Longitudinal study of adverse driving outcomes among adolescents with ADHD

多动症青少年不良驾驶结果的纵向研究

• 批准号: 10470711
• 负责人: Allison Elizabeth Curry
• 金额: $ 72.64万
• 依托单位: CHILDREN'S HOSP OF PHILADELPHIA
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-22 至 2026-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10470711
• 关键词: Accelerometer; Address; Adolescence; Adolescent; Alcohol consumption; Attention deficit hyperactivity disorder; Automobile Driving; Behavior; Cause of Death; Cellular Phone; Childhood; Complement; Data; Disease; Disruptive Behavior Disorder; Distal; Ecological momentary assessment; Economics; Environment; Event; Executive Dysfunction; Eye; Family; Foundations; Goals; Impairment; Individual; Intervention; Knowledge; Learning; Licensing; Licensure; Link; Longitudinal Studies; Measurement; Measures; Methods; Modernization; Monitor; Outcome; Parents; Participant; Patient Self-Report; Pattern; Performance; Persons; Pharmaceutical Preparations; Phase; Policies; Population Study; Prevalence; Prospective cohort study; Records; Research; Research Design; Resources; Risk; Risk Factors; Safety; Seat Belts; Societies; Speed; Stimulant; Subgroup; Surveys; System; Technology; Teenagers; Text; Time; Vehicle crash; Work; Young driver; adverse outcome; aged; behavioral outcome; cohort; data warehouse; design; driving behavior; driving safety; evidence base; executive function; high risk; innovation; intervention program; kinematics; modifiable risk; recruit; risky driving; skills; social; teen drivers; therapy development; unsafe driving

Project Abstract ADHD is one of the most common childhood disorders and often persists into adolescence—a period in which many individuals get licensed to drive. The ability to drive is important to an individual's participation in modern society, as it enhances independence and social and economic opportunity. However, motor vehicle crashes are the leading cause of death among teens. Skills that are critical in driving, including executive functioning, are frequently impaired in individuals with ADHD. Thus, research is critically needed to establish the scientific foun- dation for driving risks among teens with ADHD so that evidence-based countermeasures to reduce crash risk can be developed. Our initial R01 project established that the risk of crash involvement for newly licensed teen drivers with ADHD is 30%-40% higher than same-aged drivers without ADHD (Curry 2017 and 2019). This R01 renewal directly addresses the next logical critical gap: understanding why crash risk is elevated for teen drivers with ADHD. Our overall objective is to identify specific factors that heighten driving risks for teen drivers with ADHD. We will accomplish this with three specific aims. In Aim 1 we will identify distal factors (outside vehicle environment) that heighten risk of adverse driving outcomes for teens with ADHD. In Aim 2 we will identify prox- imal factors (within vehicle environment) that heighten risk. Finally, in Aim 3 we will examine (among drivers with ADHD) the association between ADHD-related factors—including medication use, current ADHD impairment, and the presence of co-occurringdisruptivebehavioral disorder—andadversedriving outcomes. To achieveAim 1, we will conduct a prospective cohort study of 1,000 teen-parent dyads (500 with ADHD, 500 without ADHD). Participants will complete a baseline and four wave surveys that span from the learner phase through the first 15 months of independent driving. Survey data will be linked to objective driving outcomes captured via a smartphone data logger and existing state-level administrative data on moving violations and crashes. To achieve Aims 2 and 3, we will conduct a naturalistic driving study that will include 90 teens from Study 1 as they obtain an intermediate license (10 without ADHD, 40 with ADHD and prescribed ADHD medication, 40 with ADHD and not prescribed ADHD medication). Innovative in-vehicle technology in teens' vehicles will continu- ously monitor driving patterns, behaviors, and performance for the first 12 months of licensure. We will also collect daily medication use for the first 3 months of licensure utilizing innovative ecological momentary assess- ment methods via text prompts. This will enable us to conduct the first examination of how ADHD medication use influences real-world naturalistic driving performance. We expect that the rich foundational information gen- erated from this project will provide critical knowledge about driving risks for teens with ADHD. The project will make a positive impact in that it will enable us to begin addressing the pressing need for targeted interventions for teens with ADHD and their families during the learning-to-drive period—ultimately optimizing their safety as independent drivers.

项目摘要 多动症是最常见的儿童期疾病之一，通常会持续到青春期——在这个时期 许多人获得驾驶执照。驾驶能力对于个人参与现代社会非常重要 社会，因为它增强了独立性以及社会和经济机会。然而机动车碰撞事故 是青少年死亡的主要原因。对驾驶至关重要的技能（包括执行功能）是 多动症患者经常受到损害。因此，迫切需要进行研究来建立科学基础 确定患有多动症的青少年的驾驶风险，以便采取基于证据的对策来降低碰撞风险 可以开发。我们最初的 R01 项目确定了新获得驾照的青少年发生碰撞事故的风险 患有 ADHD 的驾驶员比没有 ADHD 的同龄驾驶员高 30%-40%（Curry 2017 和 2019）。这个R01 更新直接解决了下一个逻辑上的关键差距：了解为什么青少年驾驶员的碰撞风险会升高 患有多动症。我们的总体目标是确定增加青少年驾驶员驾驶风险的具体因素 多动症。我们将通过三个具体目标来实现这一目标。在目标 1 中，我们将识别远端因素（车辆外部 环境），这增加了患有多动症的青少年出现不良驾驶结果的风险。在目标 2 中，我们将确定 prox- 增加风险的自然因素（车辆环境内）。最后，在目标 3 中，我们将检查（在具有 ADHD）ADHD 相关因素之间的关联，包括药物使用、当前 ADHD 损伤、 以及同时发生的破坏性行为障碍和不良驾驶后果。达到目的 1，我们将对 1,000 名青少年父母（500 名患有 ADHD，500 名不患有 ADHD）进行前瞻性队列研究。 参与者将完成从学习者阶段到第一阶段的基线调查和四波调查 15个月独立驾驶。调查数据将与通过 智能手机数据记录器和现有的有关移动违规和碰撞的州级管理数据。到 为了实现目标 2 和 3，我们将开展一项自然主义驾驶研究，其中包括研究 1 中的 90 名青少年，因为他们 获得中级许可证（10 名没有 ADHD，40 名患有 ADHD 并服用了处方 ADHD 药物，40 名患有 ADHD） 注意力缺陷多动症（ADHD）且未处方注意力缺陷多动症（ADHD）药物）。青少年车辆中的创新车载技术将继续 密切监控获得驾照后前 12 个月的驾驶模式、行为和表现。我们还将 利用创新的生态瞬时评估收集许可证前 3 个月的每日用药情况 通过文本提示的更换方法。这将使我们能够首次检查多动症药物治疗 使用会影响现实世界的自然驾驶性能。我们期望丰富的基础信息生成 该项目的成果将为患有多动症的青少年提供有关驾驶风险的重要知识。该项目将 产生积极影响，使我们能够开始解决有针对性的干预措施的迫切需要 为患有多动症的青少年及其家人在学开车期间提供帮助——最终优化他们的安全 独立司机。