The Risk of Injury to Children in Compact Pickup Trucks

Nearly one million compact pickup trucks were sold last year in the US. Manufacturers now produce extended-cab models of pickups such as the Ford Ranger, Chevrolet S-10, Dodge Dakota, and Toyota Tacoma that can accommodate at least two rear-seated passengers, making them attractive to families with children. However, the safety of these rear seats for children has not been determined. This Issue Brief summarizes a new study that examines and quantifies the risk of injury to children riding in compact pickup trucks. Based on these findings, parents should be advised against using these vehicles as family transportation

A practical approach for applying best practices in behavioural interventions to injury prevention

Behavioural science when combined with engineering, epidemiology and other disciplines creates a full picture of the often fragmented injury puzzle and informs comprehensive solutions. To assist efforts to include behavioural science in injury prevention strategies, this paper presents a methodological tutorial that aims to introduce best practices in behavioural intervention development and testing to injury professionals new to behavioural science. This tutorial attempts to bridge research to practice through the presentation of a practical, systematic, six-step approach that borrows from established frameworks in health promotion and disease prevention. Central to the approach is the creation of a programme theory that links a theoretically grounded, empirically tested behaviour change model to intervention components and their evaluation. Serving as a compass, a programme theory allows for systematic focusing of resources on the likely most potent behavioural intervention components and directs evaluation of intervention impact and implementation. For illustration, the six-step approach is applied to the creation of a new peer-to-peer campaign, Ride Like a Friend/Drive Like You Care, to promote safe teen driver and passenger behaviours

Risky Driving by Recently Licensed Teens: Self-Reports and Simulated Performance

U.S. teens are overrepresented in motor vehicle crashes, with the majority due to driver error; however, causal pathways remain to be elucidated. This research aimed to identify driving performance factors that might underlie newly-licensed male teens’ risk. Surveys were conducted with 21 16-year-olds at the time of intermediate licensure. During the second month of licensure they completed drives in a high-fidelity simulator. Simulator scenarios allowed assessment of responses to yellow traffic lights changing to red and to a visual search task, for which previous data on older age groups of drivers were available. All teens had an A or B grade point average, previously found to be associated with lower crash and citation risk. Nonetheless, 71% reported risky driving in terms of prior unlicensed, unsupervised driving. In the simulator, 46% went through an intersection as the light turned red, compared to 33% of adults. In the visual search task, teens had shorter mean perception-reaction times and identified more targets than adults and older drivers, but similar to young drivers. Therefore, even teens with good grades, perceived to be less risky, were willing to take driving risks. Their driving performance suggests there may be subtle differences in the way recently-licensed teens drive that might predispose them to crashes. Further research of this nature can increase understanding of such differences and inform the development of more targeted intervention

Headway Time and Crashes Among Novice Teens and Experienced Adult Drivers in a Simulated Lead Truck Braking Scenario

Driving simulators can be used to evaluate driving performance under controlled, safe conditions. Teen drivers are at particular risk for motor vehicle crashes and simulated driving can provide important information on performance. We developed a new simulator protocol, the Simulated Driving Assessment (SDA), with the goal of providing a new tool for driver assessment and a common outcome measure for evaluation of training programs. As an initial effort to examine the validity of the SDA to differentiate performance according to experience, this analysis compared driving behaviors and crashes between novice teens (n=20) and experienced adults (n=17) on a high fidelity simulator for one common crash scenario, a rear-end crash. We examined headway time and crashes during a lead truck with sudden braking event in our SDA. We found that 35% of the novice teens crashed and none of the experienced adults crashed in this lead truck braking event; 50% of the teens versus 25% of the adults had a headway time time \u3c 3 seconds at the time of truck braking. Among the 10 teens with \u3c 3 seconds headway time , 70% crashed. Among all participants with a headway time of 2-3 seconds, further investigation revealed descriptive differences in throttle position and brake pedal force when comparing teens who crashed, teens who did not crash and adults (none of whom crashed). Even with a relatively small sample, we found statistically significant differences in headway time for adults and teens, providing preliminary construct validation for our new SDA

A new method for assessing content validity in model-based creation and iteration of ehealth interventions

Background: The advent of eHealth interventions to address psychological concerns and health behaviors has created new opportunities, including the ability to optimize the effectiveness of intervention activities and then deliver these activities consistently to a large number of individuals in need. Given that eHealth interventions grounded in a well-delineated theoretical model for change are more likely to be effective and that eHealth interventions can be costly to develop, assuring the match of final intervention content and activities to the underlying model is a key step. We propose to apply the concept of 'content validity' as a crucial checkpoint to evaluate the extent to which proposed intervention activities in an eHealth intervention program are valid (eg, relevant and likely to be effective) for the specific mechanism of change that each is intended to target and the intended target population for the intervention. Objective: The aims of this paper are to define content validity as it applies to model-based eHealth intervention development, to present a feasible method for assessing content validity in this context, and to describe the implementation of this new method during the development of a Web-based intervention for children. Methods: We designed a practical 5-step method for assessing content validity in eHealth interventions that includes defining key intervention targets, delineating intervention activity-target pairings, identifying experts and using a survey tool to gather expert ratings of the relevance of each activity to its intended target, its likely effectiveness in achieving the intended target, and its appropriateness with a specific intended audience, and then using quantitative and qualitative results to identify intervention activities that may need modification. We applied this method during our development of the Coping Coach Web-based intervention for school-age children. Results: In the evaluation of Coping Coach content validity, 15 experts from five countries rated each of 15 intervention activity-target pairings. Based on quantitative indices, content validity was excellent for relevance and good for likely effectiveness and age-appropriateness. Two intervention activities had item-level indicators that suggested the need for further review and potential revision by the development team. Conclusions: This project demonstrated that assessment of content validity can be straightforward and feasible to implement and that results of this assessment provide useful information for ongoing development and iterations of new eHealth interventions, complementing other sources of information (eg, user feedback, effectiveness evaluations). This approach can be utilized at one or more points during the development process to guide ongoing optimization of eHealth interventions

Examining virtual driving test performance and its relationship to individuals with HIV-associated neurocognitive disorders

SIGNIFICANCE: Existing screening tools for HIV-associated neurocognitive disorders (HAND) are often clinically impractical for detecting milder forms of impairment. The formal diagnosis of HAND requires an assessment of both cognition and impairment in activities of daily living (ADL). To address the critical need for identifying patients who may have disability associated with HAND, we implemented a low-cost screening tool, the Virtual Driving Test (VDT) platform, in a vulnerable cohort of people with HIV (PWH). The VDT presents an opportunity to cost-effectively screen for milder forms of impairment while providing practical guidance for a cognitively demanding ADL. OBJECTIVES: We aimed to: (1) evaluate whether VDT performance variables were associated with a HAND diagnosis and if so; (2) systematically identify a manageable subset of variables for use in a future screening model for HAND. As a secondary objective, we examined the relative associations of identified variables with impairment within the individual domains used to diagnose HAND. METHODS: In a cross-sectional design, 62 PWH were recruited from an established HIV cohort and completed a comprehensive neuropsychological assessment (CNPA), followed by a self-directed VDT. Dichotomized diagnoses of HAND-specific impairment and impairment within each of the seven CNPA domains were ascertained. A systematic variable selection process was used to reduce the large amount of VDT data generated, to a smaller subset of VDT variables, estimated to be associated with HAND. In addition, we examined associations between the identified variables and impairment within each of the CNPA domains. RESULTS: More than half of the participants ( CONCLUSION: We identified a subset of VDT performance variables that are associated with HAND and assess relevant functional abilities among individuals with HAND. Additional research is required to develop and validate a predictive HAND screening model incorporating this subset