NHTSA Form 1199(a) Questionnaire Version A

Young Driver Survey

March 2014 Web Version A Questionnaire

Young Driver Survey Pilot Test

OMB: 2127-0704

Document [doc]
Download: doc | pdf


OMB No. 2127-XXXX

Expiration Date: X/XX/2017


Questionnaire – Version A


Intro/Vehicle Use


First, for some general background, we have a few questions about your living arrangement.


  1. Right now, are you living in a………..

_______ House

________Townhouse

________Condo

_______ Apartment

_______ Dormitory

_______ or something else?



2. At this residence, with whom do you live?


a. Both parents

b. One parent – mother

c. One parent – father

d. A guardian (either a legal guardian, or a guardian who cares for you but hasn’t been appointed by the courts)

e. Others, but not with parent(s) or guardian(s)

f. I live alone.



  1. Do you live there ………….


_______ All of the year

_______ More than 6 months, but less than a year

_______ About 6 months of the year

_______ Less than 6 months of the year










NHTSA Form 1199(a)

If Q3is less than all of the year CONTINUE, OTHERWISE GO TO Q7


  1. During the rest of the year, do you live in a……..


_______ House

_______Townhouse

_______Condo

_______ Apartment

_______ Dormitory

_______ or something else



5. Who do you live with during those other times of the year?


a. Both parents

b. One parent – mother

c. One parent – father

d. Guardian (either a legal guardian, or a guardian who cares for you but hasn’t been appointed by the courts)

e. Others, but not with parent(s) or guardian(s)

f. Alone.



6. Do you tend to drive more while living at the place you are living at right now, or do you tend to drive more while living at the place(s) where you live the rest of the year?


_______ Drive more while living at current residence

_______ Drive more while living at the place(s) I live the rest of the year

_______ Neither, it’s about the same



[IF Q3 is less than all of the year > For the next set of questions, please think about the place where you drive the most.] Every week can be a little different, but we would like you to think about how much you drive and ride in a typical driving week. [Have a link to provide greater clarification. Also how to respond if there is no typical week.]


7. In a typical driving week, on how many days do you drive a motor vehicle?

_______ days

____ Never drive [SKIP TO Q14]



9. Is the vehicle you drive most often a car, SUV, van or minivan, pickup truck, motorcycle, or something else? (If you drive multiple vehicles about the same amount and can’t determine which of them you drive most often, select the one you drove most recently)


    1. Car

    2. SUV/Sport utility vehicle

    3. Van or minivan

    4. Pickup truck

    5. Motorcycle

    6. Other (including other kinds of trucks)—specify: ______________________



10. Who owns the vehicle that you drive most often? [mark all that apply]


□ I do Yes__ No__

□ My parent(s) Yes__ No__

□ Family member other than parent Yes__ No__

□ Someone else who is not a family member Yes__ No__



Again, if you live at different places during the course of the year, please base your response on the location where you drive the most.


  1. In a typical driving week, how many days do you drive a motor vehicle at night, after 10:00 PM?

_______ days [DROPDOWN LIST]


12. In a typical driving week, how often do you drive by yourself?


    1. All of the time

    2. Most of the time

    3. Some of the time

    4. Rarely

    5. Never



13. In a typical driving week, how many days do you drive with passengers in the vehicle who are under the age of 21?


_______ days per week

_______ less than once a week

_______ never drive with passengers in the vehicle who are under 21



14. In a typical week, how many days do you ride as a passenger in a motor vehicle with a driver who is under the age of 21? [Add link to define typical week]


_______ days per week

_______ less than once a week

_______ never ride as a passenger with a driver who is under 21



If Q7 = never drive SKIP TO Q22


15. Are there rules you are supposed to follow that restrict the following?


    1. How late you are allowed to stay out with a motor vehicle □yes □no □n/a

    2. The number of passengers that you are allowed to drive □yes □no □n/a

    3. The age of the passengers that you are allowed to drive □yes □no □n/a

    4. Your use of a cell phone while driving □yes □no □n/a



[FOR EACH YES IN 15 a., b., c., OR d., ASK #16, #17 And #18. IF NO TO ALL, GO TO #19.]


  1. Who is requiring you to follow the rule? [Check all that apply.]


□ The law YES__ NO__

□ My School YES__ NO__

□ My Employer(s) YES__ NO__

□ My parent(s) YES__ NO__

□ Myself YES__ NO__

□ A family member other than parent YES__ NO__

□ Someone else who is not a family member (specify _____) YES__ NO__



  1. If you broke the rule, how likely is it that you would be reprimanded by a parent (for example, being told not to do it again)?


  1. Very likely

  2. Somewhat likely

  3. Not at all likely

  4. Not applicable



18. If you broke the rule, how likely is it that you would be punished by a parent, where a privilege is taken away (for example, being grounded or having the keys taken)?


  1. Very likely

  2. Somewhat likely

  3. Not at all likely

  4. Not applicable



There are devices that parents can use to monitor how their children drive. The devices are installed in the car and may record specific actions such as quick stops or lane changes, seat belt use, driver speed, driving locations, or sound in the vehicle.



  1. Are you driving a vehicle that has a monitoring device that your (parents/guardians) use to check your driving?


    1. yes

    2. no (Skip to Q21)

    3. Don’t know (skip to Q21)

    4. Not applicable (skip to Q21)



20 What is being recorded by the monitoring device that your (parents/guardians) are using to check your driving? (Check all that apply)


_____ Speed

_____ Driving maneuvers (such as lane changes or quick stops)

_____ Seat belt use

_____ Alcohol use

_____ Locations where the driver has driven

_____ Sound in the vehicle

_____ Crashes or accidents if they occur

_____ A video of driving activity

_____Other (specify)



21. In general, do you approve or disapprove of parents using devices such as these to monitor the driving of their children?


  1. Strongly approve

  2. Approve

  3. Neither approve nor disapprove

  4. Both approve and disapprove

  5. Disapprove

  6. Strongly disapprove


Driver Licensing


22. Which of the following describes your own license for driving (Check all that apply):


a) a Full Driver’s License, with no provisions

b) a Provisional Driver’s License

c) a Learner’s Permit

d) a Farm Permit or License

e) a Motorcycle License

f) a Suspended or Revoked License

g) I do not have a Learner’s Permit or any kind of driver’s license [go to Q34]


[PROVIDE A HYPERLINK WITH CLARIFICATION UNDER CATEGORY b: A provisional license has special rules that a driver must follow. Some States require that new drivers receive a provisional license before they can receive a full, unrestricted driver’s license

[DROPDOWN LIST WITH ALL THE 50 STATES]


23. What State did you get your driver’s license in? _________ [STATE]



Cell Phone Use


  1. When you drive a motor vehicle, do you usually have a cell phone in the vehicle with you?


    1. Yes

    2. No



25 When you are driving, how often do you keep the cell phone within arm’s length? Arm’s length is when you don’t have to move to reach it.


    1. On all driving trips

    2. On most driving trips

    3. On some driving trips

    4. On almost no driving trips

    5. Never



26. How often do you talk on the phone while you are driving?


    1. On all driving trips

    2. On most driving trips

    3. On some driving trips

    4. On almost no driving trips

    5. Never (skip to #28)



27. When you talk on the phone while driving, which do you do most often:


______ Hold the phone

______ Use a hands-free set

______ Use a speakerphone

______ Half and half between holding the phone and using a hands-free set

_______ Half and half between holding the phone and using a speakerphone



28. If you are driving and your phone rings, what do you do most often:


_____ Answer the phone

_____ Look to see who is calling, then decide whether to answer the phone

_____ Look to see who is calling, but always delay answering until no longer driving

_____ I ignore it until later

_____ Never rings while driving/I turn it off



29. How often do you read text messages while you are driving and the vehicle is moving?


a) On all driving trips

b) On most driving trips

c) On some driving trips

d) On almost no driving trips

e) Never



30. How often do you send text messages while you are driving and the vehicle is moving?

a) On all driving trips

b) On most driving trips

c) On some driving trips

d) On almost no driving trips

e) Never



  1. When you’re the driver of a car, how much do you think each of the following things would reduce the quality of your driving? (RANDOMIZE)


    1. using a hands-free cell phone while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. using a hand-held cell phone while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. reading text messages while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. sending text messages while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. eating snack foods while driving, such as chips or candy

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. drinking a beverage while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. talking to passengers while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving


    1. operating the radio or entertainment system while driving

      1. does not reduce quality of driving

      2. somewhat reduces the quality of driving

      3. greatly reduces the quality of driving



33. When you take your eyes off the road for more than a few seconds at a time while driving, is it usually because you are……..?


Looking around to see what’s in the area

Checking something in the vehicle

______ Looking at a passenger

______ Eating or drinking

______ Using a mobile electronic device such as a cell phone or iPod

______ Reading

______ Touching or adjusting the entertainment system

______ Grooming yourself, such as putting on makeup, shaving, or looking at yourself in the mirror

Or something else (specify )



34. How many seconds do you believe a driver can take his or her eyes off the road before driving becomes significantly more dangerous?


Seconds Range 0-60



35. In the past 30 days, how many days, if any, have you been a passenger in a motor vehicle when you had concerns for your safety because the driver was not paying enough attention to his or her driving?


_____ DAYS Range 0-30



Belts


IF Q7=never drive SKIP TO Q40


  1. When you are driving a motor vehicle, how often do you wear a seatbelt?


      1. all of the time

      2. most of the time

      3. some of the time

      4. rarely

      5. never



37. When was the last time that you did not wear a seat belt while driving—was it


a) within the past week

b) within the past month

c) within the past year

d) more than a year ago [go to #40]

e) never [go to #40]



38. Who was in the vehicle with you the last time you were driving without wearing a seat belt? (check all that apply).


___ Nobody, was driving alone

___ Friends about your age

___ Brother(s) or sister(s)

___ Your parent(s)

___ Adult(s) other than your parent(s)

___ Someone else (specify) ___________



39. Do you agree or disagree with the following statements.

“Sometimes I do not wear my seat belt while driving because…


a. I’m only driving a short distance ___agree ___ disagree

b. I’m in a rush ___ agree ___ disagree

c. The seat belt is uncomfortable ___ agree ___ disagree

d. I forgot to put it on ___ agree ___ disagree

e. My passengers aren’t wearing them ___ agree ___ disagree

f. I just don’t feel like it ___ agree ___ disagree



40. When you are a passenger in the front seat of a motor vehicle, how often do you wear a seat belt?


a) all of the time [go to #43}

b) most of the time

c) some of the time

d) rarely

e) never

f) never ride as a passenger in the front seat of a motor vehicle [go to #43]



41.The last time that you were a passenger in the front seat and were not wearing a seat belt, who was driving the motor vehicle?


a) a friend about your age

b) a brother or sister

c) one of your parents

d) an adult other than your parent

e) someone else (specify) ___________



42. Do you agree or disagree with the following statements.

“Sometimes I do not wear my seat belt while riding as a passenger in the front seat because…


a. I’m only riding a short distance ___agree ___ disagree

b. I’m in a rush ___ agree ___ disagree

c. The seat belt is uncomfortable ___ agree ___ disagree

d. I forgot to put it on ___ agree ___ disagree

e. The driver isn’t wearing one ___ agree ___ disagree

f. I just don’t feel like it ___ agree ___ disagree

g. It might insult the driver ___ agree ___ disagree



43. When you are a passenger in the back seat of a motor vehicle, how often do you wear a seatbelt?


a) all of the time [go to #46]

b) most of the time

c) some of the time

d) rarely

e) never

f) I never ride as a passenger in the back seat of a motor vehicle [go to #46]



44. The last time that you were a passenger in the back seat and were not wearing a seat belt, who was driving the motor vehicle?


a) a friend about your age

b) a brother or sister

c) one of your parents

d) an adult other than your parent

e) someone else (specify) ___________



45. Do you agree or disagree with the following statements?

“Sometimes I do not wear my seat belt while riding as a passenger in the back seat because…


a. I’m only riding a short distance ___agree ___ disagree

b. I’m in a rush ___ agree ___ disagree

c. The seat belt is uncomfortable ___ agree ___ disagree

d. I forgot to put it on ___ agree ___ disagree

e. The driver isn’t wearing one ___ agree ___ disagree

f. I just don’t feel like it ___ agree ___ disagree

g. It might insult the driver ___ agree ___ disagree

h. I can’t find the seat belt ___ agree ___ disagree

i. It’s not necessary to wear a belt in the back seat ___ agree ___ disagree



46. How often [does your parent, do your parents] usually wear their seat belts when driving a motor vehicle? [If answer differs by parent, please answer according to the parent you ride with most often.]


  1. all of the time

  2. most of the time

  3. some of the time

  4. rarely

  5. never

  6. Not applicable



47. In general, how often do friends about your age wear their seat belts when they’re driving?

a) all of the time

b) most of the time

c) some of the time

d) rarely

e) never



48. Do you ever ask passengers to fasten their seat belt when you’re driving?


  1. Yes, I ask every time I see a passenger not buckling up

  2. Yes, I sometimes ask

c) No, I never drive with passengers

d) No, my passengers always buckle up

e) No, I never ask unbuckled passengers to buckle up

f) Not applicable



Police Stops/Enforcement


IF Q7=never drive SKIP TO Q52


49. In the past 12 months, how many times have you been stopped by the police while driving a motor vehicle? [Provide link for definition of stop]


_____ [NUMBER] {If zero, go to question #52}



50. Of the times you were stopped, how many times did you receive a ticket?


_____ [NUMBER] {If zero, go to question #52}



51. What was/were the violation(s) that were marked on the ticket(s)?

[check all that apply]


_____ Speeding

_____ Running a red or yellow light

_____ Driving without a seat belt

_____ failure to use a turn signal

_____ careless or reckless driving

_____ failure to stop at a stop sign

_____ using a cell phone while driving

______ minor in possession

______ violation of zero tolerance

___________________________ other (specify)



52. How much attention do you pay to messages in the media about police enforcement of traffic safety laws?


I pay a lot of attention

I pay some attention

I pay almost no attention

I never see or hear enforcement messages



Crash Experience


The next questions are about crashes and accidents where there was moderate or greater damage to a vehicle. Do not include crashes that resulted only in small scratches or small dents.


  1. Regardless of who was at fault, have you ever been the driver of a vehicle involved in a crash or accident?


____ Yes

____ No [Skip to Q58]

____ Never been a driver [skip to Q58]



  1. How many times have you been the driver of a vehicle that was involved in a crash or accident? Again, do not include crashes that resulted only in small scratches or small dents. [DROPDOWN LIST]


____ times [if Q54=0 skip to Q58]



  1. In how many of these crashes or accidents where you were driving were you wearing a seat belt?

____ times



  1. In how many of these crashes or accidents where you were driving were you injured seriously enough that you received medical attention?


____ times



  1. How long ago was the most recent time you were involved in a crash or accident as a driver?


a. Less than one year ago

b. Between one and two years ago

c. Between two and three years ago

d. More than 3 years ago



58. Have you ever been a passenger in a vehicle involved in a crash or accident where the driver was under 21 years of age? Again, do not include crashes that resulted only in small scratches or small dents.


____ Yes

____ No [go to Q63]

59. How many times have you been a passenger in a vehicle that was involved in a crash or accident where the driver was under 21 years of age? [DROPDOWN LIST]


____ times [If Q59=0 skip to Q63]



60. In how many of these crashes or accidents where you were a passenger were you wearing a seat belt?


____ times



61. In how many of these crashes or accidents where you were a passenger were you injured seriously enough that you received medical attention?


____ times



  1. How long ago was the most recent time you were involved in a crash or accident as a passenger where the driver was under 21 years of age?


a. Less than one year ago

b. Between one and two years ago

c. Between two and three years ago

d. More than 3 years ago



IF Q7=never drive SKIP TO Q67


63. Near misses occur when a driver has to suddenly brake or rapidly steer the vehicle to avoid a crash or accident.



In the past 30 days, how many near misses have you been involved in as a driver? [dropdown list]

____ times



Alcohol/Substance Use


The next questions ask about driving after drinking alcohol.


64. In the past 30 days, how many days, if any, have you driven a motor vehicle within 2 hours after drinking alcoholic beverages? [dropdown list] [pop-up message (enter digits) Q64 to Q70]


_____ DAYS [IF ZERO, GO TO #67]



65. In the past 30 days, how many days, if any, have you driven a motor vehicle within 2 hours of having 5 or more drinks of alcohol?


_____ DAYS



66. In the past 30 days, how many days, if any, have you driven a motor vehicle while feeling buzzed from drinking alcohol?


_____ DAYS



67. In the past 30 days, how many days, if any, have you been a passenger in a motor vehicle when you think the driver was buzzed from drinking alcohol?


_____ DAYS



68. In the past 30 days, how many days, if any, have you been a passenger in a motor vehicle when you had concerns for your safety because of the amount of alcohol the driver had been drinking?


_____ DAYS



IF Q7=never drive SKIP TO Q70


69. In the past 30 days, how many days, if any, have you driven a motor vehicle while you were feeling buzzed, sleepy, or disoriented from using a drug other than alcohol? This could be a prescription or non-prescription drug.


_____ DAYS



70. In the past 30 days, how many days, if any, have you been a passenger in a motor vehicle when you think the driver was high on some drug or substance other than alcohol?


_____ DAYS


IF Q7=never drive SKIP TO Q79


Drowsy Driving


71. Have you ever fallen asleep or nodded off even for a moment while driving?


____ Yes

____ No



72. If you feel sleepy while driving, what if anything do you do to stop it? (Check all that apply)


____Pull over and take a nap

____Eat

____ Get coffee/soda/caffeine

____Take a stimulant (such as No-Doz)

____Turn the radio on loud

____Shake your head

____Open the widow

____Make a call on your cell phone

____ Sing or talk to yourself

____Change drivers

____Nothing



Speed


73. Which statement best describes your driving?


______ I tend to pass other cars more often than other cars pass me

______ other cars tend to pass me more often than I pass them

______ It’s about equal – I pass other cars as often as other cars pass me



74. How often do you drive 20 or more miles faster than most other vehicles are going?


____ All the time

____ Most of the time

____ Some of the time, or

____ Never


75. To what extent do you agree or disagree with the following statements:

    1. “I like driving fast.”


____ Strongly agree

____ Somewhat agree

____ Neither agree nor disagree

____ Somewhat disagree

____ Strongly disagree


    1. “Slow drivers make me angry.”


____ Strongly agree

____ Somewhat agree

____ Neither agree nor disagree

____ Somewhat disagree

____ Strongly disagree


    1. “The faster I drive, the more alert I am.”


____ Strongly agree

____ Somewhat agree

____ Neither agree nor disagree

____ Somewhat disagree

____ Strongly disagree


    1. “I try to get where I am going as fast as I can.”

____ Strongly agree

____ Somewhat agree

____ Neither agree nor disagree

____ Somewhat disagree

____ Strongly disagree



The next questions are about racing. By racing, we mean any time that two or more drivers are trying to go faster than each other. Racing may occur on public roads, private roads, parking lots, official or non-official racetracks, or in other locations. Racing can be for short or long distances and have an end point.


76. In the past 12 months, have you ever raced while driving a motor vehicle? Check all that apply.


____ Yes, on public roads [provide link to define]

____ Yes, on private roads [provide link to define]

____ Yes, in parking lots

____ Yes, on sanctioned or official racetracks

____ Yes, on non-sanctioned or non-official racetracks

____ Yes, other location (specify______)

____ No [go to #79]



77. In the past 12 months, how many times have you raced while driving a motor vehicle.


______ times



78.The last time you raced while driving a motor vehicle, how many people were in the vehicle with you? [dropdown list]



______ [NUMBER]



79. In the past 12 months, have you ever been a passenger in a motor vehicle that was racing another motor vehicle? Check all that apply.


____ Yes, on public roads [provide link to define]

____ Yes, on private roads [provide link to define]

____ Yes, in parking lots

____ Yes, on sanctioned or official racetracks

____ Yes, on non-sanctioned or non-official racetracks

____ Yes, other location (specify______)

____ No [go to #78]



80. In the past 12 months, how many times have you been a passenger in a motor vehicle that was racing another motor vehicle?


_____ [NUMBER]


The next questions are about your opinions about racing.


81. Do you think racing another vehicle is…


_____ Very dangerous

_____ Somewhat dangerous

_____ A little dangerous

_____ Not at all dangerous


82. Do you think the idea of racing another vehicle sounds…


_____ Very exciting

_____ Somewhat exciting

_____ A little exciting

_____ Not at all exciting



The next questions collect some basic information about you, and are the final questions in the survey.


83 What is your age?


_____ Years old (RANGE=16-21)



84 Are you a male or a female?


1 Male

2 Female



85 Do you consider yourself to be Hispanic or Latino?


1 Yes

2 No



86 Which of the following racial categories describes you? You may select more than one. READ LIST AND MULTIPLE RECORD.


1 American Indian or Alaskan Native

2 Asian

3 Black or African‑American

4 Native Hawaiian or Other Pacific Islander

5 White



87 Are you currently attending school full time or part time?


1 Yes, attending school full time

2 Yes, attending school part time

3 No



88 Are you currently working for pay, either full time or part time?


1 Yes, working full time

2 Yes, working part time

3 No



That completes the survey. Thank you very much for your time and cooperation.


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File TitleVehicle Use
AuthorKristen Miller
Last Modified Byalan.block
File Modified2014-05-05
File Created2014-03-28

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