Mobility management to prevent, reduce, or delay driving a car in teenagers.
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ABSTRACT:
SUBMITTER: Ward A
PROVIDER: S-EPMC8094927 | biostudies-literature |
REPOSITORIES: biostudies-literature
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| S-EPMC10291330 | biostudies-literature
Project description:ImportanceOne mechanism for teenagers' elevated crash risk during independent driving may be inadequate learner driving experience.ObjectiveTo determine how learner driver experience was associated with crash risk during the first year of independent driving.Design, setting, and participantsYouth aged 15.5 to 16.1 years at recruitment were eligible to participate. Participants' vehicles were instrumented with sensors, and driving was recorded during the learner period through 1 year of independent driving. Data were collected from January 2011 through August 2014 in southwestern Virginia.ExposuresThe amount, consistency and variety of practice, driving errors, and kinematic risky driving (KRD) rates during the learner period were recorded. Surveys, including one on sensation-seeking personality traits, were assessed at baseline.Main outcomes and measuresCox proportional hazard regressions examined associations between individual characteristics and learner driving experience with driving time to first crash and all crashes in the first year of independent driving. So that hazard ratios (HRs) can be directly comparable, units of measurement were standardized to the interquartile range.ResultsOf 298 individuals who responded to recruitment, 90 fulfilled the criteria and 82 completed the study (of whom 75 were white [91%] and 44 were girls [54%]). Teenage participants drove a mean (SD) of 1259.2 (939.7) miles over 89 days during the learner period. There were 49 property-damage crashes and/or police-reportable crashes during independent driving. Factors associated with driving time to first crash included higher sensation-seeking personality scale scores (HR, 1.67 [95% CI, 1.08-2.57] per 0.75-unit increase), learner driving KRD rates (HR, 1.27 [95% CI, 1.12-1.43] per 9.24-unit increase), and learner driving errors (HR, 0.44 [95% CI, 0.22-0.86] per increase of 6.48 errors). Similar results were obtained for all crashes in the first year, with the addition of consistency of learner driving practice (HR, 0.61 [95% CI, 0.38-0.99] per 0.23-unit increase).Conclusions and relevanceIndividual characteristics and learner driving experiences were associated with crash risk during independent driving. As expected, there was an association between sensation seeking and crashes. Elevated KRD rates during the learner period may reflect risky driving behavior among novices or tolerance to abrupt maneuvers by parents who supervise driving. Consistent practice throughout the learner period could reduce teenage crash risk, which is supported by learning theories indicating distributed practice is effective for developing expertise. Errors during practice may constitute learning events that reinforce safer driving. Physicians could encourage parents to provide opportunities for regular practice driving and monitor their teenager's KRD rates during the learner period using in-vehicle or smartphone-based technology.
| S-EPMC7136860 | biostudies-literature
Project description:Teenage passengers might influence risky driving, particularly in certain mental states. Notably, social exclusion could increase social conformity. Two studies examined simulated intersection management among young drivers after a social exclusion activity (Cyberball). In Study 1 [112 males (mean = 17.3 years)], risky driving was significantly greater among excluded males driving with a risk-accepting vs. passive passenger; no effect of social exclusion. In Study 2 [115 females (mean = 17.1 years)], risky driving was significantly greater among excluded females driving with a risk-accepting vs. a passive passenger, and greater among those included (fair play) vs. excluded when driving with a risk-accepting passenger. Risky driving behavior among male and female teenagers may be influenced uniquely by passenger norms and social exclusion.
| S-EPMC6524721 | biostudies-literature
Project description:BackgroundDisability and falls are common following fall-related lower limb and pelvic fractures.ObjectiveTo evaluate the impact of an exercise self-management intervention on mobility-related disability and falls after lower limb or pelvic fracture.DesignRandomized controlled trial.ParticipantsThree hundred thirty-six community dwellers aged 60+ years within 2 years of lower limb or pelvic fracture recruited from hospitals and community advertising.InterventionsRESTORE (Recovery Exercises and STepping On afteR fracturE) intervention (individualized, physiotherapist-prescribed home program of weight-bearing balance and strength exercises, fall prevention advice) versus usual care.Main measuresPrimary outcomes were mobility-related disability and rate of falls.Key resultsPrimary outcomes were available for 80% of randomized participants. There were no significant between-group differences in mobility-related disability at 12 months measured by (a) Short Physical Performance Battery (continuous version, baseline-adjusted between-group difference 0.08, 95% CI - 0.01 to 0.17, p = 0.08, n = 273); (b) Activity Measure Post Acute Care score (0.18, 95% CI - 2.89 to 3.26, p = 0.91, n = 270); (c) Late Life Disability Instrument (1.37, 95% CI - 2.56 to 5.32, p = 0.49, n = 273); or in rate of falls over the 12-month study period (incidence rate ratio 0.96, 95% CI 0.69 to 1.34, n = 336, p = 0.83). Between-group differences favoring the intervention group were evident in some secondary outcomes: balance and mobility, fall risk (Physiological Profile Assessment tool), physical activity, mood, health and community outings, but these should be interpreted with caution due to risk of chance findings from multiple analyses.ConclusionsNo statistically significant intervention impacts on mobility-related disability and falls were detected, but benefits were seen for secondary measures of balance and mobility, fall risk, physical activity, mood, health, and community outings.Trial registrationAustralian New Zealand Clinical Trials Registry: ACTRN12610000805077.
| S-EPMC7573017 | biostudies-literature