Huei-Yang Chen

Young Driver Education Programs That Build Resilience Have Potential to Reduce Road Crashes

OBJECTIVE: The research aimed to explore associations between participation in 2 education programs for school-based learner drivers and subsequent road traffic offenses and crashes among a large cohort of newly licensed drivers. METHODS: DRIVE is a prospective cohort study of 20822 first-year drivers aged 17 to 24 in New South Wales (NSW), Australia. Participants completed a detailed questionnaire and consented to data linkage in 2003–2004. Questionnaire items included year of participation in 2 specific education programs: a 1-day workshop-only program focusing on driving risks (“driver-focused”) and a whole-of-community program also including a 1-day workshop but also longer term follow-up activities and a broader focus on reducing risk-taking and building resilience (“resilience-focused”). Survey data were subsequently linked to police-reported crash and offense data for 1996–2005. Poisson regression models that adjusted for multiple confounders were created to explore offenses and crashes as a driver (dichotomized as 0 vs ≥1) after program participation. RESULTS: Offenses did not differ between groups; however, whereas the driver-focused program was not associated with reduced crash risk, the resilience-focused program was associated with a 44% reduced relative risk for crash (0.56 [95% confidence interval: 0.34–0.93]). CONCLUSIONS: The large effect size observed and complementary findings from a comparable randomized, controlled trial in the United States suggest programs that focus more generally on reducing risks and building resilience have the potential to reduce crashes. A large, representative, randomized, controlled trial is urgently needed to confirm road safety benefits and ensure evidence-based spending and practitioner recommendations in this field.

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.

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.

Risky driving behavior and road traffic crashes among young Asian Australian drivers: findings from the DRIVE study

Objective: To examine differences in risky driving behavior and likelihood of traffic crash according to the country of birth of recently licensed young drivers. The groups examined include those born in Australia, those born in Asia, and those born in other countries. Design and setting: The DRIVE study is a prospective cohort study of drivers aged 17–24 years holding their first-year provisional driver license in New South Wales, Australia. Information obtained from 20,822 participants who completed a baseline questionnaire was linked to police-reported traffic crashes. Main outcome measures: Self-reported risky driving behaviors and police-reported traffic crashes in young drivers. Results: Young drivers who were born in Asian countries were less likely to report engaging in risky driving behaviors than their Australian-born counterparts. The proportion of participants reporting a high level of risky driving was 31.5 percent (95% confidence intervale [CI], 30.8–32.1) among Australian-born drivers compared to 25.6 percent (95% CI, 23.1–28.2) among Asian-born drivers and 30.4 percent (95% CI, 28.4–32.5) among those born in other regions. Asian-born participants had half the risk of a crash as a driver than their Australian-born counterparts (relative risk [RR] 0.55; 95% CI, 0.41–0.75) after adjusting for a number of demographic factors and driving and risk-taking behaviors. The comparative risk was even lower among those aged 17 years (RR 0.29; 95% CI, 0.29–0.75). Risk estimates for people born in other regions did not differ to those for Australian-born respondents. Conclusions: The study highlights the lower level of risky driving and significantly reduced crash risk for Australian drivers born in Asian countries relative to those born locally. Further research is needed to examine factors underlying this reduced risk and the impact of the length of residence in the host country.

Driving offences and risk of subsequent crash in novice drivers: the DRIVE Study

Background Little research has examined associations between traffic offences and risk of crash in novice drivers. Methods 20 822 NSW drivers aged 17–24 years holding a provisional licence completed a detailed questionnaire; data were linked to driving offences, and police recorded crashes 2 years following participation. Poisson regression models were adjusted for multiple risk factors including driving exposure, risky driving, and previous crash and offences. Results During follow-up, 9.0% of drivers had one crash, 0.6% had two crashes and 0.04% had three crashes; 35.3% of males had offences recorded compared to 21.3% of females and 41.1% of those reporting high levels of risky driving behaviours had offences compared to 16.3% of people reporting lower levels. In multivariable models, drivers who had any offence had a reduced risk of crash compared to those who had no offences (relative risk (RR) 0.47, 95%CI 0.41 to 0.54). The relationship was sustained for speeding and other offences, but not for reckless driving (RR 0.96, 95%CI 0.61 to 1.49) or alcohol related offences (RR 0.57, 95%CI 0.31 to 1.08). Having any driving offence was associated with increased time to crash (RR 1.21 95%CI 1.1 to 1.27 to 0.86). Conclusion Traffic offences, particularly speeding related offences, are associated with reduced risk of crash for novice drivers. These results suggest that enforcement based approaches are an important component of crash prevention programs for novice drivers.