 100M 2                                                       1.8
VMT)                               1.1
              1.0
          1                                   0.7        0.8


          0
              Total   16 to 19   20 to 34   35 to 54   55 to 64   65+
                          Age group of driver (years)
Teens and driving
The perfect storm
• Developmental risk factors
   – Know what to do, but
      • Impulses get in the way
      • Difficulty handling peers
   – Desires
      • Fit in, appear mature
      • Independence
      • Thrill-seeking
• Inexperience
• Several thousand pounds of steel at 55 mph
Causes of fatal crashes:
Much more than drunk driving
100%


75%

                                                                    Driver error
50%                                                                 Speeding
                                                                    Drunk driving

25%


 0%
       16             17 to 19             20 to 49

       Source: Williams et al Journal of Public Health Policy, 16: 3 (1995)
Teens perceptions
Inexperience

  Teen Passengers


        Speeding


       Cell phone


       Driver lost


          Alcohol

        Driver
     inexperience

                     0   10     20      30      40     50       60   70
                              % teens witness often or always


    • Though 60% believed inexperience strongly influences
    safety, only 15% reported exposure to inexperienced drivers
How to avoid a crash



    SCAN

     Good scanning
     •Far ahead
     •To the sides
     •In the rear
     •Anticipate hazards
How to avoid a crash

               SECONDS


    SCAN


    Detect
    Hazard
How to avoid a crash

                       SECONDS


    SCAN


           Recognize
           Hazard
How to avoid a crash

                 SECONDS


    SCAN                CHOOSE


            Decide to
            Respond
How to avoid a crash

               SECONDS


    SCAN


                  ACT
Why teen crash rate is high

• Late hazard detection
  – Poor scanning and anticipation/planning
    • Inexperience
  – Distraction/poor attention
    • Cell phones
    • Passengers
    • Emotions
  – Impairment
    • Fatigue, alcohol, drugs
Why teen crash rate is high
Poor scanning
Why teen crash rate is high
Poor hazard detection




             Iver001_NearLossInCorner.DCE
Why teen crash rate is high
Distraction
Why teen crash rate is high


• Ineffective actions to avoid crash
  – Inexperience
     • Not prepared with appropriate response
     • Delayed action
     • Over-correct
  – Distraction
     • passengers, cell phones, emotions
  – Impairment
     • alcohol, fatigue, drugs
Why teen crash rate is high
Poor response choice




            bald001_1862_near fatal T-bone.DCE
Why teen crash rate is high
Risky driving
• Intentional risk-      • Driving under risky
  taking                   conditions
   –   Speeding            – With peer passengers
   –   Close following     – At night
   –   Goofing off         – On weekends
   –   Showing off         – Recreational driving (no
                             destination)
                           – Older, smaller cars
Why teen crash rate is high
Recklessness
Peer passengers
Increase the risk of a fatal crash

                             9
  Crashes per 10,000 trips



                             8
                             7
                             6
                             5                             No Pass
                             4                             1 Pass
                                                           2 Pass
                             3
                                                           3+ Pass
                             2
                             1
                             0
                                 16      17        30-59
                                      Driver Age
Teen perceptions
Peer passengers
          Alcohol


  Text messaging


    Inexperience


        Speeding


   Cell Phone use


Other teens in car

                     0      20         40         60         80       100
                         % teens perceive makes a lot of difference
Teen perceptions
Peer passengers
 Acting wild


  Encourage
   speeding


 Intoxicated


 Dance/sing


 Other teens


               0   10     20       30       40      50       60   70
                    % teens perceive makes a lot of difference


 • May provide insight into how teen passengers increase crash risk
Why teen crash rate is high
Passengers – compound challenges
                Why teens die




1/3 of teens consistently don’t use seat belts (NYDS)
 2/3 of teens killed in crashes weren’t belted (FARS)
The first 6 months: Highest risk



       Time Zero
Timeline for safety
Anticipatory guidance



 Prepare                           Coach
 Assess                            Monitor
 Model                             Assess
 Teach          Time Zero          Supervise
 Set rules                         Teach
                                   Remediate
                 Time Zero
             Independent driving
What can parents do?

• Model good driving
• Positive parenting
  – Rules, monitor, support, time
• Improve skills
  – Teaching, listening, feedback
• Work together
  – Lobby for better laws and school policies
  – Set shared rules among parents
Role of Parents in Driver
Education
 • Parents’ at-fault crashes & speeding tickets
   predict teen at-fault crashes
        (61,000 teen drivers in British Columbia. Wilson RJ)

   –   Father crash      RR =1.25 (boy)         =   1.28 (girl)
   –   Mother crash          1.20               =   1.34
   –   Father speed          1.09               =   1.13
   –   Mother speed          1.23               =   1.23
Role of Parents in Driver
Education
• Many parents feel ill- prepared to teach
  their teen to drive
  – 50% felt capable1
  – 1/3 were enthusiastic while another 1/3
    were “nervous”1
  – 2/3 stepped on an imaginary brake2
• Handouts did not change the number of
  hours of practice, frequency of raising
  voice, or use of compliments
                                 1Sherman et al 2004
                                 2Goodwin et al 2006
Role of Parents in Driver
Education
• Driving
                               Teen:
  Instructor is                Learner
  expert coach
   – Teaches new
     skills
                                          Parent:
• Parent is                              Reinforcer
  reinforcer of           Driving
                        Instructor:
  skills
                        Instructor
   – Regular practice
Role of Parents in Driver
Education
 • Parent-taught (PT) vs. school or commercial

 • No difference in age of licensing
 • More failed permit test (18% vs. 3% - 6%)
 • More failed road test (29% vs. 4% - 14%)

 • In first 6 months unsupervised, PT had:
   – More violations (648 vs. 560/10,000 drivers)
   – More fatal crashes (2.8 vs. 1.9/ 10,000 drivers)
Preparing teens to drive alone
GDL laws
Graduated Driver Licensing (PA)
• Permit
  – at least 16 years old
• Learner phase
  – at least 50 hours
  – at least 6 months
• Junior license
  – at least 6 months
  – night-time restriction
Preparing teens to drive alone
GDL laws
Graduated Driver Licensing
  (PA)
• Provisions under consideration
   – No more than 1 passenger during
     junior license phase (sibling
     exception)
   – Wireless device ban during learner
     and junior license phases
   – Increase minimum supervised
     driving to 65 hrs (10 of which at
     night)
Preparing teens to drive alone
The Learner Phase
• Evidence:
  – Formal Driving Education
     • Does help teen to learn rules and
       pass test
     • Unclear effect on crashes
     • Experience behind the wheel is
       more effective than time in
       classroom
  – Supervised driving
     • Not clear how long (minimum of
       50 hours)
     • Varied conditions with progressive
       challenge
Driver Education in PA
• Driver education not
  required for
  licensure
• 30 hrs classroom
  and/or 6 hours
  behind the wheel
• BTW instruction can
  be counted toward
  50 hr requirement
Driving lesson plan
www.chop.edu/youngdrivers
• Beginning
  – Vehicle operation
  – Low speed/low traffic volume
• Intermediate
  – Various roads
  – More traffic
• Advanced
  –   Higher speed
  –   Variety of road conditions
  –   Unfamiliar routes
  –   Higher order thinking skills
  –   May need to teach after gets restricted license
Coaching the early driver
The junior license phase
• First 6 months most dangerous
• Gain experience under low risk
  conditions
• Gradually increase privileges when
  mastery demonstrated (not time)
• Requires clear expectations and close
  monitoring
Monitoring early independent driver:
Parent-teen agreement
• Create plan with teen
• Cover at least first 6 months-1 year
• Start: limit to low risk conditions
  – DO NOT give access to own vehicle
• Gradually increase privileges
  – Include how this will happen (not just time)
• Set clear rules, rewards, consequences
• Include rules for teen as passenger
• Monitor closely and follow through
Suggested rules for the road
• Absolutes
  –   ALWAYS wear seat belts (everyone in car)
  –   NO speeding
  –   NO cell phones/text messaging
  –   NO alcohol, drugs, drowsy driving
• Earned privileges (based on behavior/mastery)
  –   Passengers
  –   High speed roads
  –   Nighttime driving
  –   Non-ideal road conditions
  –   Unfamiliar routes
  –   Own vehicle
Summary: What works
• Learner
  – Delay licensure to older age
       • Make sure child is ready; law is a minimum age
  – Sufficient quantity of practice driving under varied
    conditions (>50h)
  – Assess competence, not just time or age
• Early Driver (first 6 months)
  –   Graduated privileges: low risk then high risk
  –   No passengers
  –   Mandatory seat belt use
  –   Zero tolerance for alcohol, cell phone use, texting
For more information

 •   www.chop.edu/youngdrivers
 •   Contact information:
     – Karen Holm – holmk@email.chop.edu
 • Funding support from State Farm

								
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