摘要：Objectives. We examined whether feedback from an event-triggered video intervention system reduced the number of safety-relevant driving errors made by newly licensed adolescents. Methods . We used a 1-group pretest–posttest quasi-experimental design to compare the rate of coachable error events per 1000 miles for 18 drivers who were aged 16 years. The intervention consisted of immediate visual feedback provided to the drivers and weekly event reports and videos provided to the drivers and their parents. Results . The number of coachable events was reduced by 61% overall during the intervention (χ2 = 11.42; P = .001) and did not significantly increase during the second baseline, which was assessed after the intervention ended (χ2 = 1.49; P = .223). The greatest reduction was seen in the category of improper turns or curves and for drivers identified at the first baseline as “high-event” drivers. Conclusions . Our results show that immediate visual feedback for adolescents and cumulative video feedback for parents and adolescents during the early period of independent driving can have a dramatic influence on the rate of safety-relevant driving events. To the extent that such events are a proxy for crash risk, we suggest that feedback can enhance adolescent driving safety. In 2005, motor-vehicle crashes accounted for more adolescent deaths in the United States (5253) than did homicide (2219), suicide (1809), and all forms of cancer (981) combined. 1 Fatal crashes occur more frequently for adolescents—especially for newly licensed adolescents—than they do for any other segment of the population. In fact, the crash rate per mile driven for 16-year-old drivers is roughly 4 times the crash rate for all drivers (61.4 per 1000 drivers vs. 16.8 per 1000 drivers). 1 Inexperience, immaturity, and risky driving all contribute to the disproportionate number of adolescents involved in motor-vehicle crashes. 2 Parents generally play an important role in their adolescents’ driving development by mentoring and monitoring them during the supervised-learning phase of driver licensing. However, once adolescents receive their independent driver's license, parental involvement wanes. 3 , 4 This occurs at the worst possible time, because research shows that the first 6 months of independent driving are the most dangerous. In fact, the crash rate per mile driven for newly licensed drivers aged 16 years is twice that of drivers aged 18 to 19 years. 1 Experts on the issue of adolescent driving advocate a dual approach for helping adolescents become independent drivers: the adoption of a graduated driver licensing policy and an increase in parental supervision. 5 Most graduated driver licensing policies restrict exposure of newly licensed adolescents to the riskiest conditions, extend training periods, and require drivers to pass tests in order to progress to the next levels. Doing so increases new drivers’ experience and allows additional time for them to develop maturity and driving skills. Recent research has shown graduated driver licensing to be successful in reducing crashes among beginning drivers by 7% to 37%. 6 – 8 In addition, parental monitoring can reduce intentionally risky driving behaviors, and parental mentoring can fill the gaps left by standard driver education by helping adolescents become more aware of roadway hazards. The crash risk for adolescent drivers is the lowest during the supervised-learner period because of parental involvement. 9 Several new technologies are designed to extend this “low-risk” period by allowing parents to continue in their supervisory role even after independent driving has begun. Data recorders and global positioning systems can provide data to parents on general driving behavior (e.g., speed, acceleration, location). Although there is a lack of research on these more traditional monitoring technologies, our recent study of adolescents aged 16 to 17 years in rural Iowa found that event-triggered video-based interventions may have the potential to improve driving safety among adolescents. 10 , 11 Parents can use such systems to monitor adolescents and enforce restrictions on driving behavior. Alternatively, the systems can be used to mentor adolescents and train them to detect hazards. This follow-up study builds on our previous research with rural Iowa drivers by examining 16-year-old adolescents with less than 6 months of driving experience who drive in an urban environment. Urban adolescents experience very different driving conditions from their rural counterparts and are at greater risk for being involved in a crash. 12 We assessed whether event-trigged video technology that provides feedback to newly licensed adolescents and their parents regarding potentially unsafe driving behaviors reduced the number of safety-relevant driving errors committed by the adolescents. We addressed the following questions: (1) Does the intervention reduce the frequency of safety-relevant driving errors? (2) What types of unsafe behaviors are most influenced by this type of intervention? (3) Does the intervention have a lasting effect? and (4) Does the intervention benefit drivers by enabling parental monitoring or mentoring? To the extent that such technology enables parental monitoring, we hypothesized that the benefit would be immediate but that it would not last once the intervention was complete. Such a benefit would also be greater for intentional behaviors that are unsafe. On the other hand, if the technology enables parental mentoring, we hypothesized that the benefit would emerge over time, would not be greater for intentional behaviors that are unsafe, and would persist beyond the intervention.
