Exploring Risk Factors Contributing to Motor Vehicle Crashes Among Saudi Young Drivers

Abstract

Background: Road traffic crashes (RTCs) have a devastating impact on morbidity and mortality globally. RTCs constitute the eighth leading cause of death globally, and road traffic injuries (RTIs) are the most common cause of death for children and young adults aged 5–29 years. Various countries have exerted efforts to identify the risk factors contributing to motor vehicle crashes (MVCs) and the related injuries and deaths among adolescent and young adult vehicle drivers. However, there is insufficient knowledge of the crash risk factors among adolescents and young adult drivers in the Kingdom of Saudi Arabia (KSA).

Purpose: This dissertation purpose to explore and understand the MVC risk factors in male adolescent and young adult drivers. This dissertation includes three studies. The first study (Chapter 2) identifies the current state of science on MVC risk factors for adolescent and young adult male drivers. In particular, this paper identifies whether the MVC risk factors for adolescent and young adult male drivers in the Middle Eastern region differ from those in other regions of the world. The second study (Chapter 3) examines the distinctive risk factors associated with injuries and deaths in MVCs involving young male Saudi drivers aged 16–29. The factors include driver characteristics, RTC timing, driver behavior, road condition, and vehicle type and condition. The third study (Chapter 4) aims to understand the perceptions and attitudes of young male Saudi drivers regarding the factors contributing to prior crashes, as well as their perceptions of the driver education curriculum related to the risk factors identified in the second study (Chapter 3).

Methods: This dissertation's purpose is to explore and understand the MVC risk factors in male adolescent and young adult drivers. The first paper uses scoping review methods, following the Arksey and O’Malley framework using a five-stage process. In addition, this review follows the PRISMA guidelines, and the articles are appraised using the Joanna Briggs Institute criteria. The second paper is a quantitative study that employs a retrospective cohort study design using de-identified administrative RTC data from Dammam’s Central Traffic Police Department in the Eastern Province of the KSA from January 2018 to December 2021. This study includes 2,367 different drivers aged 16–29 years. Numerous analyses are used, including multiple quasibinomial logistic regression, analysis of variance, and negative binomial regression analyses. The third paper is a qualitative descriptive study that uses semi-structured, in-depth interviews. A total of 19 young male Saudi drivers participated in the study. The transcripts are inductively coded and analyzed using a content and thematic approach.

Results: In the first paper, the review of the literature indicates that global and Middle Eastern research have identified numerous driver risk factors contributing to MVCs and injuries among young male adult drivers, including cell phone use, speeding, intoxicated driving, and falling asleep. Other risk factors identified by global studies, but not in Middle Eastern countries, include environmental- (nighttime driving), weather- (slippery roads related to weather conditions), vehicle condition- (smaller, older vehicles), and driver-related factors (carrying adolescent or young adult passengers). All these factors are understudied in Middle Eastern countries. The second study provides evidence that running a red light and violating a driving order are positively associated with MVC injuries in male drivers aged 16–29, passengers, and pedestrians. Exceeding the speed limit is also associated with MVC deaths in adolescents and young male drivers, passengers, and pedestrians. The driver’s age and the day of the week are significantly associated with the odds of driver injury. Adolescents and younger drivers (less than 18 years and 19–24 years) have 2–3 times higher odds of driver injury than drivers aged 25–29 years when a crash occurs on the weekend. Furthermore, distracted driving is associated with MVC injuries in male drivers, passengers, and pedestrians. Meanwhile, the third study findings have five themes: 1) risk factors for RTCs and suggestions to address these factors; 2) personal strategies to prevent (future or recurrent) crashes; 3) underlying behaviors contributing to risks for RTCs; 4) enforcement camera and traffic law benefits; and 5) driving education experience and recommendations for improvement. This study provides an understanding of young Saudi drivers’ perceptions of crash risk factors, their attitudes toward these factors, and Saudi driver education. It also reveals some of the reasons why young Saudi drivers engage in risky driving behaviors.

Conclusion: Altogether, these papers contribute to providing a further comprehensive understanding of adolescent and young adult Saudi male drivers’ risk factors for MVC. Future research should address specific crash risk factors in this population. Dissertation findings demonstrated that there are gaps in the driving education curriculum and training that can be addressed in future health prevention and policy interventions. In addition, engaging in risky driving behavior was associated with low-risk perception and engrained habits. As such, these findings also point to future areas for intervention to reduce the risk of MVC and MVIs.