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

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

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

Comparison of Virtual Driving Test Performance and On-Road Examination for Licensure Performance: A Replication Study

For novice drivers, passing the on-road examination (ORE) for licensure marks the transition from supervised to unsupervised driving. However, the first months post-licensure pose the highest lifetime risk of crashing. In partnership with the Ohio Bureau of Motor Vehicles (OBMV), we have developed a virtual driving test (VDT) to enhance new driver skills testing. Through simulation, license applicants were exposed to common serious crash scenarios too dangerous for inclusion in the ORE. In a previous study of an initial sample of 2,143 driver applicants in Ohio, the acceptability, feasibility and construct validity for the VDT was demonstrated: VDT performance variables (simulated traffic collisions and failing to stop at red lights and stop signs) were associated with failing the ORE (all

Child passenger injury risk in sibling versus non‐sibling teen driver crashes: a US study

Several international jurisdictions allow family exemptions to graduated driver licensing passenger restrictions. The objective of this research was to examine differences in injury risk to US child passengers in crashes involving sibling versus non‐sibling teen drivers, and to compare outcomes with crashes involving adult drivers. Insurance claim and telephone survey data were collected on 16 233 child passengers (representing 289 329 children) in 17 US jurisdictions. There was a trend toward higher restraint non‐use by child passengers in the non‐sibling group than in the sibling group (9.6% vs 4.7%; p = 0.08). Children in the sibling group had a 40% lower risk of injury than those in the non‐sibling group (adjusted OR 0.60, 95% CI 0.40 to 0.90); however, injury risk was higher in the sibling group than in children traveling with adults (adjusted OR 1.57, 95% CI 1.09 to 2.26). Child passengers riding with sibling teen drivers may be safer than those riding with non‐sibling teens, but not as safe as those riding with adult drivers