Effectiveness of Behavioral Highway Safety Countermeasures (2008)

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33 Countermeasures shown in the text as Unknown/Uncertain/ Unlikely were further rated as: + some basis for thinking they should work; − some basis for thinking they will not work; and 0 unknown whether or not they will work. The main criterion for this rating was the research evidence. There may be no research evidence at all, there are cases where the weight of evidence tips the scale toward a + or − rating, and there are cases where the available research evi- dence does not allow a judgment. The second criterion, used in the absence of research evidence, involved whether the countermeasure has characteristics associated with success- ful or unsuccessful measures. For example, in the Voluntary Action Group, programs targeting children would be con- sidered likely to work. Voluntary Action + Child pedestrian supervision training for caregivers (research lacking; has characteristics associated with successful programs). + Child safety clubs (the mostly European research base does not have clear-cut findings; has characteristics associated with successful programs) (West, Sammons, and West, 1993; Gregersen and Nolen, 1994; Dragutinovic and Twisk, 2006). + Bicycle education for children (research lacking; has characteristics associated with successful programs). 0 School-based alcohol education programs to reduce drinking and driving (insufficient evidence from re- search; does not have characteristics associated with suc- cessful programs) (Stewart, 1999; Elder, Nichols, Shults et al., 2005; Shope, Elliott, Raghunathan et al., 2001; D’Amico and Fromme, 2002). − PI&E for elderly drivers (no relevant evaluations; does not have characteristics associated with successful programs). + PI&E for low belt users (weight of evidence suggests the high-quality programs can increase belt use) (Solomon and Chaffe, 2006). − Motorcycle education and training courses (weight of re- search evidence suggests no effects on crashes) (Mayhew and Simpson, 2001; Ivers, in progress). − Formal driver education courses for elderly drivers (weight of evidence suggests no effects on crashes) (Owsley, McGwin, Phillips et al., 2004; Kua, Korner-Bitensky, Desrosiers et al., 2007). + Bike fairs, rodeos (no relevant research; has characteris- tics associated with successful programs). − Driver training about sharing the road with bicycles (no relevant research; does not have characteristics associated with successful programs). − Teaching bike rules/safety in driver education (no rele- vant research; does not have characteristics associated with successful programs). − Education encouraging bicyclists to increase their con- spicuity (no relevant research; does not have character- istics associated with successful programs). − Education to encourage pedestrians to increase their conspicuity (no relevant research; does not have charac- teristics associated with successful programs). − Driver education in regard to pedestrians (no relevant research; does not have characteristics associated with successful programs). − Programs to teach driver awareness about motorcyclists (no relevant research; does not have characteristics associated with successful programs). − PI&E about driver fatigue (no relevant research; does not have characteristics associated with successful programs). − PI&E about distracted driving (no relevant research; does not have characteristics associated with successful programs). A P P E N D I X A Unknown/Uncertain/Unlikely Countermeasures

− PI&E on sleep disorders for general population and physicians (no relevant research; does not have charac- teristics associated with successful programs). + Employer programs for shift workers, medical interns (insufficient research; has characteristics associated with successful programs). + Alternative transportation for alcohol-impaired drivers (weight of evidence suggests positive effects) (Lacey, Jones, and Anderson, 2000; Rothschild, Nastin, and Miller, 2006). 0 Designated driver programs (research evidence incon- clusive; does not have characteristics associated with successful programs) (Ditter, Elder, Shults et al., 2005). − Motorcycle helmet use promotion programs (no rele- vant research; does not have characteristics associated with successful programs). − PI&E regarding drinking and motorcycling (no relevant research; does not have characteristics associated with successful programs). − Education to encourage motorcyclists to increase their conspicuity (no relevant research; does not have charac- teristics of successful programs). 0 Programs to help police detect impaired motor- cyclists (no relevant research; facilitates the enforce- ment process). − Communications and outreach regarding impaired pedestrians (no relevant research; does not have charac- teristics associated with successful programs). − Extreme fear and scare tactics in youth programs (no rel- evant research; has characteristics thought not to be as- sociated with successful programs) (Elliott, 2005; DeJong and Wallack, 1999). 0 High school driver education (not leading to early learning/ licensing). + School bus training for children (no relevant research; has characteristics associated with successful programs). Laws, Regulations, and Policies + General cell phone laws (mixed research evidence, short- term effects that may or may not last depending on enforcement and publicity; has characteristics associ- ated with successful laws) (McCartt, Hellinga, and Geary, 2006; McCartt and Hellinga, 2007). 0 Open container laws (scant evidence; does not have char- acteristics associated with successful laws) (Stuster, Burns, and Fiorentino, 2002). + Lower BAC limit for repeaters (weight of evidence sug- gests positive results) (Hingson, Heeren, and Winter, 1998; Jones and Rodriguez-Iglesias, 2004). + Cell phone laws as part of graduated licensing (limited research evidence). + Belt use as part of graduated licensing (limited research evidence) (Goodwin, Wells, Foss et al., 2006). 0 Motorcycle licensing laws, especially in regard to having a valid license (some limited evidence that programs can increase licensure) (Braver, Kufera, and Volpini et al., 2007). 0 Comprehensive belt laws versus laws with significant ex- ceptions (no relevant research, e.g., on extent to which belt laws that cover rear passengers increase belt use; does not have characteristics associated with successful laws). 0 Keg registration laws (positive but inconclusive evidence they reduce crash rates; does not have characteristics as- sociated with successful laws) (Grube and Stewart, 2004). 0 Medical advisory boards for elderly drivers (no relevant studies; some likelihood that medical advisory boards can assist licensing agencies in evaluating people with medical conditions/functional limitations affecting driving ability). − Aggressive driving laws (no relevant research; does not have characteristics associated with successful laws). − Driver fatigue and distracted driving laws (no relevant research; does not have characteristics associated with successful laws). + Referring elderly drivers to licensing agencies (limited research; likelihood that states establishing and publi- cizing referral procedures will increase referrals). + Elderly licensing screening and testing (limited research; likelihood that model guidelines can identify with rea- sonable accuracy those whose driving should be cur- tailed) (Staplin and Lococo, 2003; Staplin, Lococo, Gish et al., 2003). + Elderly licensing restrictions (weight of evidence suggests restrictions lower crash risk) (Vernon, Diller, Cook et al., 2001). Laws Plus Enhancements + Aggressive driving enforcement (weight of evidence sug- gests positive effects) (McCartt, Leaf, Witkowski et al., 2001; NHTSA, 2002; Stuster, 2004; Davis, Bennink, Pepper et al., 2006). + GDL enforcement (weight of evidence suggests positive though limited effects) (Goodwin, Wells, Foss et al., 2006). − Enforcement of pedestrian rules (for both drivers and pedestrians; limited research); one study showed no effect on driver yielding; does not have characteristics associated with successful programs (Britt, Bergman, and Moffat, 1995). − Enforcement of bike rules (for both bikers and drivers) (no relevant research; does not have characteristics as- sociated with successful programs). 34

+ Enforcement against unapproved motorcycle helmets (no relevant research; has characteristics associated with successful programs). Sanctions and Treatments + Vehicle forfeiture (no relevant research; has characteris- tics associated with successful sanctions). 0 GDL penalties (limited unsupportive research; does not have characteristics associated with successful sanctions) (Goodwin and Foss, 2004; Williams, 2007b). 0 DUI fines (limited evidence suggests no effects in reduc- ing alcohol-impaired driving) (Century Council, 2003). 0 DUI jail (weight of evidence suggests no positive effects) (Wagenaar, Zobek, and Williams, 2000). + High BAC sanctions (limited evidence suggests positive effects on recidivism) (McCartt and Northrup, 2004). + DWI courts (results are mixed, some positive, some not) (Guerin, 2002). 35