The effectiveness of behavioural interventions on young, novice drivers’ motor vehicle crash risk: A systematic review

Abstract

Introduction

Motor vehicle crashes (MVCs) are a leading cause of injury and death of adolescents world-wide. There is no consensus on the most efficacious individual-level behavioral interventions for reducing young drivers’ risk for MVCs. The purpose of this systematic review was to evaluate evidence of effectiveness of such interventions. We were interested in only fully randomized-controlled trials (RCT) owing to the superior quality of evidence they provide.

Methods

Eligible studies needed to have all of the following attributes: 1) random assignment, 2) concern individual-level behavioural interventions, 3) target young drivers (16–24 years of age), young drivers and their carer (dyads), or carers of young drivers, and 4) report young drivers’ post-license MVC outcomes. The Risk-of-Bias 2 assessment tool was used. Fourteen databases were searched from May-to-June 2023 and re-checked in April 2024. The protocol was pre-registered with Prospero: CRD42023425135.

Results

Sixteen papers corresponding to 12 distinct RCTs of individual-level behavioural interventions were identified as meeting all criteria for inclusion. Of these, none were found to be effective in reducing risk for MVC.

Conclusion

We propose that the limited amount of success thus far is caused by: 1) the quality of research evidence coupled with a lack of individual-level interventions mature enough to evaluate; 2) the small number of randomised controlled trials conducted; 3) the low statistical power of these trials; and related to this 4) the practice of combining MVCs with other outcomes. A more rigorous and collaborative approach is necessary to move the field forward in order to prevent MVCs in this vulnerable group.