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Federal Highway Administration Research and Technology
Coordinating, Developing, and Delivering Highway Transportation Innovations

This report is an archived publication and may contain dated technical, contact, and link information
Publication Number: FHWA-HRT-04-145
Date: December 2005

Enhanced Night Visibility Series, Volume XIV: Phase III—Study 2: Comparison of Near Infrared, Far Infrared, and Halogen Headlamps on Object Detection in Nighttime Rain

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Name _______________________________________________________________________ Male/Female
Phone Numbers (Home) _____________________________________________ (Work) _________________________________
Best Time to Call __________________________________________________________________
Best Days to Participate __________________________________


Note to Screening Personnel:

Initial contact with the potential participants will take place over the phone. Read the following Introductory Statement, followed by the questionnaire (if they agree to participate). Regardless of how contact is made, this questionnaire must be administered before a decision is made regarding suitability for this study.

Introductory Statement (Use the following script as a guideline in the screening interview):

My name is _____ and I work at the [contractor]. I’m recruiting drivers for a study to evaluate new night vision enhancement systems for vehicles.

This study will involve you driving at vehicle instrumented with data collection equipment on the Smart Road at night and filling out questionnaires. Participants will come in for one driving session that will last approximately 3 hours. We will pay you 20 dollars per hour. Would you like to participate in this study?

If they agree:

Next, I would like to ask you several questions to see if you are eligible to participate.

If they do not agree:

Thanks for your time. Would you like me to remove you from the database?


  1. Do you have a valid driver’s license?

          Yes _____          No _____

  2. How often do you drive each week?

          Every day ____     At least 2 times a week____     Less than 2 times a week_____

  3. How old are you? ______

  4. What is your date of birth? ______

  5. Have you previously participated in any experiments at the [contractor facility]? If so, can you briefly describe the study?

          Yes _____  Description:______________________________________________________
          No _____

  6. How long have you held your drivers’ license? _____________________________________

  7. Are you able to drive an automatic transmission without assistive devices or special equipment?

          Yes _____     No _____

  8. Have you had any moving violations in the past 3 years? If so, please explain.

          Yes _____      ___________________________________
          No _____

  9. Have you been involved in any accidents within the past 3 years? If so, please explain.

          Yes _____     ___________________________________
          No _____

  10. Do you have a history of any of the following? If yes, please explain.

          Heart condition     No____          Yes________________________________
          Heart attack     No____ Yes________________________________
          Stroke     No____ Yes________________________________
          Brain tumor     No____ Yes________________________________
          Head injury     No____ Yes________________________________
          Epileptic seizures     No____ Yes________________________________
          Respiratory disorders     No____ Yes________________________________
          Motion sickness     No____ Yes________________________________
          Inner ear problems     No____ Yes________________________________
          Dizziness, vertigo, or other
                balance problems
        No____ Yes________________________________
          Diabetes     No____ Yes________________________________
          Migraine, tension headaches     No____ Yes________________________________

  11. Have you ever had radial keratotomy, [corrective] eye surgery, or other eye surgeries? If so, please specify.
          Yes_____     __________________________________________________

  12. (Females only, of course) Are you currently pregnant?

          Yes _____      No _____

          (If “yes” then read the following statement to the subject: “It is not recommended that pregnant women participate in this study. However, female subjects who are pregnant and wish to participate must       first consult with their personal physician for advice and guidance regarding participation in a study where risks, although minimal, include the possibility of collision and airbag deployment.”

  13. Are you currently taking any medications on a regular basis? If yes, please list them.

          Yes _____     ____________________________________
          No _____

  14. Do you have normal or corrected to normal hearing and vision? If no, please explain.
          Yes _____
          No _____

Criteria For Participation:

  1. Must hold a valid driver’s license.
  2. Must be 18-25, 40-50, or 65+ years of age.
  3. Must drive at least 2 times a week.
  4. Must have normal (or corrected to normal) hearing and vision.
  5. Must be able to drive an automatic transmission without special equipment.
  6. Must not have more than two driving violations in the past three years.
  7. Must not have caused an injurious accident in the past two years.
  8. Cannot have a history of heart condition or prior heart attack, lingering effects of brain damage from stroke, tumor, head injury, or infection, epileptic seizures within 12 months, respiratory disorders, motion sickness, inner ear problems, dizziness, vertigo, balance problems, diabetes for which insulin is required, chronic migraine or tension headaches.
  9. Cannot currently be taking any substances that may interfere with driving ability (cause drowsiness or impair motor abilities).
  10. No history of radial keratotomy, [corrective] eye surgery, or any other ophthalmic surgeries.

Accepted: ________

Rejected: ________        Reason:__________________________________________

Screening Personnel (print name):______________________       (Date):________


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