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2023 BE H AVIORAL TRAFF IC SA FETY COOPERAT IVE RESEARCH PROGRA M BTSCRP RESEARCH REPORT 6 Research sponsored by the Governors Highway Safety Association and National Highway Traf c Safety Administration Subscriber Categories Passenger Transportation ⢠Safety and Human Factors ⢠Vehicles and Equipment Identifying and Prioritizing Behavioral Interventions to Improve Child Passenger Safety in For-Hire Vehicles Guide and Conduct of Research Johnathon P. Ehsani Je rey Michael Alexander D. McCourt Andrew Hellinger Wendy Shields Eileen M. McDonald Gayane Yenokyan Center for Injury Research and Policy Johns Hopkins Bloomberg School of Public Health Baltimore, MD
BEHAVIORAL TRAFFIC SAFETY COOPERATIVE RESEARCH PROGRAM Since the widespread introduction of motor vehicles more than a century ago, crashes involving their operation remain a significant public health concern. While there have been enormous improvements in highway design and construction, as well as motor vehicle safety, which have been instrumental in lowering the rate of crashes per mil- lion miles in the United States, more than 35,000 people die every year in motor vehicle crashes. In far too many cases, the root causes of the crashes are the unsafe behaviors of motor vehicle operators, cyclists, and pedestrians. Understanding human behaviors and developing effective countermeasures to unsafe ones is difficult and remains a major weak- ness in our traffic safety efforts. The Behavioral Traffic Safety Cooperative Research Program (BTSCRP) develops practical solutions to save lives, prevent injuries, and reduce costs of road traffic crashes associated with unsafe behav- iors. BTSCRP is a forum for coordinated and collaborative research efforts. It is managed by the Transportation Research Board (TRB) under the direction and oversight of the Governors Highway Safety Association (GHSA) with funding provided by the National Highway Traffic Safety Administration (NHTSA). Funding for the program was originally established in Moving Ahead for Progress in the 21st Century (MAP-21), Subsection 402(c), which created the National Cooperative Research and Evaluation Program (NCREP). Fixing Americaâs Surface Transportation (FAST) Act continued the program. In 2017, GHSA entered into an agreement with TRB to manage the research activities, with the program name changed to Behavioral Traf- fic Safety Cooperative Research Program. The GHSA Executive Board serves as the governing board for the BTSCRP. The Board consists of officers, representatives of the 10 NHTSA regions, and committee and task force chairs. The Research Committee Chair appoints committee members who recommend projects for funding and provide oversight for the activities of BTSCRP. Its ultimate goal is to oversee a quality research program that is committed to addressing research issues facing State Highway Safety Offices. The Executive Board meets annually to approve research projects. Each selected project is assigned to a panel, appointed by TRB, which provides technical guidance and counsel throughout the life of the project. The majority of panel members rep- resent the intended users of the research projects and have an important role in helping to implement the results. BTSCRP produces a series of research reports and other products such as guidebooks for practitio- ners. Primary emphasis is placed on disseminating BTSCRP results to the intended users of the research: State Highway Safety Offices and their constituents. BTSCRP RESEARCH REPORT 6 Project BTS-11 ISSN 2766-5976 (Print) ISSN 2766-5984 (Online) ISBN 978-0-309-69860-3 Library of Congress Control Number 2023936404 © 2023 by the National Academy of Sciences. National Academies of Sciences, Engineering, and Medicine and the graphical logo are trade- marks of the National Academy of Sciences. All rights reserved. COPYRIGHT INFORMATION Authors herein are responsible for the authenticity of their materials and for obtaining written permissions from publishers or persons who own the copyright to any previously published or copyrighted material used herein. Cooperative Research Programs (CRP) grants permission to reproduce material in this publication for classroom and not-for-profit purposes. Permission is given with the understanding that none of the material will be used to imply TRB, AASHTO, APTA, FAA, FHWA, FTA, GHSA, or NHTSA endorsement of a particular product, method, or practice. It is expected that those reproducing the material in this document for educational and not-for-profit uses will give appropriate acknowledgment of the source of any reprinted or reproduced material. For other uses of the material, request permission from CRP. NOTICE The research report was reviewed by the technical panel and accepted for publication according to procedures established and overseen by the Transportation Research Board and approved by the National Academies of Sciences, Engineering, and Medicine. The opinions and conclusions expressed or implied in this report are those of the researchers who performed the research and are not necessarily those of the Transporta- tion Research Board; the National Academies of Sciences, Engineering, and Medicine; or the program sponsors. The Transportation Research Board does not develop, issue, or publish standards or spec- ifications. The Transportation Research Board manages applied research projects which provide the scientific foundation that may be used by Transportation Research Board sponsors, industry associations, or other organizations as the basis for revised practices, procedures, or specifications. The Transportation Research Board; the National Academies of Sciences, Engineering, and Medicine; and the sponsors of the Behavioral Traffic Safety Cooperative Research Program do not endorse products or manufacturers. Trade or manufacturersâ names or logos appear herein solely because they are considered essential to the object of the report. Published research reports of the BEHAVIORAL TRAFFIC SAFETY COOPERATIVE RESEARCH PROGRAM are available from Transportation Research Board Business Office 500 Fifth Street, NW Washington, DC 20001 and can be ordered through the Internet by going to https://www.mytrb.org/MyTRB/Store/default.aspx Printed in the United States of America
e National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, non- governmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president. e National Academy of Engineering was established in 1964 under the charter of the National Academy of Sciences to bring the practices of engineering to advising the nation. Members are elected by their peers for extraordinary contributions to engineering. Dr. John L. Anderson is president. e National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on medical and health issues. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president. e three Academies work together as the National Academies of Sciences, Engineering, and Medicine to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. e National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine. Learn more about the National Academies of Sciences, Engineering, and Medicine at www.nationalacademies.org. e Transportation Research Board is one of seven major programs of the National Academies of Sciences, Engineering, and Medicine. e mission of the Transportation Research Board is to provide leadership in transportation improvements and innovation through trusted, timely, impartial, and evidence-based information exchange, research, and advice regarding all modes of transportation. e Boardâs varied activities annually engage about 8,000 engineers, scientists, and other transportation researchers and practitioners from the public and private sectors and academia, all of whom contribute their expertise in the public interest. e program is supported by state transportation departments, federal agencies including the component administrations of the U.S. Department of Transportation, and other organizations and individuals interested in the development of transportation. Learn more about the Transportation Research Board at www.TRB.org.
AUTHOR ACKNOWLEDGMENTS The research reported herein was performed under BTSCRP Project BTS-11 by Johns Hopkins University (JHU). JHU was the contractor and fiscal administrator for this study. Dr. Johnathon P. Ehsani, Assis- tant Professor at the Bloomberg School of Public Health (BSPH), was the Project Director and Principal Investigator. The other authors of this report are Dr. Jeffrey Michael, Distinguished Scholar at BSPH, Dr. Alexander D. McCourt, Assistant Professor at BSPH, Andrew Hellinger, Senior Programmer Analyst at BSPH, Wendy Shields, Associate Scientist at BSPH, Eileen M. McDonald, Senior Scientist at BSPH, and Dr. Gayane Yenokyan, Executive Director of the Biostatistics Center at BSPH. This work was done under the general supervision of Dr. Ehsani at BSPH. C O O P E R A T I V E R E S E A R C H P R O G R A M S CRP STAFF FOR BTSCRP RESEARCH REPORT 6 Christopher J. Hedges, Director, Cooperative Research Programs Waseem Dekelbab, Deputy Director, Cooperative Research Programs Richard A. Retting, Senior Program Officer Dajaih Bias-Johnson, Senior Program Assistant Natalie Barnes, Director of Publications Heather DiAngelis, Associate Director of Publications BTSCRP PROJECT BTS-11 PANEL Sarah Cattie, Delaware Office of Highway Safety, Dover, DE (Chair) Kakan Chandra Dey, West Virginia University, Morgantown, WV Rebecca Dieken, Illinois Department of Transportation, Springfield, IL Timothy Kerns, Maryland Department of Transportation, Glen Burnie, MD Jessica Hafetz Mirman, University of Edinburgh, Edinburgh, United Kingdom Angela A. Osterhuber, American Academy of Pediatrics, Pennsylvania Chapter, Media, PA John W. Shaw, Iowa State University, Ames, IA Maria E. Vegega, Road Safety Consulting, Alexandria, VA Elizabeth M. Waller, Transurban, Inc., Docklands, Victoria, Australia Christine Watson, NHTSA Liaison
BTSCRP Research Report 6 provides guidelines to identify and prioritize the types of behav- ioral interventions needed to improve child passenger (defined as people under 13Â years of age) safety in the for-hire rideshare environment, including taxis. The guide describes steps that can be taken to help ensure that the requirements for child restraint systems (CRS) use in for-hire vehicles provide complete and consistent coverage; describes steps that can be taken to communicate with for-hire companies to request that they work to help address challenges associated with CRS use in rideshare and taxi vehicles; and discusses legislative provisions that require for-hire companies to provide CRS in their vehicles or facilitate CRS use. This guide will be of interest to state highway safety offices, for-hire vehicle operators, and other stakeholders concerned with improving child passenger safety in for-hire vehicles. Rideshare and taxi services provide tens of millions of trips per day worldwide. As vehicle ownership becomes less common among urban residents, rideshare and taxi services will likely continue to become more popular. Unfortunately, growing evidence suggests that the use of CRS in rideshare and taxi vehicles is lower than usage rates in personal vehicles. Since CRS are crucial for decreasing the risk of crash injuries among children, efforts are needed to ensure that a modal shift from personal vehicles to rideshare and taxi services is not accompanied by setbacks in child passenger safety. In BTSCRP Project BTS-11, Johns Hopkins University was asked to (1) annotate state and local policies for ensuring child passenger safety in for-hire motor vehicles; (2) describe current company practices, both national and international, for providing CRS in for-hire motor vehicles; (3) determine the CRS experiences and attitudes of parents, other caregivers, and for-hire drivers; (4) identify objective techniques to measure the use of CRS in for-hire motor vehicles; (5) identify international policies and practices for CRS use applicable to the United States; (6) document the barriers and facilitators to CRS use with a focus on companies, drivers, and caregivers; (7) describe the roles of stakeholders who can influence the use of CRS; (8) develop targeted behavioral change strategies and messages to promote child passenger safety, including for at-risk and hard-to-reach populations; and (9) propose strategies to evaluate the guidance. Supplemental to this report are a State CRS Policy Summary, a City CRS Policy Summary, and the appendices. This supplemental material is available from the National Academies Press website (nap.nationalacademies.org) by searching for BTSCRP Research Report 6. F O R E W O R D By Richard A. Retting Staff Officer Transportation Research Board 16519-00b_FM-4thPgs.indd 5 5/12/23 12:32 PM
P A R T I Guide 3 Part I Summary 5 Chapter 1 Introduction 6 Chapter 2 Strengthening CRS Requirements That Apply to For-Hire Vehicles 6 Existing Policies 7 Legislative Options 8 Chapter 3 Encouraging For-Hire Companies to Play a More Active Role in Ensuring Child Passenger Protection 8 Current Company Involvement and Proposed Actions 8 Example Talking Points for Safety Advocates 10 Chapter 4 Introducing Legislation to Require For-Hire Companies to Provide CRS in Their Vehicles or Facilitate CRS Use 11 References P A R T I I Conduct of Research 15 Part II Summary 17 Chapter 5 Background 19 Chapter 6 Research Approach 19 Document Review 21 Surveys 24 Expert Opinion from an Advisory Group 27 Chapter 7 Findings and Applications 27 Task 1: Annotate Current State and Local Policies for Ensuring Child Passenger Safety in For-Hire Motor Vehicles 28 Task 2: Describe Current Company Practices, Both National and International, for Providing CRS in For-Hire Motor Vehicles 28 Task 3: Identify Noteworthy International Policies and Practices for CRS Use Applicable to the United States 29 Task 4: Determine the CRS Experiences and Attitudes of Parents, Other Caregivers, and For-Hire Drivers 41 Task 5: Document the Barriers and Facilitators to CRS Use with a Focus on Companies, Drivers, and Caregivers C O N T E N T S
45 Task 6: Identify Objective Techniques to Measure the Use of CRS in For-Hire Motor Vehicles 46 Task 7: Describe the Roles of Stakeholders Who Can Influence the Use of CRS 47 Task 8: Develop Targeted Behavioral Change Strategies and Messages to Promote Child Passenger Safety, Including At-Risk and Hard-to-Reach Populations 47 Task 9: Propose Strategies to Evaluate the Guidance 48 Chapter 8 Conclusions and Suggested Research 48 Areas for Further Research and Intervention 48 Limitations 49 Conclusions 50 References 51 Appendices AâJ Note: Photographs, figures, and tables in this report may have been converted from color to grayscale for printing. The electronic version of the report (posted on the web at nap.nationalacademies.org) retains the color versions.
