Can Unlicensed Motorcycle Owners Be Persuaded to Obtain a License? Evaluation of a Safety Program in Maryland
نویسندگان
چکیده
Background: Unlicensed motorcycle operators appear to be disproportionately involved in police-reported motorcycle crashes in Maryland, accounting for about 27 percent of motorcycle operators in police-reported crashes, although unlicensed owners comprise 17 percent of primary motorcycle owners. A randomized controlled trial was conducted to determine whether an educational intervention could increase licensure rates among Maryland motorcycle owners. Methods: Based on focus groups and outreach to organizations interested in motorcycle safety in Maryland, a cover letter and brochure were developed to provide information about the benefits of motorcycle licensure, methods of obtaining licenses, including rider education courses, and adverse legal consequences of being caught operating a motorcycle while unlicensed. Maryland Motor Vehicle Administration (MVA) records of registered motorcycles were linked with licensure files to determine which motorcycle owners lacked valid motorcycle licenses or learner’s permits. The population eligible for an intervention consisted of 8,500 unlicensed motorcycle owners who had no licensed co-owners listed in MVA vehicle registration records. Half of them were randomized to receive a cover letter and brochure from MVA, which was mailed to them in early June, 2005. Licensure rates among the intervention group and comparison group of unlicensed motorcycle owners were followed for five months postintervention. Results: Licensure rates remained low in both the intervention and comparison groups. As of November 15, 2005, a total of 268 unlicensed owners in the intervention group had obtained Class M motorcycle licenses and 157 had obtained Class R motorcycle learner’s permits. The comparison group obtained 201 Class M licenses and 121 Class R permits during the same period. The overall success rate in the intervention group, defined as obtaining Class M or R, was 10.1 percent compared with 7.6 percent in the comparison group, a statistically significant increase (licensure ratio (LR)=1.33; 95 percent confidence interval (CI) = 1.15-1.52). Women were overrepresented within the unlicensed group relative to the entire population of motorcycle owners. A low percentage of unlicensed female owners obtained M licenses or R permits. The intervention appeared to be more successful among unlicensed male owners, who had a LR for obtaining M licenses of 1.46 (95% CI=1.21-1.75). LRs were significantly higher among unlicensed owners ages 41-48 and 49+ receiving the intervention compared with younger age groups. Regional comparisons were limited by small numbers; however, those counties falling into the Capital region close to Washington, DC had higher response rates to the intervention (LR=1.63; 95% CI=1.12-2.38) than other Maryland regions. Conclusions: The intervention did appear to increase licensure rates, yet the success rate was far less than optimal. One potential barrier to licensure was the high demand for motorcycle training courses during 2005, which led to a scarcity of spaces in the courses; however, the unlicensed motorcycle owners had the option of obtaining a license without taking a rider education course. Further research should explore whether licensure rates could be increased by modifying the intervention, such as mailing brochures earlier in the year, incorporating a stronger message from MVA, and repeating the mailings to owners who remain unlicensed. In addition, future research should explore the relationship between licensure, ownership, and crash risk. Introduction The number of deaths and non-fatal injuries has been increasing among motorcycle riders in the United States since 1997 (National Highway Traffic Safety Administration, 2005; Insurance Institute for Highway Safety, 2005). The 89 percent increase in motorcycle-related deaths likely is attributable to several trends: increasing numbers of motorcycle registrations, accompanied by increased travel on motorcycles, and the higher proportion of motorcycle riders who are older than 40 and thus more susceptible to injury. Effective interventions are needed to reduce the burden of injury arising from motorcycle crashes. One potential risk factor for involvement in a motorcycle crash is lack of licensure. Unlicensed motorcycle operators appear to be disproportionately involved in police-reported motorcycle crashes in Maryland, accounting for about 27 percent of motorcycle operators in police-reported crashes, although they comprise only 17 percent of Maryland motorcycle owners. The absence of a valid license may indicate potential deficits in the skills needed to operate a motorcycle safely; however, the absence of a license also may be a marker for risky driving behavior that would not necessarily improve after obtaining a motorcycle license. The purpose of this study was to determine whether a persuasive educational intervention could increase licensure rates among unlicensed motorcycle owners in Maryland. The intervention was designed so as to increase the likelihood of the target population being motivated to obtain licenses. Methods The intervention consisted of a mailing from the Maryland Motor Vehicle Administration
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