BTW App for Reckless Driving

(BTW Trial)

Overseen By Motao Zhu, MD, MS, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Motao Zhu

Disqualifiers: Under 15.5 years old

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 months

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores whether a smartphone app can help teenagers and new drivers improve their driving skills. Two main approaches are being tested: one where the app, called the BTW app with reward-based feedback, provides rewards and feedback on driving performance, and another, the BTW app with situational supervised driving practice, combines this feedback with supervised driving practice. Teens aged 15.5 to 17 who are developing their driving skills in line with Ohio's Graduated Driver Licensing (GDL) system, and have a parent or guardian willing to participate, might be a good fit. The trial aims to make learning to drive safer and more effective through technology.

As an unphased trial, this study offers a unique opportunity to contribute to innovative research that could enhance driving safety for teens.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications.

What prior data suggests that the BTW app is safe for use in learning-to-drive programs?

Research has shown that apps like the BTW app, which rewards feedback, can help young drivers improve their safe driving skills. The app encourages safer driving habits. No major reports of negative effects from using the app have emerged, indicating its safety.

For the BTW app that includes supervised driving practice, studies have highlighted the importance of supervised driving for teens. This practice reduces risky behaviors like speeding and distracted driving. No specific safety issues have been identified, suggesting it is generally safe.

Overall, both parts of the trial involve using smartphone apps and supervised driving. These methods have demonstrated positive effects on driving behavior without major safety concerns. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the BTW app for reckless driving because it offers innovative approaches to improving teen driving habits. Unlike traditional methods that might involve lectures or written feedback, the reward-based feedback arm of the app uses gamification to provide real-time, engaging feedback on driving performance, making learning more interactive and fun. Additionally, the situational supervised driving practice arm pairs the app with hands-on practice, enhancing the learning experience by involving both teens and their parents. These unique features have the potential to make driving education more effective and appealing to young drivers, potentially reducing reckless driving incidents.

What evidence suggests that this trial's treatments could be effective for improving the learning-to-drive process among teenagers and novice drivers?

Research has shown that the BTW app, which participants in this trial may receive, uses rewards and guided driving practice to improve teen driving habits. This trial will test different versions of the BTW app. One version provides reward-based feedback, while another combines this feedback with situational supervised driving practice. Studies have found that smartphone apps providing feedback can reduce speeding and promote safe driving. Specifically, one study found that apps offering cash rewards for good driving led to better results for teen drivers. Additionally, teens who practiced more with a supervisor had fewer accidents, especially in challenging conditions like at night or on unfamiliar roads. These findings suggest that the BTW app, by combining feedback with supervised practice, could help new drivers become safer on the road. ^{1 2 3 5 6}

Who Is on the Research Team?

Motao Zhu, MD,MS,PhD

Principal Investigator

Nationwide Children's Hospital

Are You a Good Fit for This Trial?

This trial is for teen drivers aged 15.5-17 who've completed a driver's ed class, have at least 50 hours of driving experience including night time, and have held their permit for 6 months. They need a smartphone compatible with the BTW app, must not join other driving studies, speak English, and have parental consent plus car insurance.

Inclusion Criteria

I completed a driving course with 24 hours of theory and 8 hours of practice.

Participants must speak and read English

Participants must be a US citizen or have permanent resident status

Exclusion Criteria

I am at least 15.5 years old, as required for a learner's permit in Ohio.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants use the BTW app to track and improve driving behaviors over a 6-month period

6 months

Regular app usage and data collection

Follow-up

Participants are monitored for long-term effects on driving performance and safety attitudes

12 months

What Are the Treatments Tested in This Trial?

Interventions

• BTW app with reward-based feedback
• BTW app with situational supervised driving practice
• Sham BTW app

Trial Overview The study tests if a smartphone application (BTW) can improve safe driving habits in teens. It compares three versions: one with supervised practice scenarios, another with rewards feedback, and a sham app that doesn't provide real guidance or feedback.

How Is the Trial Designed?

Group I: BTW app with situational supervised driving practice Experimental Treatment 1 Intervention

Teens will install the BTW app the same as the app with reward-based feedback in conjunction with a situational supervised driving practice intervention for teen-parent dyads.

Group II: BTW app with reward-based feedback Experimental Treatment 2 Interventions

Teens will install the BTW app with reward-based feedback. This tracks driving performance while providing individualized driving feedback using gamification concepts.

Group III: Sham BTW app Placebo Group 1 Intervention

Teens will install the sham BTW app with driving performance tracking only.

Who Is Running the Clinical Trial?

Motao Zhu

Lead Sponsor

Trials

2

Recruited

1,400+

Centers for Disease Control and Prevention

Collaborator

Trials

902

Recruited

25,020,000+

Published Research Related to This Trial

Non-adherence to treatment is a significant issue in healthcare, costing the US over $100 billion annually in avoidable healthcare expenses and an additional $230 billion in lost productivity.

The proposed framework combines gamification techniques with real-world rewards to enhance patient motivation and adherence, implemented through modifications to a health tracking app and video feedback on potential rewards.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Increasing Health Care Adherence Through Gamification, Video Feedback, and Real-World Rewards. Saric, K., Redd, C., Varnfield, M., et al.[2020]

The SMART application, designed for youth recovering from mild traumatic brain injury (mTBI), received a high usability score of 85, indicating it is user-friendly and well-received by both children and parents.

User feedback led to improvements in the application, such as adding audio files to reduce reading demands, suggesting that the tool can be effectively tailored to enhance recovery strategies for mTBI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Usability evaluation of the SMART application for youth with mTBI. Dexheimer, JW., Kurowski, BG., Anders, SH., et al.[2019]

The Behavioral Apptivation mobile application was developed to support Brief Behavioral Activation Treatment for Depression (BATD), which is a well-supported psychotherapy for treating depression.

Initial pilot testing of the app in a small open-label trial showed feasibility for use alongside individual BATD therapy, suggesting it could enhance clinical practice for treating depressive symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Preliminary Feasibility Study of a Brief Behavioral Activation Mobile Application (Behavioral Apptivation) to Be Used in Conjunction With Ongoing Therapy. Dahne, J., Kustanowitz, J., Lejuez, CW.[2020]

Gamified interventions, which often use point systems as rewards, are prevalent in behavior change strategies, with 18 out of 21 reviewed studies incorporating some form of reward system.

While rewards like points and tangible items are common, their use may hinder the development of intrinsic motivation, suggesting a need for future research to better understand how these rewards affect long-term behavior change.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What's the Point?: A Review of Reward Systems Implemented in Gamification Interventions. Lewis, ZH., Swartz, MC., Lyons, EJ.[2022]

Error training in a driving simulator significantly improved participants' ability to transfer skills to real driving tests and enhanced their coping strategies for new driving situations, despite reducing their self-confidence in driving skills.

Guided error training showed only weak benefits over errorless learning and did not improve self-confidence or transfer skills to novel driving tests, suggesting that active engagement with errors may be more effective than passive observation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning from errors in a driving simulation: effects on driving skill and self-confidence. Ivancic, K., Hesketh, B.[2019]

The SMART mHealth app was used by adolescents with mild traumatic brain injuries (mTBIs) for an average of 9 days over a month, indicating a moderate level of engagement with the symptom monitoring and educational modules.

Factors such as higher parental income, the presence of comorbid ADHD, and a coping style focused on emotional engagement were associated with increased usage of the app, suggesting that socioeconomic and psychological factors influence recovery management in adolescents.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Usage Patterns of an mHealth Symptom Monitoring App Among Adolescents With Acute Mild Traumatic Brain Injuries. Schmidt, M., Babcock, L., Kurowski, BG., et al.[2023]

Citations

1. withpower.com withpower.com/trial/phase-high-risk-driving-events-9-2022-bf29d

BTW App for Reckless Driving (BTW Trial) The BTW app treatment is unique because it uses reward-based feedback and situational supervised driving practice to improve driving behavior, ...

2. sciencedirect.com sciencedirect.com/science/article/pii/S2590198223001240

The positive outcome for young drivers of a safe-driving ... The current study evaluates potential changes in young drivers' speeding intention and behaviour after exposure to a smartphone safe-driving app intervention.

3. rosap.ntl.bts.gov rosap.ntl.bts.gov/view/dot/77152/dot_77152_DS1.pdf

Evaluation of Web-Based Driving Feedback for Teens and ... The purpose of this study was to examine how providing a web-based feedback app and monetary incentives to reward teen drivers for safe driving can improve teen ...

4. aaafoundation.org aaafoundation.org/wp-content/uploads/2025/03/202504-AAAFTS-App-Feedback.pdf

A Randomized Field Trial of Smartphone-Based Feedback ... The AAA Foundation for Traffic Safety commissioned research, presented in this report, to examine whether a safe driving app can reduce rates of speeding ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT05554614

Behind the Wheel (BTW) Smartphone Application This project will assess the feasibility and preliminary efficacy of an app (BTW) to quantify driving behaviors and promote safe driving in adolescents who ...

6. sciencedirect.com sciencedirect.com/science/article/pii/S1369847820300267

App-based feedback on safety to novice drivers We found moderate improvements in safety-relevant driving skills due to app-based feedback. The improvements were more pronounced under the treatment with ...