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

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

3. Background

4. 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)

5. 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

6. 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

7. Method

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

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

17. Workshop Attendees

18. Findings

19. 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

20. 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…

21. 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

22. 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

23. Discussion and recommendations

24. 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

25. 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

26. 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?

27. 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

28. ‘Short list’ of interventions1
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

29. 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.

30. 1
An intervention to engage parents in managing post-test driving in specific risky situations

31. 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)

32. 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

33. 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)

34. 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’

35. 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

36. 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)

37. 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

38. 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

39. Do you have any questions?