CBT program to reduce recidivism risk for road crashes among adolescents and young adults: Results of a randomized controlled study and prospects
DOI: 10.1016/j.heliyon.2023.e20074
archive: archived pipeline: cataloged verified
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Summary
This study addresses the high rate of road crash recidivism among adolescents and young adults, a demographic for whom traffic accidents are the leading cause of mortality. Given that human factors contribute to 90–95% of crashes and that one in four injured adolescents experiences a second accident within a year, the researchers aimed to evaluate the efficacy of ECARR2, a brief cognitive behavioral therapy (CBT) program designed to prevent recurrence. The study also sought to validate the Evaluation of Circumstances surrounding an Accident and the Risk of Repetition (ECARR) scale as a predictor of future crashes. The research employed a multicenter randomized controlled trial involving 288 participants aged 14–25 who had been hospitalized following a road crash and scored ≥5 on the ECARR scale, indicating high recurrence risk. Participants were randomly allocated to either an intervention group receiving the ECARR2 program or a control group. The ECARR2 intervention consisted of three sessions led by clinical psychologists, utilizing motivational interviewing, psychoeducation, and cognitive restructuring to address risk perception, emotional regulation, and impulsivity. Data were collected at baseline and at 3, 6, and 12 months post-inclusion. Statistical analyses included intention-to-treat and per-protocol assessments, using Kaplan-Meier estimates for recurrence rates and multivariate logistic regression to identify predictors and mediators. Results indicated that the risk of recurrence was highest during the first six months, accounting for 66% of all recurrences. In the per-protocol analysis, the accident recurrence rate at six months was 14.2% in the intervention group compared to 23.5% in the control group. At one year, rates were 22.1% versus 37.8%, respectively. The intervention demonstrated a significant independent effect on reducing recurrence (p = 0.020). This effect was mediated by improvements in depression scores (BDI), reduced lack of perseverance (Impulsive Behavior Scale), and increased engagement (Orientation to Happiness). Additionally, the ECARR score was confirmed as a significant predictor of recurrence regardless of group assignment (p = 0.045). Notably, the study found no significant association between recidivism and gender, substance abuse, or ADHD symptoms within this specific post-crash population. The findings confirm that the ECARR2 program effectively halves the risk of road crash recurrence at six months when administered shortly after hospitalization. The study validates the predictive utility of the ECARR scale for identifying high-risk individuals. These results suggest that brief, targeted psychological interventions can significantly mitigate recidivism in young drivers and road users. The authors recommend integrating such screenings and interventions into emergency care protocols and propose future development of mobile applications or school-based programs to improve accessibility and scalability.
Provenance
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| Stage | Outcome | Tool | Model | Prompt | Attempts | Completed |
|---|---|---|---|---|---|---|
| discover | success | OpenAlex-citations | — | — | 1 | 2026-06-18 |
| archive | success | openalex | — | — | 5 | 2026-06-25 |
| extract | success | cached | — | — | 2 | 2026-06-26 |
| clean | success | clean | — | — | 1 | 2026-06-18 |
| chunk | success | chunk | — | — | 1 | 2026-06-18 |
| embed | success | embed | Qwen/Qwen3-Embedding-8B | — | 1 | 2026-06-18 |
| promote | success | — | — | — | 1 | 2026-06-18 |
| summarize | success | llm | qwen3.6-27b-prismaquant | summ-v5 | 1 | 2026-06-26 |
| tag | success | vector_similarity | — | — | 6 | 2026-06-18 |
| verify | success | — | — | — | 1 | 2026-06-26 |
Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.
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Information type
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- Applied Guidance: countermeasure evaluation
- Empirical Findings: crash risk outcomes