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National EMS Scope of Practice Model 2019: Including Change Notices 1.0 and 2.0 The President’s National Strategy for the COVID-19 Response and Pandemic Preparedness calls for immediate actions to support State and local efforts to enlist emergency medical services and firefighters to support vaccination efforts. The 2019 National EMS Scope of Practice Model Including Change Notices 1.0 and 2.0 adds intramuscular injection, vaccinations during a public health emergency, and nasal swab specimen collection to the scope of practice of EMS clinicians at the EMT and higher levels.	DOT HS 813 151
A Primer for Evaluating Underage Drinking and Driving Programs This primer is a practical “how-to” guide for practitioners and researchers interested in evaluating underage drinking and driving programs. It distills program evaluation and provide guidance specific to underage drinking and driving. Components address barriers to program evaluation; how to address challenges unique to developing and evaluating underage drinking and driving programs; key elements to look for when searching for effective interventions or programs; models and theories grounded in both public health and psychology that can serve as a guide for developing, implementing, and evaluating interventions and/or programs; evaluation standards from the CDC framework that can support a quality evaluation and assist when prioritizing and/or choosing from the multitude of options at each phase of program evaluation; and how to obtain Institutional Review Board approval.	DOT HS 812 953
Update to Special Reports on Traffic Safety During the COVID-19 Public Health Emergency: Fourth Quarter Data, Research Note, Traffic Safety Facts NHTSA is reviewing nationwide changes in traffic safety and observed behaviors caused by the COVID-19 public health emergency. This research note includes data through the end of the 2020 calendar year, updating earlier preliminary reports. The research note includes changes in travel patterns, rates of crash severity, and the prevalence of drugs and alcohol among seriously and fatally injured road users at select trauma centers.	DOT HS 813 135
Exploring the Predictive Validity of Drug Evaluation and Classification Program Evaluations This report seeks to determine which combinations of drug-related signs and symptoms from the Drug Evaluation and Classification (DEC) protocol most efficiently and effectively predict the drug category or combination used by the subject. A sample of 2,261 DEC evaluations conducted on suspected drug-impaired drivers included cases involving specific drug categories and two-drug combinations commonly encountered by DREs. This study also examined how effectively the set of drug-related measures from the DEC procedure could distinguish drug-positive from drug-negative cases for two common drug categories (cannabis and CNS depressants) and the relative importance of clinical, behavioral and observational measures in predicting drug categories responsible for impairment. Thirteen drug-related indicators were found to significantly contribute to the prediction of drug category; 12 indicators contributed significantly to the prediction of drug combinations.	DOT HS 812 959
High-Visibility Enforcement: Assessing Change and Identifying Opportunities In this study the research team interviewed nine officials from State Highway Safety Offices (SHSOs) to determine if they perceived a change in participation in or support for high-visibility enforcement (HVE) over the past decade. The research team also interviewed six SHSO or local law enforcement agency (LEA) officials to profile innovative strategies that States or LEAs are using to increase law enforcement participation in HVE. Most of the nine SHSO officials believed there has been a decrease in law enforcement participation in and support for grant-funded HVE activities over the last 10 years, and the SHSO officials identified several common challenges to participation in HVE. However, interviews with SHSO and LEA officials regarding innovative strategies being used to increase participation in HVE revealed possible solutions for these challenges.	DOT HS 813 066
Physical Fitness Training and Older Driver Performance and Exposure This research hypothesized that participation in a structured exercise program by inactive adults 70 or older would result in improved road test performance and increased driving exposure (the amount and circumstances under which people choose to drive). Participants were randomly assigned to an exercise group (n=20) that involved activities including weight-bearing, resistance, or dance/movement elements, or a control group (n=10). The researchers assessed physical and cognitive status before and after training, and a certified driver rehabilitation specialist evaluated behind-the-wheel performance using a recognized road test. Treatment effectiveness was gauged in terms of “change scores” for road test performance and for multiple indices of driving exposure. Correlations between measures of physical/functional status and driving performance were weak or very weak.	DOT HS 813 107
Pilot Test of a Methodology for an Observation Survey of Motorcycle Personal Protective Equipment This project addressed the need for information on use of motorcycle personal protective equipment (PPE), including the use of certified helmets, sturdy jackets and pants, over-the-ankle boots, and riding gloves. Although motorcycle safety advocates and safety programs encourage the use of PPE, the use rate is not well known or easily determined. This project sought to develop a methodology suitable for jurisdictions to use when seeking data on the motorcycle PPE usage, and to produce a valid assessment of PPE. The methodology was deployed in Florida across two rounds of data collection. The project outcome supports motorcycle safety programs and highway safety offices in their efforts to obtain information on the use rate of motorcycle safety gear.	DOT HS 813 062
State of Knowledge and Practice for Using Automated License Plate Readers for Traffic Safety Purposes Automatic license plate readers (ALPRs) are an important tool in law enforcement and traffic safety. This report gathered information on and provided insight into law enforcement agency implementation and use of ALPRs for traffic safety purposes, with specific emphasis on its use for detecting drivers with revoked, suspended, or restricted licenses. Researchers used two research methods, a literature review and six case studies representing city, county, and State LEAs in a mix of geographic locations. The evidence gleaned from the case studies provides additional indicators to support the effectiveness of ALPR for traffic safety purposes—when viewed in terms of efficiency and productivity gains as well as improvements in traffic safety by culling vehicles that are more prone to crash risk. Effectiveness as a traffic safety countermeasure was often viewed as a secondary outcome—as a by-product of looking for stolen vehicles or other criminal activity.	DOT HS 813 051
Evaluation of On-Site Oral Fluid Drug Screening Technology Oral fluid (saliva) has become popular for drug detection in criminal justice, workplace, and impaired-driving populations. The advantages compared to blood and urine include a noninvasive procedure with minimal potential for adulteration. They can be collected at the time of driving and/or arrest, allowing for better correlation between signs and symptoms of impairment compared to drugs detected in a biological sample collected later. Several point-of-contact oral fluid collection devices have been developed and marketed for use in the field without any controlled assessment to evaluate their applicability and quality. This report evaluates the latest generation to assess their accuracy, reliability and performance. Five devices, the Dräger DrugTest® 5000 (DDT5000), Dräger DrugCheck 3000 (DDC3000), Securetec DrugWipe S 5-Panel (DrugWipe), the Alere DDS 2 Mobile System (DDS2), and the AquilaScan Oral Fluids Testing Detection System were chosen. Testing and cutoff concentrations were based on two important previous studies, the Roadside Testing Assessment, which recommended greater than greater than 90% sensitivity and specificity and greater than 95 percent% accuracy, and Driving Under the Influence of Drugs, Alcohol and Medicines method, which recommended greater than 80% percent sensitivity, specificity and accuracy.	DOT HS 812 811
Indirect Effects of School Bus Seat Belt Installation The project is a synthesis of the research findings, a literature review, and program scan summarizing data on the indirect effects of seat belts on school buses. Findings also include anecdotal observations from bus drivers and school district officials obtained from a concurrent NHTSA report, Education on Proper Use of Seat Belts on School Buses (Report No. DOT HS 812 999). Overall, findings indicate seat belt use is associated with improved student behavior and reduced bus driver distraction. Seat belt use is higher when required-use policies are in place, and that seat belt use is heavily reliant on the efforts of the bus drivers. A more-detailed study focusing on the indirect benefits experienced by a sample of school jurisdictions would better quantify the potential outcomes of school bus seat belts.	DOT HS 813 049