1. Michigan’s Graduated Driver Licensing (GDL) and Beyond Jean T. Shope, MSPH, PhD Michigan Traffic Safety Summit March 15, 2007 Support: NHTSA, NIH, CDC/NCIPC, NSC Colleagues: Waller, Molnar, Zakrajsek, Bingham, Elliott, Simons-Morton

2. Overview n Michigan’s GDL evaluation n Other jurisdictions’ GDL evaluations n National GDL evaluations n Program to enhance parental involvement

3. Background n US: MVC injury leading cause of teen deaths n Crash risk highest first few months driving solo n 1996-2007: GDL adopted by nearly all states o Under 18 years old o 3-stage license process o Extended learner phase (practice requirements) o Restrictions in intermediate phase (night, passenger)

4. Segment 1 DriverEducation Level 1 License 14 yr 9 mo Segment 2 DriverEducation Level 2 License 16 yr Level 3 License 17 yr 24 hr class 6 hr driving Written exam Drive only with parent or adult 6 hr class Drive alone Night restriction Michigan GDL/Driver Education April 1, 1997 No restrictions Healthy Parent sign 6 mo Level 1 Driven 50 hr Road test 90 day clean Parent sign 6 mo Level 2 12 mo clean

5. Parental Experience with Michigan’s GDL Program (July 1998 Survey) Hours of practice:  9% less than required  23% required 50 hours  68% more (mean = 75.3 hours) Quality of GDL experience:  97% good/very good Waller, Olk, Shope. J Safety Research (2000) 31:9-15

6. Michigan’s GDL: Early Impact on MVCs Among 16-Year-Olds 1996 vs 1999 crash data, adjusted All crashes: down 25% Fatal plus nonfatal injury crashes: down 24% Night crashes: down 53% Shope, Molnar, Elliott, Waller. JAMA (2001) 286:1593-1598

7. All Crashes: Counts, Pop Rates, Licensee Rates Shope, Molnar. Journal of Safety Research 35 (2004) 337-344.

8. Casualty Crashes: Counts, Pop Rates, Licensee Rates Shope, Molnar. Journal of Safety Research 3 (2004) 337-344.

9. Michigan’s GDL: First Four Years: 16 yo MVCs 1996 vs 1998-2001 Significant crash reductions maintained (2001 all crashes down 19%, adjusted) Reductions in #, crashes/population, crashes/driver Reductions in both sexes, but men still higher Evening crash reduction not significant after adjusting (3 X that of 25+ yo) Crashes with passenger reduced (3 X that of 25+ yo) Lower proportion of 16-year-olds licensed Shope, Molnar. J Safety Research (2004) 35:337-344

10. Updated Michigan GDL Results Age of licensure increased somewhat Time in each GDL level exceeds minimum Number of crashes per driver less each GDL year Time until first crash/offense longer each GDL year Time until first injury crash:  Each cohort longer than pre-GDL  Each cohort longer than previous cohort

11. Novice Teen Driving/GDL Invited Symposium n February 5-7, 2007 in Tucson n Shope: Review of GDL evaluations n Williams: Components of GDL n Papers to be published in April n Journal of Safety Research

12. GDL Evaluation Results (20): Individual Jurisdiction Studies n Can’t compare - different pre/post programs & evals n Consistent positive findings o Substantial crash reductions from 19 of 20 studies (20%-40%) o Convictions down in Iowa o Hospitalization and charges down in NC n California studies: differing methods and results

13. GDL Evaluation Results (6): Nationwide Studies n Consistent, positive findings n Reductions 6% (15-17 yo traffic fatalities) to 40% (16 yo driver involvement in injury crashes) n Greater reductions found with stronger GDL programs n Greater reductions among teen vs. older drivers n No increase in crash risk for 17 or 18 yo n No male/female differences in reductions

14. What in GDL works? n Whole program works as a package n GDL programs with recommended components more effective o Learner: 16 yrs, minimum 6 months, 30+ hours practice o Intermediate: Night restriction start 10 pm Passenger restriction - no more than one teen except family n Effectiveness of each component? o Allan Williams’ paper (April J Safety Research)

15. How do we enhance GDL? n Even with GDL, teen drivers still crash n Based on research, enact the best GDL program n Implement the program well n Enhance parent involvement

16. Checkpoints Program Developed by: National Institute of Child Health & Human Development (Bruce Simons-Morton & colleagues) Purpose: To facilitate parental management of teen driving and reduce adolescent driving risk

17. Checkpoints Program Parent-Teen Written Driving Agreement n Initially: o low-risk conditions, can drive alone o high-risk conditions, with adult n Later, increase privileges with experience and responsible behavior

18. Checkpoints Program n Persuasive Communications (mailed/DMV) o Video o Newsletters o Agreement n 3 studies completed (CT, MD) n 1 study underway (RI) n 2 studies underway (MI)

19. Checkpoints Study Results (Simons-Morton & Colleagues) n Parents set limits on teen drivers o Nearly all set limits; not strict; rapid decline (Prev Sci 2001, Inj Prev 2004, Am J Pub Hlth 2005) o More limits set in GDL vs non-GDL state (Acc Anal Prev 2005) n Greater parent limits associated with less risky driving, fewer violations and crashes (J Adol Res 2000, Prev Sci 2001, Hlth Ed Behav 2002, Traffic Inj Prev 2006)

20. Segment 1 DriverEducation Level 1 License 14 yr 9 mo Segment 2 DriverEducation Level 2 License 16 yr Level 3 License 17 yr 24 hr class 6 hr driving Written exam Drive only with parent or adult 6 hr class Drive alone Night restriction Michigan GDL/Driver Education No restrictions Healthy Parent sign 6 mo Level 1 Driven 50 hr Road test 90 day clean Parent sign 6 mo Level 2 12 mo clean CHECKPOINTS

21. Michigan “Checkpoints One” Driver Education (NICHD-funded) n Randomized controlled trial n Driver education setting n Timing just prior to independent driving n Ensure parent/teen complete agreement o Conditions/privileges (night, passengers, weather, roads) o Rules: check in, risks, traffic laws (alcohol, safety belts)

22. “Checkpoints One” Intervention n Recruited from Segment 2 classes (Sears) n Parent/teen session (30 minutes) taught by health educator (research staff) at end of Segment 2 o Baseline survey, video, agreement discussed/completed n Mailing 1 week prior to expected Level 2 license date o Newsletter, agreement

23. “Checkpoints One” Status n Enrollment: 326 parent-teen dyads n Telephone surveys: licensure, 3 & 6 mo after n Teens: most at Level 2 licensure; in follow-up n Results soon from baseline and licensure surveys

24. Michigan “Checkpoints Two” (CDC/NCIPC-funded) n Randomized controlled design n Baseline survey by mail; ask expected license date n Driver educators trained to teach parent/teen session (30 minutes) in Segment 2 o Video, persuasion, agreement discussed/completed o Booklet / agreement n Telephone surveys: licensure, 3 & 6 months after

25. “Checkpoints Two” Status n Permission granted for Checkpoints in Segment 2 n Driving schools recruited and randomized (8) n Training video, materials developed n Driver educators trained n First classes scheduled n Recruitment starting soon

26. Summary n GDL reduces teen driver crashes and consequences n More needed, especially in first six months driving solo n Parental involvement, limit-setting important n Checkpoints approach effective n Checkpoints in Michigan’s driver education Segment 2 being evaluated with researchers and driver educators n If effective, could be implemented widely

27. Thank you! JShope@umich.edu