Young and novice driver intervention review Dr Shaun Helman - November 2016

Background to the project Contents 1 Background to the project 2 Method used 3 Findings 4 Discussion and recommendations

Background

Background Newly qualified drivers of all ages experience an elevated risk of crashing their car within the first three years of passing their test (risk is even higher for those under the age of 25) Proportionately higher accident rates of young and novice drivers compared with other groups are due to: Lack of driving experience Behaviours associated with elevated crash risk (e.g. poor perceptions of risks, hazards, drink driving, speeding)

Background Some interventions seek to reduce the risk through licensing systems that maximise maturity and on-road experience before full licensure (e.g. Graduated Driver Licensing approaches) Some interventions take an alternative approach using a variety of methods (e.g. training, education, technology, support networks) in attempts to equip learners with skills, knowledge and attitudes they need to become a safer driver, or in an attempt to target specific risk factors at the behavioural level This project focuses on the second type of intervention

Project aims To conduct an evidence base review, which builds on the existing evidence, helping to understand the effectiveness of pre- and post-test interventions, in terms of their ability to influence the attitudes and behaviours of young and novice drivers To prioritise and shortlist those interventions that may have the greatest potential to reduce collision rates among this group

Method

Method overview Inception Evidence reviews Rate interventions Final report Synthesis of the effectiveness of different pre- and post-test interventions Synthesis of evidence linking ‘proxy’ measures such as those covered in the first review Expert workshop

Review Included interventions from the year 2000 Initial search yielded 402 articles List of abstracts were reviewed to establish potential relevance 52 articles remaining after relevance scoring – these were scored for quality on the Adjusted Maryland Scientific Methods Scale (AMSMS) List of proxy measures / risk factors pertinent to collision and injury risk in novice drivers was developed

Proxy measures / risk factors Many evaluations of interventions do not measure effects on collision involvement Studies that use collision or injury outcomes are often based on small sample sizes (so lack statistical power) The multifactorial nature of collision involvement makes the task of finding a true proxy measure challenging The focus of the review evolved to consider risk factors as an alternative

Risk factors Risk factors can be thought of as any measure that is known to be associated with the final outcome (in this case, collisions) In contrast to proxy measures, risk factors are not assumed to be completely equivalent to the final outcome By “Final Measure” we mean a collision

Risk factors Supplementary literature review undertaken to identify pertinent risk factors associated with collision and injury risk Implication: interventions that demonstrate impact on these risk factors would show promise as interventions to reduce collision risk By “Final Measure” we mean a collision

Desirable changes in risk factors Less driving with peer age passengers, or fewer peer age passengers More supervised on-road experience pre- or post-test Older age at licensure Less night time driving More seat belt wearing Lower speeds Lower levels of drink driving Less use of distracting devices when driving Higher hazard perception skill Less close following Reducing unsafe attitudes and behavioural intentions

Scoring of interventions Design quality (on AMSMS) Magnitude of impacts seen (small, medium, large) Weight of evidence (number of studies with safety improvements, safety disbenefits, or demonstrating no change) The outcome measure targeted for change (whether injuries/collisions or risk factors) The theoretical plausibility of the mechanisms proposed for impact Historical literature also considered

Workshop Purpose was to provide a mechanism by which interventions could be scrutinised by road safety professionals and stakeholders Workshop did not consider evidence of effectiveness, instead it focused on a list of interventions and the practical issues associated with their potential implementation Goal was to reduce the list of interventions to the three to five with the greatest potential on likely effectiveness and consideration of a range of characteristics that might influence larger scale implementation

Criteria Acceptability Applicability Cost Ease of implementation Ownership Target audience Any other issues

Workshop Attendees

Findings

Review findings Almost all interventions are evaluated against non-collision or non-injury outcome measures Even when collision or injury outcomes are included, sample sizes achieved are often insufficient to draw any firm conclusions This made the consideration of risk factors targeted by interventions more important

Review findings Few ‘off the shelf’ interventions which had been evaluated in multiple studies of high enough quality to consider them for inclusion in the workshop There were however some interventions and intervention types that tended to focus on plausible risk factors…

Review findings Seven evidence-based interventions/intervention types were taken forward for discussion at the workshop Three involved parental engagement, three involved the use of technologies to help promote behavioural change in pre-test and post-test phases, and one involved hazard perception training Classroom education and behind-the-wheel training were also included for discussion at the workshop so that ease of implementation could be assessed against existing delivery capacity and provision

Workshop findings None of the interventions discussed were ‘ruled out’ Most interventions were positively received and described as having key positive and negative aspects Discussion focused on how the different potential interventions might be best built into the existing licensing process Incentives were discussed in terms of being required to maximise market penetration if a voluntary (i.e. non-mandatory participation) approach is taken

Discussion and recommendations

Discussion Almost no ‘off-the-shelf’ interventions that have been properly evaluated and found to be effective Consideration of the largest group of interventions (traditional education and training approaches) that are currently in circulation and which target newly qualified drivers reveals a bleak picture Some interventions (e.g. SDSA) being delivered widely in GB have been evaluated to some degree and found to be ineffective in producing real change, even in ’softer’ measures

Discussion There are a number of so-called ‘innovative’ interventions that have not yet been evaluated properly, but for which no plausible mechanisms of effectiveness can be identified Novel approaches undertaken by insurers, for which commercial confidence exists but which lack any support from rigorous and independent review

Reason for apparent ineffectiveness Interventions do not target relevant risk factors Driving skill, knowledge, attitudes and other measures with ‘intuitive appeal’ are offered as potential outcomes of merit, but when the theoretical plausibility of such outcomes as genuine indicators a later collision risk is examined, none is found Dosage?

Recommended interventions Four interventions recommended for properly controlled scientific evaluation in a future trial in GB Supported by a reasonable level of empirical evidence Target risk factors that are plausibly important in contributing to collisions in newly qualified drivers, and use theoretically plausible mechanisms to achieve change Seem feasible in terms of the practicalities of both an evaluation trial and subsequent roll-out

‘Short list’ of interventions 1 An intervention to engage parents in managing post-test driving in specific risky situations 2 An intervention to engage a range of stakeholders (utilising a logbook approach) in increasing the amount and breadth of pre-test on-road experience 3 An intervention utilising technology (in-vehicle data recorders or ‘telematics’) and possibly parents to manage driver behaviour post-test 4 An intervention to train hazard perception skill

1 An intervention to engage parents in managing post-test driving in specific risky situations The one ‘of the shelf’ intervention which showed some promise is the ‘Checkpoints’ Programme The programme helps parents to manage the risks faced in early licensed driving (e.g. driving at night, driving with peer-age passengers, driving in poor weather conditions) A key component is the ‘parent-teen’ driving agreement that sets a number of restrictions that can be gradually ‘lifted’ The programme can be delivered using online resources The programme relies on a newly qualified driver having access to someone who can fulfil the ‘parent’ role.

1 An intervention to engage parents in managing post-test driving in specific risky situations

Relatively low cost (online) Relatively easy to implement (at national/ governmental level) Increased parental involvement is always positive Parental role allows for some control over the implementation of restrictions The intervention directly targets known risk factors Difficult to get parents’ buy-in and/or to maintain commitment longer term Parents may not see themselves as part of the learning process Reliant on good parent-teen relationships Self selection bias (younger, and more affluent, still living at home, supportive parents)

2 An intervention to engage a range of stakeholders (utilising a logbook approach) in increasing the amount and breadth of pre-test on-road experience This intervention is based on evidence that increased amounts and (and breadth) of on-road experience before licensure can decrease post-licence collision risk Previous studies have suggested around 120 hours as a target Buy-in from ADIs and the parent is critical Support from the DVSA to provide a mechanism for logging practice will be required The programme relies on a learner having access to a supervising driver

DVSA would be prepared to support the log-book component Increasing amounts (and breath) of on-road experience can reduce collision risk Can expose newly qualified drivers to risky situations in a relatively controlled way Considerable time commitment from all parties involved 120 hours of supervised driving is desirable but potentially unrealistic Parents may not see themselves as part of the learning process Reliant on good parent-teen relationships Self selection bias (younger, and more affluent, still living at home, supportive parents)

3 An intervention utilising technology (in-vehicle data recorders or ‘telematics’) and possibly parents to manage driver behaviour post-test There are some questions around the consistency of driver ‘models’ that are used – a bespoke system may need to be developed for a trial Some young drivers may not be comfortable having their driving tracked There is an obvious potential link with the insurance industry in the form of ‘Pay As You Drive’ polices but there is likely to be some self-selection bias The programme would rely on a ‘parent’ figure to oversee and respond to negative driving ‘events’

Driving difficulties backed by concrete data – harder to dispute Parents would be interested to know young driver’s performance Could be used as a tool to help the driver through the initial high-risk phase of driving Opportunities for incentivising may help increase uptake Challenges around data usage, data protection, opt-outs and general understanding of the data collected Monitoring the use of feedback Installation and/or policy costs Challenges with uptake and continued engagement The longer term impacts on behaviour are questionable

4 An intervention to train hazard perception skill The evidence base is fairly robust (its inclusion in the current test has suggested positive effects on collisions) The delivery mechanism is relatively straightforward and understood by stakeholders Given that it is an existing component of the test, it would be a less challenging intervention to ‘sell’ than some of the others being considered A consideration is whether to make it compulsory or voluntary (possibly incentivised by insurance premiums)

Proven to be important for safety; industry is comfortable with it Low cost/ if self-financed Easy to implement (e-learning) Could appeal to wider audience if this dynamic could also include partners/ spouses The evidence base is quite robust as a behaviour change tool Challenges in encouraging uptake, particularly post-test Need to select/ develop the appropriate training Might be perceived as unnecessary duplication of existing test components

Evaluation and later implementation Evaluate using a Randomised Control Trial design, and ideally using collisions as the outcome measure of interest Trial design provides a robust appraisal to be made of the efficacy of each intervention, and permits causality to be inferred

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