title: Persuasion and licensure: a randomized controlled intervention trial to increase licensure rates among Maryland motorcycle owners.
abstract: OBJECTIVE
  This study aimed to determine whether a persuasive educational intervention could increase licensure among motorcycle owners. Unlicensed motorcycle operators appear to be disproportionately involved in police-reported motorcycle crashes in Maryland, accounting for about 27% of motorcycle operators in police-reported crashes, although unlicensed owners comprise 17% of primary motorcycle owners.
  
  
  METHODS
  A randomized controlled trial was conducted among unlicensed owners. Linking Maryland records of registered motorcycles with license files, 8,499 unlicensed owners who had no licensed co-owners were identified. Half were randomized to receive a persuasive educational mailing in early June 2005 from Maryland Motor Vehicle Administration (MVA). Motorcycle licenses can be attained by passing an accredited motorcycle training class or passing knowledge and skills tests administered by the state driver licensing agency. Licensure rates and motorcycle class enrollment were followed for 6 months post-intervention.
  
  
  RESULTS
  As of December 16, 2005, 280 intervention group owners had obtained Class M motorcycle licenses and 158 had obtained Class R motorcycle learner's permits. The comparison group obtained 209 M licenses and 122 R permits. The overall success rate in the intervention group, defined as obtaining Class M or R, was 10.4% compared with 7.9% in the comparison group (licensure ratio (LR) = 1.33; 95% confidence interval (CI) = 1.16-1.52). The intervention was most successful among men, whose LR for obtaining M licenses was 1.45 (95% CI = 1.21-1.75). LRs were higher among owners ages 40-48 and 49+ receiving the intervention compared with younger groups. Motorcycle training class enrollment rates were higher in the intervention group, particularly among those taking a course for riders with intermediate skills (enrollment ratio = 2.24; 95% CI = 1.41-3.55).
  
  
  CONCLUSIONS
  The intervention appeared to increase licensure, yet the licensure rate remained low among the intervention group. Potential risks and benefits of increasing the percentage of motorcyclists who are licensed need to be studied.
authors: War-Related Illness and Injury Study Center, Washington DC Veterans Affairs Medical Center, DC, USA.
authors: Elisa R
authors: ER
authors: Braver
authors: Joseph A
authors: JA
authors: Kufera
authors: Karen D
authors: KD
authors: Volpini
authors: Saranath
authors: S
authors: Lawpoolsri
authors: John J
authors: JJ
authors: Joyce
authors: Melvin T
authors: MT
authors: Alexander
authors: Patricia
authors: P
authors: Ellison-Potter
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control; D000328:Adult; D001333:Automobile Driver Examination; D004493:Education; D005260:Female; D006801:Humans; D008004:Licensure / Q000706:statistics & numerical data*; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009049:Motorcycles / Q000706:statistics & numerical data*; D011177:Postal Service