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.

Comparison of novice and full-licenced driver common crash types in New South Wales, Australia, 2001-2011.

OBJECTIVE: To examine the circumstances of passenger vehicle crashes for novice licenced drivers aged 17-25 years and to compare the crash circumstances of the most common crash types for novices to a sample of full-licence drivers aged 40-49 years. METHOD: A retrospective analysis was conducted of passenger vehicle crashes involving novice and full-licenced drivers during 1 January 2001 to 31 December 2011 in New South Wales (NSW), Australia. RESULTS: There were 4113 injurious crashes of novice drivers. Almost half the novice driver crashes involved a single vehicle. Vehicle speed (33.2%), fatigue (15.6%) and alcohol (12.6%) were identified risk factors in novice driver crashes. Correspondence analysis for 4 common crash types for novice drivers revealed that the crash characteristics between novice and full-licenced drivers were similar. CONCLUSIONS: Similarities exist between novice driver and full-licenced driver crash risk for common crash types. Preventive strategies aimed at crash risk reduction for novice drivers may also benefit all drivers.

Variations in car crash-related hospitalization costs amongst young adults in New South Wales, Australia.

BACKGROUND: This study aims to examine factors associated with variation in crash-related hospitalization costs for young adults in New South Wales (NSW), Australia with a particular focus on types of vehicle occupant, rurality of residence and socioeconomic status (SES). METHODS: Data on patients aged 17-25 years, admitted to public hospitals due to a crash during July 2000-June 2007 were extracted from the NSW Health Admission Collection database. The hospitalization cost of each admission was calculated based on published charges for specific Australian Refined-Diagnosis Related Groups (AR-DRG). Multivariable analyses using generalized estimating equations were used to estimate costs by vehicle occupant type (driver, passenger and other occupants), rurality of residence (urban, regional and rural areas) and SES (low, moderate and high SES areas). RESULTS: During 2000-2007, there were 11,892 crash-related hospitalizations involving young adults, aged 17-25 years, in NSW. These cost the health sector about A$87.6 million or on average, A$7363 per hospitalization (mean length of stay (LOS) 5.3 days). Compared to drivers, passengers had significantly longer LOS (<0.01) as well as higher hospitalization costs (p = 0.04). Regional and rural young adults had significantly longer LOS and higher hospitalization costs compared to urban young adults (p<0.05). Compared with young adults from high SES areas, young adults from moderate SES areas had significantly higher costs (p = 0.02), whilst the higher costs for young adults of low SES areas was borderline significant (p = 0.06), although differences in LOS by SES were not significant. CONCLUSION: Annually, young adults' crashes in NSW were estimated to cost the health sector at least A$14.6 million between 2001 and 2007. The higher hospitalization costs and LOS for young adults living in regional and rural vs. urban areas, and those living in moderate and low SES vs. high SES areas partly reflects the severity of these crashes and challenges for treatment. Based on these findings, a strong economic argument can be made for targeting prevention strategies to young people living in rural and low SES areas. The area variations in costs also suggest some scope for policy makers to consider potentially more efficient ways of targeting both treatment and preventative programmes.

Understanding novice driver policy agenda setting.

BACKGROUND: Despite the acute impact of road trauma involving novice drivers, there have been few efforts to identify the main factors influencing the novice driver policy agenda. Increasing the transparency of such policy dynamics may help inform future novice driver policy agenda-setting processes, as well as those in other public health settings. METHODS: Forty interviews were conducted between 2007 and 2009 with individuals involved in novice driver policy debates and processes in four Australian states. RESULTS: An increasing body of positive evaluations from other jurisdictions was seen to provide an initial stimulus for Australian novice driver policy activities. The dissemination of evidence by researchers, lobbying and advocacy by other influential stakeholders, and media reporting of multiple-fatality novice driver crashes were seen as other factors central to policy agenda setting. CONCLUSIONS: Australian graduated driver licensing (GDL) policy initiatives may only be acted upon once adequate political support is identified in terms of community demand for action and public acceptance of GDL policy in neighboring states. As such, researcher encouragement of community support for unpopular evidence-based policies during windows of opportunity for policy reform may act as an influential agenda-setting force.

Fatal crash trends for Australian young drivers 1997-2007: geographic and socioeconomic differentials.

BACKGROUND: Little has been published on changes in young driver fatality rates over time. This paper examines differences in Australian young driver fatality rates over the last decade, examining important risk factors including place of residence and socioeconomic status (SES). METHODS: Young driver (17-25years) police-recorded passenger vehicle crashes were extracted from New South Wales State records from 1997-2007. Rurality of residence and SES were classified into three levels based on drivers' residential postcode: urban, regional, or rural; and high, moderate, or low SES areas. Geographic and SES disparities in trends of fatality rates were examined by the generalized linear model. Chi-square trend test was used to examine the distributions of posted speed limits, drinking driving, fatigue, seatbelt use, vehicle age, night-time driving, and the time from crash to death across rurality and socioeconomic status. RESULTS: Young driver fatality rate significantly decreased 5% per year (p<0.05); however, stratified analyses (by rurality and by SES) showed that only the reduction among urban drivers was significant (average 5% decrease per year, p<0.01). The higher relative risk of fatality for rural versus urban drivers, and for drivers of low versus high SES remained unchanged over the last decade. High posted speed limits, fatigue, drink driving and seatbelt non-use were significantly associated with rural fatalities, whereas high posted speed limit, fatigue, and driving an older vehicle were significantly related to low SES fatality. CONCLUSION: The constant geographic and SES disparities in young driver fatality rates highlight safety inequities for those living in rural areas and those of low SES. Better targeted interventions are needed, including attention to behavioral risk factors and vehicle age.

Media framing of graduated licensing policy debates.

BACKGROUND: The overrepresentation of young drivers in road trauma statistics produces significant media interest. Graduated licensing restrictions involving night-time curfews and restrictions on passenger numbers are prominent topics within media coverage. This was particularly apparent in Australia between January 2004 and July 2008, when various models of either restriction were introduced in four states. METHODS: Australian newspaper and Sydney free-to-air television coverage during the peak period were analysed to identify the framing strategies used by news actors supporting or opposing these policies. RESULTS: Fifteen frames were identified. These predominantly assessed the proposed restrictions in terms of their need, evidence base, practicality and the degree to which they were consonant with 'commonsense' perceptions and had community support. While expert road injury reduction news actors primarily emphasised their moral imperative and likely effectiveness, opponents stressed their impracticality and proposed alternative solutions. CONCLUSIONS: Research evidence is only one component of information presented as policy-relevant in policy discourse conducted in news media. Policy reform advocates using the media to advocate for evidence-based policies in road injury prevention need to appreciate that evidence is not the only currency exchanged in such debates and should study opponents' rhetoric in order to anticipate and counteract the framing strategies being used.

Road crash trends for young drivers in New South Wales, Australia, from 1997 to 2007.

OBJECTIVES: The objective of this article was to explore overall crash and injury trends over the past decade for young drivers residing in New South Wales (NSW), Australia, including gender and age disparities. METHODS: Passenger vehicle crashes for drivers aged 17-25 occurring during 1997-2007 were extracted from the state crash database to calculate crash rates (per licensed driver). Generalized linear models were used to examine crash trends over time by severity of driver injury, adjusting for age, gender, rurality of residence, and socioeconomic status. Yearly adjusted relative risks of crash by gender and by age group were also examined over the study period. RESULTS: Young driver noninjury and fatality rates significantly decreased by an average of 4 percent (95% CI: 4-5) and 5 percent (95% CI: 0-9) respectively each year from 1997 to 2007. Young driver injury rates significantly increased by about 12 percent (95% CI: 9-14) to the year 2001 and then significantly decreased. The relative risk of crash (regardless of driver injury) for males compared to females significantly decreased over time. Compared to drivers aged 21-25, drivers aged 17 and particularly 18- to 20-year-olds had significantly and consistently higher crash risks across the study period. CONCLUSIONS: Overall, there has been a significant decline in young driver crashes in NSW over the last decade. Regardless of injury severity, males' risk of crash has reduced more than female young drivers, but drivers aged 17 continue to be at higher risk. These findings provide feedback on potential road safety successes and areas needing specific interventions for future improvements.

Socioeconomic status and risk of car crash injury, independent of place of residence and driving exposure: results from the DRIVE Study.

BACKGROUND: Previous studies that found increased crash risks for young drivers of low socioeconomic status (SES) have failed to adjust for factors such as driving exposure and rural residence. This aim of this study is to examine the independent effect of SES on crash risk, adjusting for such factors, and to examine the relationship between injury severity following a crash and SES. METHODS: Information on risk factors for crash collected from 20,822 newly licenced drivers aged 17-24 years in New South Wales, Australia, as part of the DRIVE Study was prospectively linked to hospitalisation data. SES was classified as high, moderate or low based on the Australia 2001 Socio-Economic Index for Areas. Poisson regression was used to model risk of crash-related hospitalisation by SES, adjusting for confounders. Two measures of injury severity--urgency of treatment and length of hospital stay--were examined by SES. RESULTS: Results of multivariable analysis showed that drivers from low SES areas had increased relative risk (RR 1.8, 95% CI 1.1 to 3.1) of crash-related hospitalisation compared to drivers from high SES areas. This increased risk remained when adjusting for confounders including driving exposure and rurality (RR 1.9, 95% CI 1.1 to 3.2). No significant association was found between injury severity and SES. CONCLUSION: The higher risk of crash-related hospitalisation for young drivers from low SES areas is independent of driving exposure and rural-urban differences. This finding may help improve and better target interventions for youth of low SES.

Risk and type of crash among young drivers by rurality of residence: findings from the DRIVE Study.

BACKGROUND: Most previous literature on urban/rural differences in road crashes has a primary focus on severe injuries or deaths, which may be largely explained by variations of medical resources. Little has been reported on police-reported crashes by geographical location, or crash type and severity, especially among young drivers. METHODS: DRIVE is a prospective cohort study of 20,822 drivers aged 17-24 in NSW, Australia. Information on risk factors was collected via online questionnaire and subsequently linked to police-reported crashes. Poisson regression was used to analyse risk of various crash types by three levels of rurality of residence: urban, regional (country towns and surrounds) and rural. RESULTS: Compared to urban drivers, risk of crash decreased with increasing rurality (regional adjusted RR: 0.7, 95% CI 0.6-0.9; rural adjusted RR: 0.5, 95% CI 0.3-0.7). Among those who crashed, risk of injurious crash did not differ by geographic location; however, regional and rural drivers had significantly higher risk of a single versus multiple vehicle crash (regional adjusted RR 1.8, 95% CI 1.3-2.5; rural adjusted RR: 2.0, 95% CI 1.1-3.6), which was explained by speeding involvement and road alignment at the time or site of crash. CONCLUSIONS: Although young urban drivers have a higher crash risk overall, rural and regional residents have increased risk of a single vehicle crash. Interventions to reduce single vehicle crashes should aim to address key issues affecting such crashes, including speeding and specific aspects of road geometry.

Validation of simulated assessment of teen driver speed management on rural roads.

More US teens die from traffic crashes than from any other cause, with speed and rural roads major contributing factors. This study aimed to validate a high-fidelity simulator to explore these risks in an injury-free environment. Twenty-one newly-licensed 16-year-old males completed simulated and on-the-road drives of the same rural roads. Average free speeds on three road segments showed no systematic differences across segments. The majority of teens exhibited speeds in the simulator within 10% of those on-the-road. These findings validate the simulator for further research on teen driver free speeds on rural roads. Further analyses are needed to validate other performance measures.

Competent independent driving as an archetypal task of adolescence.

Supplement Editor, Dr Flaura K Winston, and Co-Editor, Dr Teresa Senserrick, introduce 10 papers covering the current science of safe driving among adolescents from the varied viewpoints of an international panel of experts. This Expert Panel, convened by the Center for Injury Research and Prevention (formerly TraumaLink) at the Children's Hospital of Philadelphia and State Farm Insurance Companies(R), working jointly on the Youthful Driver Research Initiative, represents a wide range of expertise, thereby providing a broad understanding of driving, adolescence, and adolescent driving.

Reducing young driver road trauma: guidance and optimism for the future.

This paper highlights lessons from each of the Expert Panel papers in the present supplement that provide guidance for future research and initiatives. Although some shortfalls still remain in our understanding, it is argued that much has been learned and we are ready for more translation, implementation, and evaluation of multilevel interventions to help reduce young driver road trauma. Non-use of restraints, speeding, driving at night and with passengers, and fatigue are highlighted as key risk factors to address. "Best practice" intervention is proposed as implementing and strengthening graduated driver licensing systems and complementary candidate programs and research, such as hazard perception training programs. A schematic cognitive-perceptual model to explain the crash sequence process is explored. There is optimism that meaningful impacts can be made, especially coupled with the advances in vehicle technologies, but caution is necessary in the absence of targeted "real world" evaluations and broader implementation and diffusion strategies.

Graduation from a zero to .05 BAC restriction in an Australian graduated licensing system: a difficult transition for young drivers?

In Victoria, Australia, 21-26-year-old drivers are over-represented in alcohol-related fatal crashes. At this age drivers generally transfer from intermediate to full licensure, correspondingly experiencing an increase in legal BAC limit from zero to.05. This study used telephone surveys to compare drinking-driving profiles of 21-26-year-old fully-licensed, 18-20-year-old intermediate and 31-40-year-old experienced drivers ( N congruent with 700) to identify potential crash-risk factors. High driving and drinking exposure was a likely contributor to the over-involvement of male 21-26-year-olds, but not females. A tendency by 21-26-year-olds to rely on other drivers was both successful and unsuccessful in avoiding drink-driving. When driving themselves, there was a tendency to count or space drinks - less successful than abstaining from alcohol. The need to return home, convenience and lack of transport options were common reasons for drink-driving. Fear of crashes/injuries, licence loss and detection/arrest were common motivators to avoid drink-driving. Findings suggest the increase in BAC limit is a difficult transition for some drivers and may contribute to their crash involvement.

A typology approach to describing parents as communicators about sexuality.

Teenagers in Grades 8 and 10 and their parents completed a questionnaire examining the frequency of parental communications about sexuality and the communicative style when discussing sexuality and in general. Respondents also assessed parents' competence in communicating about sexual matters. For each set of respondents (teens reporting about mother, teens reporting about father, mothers' self-reports, fathers' self-reports), a cluster analysis yielded four clusters that were similar for each set. Relative to other parents, there was a group of parents that could be labelled as competent communicators and a group that could be labelled as problematic communicators about sexuality, with strong associations between cluster membership and score on the global measure of communicative competence. There were two intermediate categories that reflected more or less competence although the precise nature of these clusters differed as a function of informant group. Overall, fathers were rated as poorer communicators about sexuality than were mothers, at least by their teenage children. Consistent with other studies, mothers were more likely to be perceived as effective communicators by daughters and older teens. It appears that, independent of their level of competence, parents adjust their communication strategies according to the age and sex of their child, at least in the eyes of that child. Effective and problematic communicators among mothers were regarded as such by both sets of informants. This was not the case for fathers. We conclude that it is possible to classify parents usefully on the basis of perceived competence as communicators about sexuality.

Vowel classification in children.

Research into the developing vowel system has assumed greater importance in recent years with growing evidence for a more important theoretical role for vowels in child phonology. One limitation of acoustic studies in child speech has been the practical difficulties associated with formant-based analysis and the experiments reported in this paper compare the reliability of critical bands and formant frequencies as acoustic correlates of vowel identity in children. Gaussian classification of vowels in/CVd/Australian English words was carried out using data collected from 4-year-old children and male and female adults. The results show that the use of critical bands for the classification of vowels in children is a robust technique which requires less experimenter intervention in the analysis procedure than the use of formant frequencies, while achieving similar results. The ability to utilize an automatic methodology such as critical band analysis can provide a very powerful tool for large-scale studies in this area.