Traffic Safety ProgramsOffice of Research and Traffic Records; Strategic Plan for Behavioral Research in Traffic Safety

DEPARTMENT OF TRANSPORTATION

National Highway Traffic Safety Administration

[NHTSA Docket No. 97-062-N01]

Traffic Safety Programs--Office of Research and Traffic Records;

Strategic Plan for Behavioral Research in Traffic Safety

AGENCY: National Highway Traffic Safety Administration (NHTSA);

Transportation.

ACTION: Request for comments on strategic issues and research

requirements to support research planning.

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SUMMARY: NHTSA's Office of Research and Traffic Records, Research and

Evaluation Division (ORTR/RED) is engaged in the process of planning

its research programs for fiscal years 1998 through 2002. In

conformance with the Government Performance and Results Act of 1993

(P.L. 103-62), ORTR/RED is seeking public comment on the draft

strategic plan presented in this notice. These comments will be used to

help form a strategic implementation plan to direct the division's

research program during the next five years.

DATES: Written comments will be accepted through November 30, 1997.

ADDRESSES: Please direct all written comments to the National Highway

Traffic Safety Administration, Docket Section, Room 5111, Docket # 97-

062-N01, 400 Seventh Street, S.W., Washington, DC 20590. (Docket hours

are from 9:30 am to 4:00 pm.) Comments submitted to the docket will

become a matter of public record.

FOR FURTHER INFORMATION CONTACT: Jesse Blatt, Office of Research and

Traffic Records (NTS-30), Room 6240, 400 Seventh Street, S.W.,

Washington, DC 20590. (Telephone 202-366-5588 or Email at

[email protected])

SUPPLEMENTARY INFORMATION: More than 3 million persons were reported

injured and over 40 thousand persons died in motor vehicle crashes in

1996 (Traffic Safety Facts: 1996, National Center for Statistics and

Analysis). While a small proportion of the crashes causing these

injuries and fatalities were attributed to vehicle and roadway

problems, the vast majority were caused by human

[[Page 55304]]

performance problems. Within the National Highway Traffic Safety

Administration (NHTSA), the Office of Research and Traffic Records,

Research Evaluation Division (ORTR/RED) conducts research on human

behaviors that can bring about improvements in traffic safety. The

research is conducted in support of traffic safety programs directed at

reducing the incidence and consequences of motor-vehicle crashes.

ORTR/RED is responsible for research in the following program

areas: Impaired Driving; Occupant Protection; Speeding and Unsafe

Driving Actions; Older Drivers; and Pedestrians, Bicyclists, and

Motorcyclists. In addition, ORTR/RED efforts address Novice Driver

Education, Emergency Medical Services, evaluation of the Safe

Communities program, and the use of emerging safety and enforcement

technologies.

ORTR/RED is reexamining its research strategies in accordance with

the Government Performance and Results Act, or GPRA, of 1993 (P.L. 103-

62). The Act requires the establishment of a program mission,

assessment of external needs, development of specific strategic

objectives and accompanying performance measures, and the use of actual

performance results to redirect subsequent planning efforts. In

response to these requirements, ORTR/RED is requesting public comment

on its Draft Strategic Plan.

The Draft Strategic Plan is intended to guide behavioral traffic

safety research efforts from FY 1998 through FY 2002. It is heavily

influenced by the needs and outcomes identified as part of ongoing

budget planning processes. Input received as a result of this notice

will be used to reassess currently identified needs and projects for

fiscal years 1998 and 1999 and to further define the needs and outcomes

for fiscal years 2000 through 2002.

Electronic Access

This document is posted on NHTSA's site on the world-wide web

(http://www.nhtsa.dot.gov). To access it from NHTSA's home page ,

select ``People,'' then ``Injury Prevention,'' then ``Research and

Evaluation.'' To go directly to the appropriate page, enter: http://

www.nhtsa.dot.gov/people/injury/research/. Then select ``Draft

Strategic Plan for Behavioral Research.''

Comments Requested

The purpose of this notice is to provide an opportunity for the

public and other interested parties to review and comment on ORTR/RED's

assessment of each program area, the strategic objectives which are

identified, and the activities or outcomes that ORTR/RED intends to

pursue. Reviewers are invited to comment on program areas or issues

that are not addressed, recommend priorities, or provide rationales for

alternative approaches. Comments must be submitted in writing.

Respondents are requested to identify the program or program area

towards which their comments are directed.

The Office of Research and Traffic Records, Research and Evaluation

Division (ORTR/RED) will review comments received in response to this

notice and the draft plan described herein. These comments will be

considered as part of the development of a five-year strategic

implementation plan for the period between 1998 and 2002. The final

plan will include a section summarizing the comments received in

response to this notice and in response to other inputs.

Organization of the Draft Plan

The Draft Strategic Plan consists of two parts. Appendix A provides

a brief discussion of the most significant human performance problem

areas identified by the agency, followed by the mission and strategic

objectives of the Office of Research and Traffic Records, Research

Evaluation Division (ORTR/RED). Within each objective, the anticipated

outcomes from the research effort during the period from 1998 to 2002

are summarized by program area. Appendix B presents a more detailed

discussion of the agency's understanding of the problems, its current

research and evaluation efforts, and strategic issues for research in

each program area. The following Table of Contents provides an overview

of the plan and supporting documentation.

TABLE OF CONTENTS

Appendix A: Draft Strategic Plan for Behavioral Research in Traffic

Safety

Background

Traffic Safety Programs at NHTSA

Summary of the 1998 ORTR/RED Strategic Plan

ORTR/RED Vision and Mission

Strategic Objectives

Key Considerations in the Development of Strategic Objectives

Approach to Meeting Strategic Objectives

Strategic Objective: Problem Analysis

Strategic Objective: Countermeasure Development

Strategic Objective: Program Evaluation

Appendix B: Program Area Summaries

Impaired Driving

Occupant Protection

Speeding and Unsafe Driving Actions

Older Drivers

Pedestrians, Bicyclists, and Motorcyclists

Novice Drivers Education

Emergency Medical Services (EMS)

Safe Communities

Technology Applications

Issued on: October 17, 1997.

James L. Nichols,

Director, Office of Research & Traffic Records, National Highway

Traffic Safety Administration.

Appendix A--Draft Strategic Plan for Behavioral Research in Traffic

Safety

Background

More than 3,000,000 persons were reported injured and over

40,000 persons died in motor vehicle crashes in 1996 (Traffic Safety

Facts: 1996, National Center for Statistics and Analysis). While a

small proportion of the crashes causing these injuries and

fatalities can be attributed to vehicle and roadway problems, the

vast majority are caused by human performance problems. Despite

impressive reductions over the past two decades, the annual traffic-

related fatalities and injuries are increasing slightly since

reaching a low in 1992. An increase in travel has contributed to the

fatality rates, expressed as number of fatalities per 100 million

vehicle miles traveled, remaining at approximately 1.7 during this

period.

In developing a response to this challenge of improving human

performance, NHTSA focuses its traffic safety efforts on the most

significant causes or problems contributing to fatality-and injury-

causing crashes. ORTR/RED conducts behavioral research in the

following areas: Impaired Driving, Occupant Protection; Speeding and

Unsafe Driving Actions; Older Drivers; and Pedestrian, Bicyclists,

and Motorcyclists; Novice Driver Education, Emergency Medical

Services, Safe Communities, and Technology Applications. A brief

description of the extent of these problems is provided here. A more

detailed discussion can be found in Appendix B

Impaired Driving. In 1996, alcohol was cited as a contributing

factor in crashes leading to approximately 17,000 traffic

fatalities, and over 1,000,000 injuries. In addition, there has been

an increase in alcohol-related fatalities by approximately 4 percent

between 1994 and 1996. Driving while impaired by drugs other than

alcohol may also constitute a significant highway safety problem,

although it appears to be much smaller than the alcohol-related

problem.

Occupant Protection. The national average safety-belt usage rate

has hovered at about 68 percent for several years, despite

widespread educational efforts. However, belt use by people involved

in potentially fatal crashes is much lower, at about 50 percent. The

need to use child safety seats appears to be more widely accepted,

with usage rates currently ranging between 60 and 90 percent,

depending on the age of the child. Investigations of recent air bag

related injuries and fatalities to young children and short-statured

adults has reemphasized the need to increase proper safety belt and

child safety seat use, particularly for all children under 12.

Speeding and Unsafe Driving Actions. Many crashes are

attributable to unsafe driving behaviors such as following too

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closely, inattention, speeding, and aggressive driving. In 1996,

speed was a factor in over 13,000 fatalities. Many states repealed

speed limit laws based on the national maximum speed limit, and now

average speed limits are higher. Aggressive driving actions--such as

excess speed, running red lights, and disregard of traffic signs and

signals--have a high likelihood of causing crashes.

Older Drivers. People over 70 years of age represented 13

percent of all fatalities and are slightly over-represented in

crashes, when compared to the general population of drivers. As the

proportion of older drivers increases over the next few years, over-

involvement of this population group in fatalities and injuries

could become a more significant problem.

Pedestrians, Bicyclists, and Motorcyclists. About 30,000

pedestrian crashes involving young people occur annually. Older

persons are significantly over involved in pedestrian fatalities.

Alcohol and environmental factors are also significant components of

the pedestrian crash problem. In large urban areas, nearly half of

all those killed in motor vehicle crashes are pedestrians. There has

been little or no change in bicyclist fatalities, which are reported

as 830 in 1995, and injuries during the past few years. Currently,

bicyclist helmet use laws include requirements for children only,

even though one-half of the annual fatalities occur to people of age

21 years or older. Motorcyclists are about 16 times as likely as

vehicle occupants to die in a crash, and about 4 times as likely to

be injured. In 1996, 43 percent of the approximately 2,200 fatally

injured motorcyclists were not wearing helmets at the time of the

crash. These motorcyclists tended to have high intoxication rates as

well.

Novice Driver Education. Young drivers between the ages of 16

and 20 experience the highest fatality and injury rates per capita.

At the request of Congress, NHTSA submitted a program in 1994 to

improve novice driver education that has two-stages of education

that would parallel stages of a graduated licensing system.

Emergency Medical Services. Emergency Medical Services (EMS)

differs from the other program areas receiving research attention in

that it is entirely focused on post-crash rather than pre-crash

events. Gaps in our knowledge of effective out-of-hospital care, due

to the absence of well-defined, uniform, and complete data, impeded

efforts to define the extent to which the post-crash environment

contributes to injuries and fatalities.

Safe Communities. Safe Communities is a recent initiative

intended to bring together citizens and a wide range of community

institutions--such as law enforcement, hospitals, managed care

facilities, emergency medical services, schools, insurance

companies, other public and private businesses and local

governments--to work on solving local traffic safety problems within

the broader context of meeting the injury control challenge.

Knowledge gained from successes and setbacks will provide guidance

to expansion of this effort.

Technology Applications. Future increases in vehicle travel and

risks of crashes are anticipated, even as fewer resources are being

allocated to traffic-law enforcement. Emerging technologies--such as

``smart card'' drivers licenses that prevent fraudulent ID, ignition

interlock devices, electronic monitoring wristbands, and electronic

vehicle and driver identification systems--offer the promise to

improve the effectiveness and efficiency of safety and enforcement

programs. Adaptations of emerging electronics and communications

technologies, as part of the Intelligent Transportation Systems

(ITS) program, could have significant potential to aid emergency

rescue services, crash investigations, traffic law enforcement, and

other traffic safety efforts.

Traffic Safety Programs at NHTSA

The National Highway Traffic Safety Administration (NHTSA) is

one of seven operating administrations of the U.S. Department of

Transportation. Oversight of highway travel is split between the

Federal Highway Administration (FHWA) and NHTSA. NHTSA's

responsibilities focus on safety issues of motor vehicles and non-

commercial roadway users.

NHTSA's mission is to save lives, prevent injuries and reduce

traffic-related health care and other economic costs. The agency

develops, promotes and implements effective educational,

engineering, and enforcement programs toward ending preventable

tragedies and reducing economic costs associated with vehicle use

and highway travel. This is accomplished through research,

demonstration, and evaluation; setting and enforcing safety

performance standards for motor vehicles and items of motor vehicle

equipment; consumer outreach activities, and awarding grants to

state and local governments for implementation of safety programs.

The complex relationship between a motor vehicle and its driver is

of major interest. Factors influencing this relationship include the

driver's physical and mental abilities and driving experience, the

nature of driving, the responsiveness of the motor vehicle to the

driver's demands, and environmental conditions.

NHTSA employs two major approaches to improving highway safety.

One approach focuses on motor vehicles and investigates methods to

make them safer, in terms of improving vehicles' characteristics

that both reduce their likelihood to be involved in crashes and

increase their capabilities to protect occupants from crash forces.

The other addresses the behavior of roadway users--drivers,

bicyclists, motorcyclists, pedestrians. Approaches may be direct, by

influencing the users themselves, or indirect, by influencing

intermediary change agents--friends and family members, educators,

police, judges, legislators, licensing officials, emergency medical

service and health care practitioners--who may exert influence over

certain groups of roadway users.

The responsibility within NHTSA for improving safety-related

behaviors lies within the Associate Administrator for Traffic Safety

Programs (TSP). TSP's Mission is to: (1) Lead the national traffic

safety effort, including emergency medical services; (2) save lives

and reduce injury through behavioral research, demonstration, and

evaluation; and (3) develop safety programs and strategies for use

by public and private organizations. Program areas include impaired

driving, occupant protection, traffic law enforcement, speed and

other unsafe driving actions, motorcyclists, bicyclists,

pedestrians, older drivers, driver education and licensing, and

emergency medical services. Traffic Safety Programs (TSP) comprises

three offices: the Office of Traffic Injury Control Programs

(OTICP), the Office of Communications and Outreach (OCO), and the

Office of Research and Traffic Records (ORTR).

Within the Office of Research and Traffic Records, the Research

and Evaluation Division (ORTR/RED) conducts research in each of the

program areas listed above to specify traffic-safety problems that

can be addressed through behavioral approaches; identify populations

in need of intervention; and determine appropriate legislative,

enforcement, adjudicative, and educational countermeasure approaches

for those problems. In addition to developing and testing the

effectiveness of new countermeasures, ORTR/RED also evaluates the

implementation of existing traffic safety programs in actual

practice, thus establishing a foundation for broader adoption of

effective programs. Information developed by ORTR/RED is integrated

into traffic safety programs administered by other offices of TSP

and the Office of State and Community Services for use by community,

state, and national organizations and distributed through other

NHTSA offices.

1ORTR/RED must strike a balance between these activities in

order to meet the shorter term needs of other offices and still

conduct problem identification and countermeasure development

activities which have a longer time horizon associated with

achieving an outcome. Programs in the field now are based on past

research efforts; current research establishes a foundation for

programs in the future. A major challenge to Traffic Safety Programs

is to align the activities in all three offices to be most effective

in meeting overall agency objectives, which are to reduce traffic-

related fatalities and injuries. ORTR/RED sets priorities and

apportions its work among the competing interests through the budget

process and internal decision making. The Strategic Plan exercise is

an effort to further improve the alignment and outcomes of ORTR/RED

programs and resources.

Summary of the 1998 ORTR/RED Strategic Plan

ORTR/RED Vision and Mission

Vision Statement: Lead the nation, department, and agency with

high quality research and evaluation in traffic safety issues,

conducted in a professional environment, and responsive to the input

and needs of the public and the traffic safety community.

Mission Statement: Plan and conduct a national research program

to identify and analyze road user problems; develop and test

scientifically sound programs; and evaluate traffic safety programs

of significant potential.

[[Page 55306]]

Strategic Objectives

Problem Analysis: anticipate and understand the nature and

magnitude of various aspects of the highway crash problem and

monitor trends and public perceptions in the various program areas.

Countermeasure Development: develop program actions (e.g.,

legislation, enforcement, sanctions, incentives, technology

applications, public information and education, emergency medical

care) to reduce the number of crashes and severity and crash

consequences; and determine the effectiveness of these

countermeasures in improving behaviors that lead to reducing

crashes, deaths, or injuries.

Program Evaluation: determine whether existing countermeasure

programs should be continued, expanded, modified, or discontinued.

Key Considerations in the Development of Strategic Objectives

This Draft Strategic Plan is consistent with the 1997 Department

of Transportation Draft Strategic Plan entitled ``A Visionary and

Vigilant Department of Transportation Leading the Way to

Transportation Excellence in the 21st Century.'' The Department's

plan outlined five strategic goals:

Safety: Promote the public health and safety by working

toward the elimination of transportation-related deaths, injuries,

and property damage;

Mobility: Shape America's future by ensuring a

transportation system that is accessible, seamless and efficient,

and offers flexibility of choices;

Economic Growth and Trade: Advance America's economic

growth and competitiveness domestically and internationally through

efficient and flexible transportation;

Human and Natural Environment: Protect and enhance

communities and the natural environment affected by transportation;

and

National Security: Advance the nation's vital security

interests in support of national strategies such as the National

Security Strategy and National Drug Control Strategy by ensuring

that the transportation system is secure and available for defense

mobility, that our borders are safe from illegal intrusion, and by

promoting worldwide economic growth and stability.

The ORTR/RED Draft Strategic Plan directly supports the first

two of these departmental goals--safety and mobility--through

research, development, and evaluation and indirectly supports the

remaining goals through anticipated reductions in the number and

severity of crashes and their attendant personal, economic, societal

and environmental effects.

Prior to the development of the Departmental Strategic Plan,

NHTSA published a long term strategic plan and a five year (1995-99)

Strategic Execution Plan (SEP). The NHTSA Strategic Plan presents 11

goals is support of three strategies: Provide Leadership and Set an

Agenda; Support Research and Apply the Results to Education,

Engineering, and Enforcement to Reduce Road Casualties and Costs;

and Transform NHTSA Through Continuous Improvement. The ORTR/RED

Behavioral Research Strategic Plan is consistent with the objectives

outlined in goals 5 and 6 of the SEP, which focus on research and

the application of the results to crash avoidance challenges.

NHTSA was a pilot agency under GPRA from 1994 to 1996. The Act

requires federal agencies to plan around outcomes, rather than

outputs, and measure performance. The agency has stratified its

performance measures into three levels: overall outcomes;

intermediate outcomes; and program outputs. NHTSA's overall outcome

goals are to reduce fatalities and injuries per 100 million vehicle

miles traveled; and to reduce fatalities and injuries per 100,000

resident population. The agency has stated intermediate outcome

goals for key behavioral patterns, such as seat belt use and

impaired driving. For example, the goal for seat belt usage is to

increase use rates to 85 percent by 2000 and 90 percent by 2005. The

agency has committed to reduce the number of alcohol-related traffic

fatalities to 11,000 in 2005 from 17,126 in 1996. These and other

traffic safety goals are restated in NHTSA planning documents that

have been published since the Strategic Execution Plan, such as the

Presidential Initiative for Increasing Seat Belt Use Nationwide, EMS

Agenda for the Future, GPRA Performance Plans; and annual Budget

submissions to Congress. Achieving these goals helps the agency to

achieve its overall outcome goals. The agency measures program

outputs to ensure that products help to achieve the intermediate

outcome goals, that will, in turn, achieve the overall outcome

goals. The ORTR/RED plan describes how behavioral research will help

the agency achieve its stated goals and anticipate future needs of

the agency and the Department of Transportation.

Approach to Meeting the Strategic Objectives

Before undertaking any problem analysis or countermeasure

development effort, ORTR/RED considers, at least implicitly, several

general issues. Although these issues are described as ``either-or''

alternatives, they overlap to a certain extent, depending on the

problem and the countermeasures under consideration.

Involved Population versus Change Agents. Historically,

countermeasure research efforts have focused on the individuals

engaged in problem behaviors (e.g., drinking drivers, safety belt

non-users, motorcyclists who do not wear helmets). An alternative

approach is to target research on intermediary change agents (e.g.,

police officers, legislators, community traffic safety officials) to

obtain their support and action (e.g., to support legislation,

provide political permission for enforcement of traffic safety

laws).

Gradual Improvement versus Major Advancement. For the

most part, agency research and development has fashioned continuous

and gradual improvements to existing programs and activities.

However, experience has shown that some of the most profound and

dramatic advances in traffic safety have resulted from innovative

(and often controversial) programs that have resulted in significant

media attention and public awareness (e.g., enactment of Minimum

Drinking Age (21) Laws, passage of child passenger safety laws).

People versus Equipment and Technology. Except for

supporting technological innovation in the early years of alcohol-

impaired driving research, ORTR/RED's attention to technology has

been limited. There is currently increased interest in developing

technological solutions to behavioral problems that have resisted

change (e.g., automated speed enforcement, detection and ticketing

of red-light runners, impaired driver detection and interlocks,

repeated warnings of safety-belt non-use in vehicles) or that would

improve the efficiencies or lower the costs of current programs.

The interaction of these strategic countermeasure-development

issues and the needs of problem analysis resulted in the following

questions that ORTR/RED staff used to assess the status of each

traffic safety program area during the development of this plan:

1. What is the current status of problem assessment in this

area? Do we have a good understanding of the magnitude and

characteristics of the problem? Where are the gaps in our knowledge?

2. Is there a need for continuous tracking or monitoring to

support internal and external decision making about this program

area? What kind of monitoring is needed?

3. Do we know enough about the people whose behavior we wish to

modify? How much do we need to know to effect the desired changes?

4. Are our research products and information designed for and

reaching appropriate decision makers or intermediaries? What kinds

of research are needed to improve the effectiveness or distribution

of such products and information?

5. Are there operational countermeasures that need to be

evaluated to support decision making regarding continued or wider

implementation?

6. Are there operational countermeasure approaches where

incremental improvements in effectiveness or efficiency could be

made? What kind of research and development activity is needed?

7. Are there innovative or controversial approaches that have

the potential for major gains? Are there new technologies that could

be applied to make significant gains? What kind of research and

development activity is needed?

8. Are there countermeasures that now appear impractical because

of a lack (or shift) of change agent interest or support? What kind

of research and development activity is implied?

9. In general, is public interest and support for this area

sufficient to effect change? If not, what kind of research and

development activity is needed?

The answers to these questions provided the raw materials from

which the plan was developed, and emphasized the division of

behavioral research efforts into three distinct categories: Problem

Analysis, Countermeasure Development and Test, and Program

Evaluation.

[[Page 55307]]

Strategic Objective: Problem Analysis

Identify opportunities to intervene in unsafe behaviors by

analyzing traffic safety problems and monitoring changes in public

knowledge, attitudes, and practices regarding highway safety issues.

These efforts may identify individuals whose behavior threatens

their own or the public's safety, or situations that predispose or

precipitate unsafe actions.

The outcome objectives listed under each program area represent

the critical problem assessment factors for that area. Such factors

include: (1) Specifying quantitative relationships; (2) identifying

particular groups that are over-represented in crashes or

fatalities, or that have a direct influence on those groups; (3)

establishing the predisposing or precipitating situations or events

leading to crashes; (4) defining factors that impede or facilitate

implementation of traffic-safety programs; (5) determining the

feasibility of implementing potential changes in programs or

establishing new ones; and (6) identifying critical trends or

deficiencies in public knowledge, attitudes, and practices.

Success in achieving this strategic objective will be measured

by progress in accomplishing the following outcome objectives:

Impaired Driving

Verify the relationship between blood alcohol

concentration (BAC) and crash risk for low BACs.

Establish the degree of public support for different

types and levels of legislative and enforcement efforts to reduce

alcohol-impaired driving.

Further define the degree to which drugs other than

alcohol contribute to traffic crashes.

Acquire more detailed information regarding the driver

characteristics and situations that lead to drinking and driving.

Monitor levels of public disapproval of drinking and

driving and their acceptance of legislation, enforcement,

sanctioning, and other actions to prevent drinking and driving.

Occupant Protection

Identify factors that impede communities from adopting

highly visible traffic law enforcement efforts (e.g., Selective

Traffic Enforcement Programs) to increase the use of safety belts.

Determine the potential impact of incentive and reward

programs for different target audiences (e.g., belt users, police

groups or community groups) for increasing belt use.

Monitor public knowledge, attitudes, and practices

regarding the use of safety belts, child safety seats, and air bags,

as well as support for stronger laws, enforcement, and sanctions.

Determine characteristics of safety belt users, part-

time users, and non-users, especially among drivers who are most at

risk of being involved in a fatal or serious injury crash.

Acquire information from users of child safety seats

regarding the reasons for misuse of safety seats and premature

graduation of toddlers from safety seats to vehicle safety belts.

Speeding and Unsafe Driving Actions

Define the relationships among speed, driver

characteristics, roadway conditions, situational factors, and crash

rates.

Identify unsafe behaviors and drivers most likely to be

involved in crashes.

Define ``aggressive'' driving and determine its

incidence and relation to crash causation.

Determine the extent to which drivers who speed are

over involved in crashes.

Determine situations and conditions under which the

public and the enforcement community would accept automated

enforcement efforts and describe the legislative and administrative

actions necessary to implement automated enforcement procedures.

Older Drivers

Identify factors responsible for increased crash rates

(per mile) of older drivers and determine the extent to which these

factors account for the higher fatality rates of older drivers.

Determine the likelihood that older drivers would

purchase vehicles that offer vehicle modifications for improved

crash protection for older occupants.

Explore the acceptability of various in-vehicle

technologies designed to extend mobility by providing assistance in

compensating for disabling conditions.

Pedestrians, Bicyclists, and Motorcyclists

Develop measures of pedestrian and bicyclist crash

exposure and determine trends in exposure.

Assess the attitudes of pedestrians, cyclists, and

drivers toward each other; their awareness of high crash-risk

situations and ways to avoid them; their knowledge or the laws,

signals, and signage; and their walking, riding, and driving

experiences.

Identify and assess materials and procedures for

increasing conspicuity of pedestrians and cyclists.

Review federal, state, and local ordinances pertaining

to the interactions of drivers, pedestrians, and bicyclists; examine

the practices of these road users that lead to crashes; and assess

the need for model legislation and traffic enforcement efforts.

Monitor helmet usage rates in states with laws,

including age specific laws, and those without laws.

Analyze motorcycle crash data to classify crash types.

Novice Driver Education

Determine the consequences, including costs and

hardships, on novice drivers and their families of requiring a two-

staged driver education as part of a graduated licensing system.

Determine the impact of various options for paying for

driver education and licensing, including the option of requiring

license applicants to pay some or all of the cost.

Identify and assess alternative systems for

implementing two-staged driver education and determine the costs and

benefits of each alternative.

Determine the extent to which novice drivers over the

age of 25 would benefit from graduated licensing and determine any

special training needs they present.

Examine and determine the appropriate role of the

Federal government in developing a model driver education program

for use by others in training novice drivers.

Obtain input from partners regarding the education of

novice drivers to develop consensus regarding the basic training

content required for novice drivers.

Emergency Medical Services (EMS)

Determine the factors contributing to higher mortality

rates for persons who die in motor vehicle crashes in rural areas.

Identify the barriers to collection of reliable and

relevant data in the current EMS data collection system, and

identify the barriers to linking EMS data with other databases.

Examine the potential for and public acceptability of

using EMS personnel as injury-prevention trainers or spokespersons

at the community level.

Examine the potential consequences of increased

enrollment in managed-care health plans, and their requirements

(e.g., for approvals prior to the delivery of services) on the

provision of emergency medical services to the public.

Develop a well defined, long term research plan for

EMS, based on participation of relevant partners.

Safe Communities

Determine the feasibility and utility of including

rehabilitation records on drug- or alcohol-impaired drivers in

linkages with other Safe Communities data.

Technology Applications

Conduct an inventory of existing and planned

Intelligent Transportation System (ITS) products, determine which

products have potential for traffic-safety applications, assess the

degree to which candidate products would require modification, and

describe the adaptations necessary.

Identify relevant factors that affect costs of

production, deployment, operations, training, and maintenance of

various technological safety applications; determine how best to

foster the integration of technologies and the sharing of common

hardware or systems.

Identify institutional partners and barriers to full

acceptance and implementation of traffic safety-related

technologies; define the nature and extent of public concerns and

resistance to using technology to improve traffic safety; and

identify effective strategies for allaying public fears and for

gaining support for technological solutions to traffic-safety

problems.

Strategic Objective: Countermeasure Development

Develop and test methods to intervene with problem individuals

or to aid those in a position to modify problem situations. These

efforts may address individuals or situations needing attention

either directly, through information and education, or indirectly,

through legislation, enforcement, and adjudication.

The outcome objectives listed under each program area specify

one or more critical products that are needed to address an

[[Page 55308]]

identified safety problem. These products involve activities (e.g.,

research, development, and testing) that result in materials or

procedures to accomplish one or more of the following: assessment,

education, information, motivation, training, and instruction. In

addition, some outcome objectives produce materials documenting

strategies, technology applications, and model programs or

legislation.

Success in achieving this strategic objective will be measured

by progress in accomplishing the following outcome objectives:

Impaired Driving

Develop and test better methods for detecting impaired

drivers on the roadways.

Develop and test improvements to enforcement procedures

that make alcohol impaired driving arrests less cumbersome and that

improve the efficiency of conducting sobriety checkpoints.

Develop and test countermeasures for reducing the

recidivism of repeat DWI offenders and those who drive with a

suspended license.

Validate a problem-driver screening instrument for use

in field sobriety testing situations.

Develop model specifications for alcohol test devices.

Develop and test procedures to detect problem drinkers

at their first alcohol-related offense.

Develop and test countermeasures for various target

groups (e.g., youthful drinkers, servers, companions, police

officers, etc.), based on more detailed information regarding the

interaction of driver characteristics and the situations that lead

to drinking and driving.

Develop and test strategies to counter decreasing

interest and support among legislators, police, and other public

officials for efforts to reduce alcohol-impaired driving.

Develop and test methods for extending the

effectiveness of ignition interlocks for convicted DWI offenders

beyond the period during which such devices are installed on the

offenders vehicle.

Occupant Protection

Develop and test materials and procedures specifically

designed for part-time users to increase their perceptions of risk

in those situations in which they currently do not buckle up.

Develop and test improved methods for disseminating the

results of occupant-protection research to program developers to

ensure effective targeting and up-to-date materials.

Develop and test more effective materials for

convincing police officials and lawmakers that good laws and well-

publicized enforcement have great potential to increase safety belt

and child seat usage and thus to prevent deaths and injuries.

Develop and test various technological approaches to

increase belt use.

Speeding and Unsafe Driving Actions

Develop and test materials and procedures to reduce the

tendency (or ability) of drivers to endanger themselves and others

by driving aggressively.

Develop and test materials and procedures to increase

the acceptance of automated law enforcement by the public and the

law enforcement community.

Develop and test materials to educate drivers and the

general public about the impact of speed on crashes and resulting

deaths and injuries.

Older Drivers

Develop and test guidelines and procedures for training

driver licensing personnel how to evaluate the safe driving

abilities of older persons applying for licensing or license

renewal.

Develop and test guidelines and procedures for

assisting older drivers to make a smooth transition from driving to

other ways to meet their transportation needs.

Develop and test guidelines for medical personnel and

social service personnel to help older drivers regulate their

driving.

Establish the potential for licensing personnel to

judge older drivers' ability to drive, based on an assessment of

their skills, capabilities and training needs.

Identify and evaluate alternative federal, state, and

local roles and actions to assist older drivers in meeting both

safety and mobility needs; assess the costs and benefits of these

alternatives.

Pedestrians, Bicyclists, and Motorcyclists

Develop and test procedures for reducing the occurrence

of pedestrian crashes among major identified target groups (e.g.,

young children, alcohol-impaired adults, elderly) in large cities.

Field test software that permits communities to

identify the extent of their pedestrian and bicyclist crash problems

and suggests appropriate countermeasures to address them.

Develop and test materials and procedures to educate

drivers and the general public about the seriousness of the

pedestrian and bicyclist crash problem and how they can prevent

becoming involved in such crashes.

Develop refined countermeasures for reducing the

ocurrences of crashes involving bicyclists.

Develop and test elementary school curriculum materials

that provide information and resources to improve pedestrian and

bicyclist safety for school-aged children.

Develop and test countermeasures for reducing the

incidence of operating a motorcycle while impaired by alcohol or

other drugs.

Novice Driver Education

Develop and test materials and procedures to increase

the involvement of parents and other adults in the process of

providing effective and safe driving practice for novice drivers.

Emergency Medical Services

Develop and test materials and procedures for training

rural EMS personnel in providing appropriate care and clinical

interventions to victims of motor vehicle crashes.

Develop and test countermeasures to prevent mortality

in rural motor-vehicle crashes.

Technology Applications

Develop and test strategies to incorporate emerging

technologies in behavioral aspects of traffic safety.

Develop and test strategies for allaying public and

institutional fears of technological solutions to traffic-safety

problems and for gaining support for prudent applications of

technology.

Strategic Objective: Program Evaluation

Ensure that programs implemented by states and communities to

combat traffic safety problems are effective in achieving their

intended purpose. Evaluation may address program implementation

procedures, outcomes, or both.

The outcome objectives listed under each program area focus on

determining the effectiveness of a program in terms of specified

dependent variables. Some are designed to identify the operational

characteristics of effective programs. Final reports on completed

evaluations provide information to aid the expansion of effective

countermeasure programs by states and communities and other

organizational entities. They also help to establish useful

boundaries for adaptations of programs to local needs.

Success in achieving this strategic objective will be measured

by progress in accomplishing the following outcome objectives:

Impaired Driving

Evaluate the effectiveness of the Section 410 Alcohol

Incentive Grant Program in reducing alcohol-related fatalities in

the states.

Evaluate the effectiveness of programs with major

potential to reduce alcohol impaired driving, such as frequent and

widespread sobriety checkpoints, administrative and judicial license

and vehicle sanctions (including ignition interlocks), zero BAC

tolerance laws for youth, and .08 BAC laws for adult drivers.

Evaluate the effectiveness of various alternative

transportation programs in reducing the incidence of impaired

driving.

Occupant Protection

Evaluate the effectiveness of state legislative changes

that provide for standard (primary) enforcement of safety belt usage

laws, penalty points for violators, or higher fines.

Evaluate the effectiveness of materials, incentive

programs, and strategies on increasing safety-belt usage of part-

time users.

Evaluate the effectiveness of the President's

Initiative to Increase Safety Belt Usage.

Speeding and Unsafe Driving Actions

Evaluate the effectiveness of automated enforcement

programs such as photo radar for speeding and red-light running.

Evaluate the effectiveness of enforcement (and other)

programs that target situations where speeding is most likely to

lead to crash involvement.

Older Drivers

Evaluate model driver licensing programs that restrict

or deny licensing for

[[Page 55309]]

those older drivers who do not appropriately restrict their driving.

Evaluate model medical and social-service programs that

are designed to help older people make appropriate decisions about

driving and maintaining their mobility.

Pedestrians, Bicyclists, and Motorcyclists

Evaluate the effectiveness of NHTSA-developed school-

bus safety training program that has been adopted and distributed by

the National Safety Council.

Evaluate the effectiveness of a comprehensive

pedestrian countermeasures program, adapted for use in large urban

settings.

Determine the costs of motorcycle helmet law repeal,

relative to changes in injuries, fatalities and medical care

expenditures.

Evaluate the effectiveness of programs designed to

reduce the incidence of impaired motorcycle operation.

Novice Driver Education

Evaluate the effectiveness of a two-stage driver

education relative to citations and crashes, controlling for the

influence of graduated licensing on these outcomes.

Emergency Medical Services (EMS)

Evaluate locally implemented procedures to reduce rural

preventable mortality.

Using outcome measures determined by current research,

evaluate the effectiveness of EMS pre-hospital interventions on

health outcomes.

Determine the efficacy of training methods, retention

periods, and the need to provide training in new clinical practices

for EMS personnel.

Safe Communities

Determine the characteristics of Safe Communities that

are thriving and those that have faltered, where they are similar,

and where they are different.

Study Safe Communities programs to determine the

processes involved in establishing strong coalitions among partners,

and the mechanisms that enable, facilitate, and strengthen the

formation of such inter-organizational ties.

Determine how each partner organization's objectives

contribute toward the perpetuation of the Safe Communities

coalition, how organizations' objectives interact, and what steps

are necessary to counter the forces that contribute to a program's

demise; identify the short- and long-term successes of the Safe

Communities program for each of the constituent groups in the

coalition.

Technology Applications

Evaluate the effectiveness of various technologies to

detect drivers with suspended licenses.

Evaluate the effectiveness of various technologies that

may help increase safety-belt usage.

Evaluate the effectiveness of various technologies with

potential for reducing unsafe driving acts.

Appendix B--Program Area Summaries

Following are summaries of each program area, including a

description of the program area, past and current research in the

area, and some of the highest priority issues needing attention.

Comments are invited on strategic issues, objectives, or outcomes,

as well as on any other aspect of these summaries.

Impaired Driving

Background

In 1996, alcohol was involved in approximately 17,000 traffic

fatalities, and over 1,000,000 injuries. Arrests for Driving Under

the Influence (DUI) or Driving While Impaired (DWI) have reached a

plateau at about 1.4 million arrests annually, after reaching a high

of 1.8 million in the late 1980s. Substantial progress has been made

in reducing alcohol related crashes over the past decade. From 1986

to 1996, alcohol related fatalities fell from about 52 percent to 41

percent of total traffic fatalities. The actual number of alcohol-

related fatalities dropped from 24,000 to 17,000 over that period.

Countermeasures found to contribute to these reductions include

legislation increasing the drinking age and decreasing legal blood

alcohol concentration (BAC) limits, highly visible enforcement, and

swift and certain license sanctions. Increased awareness of the

drinking and driving problem and its gradual social unacceptability

have also helped reduce the problem.

Driving while impaired by drugs other than alcohol may also

constitute a significant highway safety problem, although it appears

to be much smaller than the alcohol-related problem. One of the most

representative studies in this area, a study of 2,000 fatally

injured drivers in 1990, showed that 18 percent involved other

drugs, either alone or in combination with alcohol.

What We Have Learned

Research has shown that driving performance can be impaired at

low alcohol levels and that the risk of crashing increases

significantly after just one or two drinks. It has also been shown

that many drugs other than alcohol can also impair driving.

Marijuana poses significant potential for driving related problems.

Two high risk drinking and driving target groups have been

identified: young drivers and repeat offenders. Drivers between 15

and 24 years of age comprise less than 14 percent of the population

but they are involved in 27 percent of alcohol-related fatalities.

Repeat offenders account for about a third of all drivers arrested

for DWI. Safe-ride and designated driver programs provide

alternatives to drinking and driving, but they are not widely used.

Some studies have shown that they can be used inappropriately.

Research has shown that highly visible law enforcement efforts,

such as sobriety checkpoints, can have a general deterrent effect on

drinking and driving. Jail time for DWI has been shown to have

limited effectiveness, usually reducing drinking and driving only

during the time the violator spends in jail. Research on both

electronic monitoring and intensive-supervision probation has

demonstrated reduced DWI recidivism among program participants.

Countermeasure research also led to the development of validated DWI

detection cues and a standardized field sobriety test (SFST) for use

in determining whether drivers are above .10 percent BAC. These

tools have contributed significantly to DWI enforcement.

ORTR/RED evaluations have documented the effectiveness of

various legislative actions such as: Minimum Drinking Age 21 laws,

Zero Tolerance laws for youth, .08 BAC laws for adults, and

Administrative License Revocation. In addition, Oregon and

Washington enacted laws allowing police to seize the registration of

motorists driving on a suspended licenses and to affix an

identifying (``zebra'') tag over the vehicle sticker. The law was

shown to be effective in Oregon but not in Washington.

Current Research and Evaluation

Currently ORTR/RED is analyzing results of a survey of close

relatives of alcohol-related fatal crash victims to refine target

group descriptions. Projects are underway to examine how alcohol

affects the driving behavior of various age, gender, and drinker-

type groups, and to re-examine the relative crash risk among drivers

at various levels of alcohol concentration. Additionally, ORTR/RED

administers a biennial national survey to track the nature and

severity of alcohol-related issues.

Other research efforts include: development of new enforcement

and adjudication programs to deter alcohol impaired driving;

examination of new technologies for identifying driving-while-

suspended (DWS) offenders and improving DWI enforcement; assessment

of enforcement system loopholes; examination of DWI detection cues

and the SFST at lower BACs; and development of improved techniques

for conducting sobriety checkpoints.

Evaluation efforts focus on vehicle-impoundment, -

immobilization, and -forfeiture laws for repeat DWI and DWS

offenders and other key legislative changes in various states, such

as lowering the BAC limit to .08 for adults.

Current drug-focused research includes a survey to determine the

nature and severity of the effects of drugs on driving, a study

examining drug involvement in serious non-fatal crashes; and an on-

the-road study of the combined effects of alcohol and marijuana.

Strategic Issues for Research on Impaired Driving

The relationship between blood alcohol concentration

(BAC) and crash risk was established nearly 40 years ago. More

sophisticated research design and alcohol measurement procedures are

available today. In addition, the trend toward lower BAC limits

necessitates refined data on the relationship of BAC and crash risk

at these lower levels.

Persistent drinking drivers are often not identified

until after they have been involved in multiple crashes.

Intervention programs would be more effective in reducing crash

involvement if these drinkers could be identified at their first

alcohol-related offense.

More than 30 states have enacted laws permitting the

use of ignition-interlock devices for drivers convicted on DWI

offenses. Research suggests that offenders

[[Page 55310]]

who have interlocks installed recidivate less often than those who

do not, but the effects do not appear to continue after the devices

have been removed. For this approach to be more widely implemented,

judges need a better measure of its effectiveness and information

about how to make the effects more durable.

Many legislators are reluctant to pass stronger laws,

and police are often reluctant to enforce strong laws. Clear and

strong evidence of the types and levels of interventions that the

public is willing to support, would aid legislative and enforcement

efforts.

Identification of population subgroups that are over-

involved in impaired driving helps to make countermeasures more

efficient, when deployed. However, developing countermeasures

tailored for specific target populations requires detailed

information about the groups and the interaction of driver

characteristics and the situations that lead to drinking and

driving. The availability of such information would help determine

the nature of effective countermeasures and procedures for various

groups including drinkers, servers, companions, legislators, police

officers, and judges.

Communities typically demand evidence that

countermeasure programs are effective and can be implemented with

available resources before they will adopt them. Current candidates

for evaluation include highly visible roadside sobriety checkpoints,

administrative and judicial license and vehicle sanctions, zero BAC

tolerance laws for youth, and .08 BAC laws for adult drivers.

Over the past 20 years, volumes of laws have been

enacted, arrests of alcohol-impaired drivers have increased in

numbers, sanctions have been imposed with greater consistency, and

the public norm has been increasingly one of non-acceptance of

driving while impaired by alcohol. However, the current level of

public support may not be adequate for implementation of new and

potentially more effective countermeasures. In addition, support for

intensified efforts to reduce alcohol-impaired driving may be lower

among legislators and other public officials. The pressures of crime

prevention have eroded support for traffic enforcement, and there

are indications that, after nearly 20 years of focus, many

legislators and police officials are ``burned out.''

Different studies have produced widely varying

estimates of the degree to which drugs other than alcohol contribute

to traffic crashes and fatalities. Studies of traffic-law offenders

and those non-fatally injured in crashes have generally produced

higher estimates than have studies of fatally injured crash victims.

More accurate and timely data would be helpful in making decisions

about resource allocations in this area.

Occupant Protection

Background

The installation of safety belts has been required on passenger

cars since the 1960s. Despite reasonably widespread educational

efforts, however, the use of these safety devices remained quite low

(i.e., less than 15 percent) until 1984, when states began to pass

laws requiring vehicle occupants to use safety belts. Following the

passage of such laws, most states experienced dramatic increases in

safety belt use (e.g., 20-40 percentage points). Belt use is now

mandated in 49 states and the District of Columbia, but only 13

states and the District of Columbia allow police to stop a vehicle

solely on the basis of observing a safety belt violation (i.e.,

standard enforcement). Most states require that another law

violation must first be observed (i.e., secondary enforcement)

before safety belt law violators can be stopped and issued a

citation. Under these conditions, national safety belt use has

reached a plateau of about 68 percent. President Clinton has

established a Presidential Initiative to Increase Safety Belt Usage,

setting a goal of 90 percent belt use by the year 2005.

The need to use child safety seats appears to be more widely

accepted than the need to use safety belts. The first law requiring

children to be in safety seats was passed in 1978 in Tennessee. By

1985, all 50 states and the District of Columbia had passed child

passenger laws. Statewide reported usage rates currently range

between 60 and 90 percent, depending on the age of the child. Most

safety seats, however, are used improperly to some degree or

another. Much remains to be done to determine the consequences of

the various kinds of misuse and to develop programs to decrease such

misuse. Investigations of air bags causing injuries and fatalities

to young children and adults of short stature has reemphasized the

need to get young children into safety seats, to get parents to

install child seats in the back seat, and to put all children under

12 in the back seat.

What We Have Learned

Belt use remains low among various groups, such as young males

and rural road users, and the overall rate of increase in belt use

is flattening out. Much non-use of safety belts can be attributed to

part-time belt users: people who use belts only on some trips or

only on certain portions of trips. The main reasons part-time belt

users offer for non-use are that, in their view, some trips entail

an extremely low crash risk and some, usually because of relatively

low speeds, entail a very low risk of serious injury. An estimated

5-10 percent of the population totally resists using safety belts

under any condition. They often claim that safety belts are too

uncomfortable, possibly dangerous, and that they don't like being

told what to do.

Standard (primary) enforcement can have a major impact on belt

use. Belt use increases of about 15 percentage points have been

observed in states following a switch from a secondary enforcement

law to a standard enforcement law. It also appears possible,

however, to realize substantial gains in states with secondary

enforcement laws. Michigan, Pennsylvania, and Washington, for

example, are secondary law states and each reports safety belt use

rates greater than 70 percent.

Child safety seat use is currently estimated to be 88 percent

for infants and 61 percent for toddlers. Use declines sharply with

age of child, although it is not clear if children are prematurely

moved out of a child seat to make room for a younger sibling, if

parents think their children no longer need the protection, or for

some other reason. In a recent study, misuse of child safety seats

included the following errors (and frequency of observation): no

locking clip used on belts with sliding latch plate (72 percent); no

chest clip (59 percent); inappropriate use of harness strap use (46

percent) or vehicle safety belt (17 percent); seat placed in wrong

direction (10 percent); and inappropriate harness connection (3

percent).

Current Research and Evaluation

Current research in the area of occupant protection is focused on

efforts to increase belt use by part-time users, and to gather data on

teenagers and other high-risk, low-usage groups to aid in developing

programs to increase their belt use. Projects are also underway to

develop guidelines for matching safety education strategies to youth

characteristics, to develop strategies for encouraging states to

upgrade from secondary to standard enforcement of belt use laws, and to

increase belt law enforcement levels. Some useful data regarding these

matters will come from analyses of findings from the second biennial

national survey of occupant protection issues to be completed in 1997.

Strategic Issues for Research on Occupant Protection

Highly publicized waves of intense belt-law enforcement

(Selective Traffic Enforcement Programs or STEPs) have been

successful in raising belt use levels but several factors appear to

impede communities from effectively adopting these procedures.

Minimum enforcement levels, characteristics of public information

messages, need for police training, and use of overtime or regular

time are among issues needing further attention.

Incentive programs have not been seriously investigated

since before occupant protection laws became commonplace. While

these programs historically provided rewards for belt use, they

could be applied to intermediary groups to reward efforts to get

others to buckle up. The potential of incentives in conjunction with

sanctions appears to be significant but not well documented.

Most observed non-use of safety belts is due to part-

time users who have judged their driving situation to have a low

risk of resulting in a crash, an injury or a citation for non-use of

a safety belt. Getting part-time users to buckle up will require an

increase in their perception of risk in the situations they now

believe to be low risk. However, beliefs concerning risk of injury

appear to be highly resistant to change.

There are several ongoing efforts to monitor changes in

safety belt use (e.g., state surveys, NHTSA's National Occupant

Protection Use Survey [NOPUS], and the Fatality Analysis Reporting

System [FARS]) and changes in public knowledge, attitudes, and

opinions (e.g., biennial National Occupant Protection Survey). These

efforts will be useful in evaluating the President's Initiative to

Increase Safety Belt Usage and the Air Bag Safety Campaign.

Knowledge of the characteristics of safety belt users,

part-time users, and non-users is modest. Youth have very low usage

[[Page 55311]]

rates, as do impaired drivers and violators of other laws. Usage is

lower in rural areas (other than interstate highways) and among

drivers of pickup trucks, sport-utility vehicles, and full-sized

vans. Public education programs require more detailed knowledge to

direct appropriate messages to specific groups using the most

efficient communications medium.

Correcting misuse of safety seats, including premature

graduation from safety seats to safety belts, requires a different

approach than does promoting safety seat use among non-users.

Accordingly, child safety seat programs require more knowledge of

the characteristics of users, part-time users, and non-users of

safety seats and their respective motivations for use, misuse, or

non-use.

Results of current research tend not to diffuse into

new occupant protection programs quickly or completely.

Consequently, programs do not target materials to appropriate groups

and messages may be ineffective for groups that are targeted.

In spite of the interest in and support for stronger

actions to increase safety belt and child seat usage expressed in

most public opinion surveys, the public fails to perceive the risks

and costs of not buckling up. State legislators and local police

officials fail to be convinced of the potential of safety restraints

to prevent death and injury and of the potential for good laws and

highly visible enforcement to increase belt usage.

It has been about 20 years since safety-belt/ignition

interlocks were ruled out as a technique for ensuring belt use.

Improvements in technology, on-board computers, and wide acceptance

of belt-use requirements provide a new environment in which to

reexamine technological approaches to increasing belt use levels.

``Smart'' belt-use reminders and interlocks with other automobile

features are now possible, but have not been tested with drivers.

Speeding and Unsafe Driving Actions

Background

Research has indicated that most crashes are attributable to

human performance (e.g., following too closely, inattention,

speeding, ``aggressive'' driving). However, progress in developing

countermeasures to reduce the incidence of unsafe driving behaviors

has been limited. Two reasons for this limited progress are the

difficulty of measuring the incidence of unsafe driving acts (UDAs),

and a poor understanding of the circumstances under which various

UDAs are most likely to lead to crashes.

One of the most frequently cited UDAs involves speeding. This

specific behavior and its effect on crash frequency remains highly

controversial. Speeding can be defined in at least two ways: (1)

exceeding the posted speed limit; and (2) driving too fast for

conditions. Speed affects both crash worthiness and crash avoidance.

It is clear that speeding increases the severity of crashes, since

the energy released in a crash increases by the square of vehicle

velocity. It has also been demonstrated that increasing speed

reduces a driver's ability to steer safely around curves or objects

in the roadway, extends the distance necessary to stop a vehicle,

and thus increases the distance a vehicle travels while the driver

reacts to a dangerous situation. According to police crash reports,

approximately one third of all fatal crashes involve speeding as a

primary cause. While this kind of information may provide a rough

estimate of the incidence of speeding in fatal crashes, it does not

provide sufficient insight into the causal relationship between

travel speed and crash involvement. All things considered, we still

have inadequate information relating to the extent to which speed

contributes to crash causation and the conditions under which

speeding most often results in a crash.

There are a variety of other UDAs that have a high likelihood of

causing crashes. They include: running red lights and stop signs,

following too closely, passing improperly, weaving through traffic,

etc. Recently, the term ``aggressive driving'' has been used to

refer to a number of unsafe driving actions that are accompanied by

an apparent aggression exhibited by one driver toward another.

What We Have Learned

Crash study work has shown unequivocally that most crashes are

attributable to human performance problems including improper

lookout, speeding, inattention, improper evasive actions, and

distractions. In terms of speed, we know that slower speeds are

accompanied by fewer and less severe crashes, but the exact nature

of this relationship needs further documentation. We also know that

higher levels of speed variance on roadways has been shown to be

associated with increased crash risk.

We do know that, among drivers involved in fatal crashes,

younger drivers of either sex are more likely to have been speeding

than older drivers. Males, at any age, are more likely than females

to have been speeding. There also appears to be a strong positive

correlation between speed and alcohol involvement in fatal crashes.

Drivers at high BACs are more likely to have been speeding than

those at lower BACs. With regard to roadway type, 43 percent of

crashes reported to have involved speeding occur on non-interstate

roads with a speed limit of 55 mph. Forty-five percent occur on

roads with speed limits of 50 mph and below. Only 12 percent of

fatalities involving speeding occur on interstate highways.

Research suggests that the perceived probability of getting

caught is more important than perceived severity of fine in

controlling speeding behavior. As in other areas of traffic law

enforcement, it appears that enforcement of speed limits must be

accompanied by publicity if general deterrence of speeding is to

occur. The importance of perceived risk of getting caught, along

with decreased resources for traffic law enforcement, have led some

officials to view the use of automated speed enforcement as a

desirable alternative. Currently, however, public support for

automated speed enforcement appears to be limited.

Current Research and Evaluation

The agency is currently conducting three separate research

projects dealing with speeding and unsafe driving: (1) A survey of

public attitudes and behaviors toward speeding and other unsafe

driving actions; (2) a crash investigation study to examine the role

of unsafe actions in crashes; and (3) a review and analysis of

existing data to suggest guidelines for setting speed limits. The

survey of public attitudes regarding speeding and other UDAs will

assess views toward enforcement, motivations for speeding,

anticipated consequences, and the acceptability of various measures

to reduce unsafe driving behaviors. The crash investigation effort

involves a clinical case study approach in which a sample of crashes

will be reconstructed with a focus on identifying the specific

behaviors that lead to the crash. The objective of the speed limits

study is to develop data-based guidelines for setting speed limits.

This study is co-sponsored by NHTSA, the Federal Highway

Administration and the Centers for Disease Control, and is being

performed by the Transportation Research Board.

One problem that current studies do not address is the absence

of research that estimates the level of crash risk associated with

speed levels, under differing traffic and environmental conditions.

To address this issue, an epidemiological study is being developed

in which the travel speeds of crash-involved vehicles will be

compared with travel speeds of matched non-crash involved vehicles.

An additional study is being initiated in October of 1997 to test

the feasibility of equipping a fleet of vehicles with speed and

position recorders to determine the crash-involvement rates of

drivers with differing speeding habits.

Strategic Issues for Research on Speeding and Unsafe Driving Actions

The nature of the relationships among speed, driver

characteristics, roadway conditions, situational factors, and crash

rates is currently unknown. Without such knowledge, speed limits are

set using somewhat arbitrary standards, and are often viewed

negatively by the driving public. In order to develop effective

countermeasures, the complex relationship between speed and crashes

must be much better understood and documented.

After the relationship between speed and crashes is

more clearly defined, drivers and members of the general public need

to be made aware of the conditions under which speed leads to

crashes.

When large numbers of drivers ignore posted speed

limits, it is difficult to identify drivers who are most likely to

be involved in crashes. Appropriate target-group identifiers might

be more related to overall driving habits than to events identified

in single episodes. Searching for characteristics of at-risk drivers

will require in-depth studies of driver behavior.

``Aggressive driving'' implies a social-interactive

component to the commission of unsafe driving actions. However,

there is no common definition of aggressive driving. Without a

definition, it is difficult to determine the incidence of such a

phenomenon and how it is related to crash causation.

Automated enforcement of speed and other UDAs are not

widely accepted by law

[[Page 55312]]

enforcement agencies or the general public. Acceptance may be

facilitated by implementation and evaluation of such technology

where compliance with speed limits is critical or where offenses are

least tolerable to the public (e.g., red-light running or speeding

near schools or hospitals).

Older Drivers

Background

NHTSA first developed a plan to address the combined safety and

mobility needs of older drivers in 1988. This plan was developed in

response to the Transportation Research Board's publication,

Transportation in an Aging Society. The plan was last revised in

1993, at the request of Congress. People over 70 currently comprise

9 percent of the population and 13 percent of fatalities. Although

older drivers are highly over-represented in crashes per miles

traveled, they are only slightly over-represented in fatal crashes

per licensed driver. However, demographic trends project that the

proportion of older drivers on the road will increase from the

current 9 percent to over 14 percent within the next 25 years.

Primarily because of increased frailty, the ratio of fatalities to

injuries for drivers over age 80 is 4 to 6 times that of crash-

involved drivers between 20 and 60. Thus, as the numbers of older

drivers on the road increase, it is inevitable that more will be

killed in crashes, unless special efforts are made to improve their

safety.

What We Have Learned

The majority of older drivers do not constitute a major safety

problem. Research has indicated that most older drivers adjust their

driving practices to compensate for declining capabilities. They

reduce or stop driving after dark or in bad weather and avoid rush

hours, high speed roads and unfamiliar routes. Men appear to be

somewhat more reluctant than women to stop driving and consequently

are at a higher risk of crashing than women of comparable age.

Conditions such as memory loss, glaucoma, and antidepressant use

appear to be related to increased crash risk.

Some older persons are not aware of their changing conditions;

most notably, those with cognitive disorders, such as Alzheimer's

disease, and certain visual problems. These drivers may not self

regulate and, as a result, pose an increased risk of crash

involvement. Such individuals may require outside intervention to

remove them from traffic. Unfortunately, research suggests that most

family members, social service agencies, and health care

professionals are either not sufficiently aware or choose not to

provide assistance in making driving-related decisions to those who

need it. For a variety of reasons, many appear hesitant to get

involved with this issue.

Those elderly drivers who remain a problem are not easily

detected with standard licensing procedures. Further, there is some

doubt as to whether most licensing staff have the skills necessary

to detect these problem drivers, even with training and state-of-the

art testing techniques. Diagnostic tests currently in use have not

been shown to be effective in identifying those older drivers who

are at increased crash risk, but some recently developed tests of

``speed of attention'' and ``visual perception'' may have such

potential.

One factor that must be considered with regard to interventions

is the fact that elderly people who give up driving often lose

mobility. For many, the automobile is their primary mode of

transportation and acceptable alternatives are simply not available.

Decreased mobility is frequently followed by decreased quality of

life as elderly people are cut off from the social events, family

visits, medical attention, and opportunities for worship that are

critical in maintaining their sense of well being.

Current Research and Evaluation

Several long-term efforts are now approaching conclusion. These

developmental projects include: (1) Procedures to help elderly

drivers make better decisions about adapting their driving to

accommodate their changing abilities; (2) procedures for family

members, friends, social service agencies, physicians, and other

health-care providers to recognize when an older person needs to

adjust his or her driving to adapt to functional limitations; (3)

procedures for driver licensing agencies to restrict or deny

licensing for those who do not appropriately restrict their driving;

and (4) model programs for medical and social-service agencies to

help older people to make appropriate decisions about driving while

maintaining their mobility. Current efforts also include a survey to

determine societal perceptions and willingness to assist older

drivers to better regulate their driving, and a field test of

special licensing requirements for older drivers.

Strategic Issues for Research on Older Drivers

Older drivers have higher fatality rates, per-mile

driven, than do average-age drivers. Two factors that contribute to

this measure of increased risk include: (1) the fact that elderly

drivers travel fewer miles on interstate highways and other major

roadways; and (2) the fact that elderly drivers are more fragile

than younger drivers. Roadways most often used by elderly drivers,

while involving lower speeds, often have more opportunities for

vehicle-to-vehicle conflict. Thus, elderly drivers are exposed to

more potential crash situations per mile than is the average driver.

Because of their fragility, an elderly person involved in a crash is

more likely to be seriously injured or killed than is a younger

person. Other factors, such as the types of crashes older drivers

are involved in, are also likely to be important and the development

of effective countermeasures will require a better understanding of

these factors.

Some state licensing officials have suggested

establishing a ``graduated'' licensing system for older drivers,

whereby driving would be systematically restricted to certain

driving situations based on reduced abilities. Such a system would

entail some expense and it would depend upon accurate and validated

testing procedures that are not yet available. Also, it must be

remembered that most older drivers appear to impose restrictions on

themselves. Development and evaluation of such a model graduated

licensing programs could provide important information with regard

to the potential for widespread adoption of such programs.

There is some disagreement as to whether licensing

personnel can accurately assess an older driver's ability to drive.

It may be that individuals with more specialized training and

experience will be required. Research is needed to determine if

licensing personnel are able to take on this role and, if so, what

kinds of selection procedures and training will be required.

It is likely that more older persons will drive longer

in the future than they do now, further increasing their exposure to

crashes, injuries, and fatalities. While NHTSA's responsibilities

for increasing safety are clearly defined, its role in extending

mobility is not. Additional information (e.g., determining the

extent to which loss of driving contributes to risk of death or

injury as a pedestrian) is needed to clarify the level of effort the

agency should place on developing programs to foster safe mobility

for older people by helping them continue to drive or by helping

them make the transition to other modes of transportation.

One of the most significant reasons for elderly

drivers' over-involvement in fatal crashes is the inability of their

bodies to absorb crash forces. What would be a survivable crash for

a younger person is often a fatal crash for an older person. Current

occupant-protection standards do not specifically address the

frailty of older occupants. More information is needed to establish

the feasibility of improving the protection of older people when

they are in a crash.

Some of the causes of older-driver crashes could

conceivably be corrected using new vehicle technology. Although

adaptive devices have a long history of permitting people to

overcome various handicaps, older persons are among the last to

adapt to new technology. Additional research in this area could

provide useful information regarding the acceptability of

technology-based innovations designed to help older, functionally

less able people continue to drive.

Pedestrians, Bicyclists, and Motorcyclists

Background

Over the past 25 years, NHTSA has made substantial progress in

improving the safety of pedestrians and bicyclists, particularly in

understanding factors leading to pedestrian and bicyclist crashes.

Pedestrian crashes involving young people aged 5-12 have declined by

about 25 percent since this training and public education work

began. However, pedestrian crashes involving young people remains a

severe problem with about 30,000 such crashes occurring annually.

Older persons also pose a significant over involvement in pedestrian

crashes. While they constitute only 13 percent of the total

population, they are involved in about 23 percent of pedestrian

crash fatalities.

Another significant component of the pedestrian crash problem

involves alcohol. Research has shown that about half of all fatal

adult pedestrian crashes involve either an intoxicated pedestrian

(31 percent of cases), or an intoxicated driver (14 percent of

[[Page 55313]]

cases). Finally, the pedestrian crash problem is especially severe

in several large urban areas where nearly half of all those killed

in motor vehicle crashes are pedestrians.

While the pedestrian (and bicyclist) crash problems remain

serious, the public's attention is not as strongly focused on these

issues as it is on other areas, such as impaired driving, aggressive

driving, etc. In addition, shifts in traffic safety priorities in

the early 1980s resulted in a reduced emphasis of pedestrian and

bicyclist issues. In spite of these obstacles, a number of prototype

public information and education products have been developed,

tested and found to be effective.

What We Have Learned

Crash investigation studies have shown that most crashes

involving pedestrians or bicyclists and motor vehicles can be

categorized into a few major types based on a combination of

behavioral errors and environmental conditions. Research has shown

that training and public education programs focused on these main

crash types can reduce the incidence of young pedestrian crashes

(age 5-12) by as much as 25 percent. Past research indicates that

there is more than a 500 percent increase in crash risk for

pedestrians at BACs of .15 percent or above. Other studies have

determined that Native Americans, male Hispanics, and African-

Americans over the age of 25 are over-represented in alcohol-related

pedestrian crashes. Alcohol is also a major factor in both bicyclist

and motorcyclist crashes, with 25 and 30 percent of such fatalities,

respectively, involving BACs over .10 percent.

In 1996, 2160 motorcyclists were killed and an additional 56,000

were injured in traffic crashes. Since 1986 the fatality rate per

hundred million vehicle miles traveled decreased dramatically: from

48.6 in 1986 to 22.7 in 1995. Per vehicle mile traveled in 1995,

motorcyclists were about 16 times as likely as passenger car

occupants to die in a motor vehicle crash and about 4 times as

likely to be injured. In 1996, there were 1,048 two-vehicle crashes

involving a motorcycle and another vehicle. In 35% of these crashes

the other vehicle was turning left while the motorcycle was going

straight, passing or overtaking the vehicle. Crash statistics show

that helmets are about 29 percent effective in preventing crash

fatalities and 67 percent effective in preventing serious injury.

Also, we know that states which have enacted mandatory helmet laws

for all riders experience almost 100 percent helmet use; however, in

states without such laws, helmet use ranges from 34 percent to 50

percent. Motorcycle operators involved in fatal crashes in 1996 had

higher intoxication rates than any other type of motor-vehicle

driver. In 1996, 31 percent of all fatally injured motorcycle

operators were intoxicated and another 11.5 percent had positive

BACs between .01-.09. As one way of countering this problem, NHTSA

research developed a set of DWI motorcyclist cues (e.g., drifting

during turn or curve, trouble with dismount, weaving) that have been

found to be predictive of impaired motorcyclist operation.

Information about these cues have been widely distributed to police

agencies throughout the country.

Current Research and Evaluation

Current research is focused on development and testing

countermeasures to reduce pedestrian crashes involving children,

alcohol-impaired adults, and elderly persons; investigating the

effect of vehicle speed on pedestrian crashes; and developing a

catalogue of available measures to reduce bicyclist crashes.

Periodic surveys are also being conducted to determine the nature

and extent of the public's view of the pedestrian and bicyclist

crash problem. In the motorcycle area, efforts are being focused on

evaluating the impact of repealing motorcycle helmet laws in various

states, on the effectiveness of various means for increasing the

visibility of motorcyclists; and on developing and evaluating

effective training and licensing programs for novice motorcyclists.

Strategic Issues for Research on Pedestrians, Bicyclists, and

Motorcyclists

Over the past 10 years, fatal crashes have declined

substantially for both pedestrians and bicyclists. In order to

determine the causes for this decline, we must find a way to measure

the magnitude and trends in the exposure of pedestrians and

bicyclists to crash situations.

Most pedestrian crashes occur in urban settings. In

some cities, half or more of those killed in motor-vehicle related

crashes are pedestrians. Thus, to be effective, existing

countermeasures must be adapted to meet the unique demands of the

large-city environment. Although existing countermeasures have been

tested individually, they have not been tested in combination, in a

big-city environment.

Nearly all of NHTSA's research on pedestrian and

cyclist crashes with motor vehicles has emphasized the role of the

pedestrian or the bicyclist, rather than the driver of the car or

truck. In order to develop more effective comprehensive programs for

pedestrians and cyclists, more information is needed regarding

driver awareness of these road users and of how they interact.

In many cities, especially in the eastern portion of

the United States, drivers do not yield to pedestrians, as required

by law. Past research has found that drivers making a right-turn-on-

red maneuver often do not fully stop their vehicles nor adequately

search for pedestrians. An assessment of driver compliance with

existing laws and ordinances is necessary before a review of current

laws governing pedestrians, bicyclists, and drivers can determine

whether existing laws should be modified or new model legislation

should be drafted.

NHTSA has developed training materials for a number of

professional groups to alert them to the safety problems of

pedestrians and bicyclists and how to address them. These groups

include police, traffic engineers, city planners, and highway safety

specialists. Another important group for which materials need to be

produced are elementary school teachers.

The lack of visibility, including nighttime

conspicuity, remains a substantial problem contributing to motor

vehicle crashes with pedestrians and bicyclists. More information is

needed on the requisite materials and devices that should be worn or

used by pedestrians and bicyclists in order to make these road users

more visible to traffic.

Research is underway to catalogue current

countermeasures available to address bicyclist safety This effort is

intended to identify those areas in need of additional development.

The Federal Highway Administration is developing a

prototype software package to permit communities to assess their

unique pedestrian and bicyclist safety problems. Before this

software can be widely distributed, it must be tested under real-

world conditions.

A joint effort with the Federal Highway Administration

resulted in a pedestrian and bicyclist safety training program for

traffic safety professionals. Research to improve awareness levels

of public and highway safety professionals has evolved into

coalition called the ``Partnership for a Walkable America.'' One of

the objectives of this group is to stimulate research to help the

general public understand the seriousness of the pedestrian and

bicyclist crash problems.

NHTSA recently developed an extensive program to

address school-bus safety issues. This program was adopted by the

National Safety Council and has been widely distributed. While the

program was tested during its development, it has not yet been

evaluated as implemented by local communities.

In nearly every state with a law requiring

motorcyclists to wear helmets, there are efforts to repeal that law.

Most of the states that repealed their motorcycle helmet laws in the

1970s and 1980s reinstated them a few years later. However, new

efforts are currently underway in most states to repeal these laws.

State legislatures change with time, and many current lawmakers, who

may not be aware of past history and demonstrated effectiveness of

these laws, may be convinced to vote for repeal. Supporters of

helmet laws need up-to-date factual information about the increased

injury severity, increased fatalities, and increased medical costs

that inevitably result from rescinding motorcycle helmet laws.

Many crashes involving motorcyclists result for drivers

who ``looked but did not see'' the cyclist. Past efforts at

increasing the conspicuity of motorcyclists resulted in the practice

of riding with headlights ``on'' at all times, including daylight

hours. Research attention must be refocused on developing more

effective means for making motorcyclists visible to car and truck

drivers and on developing and testing more effective training and

licensing programs for novice riders.

The most recent systematic analysis of motorcycle

crashes was done nearly 20 years ago. During this time, motorcycle

designs have changed dramatically, favoring sleeker and faster bikes

with lower profiles, urban areas have expanded while roadways have

deteriorated, and riding practices have adapted to these changes.

These events have an unknown effect on motorcycle crashes and,

consequently, the program actions needed to counteract them.

[[Page 55314]]

Novice Driver Education

Background

NHTSA was substantially involved in novice driver education

research from the late 1960s through the early 1980s. However, the

agency reduced efforts in this area after a major demonstration

program showed no long-term crash or violation reductions resulting

from what was then a state-of-the-art novice driver education and

training program. In 1994, Congress requested recommendations from

NHTSA on ways to improve novice driver education and the agency

developed and submitted to Congress a ``Research Agenda For an

Improved Novice Driver Education Program.'' This report reviewed the

history of driver education (including, but not limited to NHTSA's

research and demonstration efforts), suggested reasons why novice

driver education may not be as effective as it could be, and

suggested that an improved driver education program should be

developed as an integral part of a graduated driver licensing

system. The report also provided a summary of research, development,

and evaluation activities that could be used to restructure and

improve the impact of novice driver education. The proposed program

would have two-stages of education that would parallel stages of a

graduated licensing system. It would include parent participation,

and it would incorporate the use of electronic simulation to provide

risk-management training.

What We Have Learned

Driving is a complex task that requires many hours of practice

to reach proficiency in all situations. Much of the time the driving

task is non-demanding in nature and the basics of vehicle control

that are learned in a brief training program generally provide the

skills necessary to drive safely in non-demanding situations.

However these short courses do not provide the adequate training to

meet the occasional, but critical, situations where the driving task

becomes very demanding. Clearly, advanced risk-management skills

cannot be learned in a short time, nor can they be learned before

the basics of vehicle handling are mastered. This suggests the need

to separate the teaching of the two kinds of skills into two

separate learning situations. Since an additional learning

requirement would require strong motivation to get novice drivers

involved, it is logical to tie this two-stage driver education

approach to the attainment of the drivers' license. Graduated

licensing programs provide the structure in which two-stage driver

education could be most effective.

Current Research and Evaluation

Current research is focused on developing and pilot testing

materials for use in a two-staged driver education training program.

Materials include curriculum modules covering essential perceptual

and cognitive training as well as materials to guide parental

involvement in providing appropriate experience and modeling proper

driving behaviors. Current research is also examining interactive

electronic media for use in learning and practicing advanced, risk-

management skills. Evaluations of graduated driver licensing systems

are being conducted in Michigan and in North Carolina. Michigan's

system includes a two-stage driver education program with parent

participation.

Strategic Issues for Research on Novice Driver Education

In view of the finding that conventional driver

education has little impact in terms of reducing novice driver

crashes and violations, any new program approach must show that it

has the potential to reduce the number, frequency, or severity of

crashes of novice drivers. Since research on two-stage driver

education could be confounded by the independent effects of

graduated licensing, efforts must be made to control for such

effects.

The success of the two-staged driver education program

depends in large part on the novice driver obtaining a significant

amount of driving experience under low-threat conditions before he

or she moves on to the second stage of training. Graduated-licensing

systems attempt to use parents (or other significant adults) to

provide this initial experience, but it is not known to what extent

parents and other adults will actually participate or what kinds of

situations will maximize such participation.

The two-stage driver education program is designed to

be an integral part of a graduated driver licensing system. The

intent is to use the prospect of full licensure to provide the

motivation to novice drivers to fully participation in the program.

However, it may be that mandating such training will impose

significant hardships on some individuals. The ramifications of

requiring the driver education as a part of graduated driver

licensing versus providing it as an optional component need to be

explored.

If a more difficult licensing exam is given as an exit

(final) exam, most state licensing authorities could not assume the

additional costs. Alternative approaches include having states

charge applicants for this test or having training facilities

provide this testing service for the licensing agency. Additional

information about the potential consequences of these alternatives

is needed to provide guidance to the states.

When public school systems discontinue driver education

programs, aspiring novice drivers are faced with the requirement of

obtaining training though commercial agencies. A two-stage education

program would place even more demands on already burdened school

systems. Most foreign countries require that novice drivers take

formalized training and pay for it themselves. The ramifications of

adopting such a system for this country are currently unknown.

With increased immigration, there is an increase in

older novice drivers. While these older drivers do not show the age-

related judgement errors associated with young novice drivers, they

still have a higher level of crashes than experienced drivers of

their own age. Since these drivers are older, often are less fluent

in English, and may have learned to drive in another country, the

extent to which they would benefit from a graduated driver licensing

and education program oriented to younger, English-speaking novice

drivers is not clear.

Additional information is needed regarding the

appropriate role for the Federal government to assume in developing

and promoting a novice driver education program for use by states

and communities.

Developers of any complex program such as this, must

solicit and consider the viewpoints of partners. A variety of

mechanisms and approaches (e.g., consensus workshops) exist to meet

these needs. More information about the views and preferences of

various partners will be necessary to gain agreement on issues such

as the basic training content needed for novice drivers and the

development of model education and training programs that meet the

needs of the various organizations involved.

Emergency Medical Services (EMS)

Background

EMS differs from the other program areas receiving research

attention in that it is entirely focused on post-crash rather than

pre-crash events. Much of what is known regarding emergency out-of-

hospital medical care stems from clinical studies of stabilized

patients in treatment settings. This knowledge is not always

applicable to the pre-hospital setting, where EMS is provided to

injured, medically-unstable patients in the field. Consequently,

there are gaps in our knowledge of effective out-of-hospital care. A

key impediment to research on EMS is the absence of a well defined,

uniform, and complete data system to track performance of EMS

systems at local and the national levels. This lack of data makes it

difficult to set a strategy for EMS research.

What We Have Learned

EMS research conducted by NHTSA has focused primarily on the

high mortality rate found in rural settings. Results from studies in

three states indicate that from 12 percent to 29 percent of deaths

from highway trauma in rural settings could be prevented by changes

in patient care.

Current Research and Evaluation

Current research projects are developing appropriate outcome

measures for measuring EMS effectiveness and are evaluating

recommendations for reducing preventable deaths in rural traffic

crashes. These recommendations resulted from an earlier study of

rural preventable mortality.

Strategic Issues for Research on Emergency Medical Services

Data provide the foundation for all research efforts

but there are significant barriers to collecting relevant and

accurate EMS data. Either the data do not exist, are not collected

in a reliable fashion, or cannot be linked with other data sets to

allow tracking of patient outcomes. The integration of information

systems is not possible with most of the EMS data that is currently

collected.

The effectiveness of many EMS interventions currently

being delivered by pre-hospital personnel is not adequately

documented. Virtually no clinical research has been conducted with

injured patients in the pre-hospital setting. Such research is

[[Page 55315]]

needed to ascertain the effectiveness of current EMS practices on

patient outcomes, including reduction in the classic ``6D's'' (i.e.,

death, disease, disability, discomfort, destitution, and

dissatisfaction).

Retrospective analysis of EMS treatment of crash

victims in rural settings revealed that errors or omissions in care

were involved in nearly 30 percent of fatalities. Conclusions from

these studies suggest a need to improve training in specific

clinical interventions by EMS personnel, particularly in rural

settings.

EMS personnel in most states are trained and

periodically re-trained using NHTSA's pre-hospital curricula or

similar programs. Little is known about retention periods for the

material learned, need for skills updating, best methods for

training, and related professional development and certification

issues. Research into these areas will be needed to make

improvements in NHTSA's curriculum.

There are many reasons to use pre-hospital personnel to

teach injury prevention at the community level. Some of the most

obvious include: (1) The positive status and acceptance of these

providers among the general population; (2) the public's willingness

to accept an injury prevention message from pre-hospital providers;

(3) availability of EMS providers, when they are not engaged in EMS

activity; and (4) the potential cost savings that could result by

preventing injuries. However, it is not clear when or where these

people are effectively utilized for this purpose. Such knowledge

could enhance injury-prevention activities.

Accessibility and availability of emergency care to all

is a basic EMS principle. However, enrollment in managed care plans

is growing at phenomenal rates and most plans require additional

levels of review before authorization and payment for EMS services

is made. These additional requirements may consume precious time in

emergency situations that can literally mean the difference between

life and death. Research into the effects of these review

requirements on EMS outcomes is needed.

A comprehensive, well defined, national research plan

that could be embraced by the many partners in the EMS community is

needed. Such a plan would involve researchers and organizations in

both the public and private sectors. NHTSA could provide the

leadership for the development of such a plan.

Safe Communities

Background

Safe Communities is a program area managed jointly under NHTSA's

Associate Administrations for State and Community Services and

Traffic Safety Programs. Safe Communities bring together citizens

and a wide range of local agencies and businesses, such as law

enforcement, hospitals, managed care facilities, emergency medical

services, schools, insurance companies, other public and private

businesses and local governments. These organizations then appoint

members to work on solving local traffic safety (and other injury

causing) problems. Program offices within the agency (e.g., State

and Community Services and Traffic Safety Programs' Office of

Communications and Outreach) provide the day-to-day management of

the Safe Communities Program. The Office of Research and Traffic

Records, Research and Evaluation Division (ORTR/RED) provides

technical expertise on matters relating to evaluation for this key

program area.

The Safe Communities program is similar to the Corridor/

Community Traffic Safety Programs (C/CTSP). However, the Safe

Communities program uses a ``bottom-up, `` data-based approach to

identify and address key injury problems. Additionally, this program

includes an expanded base of partners than the C/CTSPs. In addition

to the traffic law enforcement, highway safety offices, and

emergency medical services groups, a Safe Community includes

citizens, business, and other health care providers such as

hospitals, managed care facilities, and rehabilitation centers.

Presently there are over 300 community-based, locally-supported Safe

Communities in various stages of development.

Four key components of a Safe Communities program are: (1)

Injury data analysis and (where possible) database linkages; (2)

expanded partnerships, especially with health care providers and

business; (3) citizen involvement and input; and (4) an integrated

and comprehensive injury control system.

What We Have Learned

The safe communities program is a new initiative. Evaluation

results and lessons learned will be published in forthcoming annual

reports on the program.

Current Research and Evaluation

As of September of 1997, NHTSA has selected two communities to

serve as model demonstration sites for the Safe Communities program.

They are Dallas, Texas and Greenville, North Carolina. ORTR/RED is

currently providing technical evaluation expertise to these two

model Safe Community sites. It is anticipated that this service will

be extended to two additional model sites that are to be selected in

the near future.

Strategic Issues for Research on Safe Communities

Success in disseminating safety programs to new

communities depends in large part on having evidence of success.

Accordingly, it is desirable to obtain information about which Safe

Communities are thriving and which are faltering and what

characteristics the stronger programs have in common. Knowledge

regarding these factors and any identified deficiencies in weaker

programs will permit intelligent revisions in these programs to

maximize success.

Currently, linkages between crash records and

rehabilitation records are usually limited to physical therapy,

occupational therapy, and recreational therapy. Information on the

feasibility including and linking additional information (e.g.,

information regarding referral to alcohol or drug rehabilitation

programs) would be extremely useful to program managers.

A Safe Community is a coalition of medical,

enforcement, educational, business, and civic groups in a community.

Such a coalition must include close ties, communication, and

cooperation among member groups. Additional research is needed to

define the mechanisms that enable, facilitate, and strengthen the

formation of such inter-organizational ties. In order to facilitate

the perpetuation of Safe Communities, information is needed

regarding the objectives of the various members, how they interact,

and how to counter the forces that contribute to a program's

disintegration.

Program evaluation provides the evidence that newly

developing Safe Communities need to survive. Information on both

short-term and long-term successes is needed, along with a better

understanding of which outcomes are most important to each of the

participating members of a safe community.

Technology Applications

Background

The traffic safety community is anticipating future increases in

vehicle travel and risks of crashes, with no such increases in

funding for safety programs. Police agencies, under pressure to

fight serious crime with reduced budgets, are allocating fewer

resources to traffic-law enforcement--even though well-publicized

traffic-law enforcement is the proven key to compliance with safety-

based laws. With the easiest gains already made, safety experts will

now have to address populations and problems that have historically

been most difficult to change (e.g., chronic offenders, risk-takers,

rural residents).

In order to improve the effectiveness and efficiency of safety

and enforcement programs, ORTR/RED plans to extend its exploration

of emerging technologies. Since the early 1980s, the agency has

evaluated equipment such as alcohol breath-test sensors and laser

speed-measuring devices. More recently, evaluations have focused on

newer technologies such as ``smart card'' drivers licenses that

prevent fraudulent ID, ignition interlock devices, electronic

monitoring wristbands (worn by drivers with suspended licenses) to

ensure court-imposed driving restrictions, and electronic vehicle

and driver identification systems. ORTR/RED is also monitoring

technology developments such as portable computers to assist police

when entering crash or ticket citation data, cellular telephones for

rescue calls, automated crash-notification systems, and photographic

systems to automate ticketing for red-light running.

In recent years, electronics and communication technologies have

been developed to improve highways and vehicles. Government agencies

and the private sector have allocated significant resources to

develop an ``Intelligent Transportation Systems'' (ITS). Their

efforts have focused on commercially appealing applications such as

congestion relief, navigation information, electronic toll

collection, and onboard ``Mayday'' communication systems for

personal security.

Adaptations of these emerging technologies could have

significant potential to aid emergency rescue services, crash

[[Page 55316]]

investigations, traffic law enforcement, and other traffic safety

efforts. However, many traffic-safety priorities, such as increasing

safety belt use and reducing impaired or aggressive driving, might

involve vehicle or driver-license technologies requiring public

investment, vehicle regulations, or court-imposed use--a contrasting

paradigm from the current ITS ``free-market'' perspective where

motorists pay for high-tech services.

What We Have Learned

Applied technology provides demonstrated benefits in safer

driving behaviors and reduced crashes. For example, speed

enforcement using photo radar reduced injury crashes by 20 percent

on Norway's rural roads, and Australia's metropolitan roads saw 20-

49 percent reductions in crash severity. At one busy intersection in

Maryland, red-light running was reduced by 27 percent, by using an

automatic system just to mail warnings to violators. Elsewhere, the

risk of alcohol traffic violations by repeat offenders was curtailed

by as much as 65 percent in the first year, while their vehicles

were equipped with alcohol breath testing equipment and ignition

interlocks.

Notwithstanding these possible benefits, the traffic safety

community in the U.S. has been reluctant to adopt technology

applications. Initial experiences with automated speed enforcement

and safety-belt interlocks have generated political opposition.

However, increasing public concerns with aggressive driving and red-

light running may create a climate of greater acceptance for

carefully selected demonstration projects. Widespread public

acceptance of traffic safety technologies will depend on the degree

to which motorists are convinced that these applications improve

traffic safety, are affordable, reliable, fairly generate ticket

revenues, deal with laws or matters that are respected by the

public, and provide sufficient privacy protection. To help alleviate

the public's fears about potential privacy intrusions and abuses by

``Big Brother,'' public information addressing technology design and

program management must accompany the introduction of new

technology.

Current Research and Evaluation

One project tested a laboratory prototype instrument that uses

an infrared laser beam to detect alcohol vapor within the passenger

compartment of the vehicle. The instrument is intended for use at

checkpoints, stop signs and other traffic environments to screen

vehicles for potentially impaired drivers. Another project is

developing a system of sensors for use at checkpoints that detect

vehicle maneuvers associated with impaired driving. If tests are

positive, the system will be field tested in a subsequent study to

assess its ability to improve police detection of drinking drivers

at checkpoints.

Strategic Issues for Research on Technology Applications

The ways in which ITS technology could be employed in

the service of improving traffic safety are currently not known.

Undoubtedly, some systems could be applied to traffic enforcement as

currently designed (e.g., traffic observation systems could record

data on law-breakers, speed monitoring devices could help enforce

speed limits). Other components would need modification or

adaptation to be used for traffic safety purposes. And there may

exist traffic safety applications for which existing products cannot

be modified to fit and will require new developmental efforts.

Providing the traffic safety community with improved knowledge of

the technological products that exist or are in development would

help foster demand for and permit assessments of how the various

technologies must be adapted in order to be applied to traffic-

safety applications.

Traffic-safety technologies face a number of practical

concerns with which other ITS systems may not have to deal. In

addition to being able to withstand crash forces, safety-oriented

products must also resist tampering, jamming, counterfeiting, and

other problems. Research is needed to identify factors that will

influence production and deployment of technological devices and to

define system characteristics that will minimize costs of

production, deployment, operations, training, and maintenance and

will foster the integration of technologies through sharing common

hardware or systems.

Development and deployment of traffic-safety

technologies will require increased political support, executive

leadership, institutional reforms, legislation, or regulations.

Acceptance of these technologies by the traffic safety community

will also require considerable attention to various critical

concerns (e.g., privacy protection, ``ticketing by mail,'' and other

institutional/legal barriers). Identification of the institutional

partners and the barriers to full acceptance and implementation of

traffic-safety technologies will permit the development of

strategies and action plans to assist states and communities to make

necessary accommodations for emerging technologies.

The ultimate success of efforts to employ new

technologies to improve traffic safety will depend on the acceptance

and support of the public. Successful applications will require

proactive dialog with members of the public to overcome their many

valid concerns and reservations. Accordingly, research is needed to

define the nature and extent of the public's concerns and to develop

technical, legal, and administrative strategies to gain public

support for technological solutions to traffic-safety problems.

Program Evaluation

Background

ORTR/RED routinely conducts evaluations in the areas of

legislative changes, enforcement programs, and educational programs.

ORTR/RED has conducted more than 200 program evaluations.

Evaluations are conducted on agency-developed countermeasure

programs and on selected programs that are implemented at the state

level or local level, independent of the agency. For example, ORTR/

RED initiated and evaluated a program in Baltimore, Maryland to

determine the effect of various NHTSA-developed countermeasures to

the alcohol-related pedestrian crash problem. ORTR/RED also

evaluated the impact of California's upgrade of its safety belt use

law to allow for primary (standard) enforcement procedures, and an

evaluation was recently conducted of Maryland's ``zero tolerance''

BAC law for underage drivers.

What We Have Learned

Evaluations provide evidence of impact for several legislative,

enforcement, education, and other countermeasure programs. As a

result of past evaluations, the impact of several important programs

has been documented to provided guidance and support for future

federal, state, and local efforts. Some of the completed evaluations

have documented the impact of programs such as: sobriety checkpoints

and saturation patrols for impaired drivers, impoundment and

forfeiture laws for repeat offenders, license plate sticker laws,

minimum drinking age (21) laws, lower BAC limits for youth, .08 BAC

levels for adults, drug evaluation and classification (DEC)

procedures, passive alcohol sensors, alternative ride programs,

safety belt laws, primary enforcement provisions of safety belt

laws, child passenger safety laws, occupant protection strategies

for rural areas, special traffic enforcement programs (STEP) for

safety belt laws, enforcement and education efforts to increase

toddler restraint use, motorcycle helmet laws (and repeals),

motorcycle rider education and training programs, driver education

and training programs, pedestrian programs for young children

(including elementary school bus riders), publicizing insurance

sanctions, speed enforcement programs using radar and laser devices,

municipal speed enforcement programs, emergency medical services

training, self-sustaining traffic safety programs, etc.

Evaluation efforts span all of the program areas. However, there

are constraints involving limited staff and monetary resources. One

of the key issues that needs to be addressed in the strategic plan

is the practical matter of deciding which evaluations to perform and

what level of resources needs to be available for quick turnaround

evaluations of unexpected events (e.g. legislation) occurring in the

states.

Current Research and Evaluation

Recently completed evaluations have demonstrated that: upgrading

a secondary-enforcement safety-belt law to standard enforcement

leads to an increase in belt use rates of about 15-19 percentage

points; routine traffic enforcement reduces crime rates, both

through police presence and by apprehending suspects for whom

warrants have been issued; and youth peer-to-peer groups positively

can affect attitudes and behaviors of teens regarding drinking and

driving.

Current evaluations include: a national evaluation of Selective

Traffic Enforcement Programs (STEPs) in 20 states; a national

evaluation of child safety seat distribution programs; an evaluation

of the repeal of the motorcycle helmet laws in Arkansas and Texas;

an evaluation of why alcohol-related fatalities declined

substantially more in 5 states than the rest of the nation; an

evaluation of the crash problem on the Capital Beltway, and an

evaluation of the

[[Page 55317]]

effects of the Section 410 Alcohol Incentive Grant Program.

Strategic Issues for Evaluation

Determining which programs and types of countermeasures

to evaluate is a question of setting priorities. Current suggestions

for evaluation projects include examining the relative effectiveness

of general deterrent legislation (e.g., .08 BAC limits) and specific

deterrent legislation (e.g., vehicle impoundment for repeat DWI

offenses) on the incidence of alcohol-related crashes.

Another need is to evaluate the effect of driver

license points as a sanction for safety belt use law violations.

ORTR/RED's ability to offer program evaluation support

to individual states and communities is limited. There are usually

more programs in need of evaluation than ORTR/RED has capability to

serve. One possible method to expand the number of evaluations that

can be conducted would be to help develop the capacities of the

states to perform evaluations.

[FR Doc. 97-28163 Filed 10-22-97; 8:45 am]

BILLING CODE 4910-59-P