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The study examines changes over time in crash risk differences between young Australian drivers born in Asia and those born in Australia.Data from the 2003 baseline survey of the DRIVE cohort of 20 806 young drivers aged 17–24 years were linked to police, hospital and death data up until 2016. The association between country of birth and crash was investigated using flexible parametric survival models adjusted for confounders.Six months after baseline, the crash risk in Asian-born drivers was less than half that of their Australian-born counterparts (mean HR, MHR 0.41; 95% CI 0.29 to 0.57), only to increase steadily over time to resemble that of Australian-born drivers 13 years later (MHR 0.94; 95% CI 0.66 to 1.36).This is likely to be associated with acculturation and the adoption by young Asian-born Australian drivers of driving behaviour patterns akin to those born locally. This needs to be considered in future road safety campaigns.

Advanced Driver Assistance Systems (ADAS) have shown substantial potential to increase road safety. To guarantee a growing presence and correct use of ADAS, road safety initiatives such as driver education and programs to promote safer vehicles need to be oriented towards the specific needs of individual drivers. The aim of this study was to explore a sample of Australian drivers’ rationale for driving a vehicle with ADAS and the strategies that they use when learning to operate the functions of ADAS. Semi-structured interviews were conducted with 48 Australian drivers aged between 19 and 78 years (M = 41.54, SD = 16.32; 25 females). The results were organised into four themes: (i) reasons for driving/purchasing a car with ADAS, (ii) systems influencing driver purchasing systems, (iii) strategies used by drivers when learning about ADAS, and (iv) perceptions regarding the importance of learning and training to use ADAS. Acquisition of vehicles with ADAS frequently occurred because of the perceived safety benefits of specific systems (e.g., rear parking sensor or in-vehicle information system). Additionally, some participants did not highlight the safety benefits as the main reason for driving/purchasing a car with ADAS. Indeed, some participants mentioned that ADAS acquisition was not a reasoned process but rather an opportunistic decision when upgrading their vehicles, mainly because these systems were already included in a vehicle. Regarding education, it was found that participants were using trial-and-error as their main approach to learning about the capabilities of ADAS and official sources of knowledge about the system were rarely consulted. On a positive note, participants recognised the importance of learning to use ADAS systems correctly, showing that there is demand for effective and engaging driver education.

Approaches to teaching young Learners to drive on-road often lack a strong, overarching theoretical framework. This paper proposes a transtheoretical model to guide instruction of higher-order skills – that are associated with reduced crash risk in young drivers – including established teaching techniques for effective instruction. Learnings from Self-Determination Theory (SDT) and the Goals for Driver Education framework (widely identified as best-practice but not effectively translated into practice) were integrated into the Higher Order Training supporting Competence, Autonomy, Relatedness (HOT-CAR) model. The model was empirically informed from naturalistic observation of professional in-vehicle lessons (n = 110) and a survey of young adolescent drivers (n = 1627). The HOT-CAR model is presented as a three-component framework that recognises learning to drive occurs within a broader system beyond the Learner and the instructor. The foundation of the model identifies the nature of the relationship between the Learner and the instructor that underlies the success of all other elements. The core of the model is the higher-order driving instruction approach including teaching strategies informed by SDT’s needs-supportive model. The context for the model incorporates some of the immediate considerations relevant to instruction; for example, the graduated driver licensing system, automated vehicle features, and peer influence. An example of the application of the model is provided to reflect the immediate practicality of the HOT-CAR model to driver training. This contributes to the limited road safety literature providing a practical solution to Learner driver training that has potential to reduce the crash risk of young novice drivers. Importantly, the model has potential to be applied and adapted to education and other training environments where higher-order skills are a safety–critical component.

School buses facilitate access to education for many children. This research aimed to systematically review factors associated with safe school bus transportation for children with neurodevelopmental disorders (NDDs). Searches of 5 databases, combining terms denoting NDDs and school buses, for English publications since 2000, yielded only 12 relevant articles among 1524 records. Literature was limited to parent-based studies, guidelines, reviews or commentaries. There was scant attention to the immediate roles of bus drivers and aides. Literature recommendations included increased attention to the needs of children with NDDs and improved communication, collaboration, support and training across all key stakeholders, particularly to improve implementation of individual child safety plans. Further research is needed on this critical support service for many families.

Scaffolding is a well-established approach to education to maximise student learning outcomes. The premise of this paper is that there is a need for formal, scaffolded road safety education (RSE) which can be delivered in schools in Australasia. This paper supports the education system as being expert in matching human growth and developing scaffolds on which to build learning stages and presents arguments to show that an RSE scaffold can and should be drawn up. Schools can provide a structured in-class and real world learning experiences within that scaffold, which, with suitable communication, can be backed up by the home and the broader community. An integrated RSE scaffold across primary through secondary schooling is currently lacking in Australasia, but could be readily integrated in current school curricula. This paper calls for such developments and welcomes further debate and implementation of next steps to achieve this.

BackgroundYoung drivers of low socioeconomic status (SES) have a disproportionally high risk of crashing compared with their more affluent counterparts. Little is known if this risk persists into adulthood and if it differs between men and women.MethodsWe used data from a 2003/2004 Australian survey of young drivers (n=20 806), which included measures of drivers’ demographics and established crash risk factors. These data were linked to police-reported crash, hospital and death data up to 2016. We used negative binomial regression models to estimate the association between participants’ SES, with car crash.ResultsAfter adjusting for confounding, drivers of lowest SES had 1.30 (95% CI 1.20 to 1.42), 1.90 (95% CI 1.25 to 2.88), 3.09 (95% CI 2.41 to 3.95) and 2.28 (95% CI 1.85 to 2.82) times higher rate of crash, crash-related hospitalisation, crash in country areas and crash on streets with a speed limit of 80 km/hour or above compared with drivers of highest SES, respectively. For single-vehicle crashes, women in the lowest SES groups had 2.88 (95% CI 1.83 to 4.54) times higher rate of crash compared with those in the highest SES group, but no differences were observed for men from different SES groups.ConclusionYoung drivers who lived in areas of low SES at the time of the survey had a sustained increased risk of crash over the following 13 years compared with drivers from the most affluent areas. Our findings suggest that in addition to traditional measures, road transport injury prevention needs to consider the wider social determinants of health.

Headway is a safety measure commonly used to investigate driving behaviour and driver performance. Its purpose is to reflect the following distance or time between a leading and following vehicle in traffic. It is therefore associated with drivers’ response time, such as in braking or swerving, during safety critical events. In the literature, distance and time headway are defined in different ways, despite standard definitions in the traffic engineering literature, which prompted this systematic review of headway definitions across a range of study designs, in order to recommend approaches to improve the accuracy and reproducibility of headway definitions used in road safety contexts. PRISMA guidelines were followed to search four databases (EMBASE, COMPENDEX, SCOPUS and MEDLINE) for studies that reported on headways or discussed methodological approaches. The search and filtering of abstracts identified 110 articles for a qualitative synthesis. Four broad approaches to measuring headways were detected: studies using simulation, roadside external features, on-road features, and on-vehicle features. Studies were coded as to whether they included written explanation, mathematical statements, or pictorial depictions of headway. Only 49.6% of studies contextualised headway sufficiently for reproducibility. Reproducibility is crucial for accurate interpretation of research findings and comparisons across studies. It is recommended that headway definitions should a) exclude vehicle or parts of vehicle lengths, b) include reference points (e.g., bumper/axle/rear), c) have a consistent terminology, and d) include the accuracy of headway measuring devices to report the precision of a study’s findings.

Introduction: Few studies have investigated what guidance occurs during the Learner phase of driving, particularly during formal lessons. The objective of this research was threefold: (a) investigate functional and higher-order driving instruction (HO-DI) in formal Learner lessons, (b) explore teaching approaches within the context of a theoretical framework, and (c) investigate variation in these three elements of instruction as a function of Learner driving experience. The theoretical framework developed to guide this research integrated the constructivist Goals for Driver Education and self-determination theory. Method: Professional instruction was explored through naturalistic observation; 15 instructors provided GoPro recordings of 110 driving lessons with Learners aged 16–19 years (n = 96) at varying levels of experience: Early ( 100 h). Results: Employing a previously-developed coding taxonomy, instructor guidance opportunities were identified as 15% HO-DI, 73% functional instruction, and 12% untaken or missed HO-DI. Functional instruction peaked in the Mid Phase, while HO-DI was prominent in the Early phase suggesting missed opportunities in the later phases when use of silence peaked. Some elements of self-determination theory’s needs-supportive model were readily identified in teaching approaches, such as feedback. Conclusions: An understanding of functional and HO-DI, including teaching strategies, was established within the context of an integrated theoretical framework, with different trajectories across Learner experience identified. Teaching strategies reflected constructivism and self-determination theory providing theoretical support for these frameworks to be applied in future driver training studies. Continued research efforts are needed to understand how best to balance functional and HO-DI to maximize young novice drivers’ learning prior to independent driving, particularly during the late Learner period. Practical Applications: Naturalistic observation of current HO-DI and teaching approaches supports the feasibility of integrating recommended improvements arising from the theoretical framework within current practice, with practical implications for improvements to industry training.

Background: Motorcycle riders have the highest injury and fatality rates among all road users. This research sought in-depth understanding of crash risk factors to help in developing targeted measures to reduce motorcycle crash injuries and fatalities. Methods: We used interview data from a study of 2,399 novice motorcycle riders in Victoria, Australia from 2010 to 2012 linked with their police-recorded crash and offence data. The outcome measure was self and/or police reported crash. The association between potential risk factors and crashes was explored in multivariable logistic regression models. Results: In the multivariable analysis, riders who reported being involved in three or more near crashes had 1.74 times (95% CI 1.11–2.74) higher odds of crashing compared to riders who reported no near-crash events, and riders who participated in a pre-learner course had 1.41 times higher odds of crashing (95% CI 1.07–1.87) compared with riders who did not attend a pre-learner course. Riders who had been involved in a crash before the study had 1.58 times (95% CI 1.14–2.19) higher odds of crashing during the study period compared with riders who were not involved in a crash. Each additional month of having held a license and learner permit decreased the odds of crashing by 2%, and each additional 1,000 km of riding before the study increased the odds of crashing by 2%. Conclusion: Measures of pre-learner training and riding experience were the strongest predictors of crashing in this cohort of novice motorcycle riders. At the time of the study there was no compulsory rider training to obtain a learner permit in Victoria and no on-road courses were available. It may be plausible that riders who voluntarily participated in an unregulated pre-learner course became or remained at high risk of crash after obtaining a rider license. We suggest systematically reviewing the safety benefits of voluntary versus mandatory pre-learner and learner courses and the potential need to include on-road components.

Communications through mobile phones and mass media have shown to be useful for health promotion activities in developing nations. This study explored the potential association of mothers’ mobile p...

Higher-order driving skills (HO-DS) are deficient in young drivers who are over-represented in road crash fatalities and serious injuries. Teaching HO-DS has strong theoretical support in reducing crash risk. This study contributes to the dearth of literature regarding on-road driver training that can develop these skills. Higher-order driving instruction (HO-DI) is explored in formal on-road driving lessons (in Queensland, Australia) via naturalistic observation. Fifteen instructors and 96 learner drivers aged 16–19 years were recruited, with 110 lessons observed. An HO-DI coding taxonomy informed by the Goals for Driver Education ( 24) was used for content analysis using an a priori approach, comprising eight HO-DI codes: driving plan (formerly driving route), vehicle control and maneuvering, mastery of traffic situations, surveillance, situational risk (formerly environmental variables), personal risk (formerly knowledge of risk), car function (formerly car knowledge), and distraction. Thirty-nine sub-themes were identified within the codes allowing a deeper understanding of instruction, including missed (unseen) and untaken (seen but not actioned) HO-DI opportunities. The findings inform recommendations for the development of best practice HO-DI. This study has implications for the driver training industry with potential for reducing the crash risk of young novice drivers.

BackgroundPenalties are a key component to improve road user safety, but previous studies suggested that they might not be successful in reducing crashing in offending drivers. However, these studies were not able to consider important crash risk factors in the analysis that might confound the results. Using data from a large prospective cohort study of young drivers in New South Wales, Australia, we explored if novice drivers with driving offences have a higher rates of car crash and if these differences are explained by established crash risk factors.MethodsWe used data from a 2003/2004 Australian survey of young drivers, linked to police reported offence and crash data, hospital data and deaths data up to 2016. We used Poisson regression models adjusted for confounders to estimate the association between driving offences during 2003–2006 with car crash during 2007–2016.ResultsThe study cohort comprised 20 781 young drivers of whom 7860 drivers (37.8%) had at least one driving offence and 2487 (12.0%) were involved in at least one crash. After adjusting for confounders in the regression model, drivers with three or more driving offences had 2.25 (95% CI 1.98 to 2.57), 2.87 (95% CI 1.60 to 5.17) and 3.28 (95% CI 2.28 to 4.72) times higher rates of any crash, crashes that resulted in hospital admission or death and single vehicle crashes compared with drivers with no driving offences.ConclusionMeasures that successfully mitigate the underlying risk factors for both, crashes and offences, have the potential to improve road safety.

IntroductionSelf-harm and suicide are leading causes of morbidity and death for young people, worldwide. Previous research has identified self-harm is a risk factor for vehicle crashes, however, there is a lack of long-term crash data post licensing that investigates this relationship. We aimed to determine whether adolescent self-harm persists as crash risk factor in adulthood.MethodsWe followed 20 806 newly licensed adolescent and young adult drivers in the DRIVE prospective cohort for 13 years to examine whether self-harm was a risk factor for vehicle crashes. The association between self-harm and crash was analysed using cumulative incidence curves investigating time to first crash and quantified using negative binominal regression models adjusted for driver demographics and conventional crash risk factors.ResultsAdolescents who reported self-harm at baseline were at increased risk of crashes 13 years later than those reporting no self-harm (relative risk (RR) 1.29: 95% CI 1.14 to 1.47). This risk remained after controlling for driver experience, demographic characteristics and known risk factors for crashes, including alcohol use and risk taking behaviour (RR 1.23: 95% CI 1.08 to 1.39). Sensation seeking had an additive effect on the association between self-harm and single-vehicle crashes (relative excess risk due to interaction 0.87: 95% CI 0.07 to 1.67), but not for other types of crashes.DiscussionOur findings add to the growing body of evidence that self-harm during adolescence predicts a range of poorer health outcomes, including motor vehicle crash risks that warrant further investigation and consideration in road safety interventions. Complex interventions addressing self-harm in adolescence, as well as road safety and substance use, are critical for preventing health harming behaviours across the life course.

Health policies and public health studies in Bangladesh primarily focus on physical aspects of health, thus creating a gap in the literature regarding the assessment of the emotional-social environment for children and their developmental vulnerabilities. Interactions though literacy activities, such as shared reading times between child and parents, are possible ways to address the developmental and cognitive needs of children. This study explores the district-wise presence of books for children (aged 0–4 years) in households and identifies vulnerable households by exploring the association between sociodemographic status and household book ownership. The Bangladesh Multiple Indicator Cluster Survey 2012–13 was used to map the spatial heterogeneity of average availability of children’s books, which revealed that ownership of age-appropriate books was clustered around divisional cities, with one exception. Around 65% of the households did not have any suitable books for children. The presence of children’s books was significantly (p

This study used data from the Australian Naturalistic Driving Study to study driver engagement in secondary tasks during every day driving and examine the role that various driver characteristics and driving context variables play in influencing the initiation of secondary tasks. Video from 186 randomly selected trips were viewed to identify a range of secondary tasks and to classify contextual variables at the point of task initiation (e.g. vehicle motion, weather, and light conditions). Results revealed that secondary task engagement when driving is highly prevalent, with drivers spending ∼45% of their driving time engaging in potentially distracting tasks. The results also showed that drivers make a number of strategic decisions regarding when to engage, such as waiting until the vehicle is stationary; however, they do not appear to consider some contextual factors that may impact risks, such as weather and light conditions. The findings will be useful in targeting distraction countermeasures and policies and determining the effectiveness of these in reducing driver distraction.

Using data from the Australian Naturalistic Driving Study (ANDS), this study examined patterns of secondary task engagement (e.g., mobile phone use, manipulating centre stack controls) during everyday driving trips to determine the type and duration of secondary task engaged in. Safety-related incidents associated with secondary task engagement were also examined. Results revealed that driver engagement in secondary tasks was frequent, with drivers engaging in one or more secondary tasks every 96 seconds, on average. However, drivers were more likely to initiate engagement in secondary tasks when the vehicle was stationary, suggesting that drivers do self-regulate the timing of task engagement to a certain degree. There was also evidence that drivers modified their engagement in a way suggestive of limiting their exposure to risk by engaging in some secondary tasks for shorter periods when the vehicle was moving compared to when it was stationary. Despite this, almost six percent of secondary tasks events were associated with a safety-related incident. The findings will be useful in targeting distraction countermeasures and policies and determining the effectiveness of these in managing driver distraction.

Background Young men have long been known to be disproportionately impacted by road crash and crash-related injury compared to young women and older drivers. However, there is limited insight into how sex differences in crash and crash-related injury changes over time as men and women get older and gain more driving experience. To explore sex differences in crash and crash-related injury, we undertook a sex disaggregated analysis in a large longitudinal cohort of over 20,000 young drivers in New South Wales, Australia, for up to 13 years after they first attained their independent car driver licence. Methods DRIVE Study survey data from 2003–04 were linked with police, hospital and deaths data up to 2016. Sex differences were analysed using cumulative incidence curves investigating time to first crash and in negative binominal regression models adjusted for driver demographics and crash risk factors. Results After adjusting for demographics and driving exposure, compared with women, men had 1.25 (95% CI 1.18–1.33), 2.07 (1.75–2.45), 1.28 (95% CI 1.13–1.46), 1.32 (95% CI 1.17–1.50) and 1.59 (95% CI 1.43–1.78) times higher rates of any crash, single vehicle crash, crash on streets with a speed limit of 80 km/h or above, crash in wet conditions and crash in the dark, respectively. By contrast, men were less likely to be involved in crashes that resulted in hospitalisation compared to women 0.73 (95% CI 0.55–0.96). Conclusions Young men are at increased risk of crash, and this risk persists as they get older and gain more driving experience. Despite lower risk of crash, women are at higher risk of crash related injury requiring hospitalisation. These differences in men's and women's risk of crash and injury signal the need for better understanding of how sex and/or gender may contribute to risk of crash and injury across the life-course., Highlights • In the DRIVE cohort sex differences were observed in crash and crash-related injury. • Men had higher rates than women for all crash types, except crashes that resulted in hospitalisation. • The largest differences between men and women were observed for single vehicle crashes and crashes in the dark. • Increased risk of crash for men persists as they get older and gain more driving experience. • Preventative efforts require a life-course approach to understanding the factors that shape risk across a person's life.

Background Older pedestrians 60+ (OP) have worse health outcomes due to pedestrian trauma. There is no available systematic evaluation of OP injury outcomes. This becomes increasingly important as the global population ages. We conducted a systematic review, meta-analysis and GRADE assessment of OP injury severity and compare them with those of younger age groups. Methods We searched PubMed, Embase, Scopus, CINAHL, PsycInfo, AMED, Web of Science, LILACS and TRID to identify studies assessing OP crashes and falls. Reporting was evaluated using STROBE, and GRADE was used to assess evidence quality. Random-effect model meta-analysis served to obtain pooled estimates. The review is registered in PROSPERO(#CRD42019140786). Results We included 60 studies (1,012,041 pedestrians). The pooled incidence proportion of OP crashes was 25% (95% CI: 22.3 – 28.5). OP were found to have higher severe injury, more critical care admissions, and higher fatality than younger pedestrians. OP also have higher incidence rates and severe injury from pedestrian falls. The overall quality of the evidence supporting the findings was low. Conclusions OP risks may offset some of the health gains from active ageing strategies, especially for developing economies with high numbers of vulnerable road users and with rapid population ageing. Learning Outcomes There is a need for research to improve the quality of evidence in regard to short and medium-term health outcomes and address long-term health outcomes for OP trauma.

Youth education on risky behaviours, such as alcohol and drug use, has long moved beyond a ‘just say no’ abstinence-only approach. While emphasising that abstinence is safest, guidance is extended to harm reduction approaches, advocating safer ways to engage in the behaviour should the risk occur. In contrast, youth road safety education generally remains abstinence-only (e.g., don't speed, don't use your phone while driving). This manuscript presents arguments in support of the premise that is time to explore applications of harm reduction approaches to young driver education. While acknowledging this is not without risk, without further debate and research there is no evidence base to determine the true potential of road safety education to contribute to reductions in road trauma.

The objective of this study was to investigate if drivers who exhibit risky driving behaviours during youth (aged 17-24 years) have an increased risk of car crash up to 13 years later. We used data from the DRIVE study, a 2003/04 survey of 20,806 young novice drivers in New South Wales, Australia. The data were linked with police crash, hospital and deaths data up to 2016. We analysed differences in crash associated with 13 items of risky driving behaviours using negative binominal regression models adjusted for driver demographics, driving exposure and known crash risk factors. The items were summarised in one index and grouped into quintiles for the analysis. After adjusting for confounding, drivers of the third (RR 1.16, 95% CI 1.05-1.30), fourth (RR1.22, 95% CI1.09-1.36) and fifth quintile (RR 1.36, 95% CI 1.21-1.53) had higher crash rates compared to the lowest risk-takers. Drivers with the highest scores on the risky driving measure had higher rates of crash related hospital admission or death (RR 1.92, 95% CI 1.13-3.27), crashes in wet conditions (RR 1.35,95% CI 1.05-1.73), crashes in darkness (RR 1.55, 95% CI 1.25-1.93) and head-on crashes (RR 2.14, 95% CI 1.07-4.28), compared with drivers with the lowest scores. Novice adolescent drivers who reported high levels of risky driving when they first obtained a driver licence remained at increased risk of crash well into adulthood. Measures that successfully reduce early risky driving, have the potential to substantially reduce road crashes and transport related injuries and deaths over the lifespan.

Introduction Walking is a healthy, environmentally sustainable, and economically profitable transportation strategy for citizens and governments. Despite these benefits, it is also important to understand, and to inform health professionals, policymakers, and public infrastructure planners about, the preventable injury potential of walking in the transportation system and the distribution of injury by gender and age. This is especially important for non-vehicle pedestrian trauma, given that is more prevalent and there is less information available about its injury outcomes in comparison to pedestrian injury caused by vehicle collisions. Method A retrospective cohort study, and cross-sectional bivariate and multivariate analyses of non-vehicle pedestrian trauma in the traffic environment (NVPTE) were conducted. Relative risks (RR) of the incidence of injury and prevalence of injury outcomes by age and gender were calculated using data collected by the Queensland Injury Surveillance Unit (QISU) in Australia. Results Pedestrians aged 60+ have a consistently higher risk of NVPTE incidence when compared with pedestrians aged Conclusion Promoting walking for transport requires the incorporation of prevention strategies that consider key differences in injury outcomes. Clinical fall risk assessments and protective pedestrian infrastructure could play an important role in reducing the health and economic burden of pedestrian falls to the health system.

Risky driving behaviours are a known contributor to young drivers’ overrepresentation in road trauma, with self-regulation suggested as an important associated construct, but yet to be extensively explored. The aims of this study were to examine the utility of self-determination theory in explaining risky driving behaviours and to explore differences between young Learner and Provisional (P1)- licensed drivers in regard to their self-regulated safety orientation and engagement in risky driving behaviours. Learners (n = 1038) and P1(n = 589) drivers, aged 16–19 years, responded to a 91-item online survey, including self-regulated safety orientation items adapted from self-determination theory and inattentive and intentional risky driving behaviour items. Results showed that self-determination theory had good predictive power for the two types of risky driving behaviours for both licence groups. Learner and P1 drivers’ engagement in risky behaviours was similar, however, the relative importance of self-regulated safety orientation elements to reduced engagement in these behaviours differed. Learners’ engagement in intentional risky behaviours reflected greater perceived effort/importance and pressure/tension compared to P1 drivers. Greater effort/importance is an overarching indicator of internalised regulation concerning safe driving behaviours, which might be primed when first exposed to driving. However, greater perceived pressure/tension suggests that internalisation of self-regulatory processes is being suppressed during the Learner phase. This might stem from the required presence of driver trainers and supervisory drivers, as well as interactions with other road users. Whilst only tentative explanations in this first exploration, the findings suggest there is potential for greater efforts in Learner driver training and supervision to encompass the types of skills and learning that encourage the development of self-regulation to reduce risky driving behaviours during both the Learner and P1 stage. These findings contribute to the limited research regarding self-regulation by young novice drivers and informs a better understanding of the psychological influences of engagement in risky driving behaviours, including the first such examination among early independent licensed drivers.

Driving instructors offer important support to the development of young motorists’ safe and competent driving practices. Research has generally neglected to consider instructors’ perspectives when exploring opportunities to improve novice driver road safety. In the application of systems thinking to road safety it is evident that instructors can play a central role in stakeholder interactions. Importantly, to further improve the successes of graduated driver licensing, instructors are integral in their interactions with Learners and their supervising parents. The current study aimed to understand 13 driving instructors’ perspectives regarding experiences of Learner driver training including interactions with Learners’ parents. Semi-structured interviews were conducted, and inductive thematic analysis employed, identifying 10 themes: 100 h of supervised driving, pressure to teach to pass the test, perceived shortcomings in instructor training, inconsistent messaging, parents’ learning disengagement, parents as ‘trainers’ or ‘supervisors’, expectations of professional instruction, Learners’ risky attitudes, bad habits, and a message for parents. A consistent message was found in instructors’ narratives regarding a better understanding of the underlying rationale of graduated driver licensing (GDL) requirements (e.g., the purpose of 100 h of supervised driving), critical given the value of parents and professional instructors working collaboratively to enhance young drivers’ safe driving skills. Practical implications for the driver trainer industry include demand for standardisation of both qualifications and practice within the driving instructor cohort. And for parents, ensuring appropriate knowledge is provided to enable an understanding of the essential components of GDL and the reciprocal roles and benefits offered by professional instructors.

This systematic review sought to assess older adult pedestrian injury severity, injury by anatomical location and incidence proportions, including comparisons to younger age groups when available and provide an analysis of the quality of the existing evidence. A structured search was conducted in PubMed, Embase, Scopus, CINAHL, PsycInfo, AMED, Web of Science, LILACS and TRID. STROBE was used to assess the reporting quality of the included studies. Random-effect model meta-analysis served to obtain pooled relative risk, incidence proportions and standardized mean differences for different outcomes due to pedestrian crashes comparing older and younger pedestrians, while meta-analyses could not be conducted for pedestrian falls. We screened 7460 records of which 60 studies (1,012,041 pedestrians) were included in the review. Injured pedestrians 60+ compared to those60 were found to have a higher relative risk of severe injury (pooled relative risk RR 1.6, 95 % CI: 1.4-2.0 p0.001), critical care admission (pooled RR 1.5, 95 %CI: 1.3-1.8 p0.001), and fatality (pooled RR of 3.7, 95 % CI: 3.0-4.5 p0.001). Pedestrians 60+ also had higher incidence rates of pedestrian falls causing higher injury severity. GRADE was used to evaluate evidence quality, with the results suggesting that the overall quality of the evidence supporting these findings was low. Further research is needed to understand health risks associated with older pedestrian trauma and to develop effective risk management strategies.

Evaluations of new graduated licensing systems (GLS) commonly examine pre-post young driver crash rates relative to another driver group. This comparison approach is important to account for other influences on crashes over time, but has limited ability to determine which GLS components are most effective and at what stage during the licensing process. We previously identified declines in young driver crashes in Queensland, Australia, following introduction of a new GLS in 2007. The objective of the current research was to conduct complementary modelling to identify at what points through the licensing process had particular GLS policies contributed to reductions. Crash trends were explored for learner and provisional drivers under the new GLS versus previous system for three time periods relative to the month of acquiring a provisional licence: the preceding learner period, the first month of provisional licensure (when crashes typically peak), and the overall provisional period. Interrupted time series analyses were conducted for the log ratio of crashes per 10,000 licensed (learner and provisional) drivers with the total number of licensed drivers as an offset. The greatest declines were found in the first month of licensure, with indications that a longer learner period, higher supervised driving hours, and a new provisional night-passenger restriction were key contributors to provisional crash reductions. There was also some indication that a restriction on all phone use reduced crashes during the learner period. We conclude that time series analysis focusing on licensing stage, rather than calendar time only, offers a complementary approach to analysing GLS effectiveness by better identifying where and how changes impact crashes.

Young driver road safety has persisted as a global problem for over 50 years, despite a plethora of interventions. These have emerged from a driver-centric approach, and as such predominantly focus upon “fixing-the-driver”. Therefore, interventions such as education target the young driver, often without addressing that the young driver is just one part of a complex – and much larger – road safety system. An alternative approach with traction in other safety critical, high risk, domains is systems thinking, which recognises there are a multitude of influential actors (e.g., government agencies, community groups) within the broader road safety system that influence young driver safety. As a vital component of an application of systems thinking, this paper presents an analysis of the young driver road safety ‘system’ (YDRSS) in Queensland, Australia by identifying systems actors, and the actors’ perceived system roles in addition to their relationships with other actors. Interviews were held with 82 participants representing 26 actors (‘organisations’) important in young driver road safety. Synthesis of semi-structured interview transcripts revealed some horizontal integration (interaction amongst organisations in the same level) and limited vertical integration (interaction between organisations in lower and higher levels), including some pertinent unidirectional reported interactions. This suggests that the current YDRSS is less than optimal and reveals potential new avenues for intervention through systems thinking – a unique solution to a complex problem.

Evidence indicates that Aboriginal people are underrepresented among driver licence holders in New South Wales, which has been attributed to licensing barriers for Aboriginal people. The Driving Change program was developed to provide culturally responsive licensing services that engage Aboriginal communities and build local capacity. Aim This paper outlines the formative evaluation of the program, including logic model construction and exploration of contextual factors. Methods Purposive sampling was used to identify key informants (n = 12) from a consultative committee of key stakeholders and program staff. Semi-structured interviews were transcribed and thematically analysed. Data from interviews informed development of the logic model. Results Participants demonstrated high level of support for the program and reported that it filled an important gap. The program context revealed systemic barriers to licensing that were correspondingly targeted by specific program outputs in the logic model. Addressing underlying assumptions of the program involved managing local capacity and support to strengthen implementation. Discussion This formative evaluation highlights the importance of exploring program context as a crucial first step in logic model construction. The consultation process assisted in clarifying program goals and ensuring that the program was responding to underlying systemic factors that contribute to inequitable licensing access for Aboriginal people.

OBJECTIVE: Education, employment and equitable access to services are commonly accepted as important underlying social determinants of health. For most Australians, access to health, education and other services is facilitated by private transport and a driver licence. This study aimed to examine licensing rates and predictors of licensing in a sample of Aboriginal and Torres Strait Islander people, as these have previously been poorly described. METHODS: Interviewer-administered surveys were conducted with 625 people 16 years or older in four Aboriginal Community Controlled Health Services in New South Wales and South Australia over a two-week period in 2012-2013. RESULTS: Licensing rates varied from 51% to 77% by site. Compared to not having a licence, having a driver licence was significantly associated with higher odds of full-time employment (adjusted OR 4.0, 95%CI 2.5-6.3) and educational attainment (adjusted OR 1.9, 95%CI 1.2-2.8 for trade or certificate; adjusted OR 4.0, 95%CI 1.6-9.5 for degree qualification). CONCLUSIONS: Variation in driver licensing rates suggests different yet pervasive barriers to access. There is a strong association between driver licensing, education and employment. IMPLICATIONS: Licensing inequality has far-reaching impacts on the broader health and wellbeing of Aboriginal and Torres Strait Islander people, reinforcing the need for appropriate and accessible pathways to achieving and maintaining driver licensing.© 2016 The Authors. Language: en