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«by Johnathon P. Ehsani A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Health Behavior ...»

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This study was based on crash rates calculated using the number of teens in the overall population. With this approach we were able to determine that the public health impact of GDL on 18-year-old drivers was limited to modest increases in possibleinjuries/POD crashes in Michigan and modest reductions in possible-injuries/PDO crashes in Maryland. A more precise evaluation of the effect of GDL would require the age of licensure (and GDL stage) associated with each individual driver’s crash record.

With this more detailed information, time-to-event analysis could be used to compare first-time crash incidence of teens licensed under GDL to those licensed at age 18.

This study examined the effects of GDL on 18-year-old drivers’ crash rates by comparing states where GDL provisions applied exclusively to 15- to 17-year-old drivers (Florida and Michigan) to a state where GDL applied to novice drivers of all ages (Maryland). The absence of individual licensure data did not allow us to determine whether changes in 18-year-old drivers’ crashes were due to some teens not becoming licensed until age 18.

However, we found that 18-year-old drivers possible-injury/PDO crash rates increased in Michigan and declined in Maryland, which is consistent with the presence of an ‘offset effect’ that reflects the crashes of novice 18-year-old drivers.

Table 4.1.

GDL components and effective dates in Florida, Michigan and Maryland.

State GDL Components (effective date) Florida 6 month minimum holding period and nighttime driving restriction (7/96) 12 month minimum hold period and 50 hr supervised driving requirement (10/00) Michigan 6 month minimum holding period, 50 hr supervised driving requirement and 12 midnight – 5 a.m. nighttime driving restriction (4/97) Maryland 4 month minimum holding period and 40 hr supervised driving requirement (7/99) 6 month minimum holding period and 60 hr supervised driving requirement (10/05)

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^ Rates for Florida and Maryland are based on the crashes after the introduction of the first program, and before the introduction of the second program # Property Damage Only * p.05 Table 4.3. Percentage change in crash rate by state, year-of-age and crash type.

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Bartels, R. H., J. C. Beatty and B. A. Barsky (1998). An Introduction to Splines for Use in Computer Graphics and Geometric Modelling. San Francisco, CA, Morgan

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Bureau of the Census. U.S. Department of Commerce (1999). 1990 to 1999 annual time series of state population estimates by age and sex: 1990 to 1999.

Bureau of the Census. U.S. Department of Commerce (2010). State single year of age and sex population estimates: 2000 to 2009.

Chen, L., S. P. Baker, E. R. Braver and G. Li (2000). "Carrying passengers as a risk factor for crashes fatal to 16- and 17-year old drivers." JAMA: The Journal of the American Medical Association 283(12): 1578-1582.

Chen, L. H., S. P. Baker and G. Li (2006). "Graduated driver licensing programs and fatal crashes of 16-year-old drivers: A national evaluation." Pediatrics 118(1): 56Dee, T. S., D. C. Grabowski and M. A. Morrisey (2005). "Graduated driver licensing and teen traffic fatalities." Journal of Health Economics 24(3): 571-589.

Florida Department of Highway Safety and Motor Vehicles. (2009). "License Requirements for Teens - Graduated Driver Licensing." Retrieved 3rd March, 2012, from http://www.flhsmv.gov/ddl/teendriv.html.

Foss, R. and A. Goodwin (2003). "Enhancing the effectiveness of graduated driver licensing legislation." Journal of Safety Research 34(1): 79-84.

Foss, R. D., J. R. Feaganes and E. A. Rodgman (2001). "Initial effects of graduated driver licensing on 16-year-old driver crashes in North Carolina." JAMA: The Journal of the American Medical Association 286: 1588–1592.

Insurance Institute for Highway Safety. (2006). "Motor Vehicle Registration and Licensed Driver Information." Retrieved 13th September, 2011, from www.iihs.org/laws/comments/pdf/fhwa_ds_atm_030906.pdf.

Insurance Institute for Highway Safety. (2011). "Graduated Driver Licensing." Retrieved 26th May, 2011, from http://www.iihs.org/research/qanda/gdl.html.

Insurance Institute for Highway Safety. (2012). "Effective dates of Graduated Driver Licensing Components." Retrieved 29th February, 2012, from www.iihs.org/laws/pdf/gdl_effective_dates.pdf.

Kirley, B. B., A. Feller, E. Braver and P. Langenberg (2008). "Does the Maryland graduated driver licensing law affect both 16-year-old drivers and those who share the road with them?" Journal of Safety Research 39(3): 295-301.

Lam, L. T. (2003). "Factors associated with young drivers car crash injury: comparisons among learner, provisional, and full licensees." Accident Analysis & Prevention 35(6): 913-920.

Males, M. (2007). "California's graduated driver license law: Effect on teenage drivers' deaths through 2005." Journal of Safety Research 38(6): 651-659.

Maryland Motor Vehicle Administration. (2012). "Rookie Driver Program." Retrieved 3rd March, 2012, from http://www.mva.maryland.gov/DriverServices/RookieDriver/default.htm.

Masten, S. V. and R. D. Foss (2010). "Long-term effect of the North Carolina graduated driver licensing system on licensed driver crash incidence: A 5-year survival analysis." Accident Analysis & Prevention 42(6): 1647-1652.

Masten, S. V., R. D. Foss and S. W. Marshall (2011). "Graduated Driver Licensing and Fatal Crashes Involving 16- to 19-Year-Old Drivers." JAMA: The Journal of the American Medical Association 306(10): 1098-1103.

Masten, S. V. and R. A. Hagge (2004). "Evaluation of California's graduated driver licensing program." Journal of Safety Research 35(5): 523-535.

Mayhew, D. R., H. M. Simpson, K. Desmond and A. F. Williams (2003). "Specific and Long-Term Effects of Nova Scotia's Graduated Licensing Program." Traffic Injury

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McCartt, A. T. and E. R. Teoh (2011). "Strengthening Driver Licensing Systems for Teenaged Drivers." JAMA: The Journal of the American Medical Association 306(10): 1142-1143.

McCartt, A. T., E. R. Teoh, M. Fields, K. A. Braitman and L. A. Hellinga (2010).

"Graduated Licensing Laws and Fatal Crashes of Teenage Drivers: A National Study." Traffic Injury Prevention 11(3): 240-248.

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McKnight, A. J. and A. S. McKnight (2003). "Young novice drivers: careless or clueless?" Accident Analysis & Prevention 35(6): 921-925.

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Morrisey, M. A. and D. C. Grabowski (2010). "Gas prices, beer taxes and GDL programmes: effects on auto fatalities among young adults in the US." Applied Economics 43(25): 3645-3654.

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Evaluation of the first four years." Journal of Safety Research 35(3): 337-344.

Shope, J. T., L. J. Molnar, M. R. Elliott and P. F. Waller (2001). "Graduated Driver Licensing in Michigan." JAMA: The Journal of the American Medical Association 286(13): 1593-1598.

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"Effect of Florida's graduated licensing program on the crash rate of teenage drivers." Accident Analysis & Prevention 32(4): 527-532.

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Williams, A. F., S. A. Ferguson and J. K. Wells (2005). "Sixteen-Year-Old Drivers in Fatal Crashes, United States, 2003." Traffic Injury Prevention 6(3): 202 - 206.

Williams, A. F., W. A. Leaf, B. G. Simons-Morton and J. L. Hartos (2006). "Vehicles driven by teenagers in their first year of licensure." Traffic Inj Prev 7(1): 23-30.

Williams, A. F. and R. A. Shults (2010). "Graduated Driver Licensing Research, 2007 Present: A Review and Commentary." Journal of Safety Research 41(2): 77-84.

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The aims of this dissertation were to determine the effect of: 1) several components of GDL on 16- and 17-year-old drivers’ fatal crashes; and 2) GDL on 18year-old drivers’ injury crash rates and shed light on a possible mechanism responsible for any increase. Chapters 2 and 3 addressed the first aim, and Chapter 4 examined the second aim.

To address the first aim, we used natural experiments in GDL policy implementation, where a single GDL component was independently implemented during the period 1990 through 2009. Using this sample, we estimated the effect of individual GDL components. Previous research examining the effects of individual GDL requirements and restrictions had rarely been designed to account for the confounding effect of simultaneously implemented GDL components; nevertheless, analysis designs assumed independent implementation of each component. To address this lapse, in chapters 2 and 3, interrupted time series analysis was used to examine the effect of each GDL component individually. Interrupted time series analysis is also ideal for examining changes related to isolated events while accounting for long-term trends in teen drivers’ crashes. This is another way in which these analyses extended previous studies examining the effect of GDL that had used pre- and post-GDL evaluation designs that were unable to distinguish changes in crashes directly attributable to GDL from differences arising from a preexisting trend.

We observed two GDL components that were independently associated with a decline in 16- and 17-year-old drivers’ fatal crash rates: a learner license period that guaranteed a six-month licensing delay and a strong passenger restriction. Supervised driving hours and nighttime driving restrictions associated with a reduction in 16- and 17year-old drivers’ fatal crashes. These findings raise a number of questions regarding how and why certain GDL components appear to affect driving behavior, while others seem not to. There is little question that GDL systems reduce young drivers’ crashes, and the deaths and injuries that result (Foss 2002). However, the relative contribution of each components and how they produce a reduction in crashes and fatalities has remained elusive.

Advances in understanding the development of expertise and mastery can be used to shed light on the findings from Chapters 2 and 3. Research suggests that the acquisition of expertise with a complex task, such as driving, is multidimensional (Rikers and Paas 2005). Expertise requires extended time to develop, and demands deliberate practice (Keating and Halpern-Felsher 2008) that is most effective when it is coordinated and focused on sequentially improving one capability at a time (Ericsson 2005).

Expertise is best acquired when there is a gradual progression from simple to complex conditions (Gagne and Paradise 1961). A final component of expertise is automaticity. A skill becomes automatic when its related competency has become incorporated into a routine (Keating and Halpern-Felsher 2008).

The architecture of GDL is structured to accommodate the development of expertise. Conceptually, the extended learner license is intended to allow teens to gain practice under very safe conditions over a protracted period of time (Mayhew, Simpson et al. 2003), with the objective of developing basic driving skills. Our finding that the introduction of a six-month learner licensure period that guaranteed licensing delay was followed by a significant reduction in fatal crash rates among 16- and 17-year-old drivers suggests that an extended time period for practice driving may be one of the mechanisms responsible for the effectiveness of GDL.

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