ERIC EJ853636: Improving the Effectiveness of Countermeasures to Prevent Motor Vehicle Crashes among Young Drivers

5 Pages·2003·0.12 MB·English

by  ERIC

Improving the Effectiveness of Countermeasures to
Prevent Motor Vehicle Crashes Among Young Drivers
Bruce G. Simons-Morton and Jessica L. Hartos
ABSTRACT
Motor vehicle crashes (MVCs) are the leading cause of injury and death among adolescents 16 to 19 years of age.
Three areas of countermeasures for decreasing young driver risk are driver education, licensing policies, and paren-
tal management. Driver education is an essential part of teaching adolescents the rules of the road and operating a
vehicle; however, it has not proven to prevent MVCs among young drivers. Graduated Driver Licensing (GDL) is a
policy innovation accepted widely in the U. S. that delays licensure and restricts driving among novices under the
most dangerous conditions. GDL programs have effectively reduced motor vehicle crashes where adopted; however,
adoption and effectiveness of these policies vary. Parental management of teen driving has not been systematically
studied until recently and may be an important part of reducing teen driving risk. Research indicates that parents
place modest restrictions on their teens’ driving and that restrictions are related to fewer risky driving behaviors,
tickets, and MVCs. The Checkpoints Program aims to increase parental management of teen driving and has been
shown to do so in short-term follow-ups in several randomized trials. Each countermeasure is important to teen
safety and may need improvements; however, the greatest protection against MVCs among young drivers would be
to provide better integration among, and wider implementation of, countermeasures.
INTRODUCTION Highway Traffic Safety Administration Thus, the current challenges are to modify,
Motor vehicle safety has improved sub- [NHTSA], 2000). Teen crash rates are higher integrate, and implement these counter-
stantially in the past several decades with than those of any other age group; dispro- measures to make them more effective.
the advent of divided highways and other portionately high on weekends, with teen
engineering practices; improved crash wor- passengers, and at nighttime, and attributed
thiness of modern vehicles; and improved to young age, lack of driving experience, and Bruce G. Simons-Morton, EdD, MPH, is Chief
passenger protective devices, including relative propensity for risky driving among and Jessica L. Hartos, PhD, is a Research Fel-
safety belts, air bags, and collapsible steer- young drivers (Williams & Ferguson, 2002). low with the Prevention Research Branch, Di-
ing columns (Centers for Disease Control Countermeasures exist to combat high teen vision of Epidemiology, Statistics, and Preven-
and Prevention [CDC], 1999). However, driving risk and include driver education, tion Research, National Institute of Child
motor vehicle crashes remain the leading graduated driver licensing policy, and pa- Health and Human Development, 6100 Execu-
cause of death and injury among teenagers rental management; however, they vary in tive Blvd, 7B05, Bethesda, MD 20892-7510. E-
between the ages of 16 and 19 (National their effectiveness and implementation. mail: [email protected].
American Journal of Health Education — September/October Supplement 2003, Volume 34, No. 5 S—57
Bruce G. Simons-Morton and Jessica L. Hartos
The purposes of this article are to de- adolescents actually drive less overall, but speeds increases both the complexity of the
scribe (1) the nature of young driver crash they drive disproportionately more at night driving task and the severity of crashes. A
risk; (2) the current status of the three ma- and have a much higher nighttime crash high proportion of fatal crashes among ado-
jor countermeasures to motor vehicle rate. Nighttime driving increases both the lescents involves speeding, particularly
crashes among young drivers, and (3) po- likelihood of teens getting into an accident among males.
tential approaches to increasing the effec- and the severity of the crash.
tiveness of existing countermeasures. Teen passengers. The presence of other COUNTERMEASURES
teens in the car may influence teen drivers The high crash rates among teens are
RISK FACTORS to take risks or become distracted, and be- attributable largely to their young age, lack
The identification of unique risk factors cause of this, teens are more likely to crash of experience, and exposure to high-risk
for motor vehicle crashes (MVCs) among when other teens are passengers. This risk driving conditions (Williams & Ferguson,
adolescents provides the basis for counter- increases as the number of passengers in- 2002). Because teen driving skill and sound
acting them within appropriate policies and creases. judgment are largely products of increas-
prevention programs. In their extensive re- Alcohol. Although national rates of ing age and driving experience, improve-
view article, Williams and Ferguson (2002) drinking and driving have declined signifi- ments are dependent upon the amount they
delineate the following risk factors for cantly from the mid-1980s, it remains a drive. However, the more teens drive, the
young drivers (Table 1). problem among teenagers. Alcohol is in- greater their exposure and the higher their
Age/Inexperience. Compared to other age volved in 21 percent of fatal crashes among risk for MVCs (Williams & Ferguson, 2002).
groups, drivers aged 16 through 18 have the drivers aged 15 to 20. Therefore, programs aimed at reducing teen
highest crash rates. Crashes are more preva- Safety belts. Safety belts are an effective crash rates focus on increasing skills and
lent for individuals who begin to drive at protective device, but teenagers are less minimizing driving exposure, especially in
younger ages, suggesting that a combina- likely to use safety belts than older drivers the most risky conditions, for young driv-
tion of inexperience and immaturity con- are, which greatly increases risk of injury ers. These goals are addressed in the three
tribute to the problem. in a crash. categories of countermeasures devoted to
Nighttime driving. Compared to adults, High-speed driving. Driving at high increasing the safety of young drivers:
Driver Education, Graduated Driver Licens-
ing, and Parental Management (Table 2).
Table 1. Unique Risk Factors for Prevention of
Motor Vehicle Crashes Among Young Drivers
DRIVER EDUCATION
Risk Factor Description By all accounts, driving is a complex task
that requires a thorough understanding of
the rules of the road and development of
Age Younger age at licensure is associated with higher risk of
motor skills that allow one to control the
MVC
vehicle. Driver education exists in some
Inexperience A crash is most likely the first month of driving, and the form in most states and serves the impor-
crash risk the first year or two of driving is several times tant function of providing prospective
greater than subsequent years drivers with classroom instruction about
the rules of the road and limited in-car
Night time Night driving is more dangerous for all drivers, but training. However, most driver education
nighttime crash rates are particularly high for teen drivers
programs provide only a few hours of
behind the wheel training, not nearly
Teen passengers The more teen passengers, the greater the risk of a crash
enough to reduce the risk of teen crashes
for teen drivers
during the first months after licensure
(Mayhew & Simpson, 2002). It is unlikely
Alcohol Alcohol is implicated in over 20% of fatal teen crashes
that any state will mandate substantially
Safety belts Teens are less likely than any other age group to wear more practice driving through driver edu-
safety belts cation, although some states now require
substantial parent-supervised practice driv-
Speed Teens drive faster than older drivers and speed is involved ing prior to licensure.
in a large percent of serious teen crashes Based on information from their 1996
review of 30 studies from several countries
S—58 American Journal of Health Education — September/October Supplement 2003, Volume 34, No. 5
Bruce G. Simons-Morton and Jessica L. Hartos
Table 2. Countermeasures for Reducing Motor Vehicle Crash Risk Among Young Drivers
Countermeasure Safety Effects Recommendations
Driver Education Not proven to affect MVCs among young ¥ Two-step approach with advanced training
drivers required during the first months of licensure
¥ Adapt to provisions of GDL
¥ Incorporate instruction on parental management
Graduate Driver Widely demonstrated to decrease MVCs ¥ Use persuasion, social marketing, diffusion
Licensing (GDL) among young drivers strategies to increase adoption of GDL programs
¥ Include the recommended provisions
¥ Include parental management requirements
Parental Management Evidence that parental restrictions related ¥ Incorporate parental management into driver
to decreased MVCs among young education
drivers; some evidence that parental ¥ Incorporate parental management into licensing
management can be increased through practices
persuasive education.
along with four other more recent, major, ing among teens, particularly in high-risk assess the impact of GDL on teen crash risk
independent reviews of evaluation research conditions such as at night and with teen in several U. S. states and other countries,
on the safety benefits/disbenefits of driver passengers, has stimulated many states to McKnight & Peck indicate that adoption of
education and training, Mayhew and adopt graduated driver licensing (GDL) GDL programs delays age at permit and
Simpson (2002) conclude that driver edu- programs (McKnight & Peck, 2002). Tradi- provisional license, increases supervised
cation does not seem to impact on driver tional licensing systems involved two stages. driving, and reduces overall amount of driv-
safety outcomes, probably because of its A teen could obtain a learner’s permit right ing, teen risky driving behaviors, crashes,
short length and limited driving instruc- around his or her sixteenth birthday that and traffic violations. However, character-
tion. Moreover, there is little evidence that allowed driving with a licensed adult. At age istics of GDL programs vary from state to
driver’s education serves to ‘weed out’ less 16, with some variation from state to state, state, and few jurisdictions have all the ele-
capable students, as the threshold for pass- teens could then apply for a full license with ments of an optimal program as put forth
ing driver education appears to be relatively all the privileges accorded to any driver. In by the Insurance Institute for Highway
modest. While minimal proficiency in ve- contrast, GDL has three stages. Teens are Safety (1999). Presumably, states with more
hicle control is essential, it is not entirely able to obtain learner’s permits around the of the specified provisions would be more
sufficient to assure safe driving. Important same time as in traditional systems; how- effective in reducing teen crashes. As an
skills involving perception, anticipation, ever, the minimum period the learner’s per- added benefit, GDL programs may enhance
and avoidance of risk develop gradually mit must be held is extended to at least sev- and support parents’ efforts to moderate
over time and many miles of driving. While eral months. In some cases, minimal teen driving.
driver education is an important part of the requirements for supervised practice driv-
training of young drivers, it does not pro- ing at night and under various other driv- PARENTAL MANAGEMENT
vide substantial safety benefits in its present ing conditions are required. GDL programs With or without GDL programs, parents
form. It could, possibly, be modified and then add a middle stage in which teens ob- would seem to be in a prime position to
improved to better address the pressing is- tain a provisional license that allows them impose and enforce driving restrictions on
sues of young driver safety (Robinson, to drive unsupervised under somewhat re- young drivers. Parents are involved in their
2002) [see Mayhew & Simpson (2002) for stricted conditions, often including a night- teenagers’ driving from the beginning,
an extensive review on the current state of time curfew and passenger limits. Eligibil- teaching them to drive, governing their
driver education]. ity for full licensure at age 18 depends on access to vehicles, and setting rules. The
violation-free completion of the provisional limited research in this area indicates that
GRADUATED DRIVER LICENSING licensing period. parents set driving rules such as “don’t
Recognition of the elevated risk of driv- After reviewing over 20 studies that drink and drive,” “tell parents where you are
American Journal of Health Education — September/October Supplement 2003, Volume 34, No. 5 S—59
Bruce G. Simons-Morton and Jessica L. Hartos
going and with whom,” and “be home at a at night, with teen passengers, and on high- driving agreement prior to provisional li-
certain time,” and that parents may delay speed roads (Hartos, Nissen, & Simons- censing. The second phase would occur
licensure until their teens are “ready” Morton, 2001). Moreover, in the first of two during the provisional or intermediate stage
(Hartos, Eitel, & Simons-Morton, 2001). randomized trials, parents exposed to the of graduated licensure and might include
Restrictions on teen driving are negatively Checkpoints Program materials prior to instruction on higher-order driving skills
associated with speeding (Beck, Shattuck, and after licensure reported significantly (such as risk assessment and avoidance) and
& Raleigh, 2001), risky driving, citations, more restrictions on driving at licensure extended parent involvement and supervi-
and crashes (Hartos, Eitel, & Simons- and three months post-licensure than did sion. Intermediate driving privileges might
Morton, 2001; Hartos, Eitel, & Simons- parents in the control condition (Simons- be linked to satisfactory completion of the
Morton, 2002). However, many parents are Morton, Hartos, & Leaf, 2002). In the sec- advanced driver education course.
less involved with their teens driving than ond trial, families exposed to the materials Graduated Driver Licensing. Although
they could be (Beck, Hartos, & Simons- only at the MVA at the time of teen provi- most states have some form of GDL, the
Morton, 2002). An alarming number of sional licensure reported significantly tendency has been for states to adopt poli-
teens report not having driving rules or re- greater restrictions on teen driving one cies that are less restrictive than may be con-
strictions for high-risk driving conditions, month later (Simons-Morton, Hartos, & sistent with safety. Foss and Goodwin
including driving at night and with teen Beck, in press; 2003). (2003) argue that GDL effectiveness is likely
passengers (Hartos, Eitel, Haynie, & to be greatest when it includes strong but
Simons-Morton, 2000; Beck et al., 2001). IMPROVING THE EFFECTIVENESS OF reasonable and acceptable protective re-
For example, Hartos et al. (2000) inter- COUNTERMEASURES strictions and moderate inducements and
viewed a sample of teens who reported that Clearly, substantial reductions in teen penalties for non-compliance. While many
on average during their first month after crash rates are most closely linked to in- local stakeholders have worked toward in-
licensure they were allowed at least some of creased adoption and improvements in creased adoption of GDL, future efforts to
the time to drive on high speed roads, with GDL. Adoption of GDL tends to delay li- obtain adoption or modification of more
2+ passengers, and in bad weather. censure and set restrictions during provi- strict GDL programs could benefit from
Surprisingly little research has focused sional licensure stage. A secondary effect of concerted efforts based on persuasion, so-
on increasing parental management of teen GDL is to alter norms regarding teen driv- cial marketing, diffusion, and policy advo-
driving to reduce teen driving risk. Seem- ing risk, parental management of teen driv- cacy theory (Simons-Morton, Gottlieb, &
ingly the first research of its kind, the ing, and teen driving behavior. While im- Green, 1996). Recent evaluations of the
Checkpoints Program is designed to in- provements in the safety effects of driver effectiveness of graduated licensing (Mc-
crease parental limits on teens’ early driv- education and parenting education are pos- Knight & Peck, 2002) and its popularity
ing, especially under high-risk conditions, sible apart from GDL, they may be more with parents (Waller, Olk, & Shope, 2000)
through the use of persuasive communica- likely and successful within the context of could be used to persuade legislatures to
tions (PCs). PCs in the forms of a video, GDL systems. A great deal more could be adopt more strict GDL policies. Also, at
newsletters, and a parent-teen driving done to advance young driver safety present efforts to enhance the effects of GDL
agreement are designed to alter attitudes through improvements in the available have been limited largely to public infor-
toward the risks of teen driving, perceptions countermeasures, as indicated in Table 2 mation campaigns. It might be possible to
about parental norms regarding restric- and discussed in the following paragraphs. increase compliance with GDL policies
tions, and expectations about adopting Driver Education. Driver education through more substantial and targeted edu-
strict driving limits. The goal of the inter- might be more effective as a safety program cation and persuasion programs.
vention is for families to adopt the driving if it were organized in phases, as is currently Parental Management. Programmatic
agreement and establish and maintain driv- being tried in Michigan, which would ex- efforts to increase parental management
ing restrictions during the first year of li- tend the period of practice driving, increase could be integrated into driver education
censure. Pilot studies have demonstrated parental involvement, and could be closely and licensing activities to increase parental
that exposure to the newsletters alter paren- linked to graduated licensing policies supervision of practice driving and paren-
tal attitudes towards the risks of teen driv- (Mayhew & Simpson, 2002). The first phase tal management practices, including the
ing and the benefits of restricting teen driv- of driver education would occur during the timing of teen licensure, vehicle availabil-
ing. In addition, when given the driving learner’s permit period and would focus on ity, and driving conditions. For example, at
agreement, most families reported using basic skills and rules of the road. It could least one state, Maryland, now requires par-
and liking it and adopting the Checkpoints also include parent education of the risks ents to provide signed statements that they
recommendations for strict initial limits on of teen driving and benefits of restrictions have supervised their teen while driving
teen driving related to driving unsupervised and even the negotiation of a parent-teen under a variety of driving conditions prior
S—60 American Journal of Health Education — September/October Supplement 2003, Volume 34, No. 5
Bruce G. Simons-Morton and Jessica L. Hartos
to licensure. Elements of the successful American Journal of Health Behavior, 25, 10-20. McKnight, A. J., & Peck, R.C. (2002). Gradu-
parent education programs, including Beck, K. H., Hartos, J. L., & Simons-Morton, ated driver licensing: What works? Injury Pre-
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ment programs might be enhanced if MVA Mortality Weekly Report, 48, 369-374. nical Report DOT HS 809066.
staff could be involved in their delivery. Foss, R., & Goodwin, A. (2003). Enhancing Robinson, A. (2002). The safety value of
Also, the effectiveness of parental manage- the effectiveness of graduate driver licensing leg- driver education and training: Discussion pa-
ment programs might be enhanced by islation. Journal of Safety Research, 34, 79-84. per. Injury Prevention, 8(supplement II), ii7-ii8.
timing their delivery and arranging the con- Hartos, J. L., Eitel, P., Haynie, D. L., & Simons-Morton, B. G., Gottlieb, N., &
tent to coincide with parental interest, for Simons-Morton, B. G. (2000). Can I take the car? Greene, W. A. (1996). Introduction to health edu-
example, by targeting parental expecta- Relations among parenting practices and ado- cation and promotion, 2nd ed. Prospect Heights,
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the time of licensure, and then target- Hartos, J. L., Eitel P., & Simons-Morton, B. K. H. (in press). Increased parent limits on
ing maintenance of parental restrictions G. (2001). Do parent-imposed delayed licensure teen driving: Positive effects from a brief in-
after licensure. and restricted driving reduce risky driving be- tervention administered at the MVA. Preven-
haviors among newly licensed teens? Prevention tion Science.
CONCLUSION Science, 2, 111-120. Simons-Morton, B. G., Hartos, J. L., & Beck,
A great deal is now known about the Hartos, J. L., Eitel P., & Simons-Morton, B. K. H. (2003). The persistence of effects of a brief
unique crash risks for young drivers. For- G. (2002). Parenting practices and adolescent intervention on parental restrictions of teen
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a number of good ideas have been proposed Health Education and Behavior, 29, 194-206. Simons-Morton, B. G., Hartos, J. L., & Leaf,
for improving the breadth and effectiveness Hartos, J. L., Nissen, W. J., & Simons- W. A. (2002). Promoting parental management
of these measures. Better integration and Morton, B. G. (2001). Acceptability of the of teen driving. Injury Prevention, 8(supplement
implementation of driver education, gradu- Checkpoints parent-teen driving agreement: II), ii24-ii30.
ated driver licensing, and parent manage- Pilot test. American Journal of Preventive Medi- Williams, A. F., & Ferguson, S. A. (2002).
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gradually, in that direction. (1999). Recommendations for an ideal gradu- ment II), ii9-ii14.
ated licensing law. Status Report, 34, p. 6. Waller, P.F., Olk, M.L., & Shope, J.T. (2000).
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Beck, K. H., Shattuck, T., & Raleigh, R. safety value of driver education and training. Michigan’s graduate licensing program. Journal
(2001). Parental predictors of teen driving risk. Injury Prevention, 8(supplement II), ii3-ii7. of Safety Research, 31(1), 9-15.
American Journal of Health Education — September/October Supplement 2003, Volume 34, No. 5 S—61