Improving parenting capacity to promote safe driving for adolescents with ADHD

提高育儿能力，促进多动症青少年的安全驾驶

• 批准号: 7896999
• 负责人: GREGORY A FABIANO
• 金额: $ 64.47万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-12 至 2015-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7896999
• 关键词: 20 year old; Academy; Accidental Injury; Accidents; Adolescence; Adolescent; Age; Alcohols; American; Attention; Attention deficit hyperactivity disorder; Automobile Driving; Behavior; Behavior Therapy; Behavioral; Cessation of life; Child; Communication; Communication Programs; Complex; Conflict (Psychology); Contracts; Data; Development; Diagnosis; Discipline; Education; Effectiveness; Effectiveness of Interventions; Electronics; Exhibits; Family; Fostering; Health Benefit; Impairment; Injury; Intervention; Joints; Learning; Left; Licensing; Literature; Measurement; Measures; Mediating; Mediation; Mental Health; Monitor; Motor Vehicles; Outcome; Parenting behavior; Parents; Patient Self-Report; Pattern; Pediatrics; Pharmaceutical Preparations; Population; Procedures; Prospective Studies; Public Health; Rage; Raja; Randomized Clinical Trials; Randomized Controlled Trials; Recording of previous events; Records; Regimen; Relative (related person); Reporting; Research; Risk; Robin bird; Running; Safety; Subgroup; Substance abuse problem; Symptoms; Teenagers; Time; Training; Treatment Efficacy; Work; age group; contingency management; cost; driving behavior; driving under influence; effective intervention; improved; innovative technologies; intervention effect; motivational enhancement therapy; parental monitoring; prevent; programs; psychosocial; public health relevance; skills; standard care; teen driving; therapy design; trafficking; treatment program

DESCRIPTION (provided by applicant): There is clear, converging evidence from multiple prospective studies with well-diagnosed adolescents with ADHD and comparison, non-ADHD adolescents, that teen drivers with ADHD have more accidents (Fischer et al., 2007; Nada-Raja et al., 1997; Thompson et al., 2007; Weiss et al., 1979; Woodward et al., 2000) that result in greater costs (Fischer et al., 2007), injuries (Woodward et al., 2000), and fatalities (Lambert, 1995). Adolescent drivers with ADHD are also more likely to be cited for a traffic citation or reckless driving, driving without a license, having hit-and-run accidents, and having a revoked or suspended license (see Barkley & Cox, 2007 for a review). Available research indicates parental monitoring and limit-setting for adolescent drivers is one of the most effective interventions for preventing negative driving outcomes (e.g., Simons-Morton et al., 2007). For children with ADHD, interventions to promote parenting capacity to effectively oversee and intervene in teen driving will likely need to be intensive and require multiple treatment components. The present proposal aims to compare the standard care for teen drivers (driver's education classes and driving practice) to the Supporting a Teen's Effective Entry to the Roadway (STEER) program, that includes a parent- teen intervention, adolescent skill building, parent training on effective adolescent management strategies, joint parent-teen negotiations sessions, practice on a driving simulator, parental monitoring of objective driving behaviors, and the targeting of safe teen driving via contingency management strategies (i.e., parent-teen contracts). To facilitate teen and parent engagement the intervention will be preceded by a motivational interview. The specific aims of the proposal are to investigate the efficacy of the STEER program relative to a standard care group in a randomized clinical trial (N=172) on measures of objective driving outcome and parenting capacity. PUBLIC HEALTH RELEVANCE: This study holds substantial public health benefit as it will be the first randomized controlled trial for the behavior modification treatment of driving behavior for adolescents with ADHD. Relative to typical adolescents, those with ADHD are most at-risk for a number of negative driving outcomes including accidents, injury, and death. In addition, the study will enhance the understanding of how increasing the parenting capacity for monitoring and limit setting improves adolescent driving behavior as measured by innovative technologies as well as by typical measurement strategies.

描述（由申请人提供）：多项前瞻性研究显示，患有 ADHD 的青少年驾驶员发生更多事故（Fischer 等人，2007 年；Nada-Raja 等人，1997 年；Thompson 等人，2007 年；Weiss 等人，1979 年；Woodward 等人， 2000）导致更大的 成本（Fischer 等，2007）、伤害（Woodward 等，2000）和死亡（Lambert，1995）。患有多动症的青少年司机也更有可能因交通罚单或鲁莽驾驶、无证驾驶、肇事逃逸事故以及吊销或吊销驾照而被传唤（参见 Barkley & Cox, 2007 年的评论）。现有研究表明，家长对青少年驾驶员的监控和限制设置是预防不良驾驶后果的最有效干预措施之一（例如，Simons-Morton 等人，2007 年）。对于患有多动症的儿童，提高养育能力以有效监督和干预青少年驾驶的干预措施可能需要加强，并且需要多种治疗成分。本提案旨在将针对青少年驾驶员的标准护理（驾驶员教育课程和驾驶实践）与支持青少年有效进入道路 (STEER) 计划进行比较，该计划包括家长与青少年的干预、青少年技能培养、家长关于有效青少年管理策略的培训、家长与青少年联合谈判会议、驾驶模拟器练习、家长对客观驾驶行为的监控以及通过应急管理策略来实现青少年安全驾驶 （即父母与青少年的合同）。为了促进青少年和家长的参与，干预之前将进行动机性访谈。该提案的具体目的是在随机临床试验 (N=172) 中调查 STEER 计划相对于标准护理组的功效，以衡量客观驾驶结果和养育能力。 公共健康相关性：这项研究具有重大的公共健康益处，因为它将是第一个针对多动症青少年驾驶行为进行行为矫正治疗的随机对照试验。与典型的青少年相比，患有注意力缺陷多动症的人最有可能发生许多负面驾驶后果，包括事故、受伤和死亡。此外，该研究还将加深人们对如何通过创新技术和典型测量策略来提高父母的监测和限制设置能力来改善青少年驾驶行为的理解。