Peer Passenger Norms and Pressure: Experimental Effects on Simulated Driving Among Teenage Males.

OBJECTIVE: Serious crashes are more likely when teenage drivers have teenage passengers. One likely source of this increased risk is social influences on driving performance. This driving simulator study experimentally tested the effects of peer influence (i.e., risk-accepting compared to risk-averse peer norms reinforced by pressure) on the driving risk behavior (i.e., risky driving behavior and inattention to hazards) of male teenagers. It was hypothesized that peer presence would result in greater driving risk behavior (i.e., increased driving risk and reduced latent hazard anticipation), and that the effect would be greater when the peer was risk-accepting. METHODS: Fifty-three 16- and 17-year-old male participants holding a provisional U.S., State of Michigan driver license were randomized to either a risk-accepting or risk-averse condition. Each participant operated a driving simulator while alone and separately with a confederate peer passenger. The simulator world included scenarios designed to elicit variation in driving risk behavior with a teen passenger present in the vehicle. RESULTS: Significant interactions of passenger presence (passenger present vs. alone) by risk condition (risk-accepting vs. risk-averse) were observed for variables measuring: failure to stop at yellow light intersections (Incident Rate Ratio (IRR)=2.16; 95% Confidence Interval [95CI]=1.06, 4.43); higher probability of overtaking (IRR=10.17; 95CI=1.43, 73.35); shorter left turn latency (IRR=0.43; 95CI=0.31,0.60); and, failure to stop at an intersection with an occluded stop sign (IRR=7.90; 95CI=2.06,30.35). In all cases, greater risky driving by participants was more likely with a risk-accepting passenger versus a risk-averse passenger present and a risk-accepting passenger present versus driving alone. CONCLUSIONS: Exposure of male teenagers to a risk-accepting confederate peer passenger who applied peer influence increased simulated risky driving behavior compared with exposure to a risk-averse confederate peer passenger or driving alone. These results are consistent with the contention that variability in teenage risky driving is in part explained by social influences.

Buffering social influence: neural correlates of response inhibition predict driving safety in the presence of a peer.

Adolescence is a period characterized by increased sensitivity to social cues, as well as increased risk-taking in the presence of peers. For example, automobile crashes are the leading cause of death for adolescents, and driving with peers increases the risk of a fatal crash. Growing evidence points to an interaction between neural systems implicated in cognitive control and social and emotional context in predicting adolescent risk. We tested such a relationship in recently licensed teen drivers. Participants completed an fMRI session in which neural activity was measured during a response inhibition task, followed by a separate driving simulator session 1 week later. Participants drove alone and with a peer who was randomly assigned to express risk-promoting or risk-averse social norms. The experimentally manipulated social context during the simulated drive moderated the relationship between individual differences in neural activity in the hypothesized cognitive control network (right inferior frontal gyrus, BG) and risk-taking in the driving context a week later. Increased activity in the response inhibition network was not associated with risk-taking in the presence of a risky peer but was significantly predictive of safer driving in the presence of a cautious peer, above and beyond self-reported susceptibility to peer pressure. Individual differences in recruitment of the response inhibition network may allow those with stronger inhibitory control to override risky tendencies when in the presence of cautious peers. This relationship between social context and individual differences in brain function expands our understanding of neural systems involved in top-down cognitive control during adolescent development.

Emergency department-based brief intervention to reduce risky driving and hazardous/harmful drinking in young adults: a randomized controlled trial.

BACKGROUND: Risky driving and hazardous drinking are associated with significant human and economic costs. Brief interventions for more than one risky behavior have the potential to reduce health-compromising behaviors in populations with multiple risk-taking behaviors such as young adults. Emergency department (ED) visits provide a window of opportunity for interventions meant to reduce both risky driving and hazardous drinking. METHODS: We determined the efficacy of a Screening, Brief Intervention, and Referral to Treatment (SBIRT) protocol addressing risky driving and hazardous drinking. We used a randomized controlled trial design with follow-ups through 12 months. ED patients aged 18 to 44 who screened positive for both behaviors (n = 476) were randomized to brief intervention (BIG), contact control (CCG), or no-contact control (NCG) groups. The BIG (n = 150) received a 20-minute assessment and two 20-minute interventions. The CCG (n = 162) received a 20-minute assessment at baseline and no intervention. The NCG (n = 164) were asked for contact information at baseline and had no assessment or intervention. Outcomes at 3, 6, 9, and 12 months were self-reported driving behaviors and alcohol consumption. RESULTS: Outcomes were significantly lower in BIG compared with CCG through 6 or 9 months, but not at 12 months: Safety belt use at 3 months (adjusted odds ratio [AOR], 0.22; 95% confidence interval [CI], 0.08 to 0.65); 6 months (AOR, 0.13; 95% CI, 0.04 to 0.42); and 9 months (AOR, 0.18; 95% CI, 0.06 to 0.56); binge drinking at 3 months (adjusted rate ratio [ARR] 0.84; 95% CI, 0.74 to 0.97) and 6 months (ARR, 0.81; 95% CI, 0.67 to 0.97); and ≥5 standard drinks/d at 3 months (AOR, 0.43; 95% CI, 0.20 to 0.91) and 6 months (AOR, 0.41; 95% CI, 0.17 to 0.98). No substantial differences were observed between BIG and NCG at 12 months. CONCLUSIONS: Our findings indicate that SBIRT reduced risky driving and hazardous drinking in young adults, but its effects did not persist after 9 months. Future research should explore methods for extending the intervention effect.

Changing mobility patterns and road mortality among pre-license teens in a late licensing country: an epidemiological study.

BACKGROUND: Whereas the safety of teens in early licensing countries has been extensively studied, little is known about the safety of pre-license teens in late licensing countries, where these teens also may be at risk. This risk exists because of the combination of a) increasing use of travel modes with a high injury risk, such as bicycles and mopeds, b) inexperience, and c) teens' developmental stage, known to be associated with risk taking and novelty seeking, especially among males. To explore the magnitude and nature of pre-license road risk, this study analysed epidemiological data from the Netherlands, and hypothesized that in this late licensing country, 'independent travel' and the use of riskier modes of transport increase among pre-license teens 10 to 17 years of age, resulting in higher fatality rates, with 'experience' and 'gender' as risk modifying factors. METHOD: National travel and fatality data of pre-license adolescents in the Netherlands were analysed by traffic role (cyclist, pedestrian, car passenger and moped rider), and compared to a younger age group (0-9 years) and an older age group (18+ years). RESULTS: The study of travel data showed that teens migrate from being car occupants to being users of riskier modes of transport, specifically bicycles and mopeds. This migration resulted in a strong rise in road fatalities, illustrating the importance of mobility patterns for understanding changes in road fatalities in this age group. The data further suggested a protective role of early cycle experience for young adolescent cyclists, particularly for young males. But further study into the underlying mechanism is needed to confirm this relationship. Moped risk was extremely high, especially among young males, and even higher than that of young male car drivers. CONCLUSIONS: The study confirmed the importance of changes in mobility patterns for understanding the rising road mortality when youngsters enter into their teens. The focus on fatalities has led to an underestimation of the magnitude of the problem because of the physical resilience of young adolescents that leads to high survival rates but probably also to long term disabilities. In addition, to explore the generalizability of these results, international comparisons among and between early and late licensing countries are necessary, especially in relation to moped riding as an alternative for car driving.

Paediatrician knowledge, attitudes, and counselling patterns on teen driving.

BACKGROUND: Motor vehicle crashes (MVCs) are the leading cause of death among teenagers. Little is known about the content of US paediatrician counselling about teen driving. OBJECTIVE: To examine US paediatrician knowledge, attitudes, and counselling patterns regarding teen driving. METHODS: A random sample questionnaire was mailed to American Academy of Pediatrics members in 2009 (n=1606; response=875 (55%)). Analysis was limited to 596 paediatricians who provide adolescent checkups. Questions addressed counselling and attitudes towards roles in promoting safe driving. Logistic regression assessed the relationship between counselling topics and practice characteristics. RESULTS: Most (89%) respondents provide some counselling about driving. Two topics commonly discussed by paediatricians were seatbelts (87%) and alcohol use (82%). Less frequently discussed were: cell phones (47%), speeding (43%), and dangers of transporting teen passengers (41%). Topics rarely discussed were: night driving (21%), graduated driver licensing laws (13%), safe cars (9%), driver education (9%), fatigue (25%), and parental limit setting (23%). Only 10% ever recommend a parent-teen driver agreement. Paediatricians who had a patient injured or killed in an MVC were more likely to discuss night driving (OR=2.86). Physicians caring for a high proportion of adolescents (OR=1.83) or patients with private insurance (OR=1.85) counsel more about the risks of driving with teen passengers. CONCLUSIONS: Paediatricians in the USA support counselling on teen driving during routine office visits, but omit many important risk factors. Few recommend parent-teen driver agreements. Methods that help clinicians efficiently and effectively counsel families about teen driving should be developed.

Past-year intentional and unintentional injury among teens treated in an inner-city emergency department.

UNLABELLED: An inner-city emergency department (ED) visit provides an opportunity for contact with high-risk adolescents to promote injury prevention. OBJECTIVES: To identify the prevalence of injuries sustained over the past year by teens presenting to an inner-city ED, and to identify factors associated with recent injury to inform future ED-based injury prevention initiatives. METHODS: Over 1 year, 7 days a week, from 1:00-11:00 p.m., patients aged 14-18 years presenting to the ED participated in a survey regarding past-year risk behaviors and injuries. RESULTS: Of the entire group of teens presenting to the ED (n = 1128) who completed the survey (83.8% response rate), 46% were male, and 58% were African-American. Past-year injuries were reported by 768 (68.1%) of the teens; 475 (61.8%) of those reported an unintentional injury and 293 (38.1%) reported an intentional injury. One-third of all youth seeking care reported a past-year sports-related injury (34.5%) or an injury related to driving or riding in a car (12.3%), and 8.2% reported a gun-related injury. Logistic regression found that binge drinking (adjusted odds ratio [AOR] 1.95) and illicit weapon carrying (AOR 2.31) predicted a past-year intentional injury. African-American youth (AOR 0.56) and those receiving public assistance (AOR 0.73) were less likely to report past-year unintentional injuries. CONCLUSIONS: Adolescents seeking care in an inner-city ED, regardless of the reason for seeking care, report an elevated prevalence of recent injury, including violence. Future injury screening and prevention efforts should consider universal screening of all youth seeking ED care.

Developing a web-based health promotion intervention: a case study from a brief motivational alcohol program.

Public health researchers and practitioners reporting findings from intervention studies seldom report in depth the processes of intervention development. However, such information would be useful for several reasons: (a) it would help guide the development of new interventions and refinement or revision of existing ones, (b) it would provide a framework and methodology on which other health practitioners and researchers could build, and (c) it would increase transparency of the development process and enhance the interpretation of the intervention's effects. The purpose of this article is to begin addressing the "black box" of Web-based intervention development by presenting the method for developing a Web-based, brief, motivational alcohol intervention program that has shown evidence of efficacy for college students, called Michigan Prevention & Alcohol Safety for Students.

Effects of a brief intervention for reducing violence and alcohol misuse among adolescents: a randomized controlled trial.

CONTEXT: Emergency department (ED) visits present an opportunity to deliver brief interventions to reduce violence and alcohol misuse among urban adolescents at risk of future injury. OBJECTIVE: To determine the efficacy of brief interventions addressing violence and alcohol use among adolescents presenting to an urban ED. DESIGN, SETTING, AND PARTICIPANTS: Between September 2006 and September 2009, 3338 patients aged 14 to 18 years presenting to a level I ED in Flint, Michigan, between 12 pm and 11 pm 7 days a week completed a computerized survey (43.5% male; 55.9% African American). Adolescents reporting past-year alcohol use and aggression were enrolled in a randomized controlled trial (SafERteens). INTERVENTION: All patients underwent a computerized baseline assessment and were randomized to a control group that received a brochure (n = 235) or a 35-minute brief intervention delivered by either a computer (n = 237) or therapist (n = 254) in the ED, with follow-up assessments at 3 and 6 months. Combining motivational interviewing with skills training, the brief intervention for violence and alcohol included review of goals, tailored feedback, decisional balance exercise, role plays, and referrals. MAIN OUTCOME MEASURES: Self-report measures included peer aggression and violence, violence consequences, alcohol use, binge drinking, and alcohol consequences. RESULTS: About 25% (n = 829) of screened patients had positive results for both alcohol and violence; 726 were randomized. Compared with controls, participants in the therapist intervention showed self-reported reductions in the occurrence of peer aggression (therapist, -34.3%; control, -16.4%; relative risk [RR], 0.74; 95% confidence interval [CI], 0.61-0.90), experience of peer violence (therapist, -10.4%; control, +4.7%; RR, 0.70; 95% CI, 0.52-0.95), and violence consequences (therapist, -30.4%; control, -13.0%; RR, 0.76; 95% CI, 0.64-0.90) at 3 months. At 6 months, participants in the therapist intervention showed self-reported reductions in alcohol consequences (therapist, -32.2%; control, -17.7%; odds ratio, 0.56; 95% CI, 0.34-0.91) compared with controls; participants in the computer intervention also showed self-reported reductions in alcohol consequences (computer, -29.1%; control, -17.7%; odds ratio, 0.57; 95% CI, 0.34-0.95). CONCLUSION: Among adolescents identified in the ED with self-reported alcohol use and aggression, a brief intervention resulted in a decrease in the prevalence of self-reported aggression and alcohol consequences. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00251212.

Alcohol availability and violence among inner-city adolescents: A multi-level analysis of the role of alcohol outlet density.

Researchers recognize that the connection between alcohol and peer violence may relate to community level ecological factors, such as the location of businesses that sell alcohol. Building on previous research among adults, this study examines the relationship between alcohol outlet density and violent behaviors among adolescents, taking into account demographic characteristics, individual alcohol use, and neighborhood level socioeconomic indicators. Data drawn from a diverse Emergency Department based sample of 1,050 urban adolescents, combined with tract level data from the state liquor control commission and U.S. Census, were analyzed. Results of multivariate multi-level regression analysis indicate that alcohol outlet density is significantly related to adolescents' violent behaviors, controlling for demographic characteristics and individual alcohol use. Census tract level socioeconomic indicators were not significantly associated with youth violence. Findings suggest that alcohol outlet density regulation should be considered as part of broader violence prevention strategies for urban adolescents.

Neural processes during adolescent risky decision making are associated with conformity to peer influence.

Adolescents demonstrate both heightened sensitivity to peer influence and increased risk-taking. The current study provides a novel test of how these two phenomena are related at behavioral and neural levels. Adolescent males (N = 83, 16-17 years) completed the Balloon Analogue Risk Task (BART) in an fMRI scanner. One week later, participants completed a driving task in which they drove alone and with a safety- or risk-promoting peer passenger. Results showed that neural responses during BART were associated with participants' behavioral conformity to safe vs. risky peer influence while later driving. First, the extent that neural activation in the anterior cingulate cortex (ACC) scaled with decision stakes in BART was associated with conformity to risky peer influence. Additionally, stake-modulated functional connectivity between ventral striatum (VS) and risk processing regions (including ACC and insula) was associated with safer driving under risky peer influence (i.e. resistance to risky peer influence), suggesting that connectivity between VS and ACC as well as insula may serve a protective role under risky peer influence. Together, these results suggest that adolescents' neural responses to risky decision making may modulate their behavioral conformity to different types of peer influence on risk taking.

Efficacy of a brief group parent-teen intervention in driver education to reduce teenage driver injury risk: a pilot study.

The purpose of this study was to test the efficacy of an adapted Checkpoints Program designed to increase parental limits on novice teen independent driving under high-risk conditions. Twenty-seven class sessions with a minimum of 5 dyads each were delivered in driver education to 231 parent-teen dyads. Entire driving school classes were randomized to Checkpoints Program or comparison group sessions, both led by a trained health educator. At licensure, compared with parents in the comparison group, treatment parents had increased awareness of teen driving risk and were more likely to have completed a parent-teen driving agreement and met Checkpoints recommendations for restrictions on teen driving in inclement weather and road types. They were also marginally more likely to have met Checkpoints restrictions on driving with teen passengers. This study indicates that it is feasible to implement the Checkpoints Program in driver education with positive effects on parent management practices.

Spatial variation in teens' crash rate reduction following the implementation of a graduated driver licensing program in Michigan.

Motor vehicle crashes are a leading cause of injury, and teen drivers contribute disproportionately to that burden. Graduated Driver Licensing (GDL) programs are effective at reducing teen crash risk, but teen crash rates remain high. Between-state variation in the teen crash rate reduction following GDL implementation has been documented, but this is the first study to examine small-area variation in such a reduction. Fusing together crash data from the Michigan State Police, census data, and organizational data (alcohol outlet, movie theatre, and school locations), we analyzed spatial correlates of teen injury crash, and place-based features that modified the injury crash rate difference following GDL implementation. Specifically, using census-based units, we estimated changes in injury crash rates among teens using negative binomial regression controlling for spatial autocorrelation, and tested whether any measured spatial characteristics modified the crash rate change in the pre versus post GDL periods. There was a substantial reduction in teen crashes after GDL implementation (RR = 0.66, 95%CI: [0.65, 0.67]), and this effect was robust across gender and time-of-day (light/dark). We found evidence that this reduction varied across space; areas with more alcohol outlets corresponded to a larger daytime crash rate reduction post-GDL, while areas near schools corresponded to a smaller daytime crash rate reduction. Concentrations of movie theatres corresponded to larger post-GDL crash rate reductions after dark. Maximizing the substantial successes of GDL programs requires understanding why crash rate reductions were larger in some areas following GDL implementation, and harnessing that understanding to improve its effectiveness across a state, focusing on identifying priorities for improving driver training (e.g., by parents and driver educators), law enforcement, and future policy changes to current GDL laws.

Teen driving: motor-vehicle crashes and factors that contribute.

The motor-vehicle crash risk of novice teen drivers is unacceptably high. This article examines the historical trends in fatal crash rates for male and female teen drivers as compared to adult drivers by both population and person-miles driven. The effect of motor-vehicle policies on teen driver crashes, characteristics of teen driver crashes, and combinations of these crash characteristics are also examined. A framework of seven categories of influences on teen driving behavior is presented, including the following elements: driving ability, developmental factors, behavioral factors, personality factors, demographics, the perceived environment, and the driving environment. Because a complex set of different factors influence teen drivers' behavior, comprehensive, multilevel interventions are needed to reduce teen drivers' exposure to high-risk driving conditions and to address factors identified in the framework.

Design and implementation of a parent guide for coaching teen drivers.

INTRODUCTION: Teens beginning to drive independently are at significant increased risk of motor-vehicle crashes relative to their other life stages. There is, however, little guidance for parents as to how best to supervise learning to drive. METHOD: This study sought to undertake an informed approach to development and implementation of a Parent Guide. We included a multi-stage development process, using theory, findings from a Delphi-study of young driver traffic-safety experts, and parent focus groups. This process informed the development of a Guide that was then evaluated for feasibility and acceptability, comparing a group that received the Guide with a control group of parent and teen dyads. Both members of the dyads were surveyed at baseline, again at the approximate time teens would be licensed to drive independently (post-test), and again three months later. RESULTS: We found no difference in the proportion of teens who became licensed between those given the new Guide and control teens (who received the state-developed booklet); that is the Guide did not appear to promote or delay licensure. Teens in the Guide group reported that their parents were more likely to use the provided resource compared with control teens. Responses indicated that the Parent Guide was favorably viewed, that it was easy to use, and that the logging of hours was a useful inclusion. Parents noted that the Guide helped them manage their stress, provided strategies to keep calm, and helped with planning practice. In contrast, control parents noted that their booklet helped explain rules. Among licensed teens there was no significant difference in self-reported risky driving at the three-month follow-up. We discuss the challenges in providing motivation for parents to move beyond a set number of practice hours to provide diversity of driving practice.

Graduated driver licensing: review of evaluation results since 2002.

UNLABELLED: Unintentional injury from motor-vehicle crashes is the number one cause of death among teenagers in the United States. Increasingly, jurisdictions have adopted three-stage graduated driver licensing (GDL) systems for young novice drivers. Since a previous review of U.S. GDL evaluation results, many more U.S. states and Canadian provinces have implemented GDL and/or had enough time pass that additional evaluation results are now available. Twenty-one studies of GDL within 14 individual jurisdictions, and six studies of GDL in the U.S. nationwide, were collected, reviewed, and summarized. Positive results (usually crash reductions) of varying degrees were reported from nearly all the studies. Given differences in approaches, study goals, methods, and analyses, the results are surprisingly consistent. Overall, GDL programs have reduced the youngest drivers' crash risk by roughly 20 to 40%. Research on teen driving and comprehensive GDL enhancements could further reduce teen drivers' motor-vehicle crashes, injuries, and fatalities. IMPACT ON INDUSTRY: Policy-makers, as well as the motor vehicle, insurance, and other industries have been involved in teen driving safety and could enhance and coordinate their roles.

Development and pilot testing of an assessment battery for older drivers.

INTRODUCTION: The purpose of the study reported here was to develop and pilot test a comprehensive battery of assessment instruments for older drivers that would be inexpensive and easy to administer so that it could be used in longitudinal studies. METHOD: The resulting battery was developed by selecting a set of validated assessment instruments and combining them into a package, with a total acquisition cost of less than $900. As part of this battery, three questionnaires were developed utilizing items from established questionnaires with minor modifications. The battery was pilot tested with a convenience sample of 38 drivers aged 65 years or older. RESULTS: Results showed that the entire battery required less than one hour to complete. Data from the assessment outcomes fell within normative ranges. Feedback from subjects indicated that the battery was acceptable, free of problems, presented tasks in a good order, and was not too long. CONCLUSIONS: Based on study findings, the assessment battery appeared to be low-cost, transportable, easy to administer, easy for subjects to complete, provides a comprehensive assessment of a person's physical health, mental health, and driving behaviors, and would serve as a valuable data collection tool for a longitudinal study of older drivers. Such a longitudinal study is needed in order to answer some of the most important questions about older driver safety and mobility.

Traffic safety in the U.S.: re-examining major opportunities.

INTRODUCTION: This article examines five major road-safety risk factors: exceeding posted speed limits, not using safety belts, driving while intoxicated, nighttime driving, and young drivers. METHOD: The importance of each of these factors is documented, known effective countermeasures (both policy and technology based) are discussed, and impediments to the implementation of these countermeasures in the United States are examined. RESULTS: Based on current understanding of the five major risk factors, and of the available countermeasures, there appear to be a variety of opportunities to make substantial gains in road safety using existing knowledge. The limited implementation of a variety of known countermeasures therefore appears to be inconsistent with high-level, strategic goals to improve road safety. Consequently, a recommendation is made to comprehensively re-examine the balance between the countermeasures discussed in this article and economic, mobility, and privacy concerns. IMPACT ON PUBLIC SAFETY: Such a re-examination is likely to result in broad support for these countermeasures, with a consequent major improvement in road safety.

Gender differences among young drivers in the association between high-risk driving and substance use/environmental influences.

OBJECTIVE: The primary aim of this article is to assess young drivers' gender differences in the associations between substance use/environmental influences and high-risk driving behavior. METHOD: We determine the association of 12th-grade self-reported substance use/ environmental influences with high-risk driving behavior as quantified by the number of offenses, serious offenses, crashes, and single-vehicle crashes on state driving records during subjects' (N = 3,607; 51% male) first 4 years of licensure. RESULTS: The associations between high-risk driving and substance use/environmental influences were generally stronger among women than among men. When matched by substance-use profiles, women had fewer risky-driving incidents than men. CONCLUSIONS: The results indicate that young women who exhibit high-risk driving behavior deviate more from the general population of young women with respect to alcohol use, alcohol misuse, and marijuana use than high-risk-driving young men differ from other young men. In addition, findings indicate that even if young men and women were to eventually have equal levels of substance use, women would likely retain their lower-risk driving profiles. These findings suggest the need for (1) future research to understand the differential associations, and (2) prevention programs that consider these gender differences.

Longitudinal examination of underage drinking and subsequent drinking and risky driving.

INTRODUCTION: Alcohol use, alcohol misuse, and risky driving from adolescence into young adulthood were compared by drinking onset age. METHODS: Surveys were administered in Grades 5/6, 6/7, 7/8, 10, 12, and at approximately age 23. Participants were placed into Drinking Onset groups based on self-reported alcohol use frequency on the adolescent surveys. Driving records were examined in three age periods: under 21, 21-25, and 26+. RESULTS: The earliest drinking initiators reported higher alcohol use and misuse on each survey, and were more likely to have risky driving offenses before age 21 and to have alcohol driving offenses in all three age periods. DISCUSSION: The earliest drinking initiators engaged in risky drinking behavior and risky driving behavior that was consistently higher than those with later drinking initiation, beginning in adolescence and persisting well into young adulthood.

Translation to Primary Care of an Effective Teen Safe Driving Program for Parents.

Addressing teen driver crashes, this study adapted an effective Checkpoints(TM) program for parents of teen drivers for dissemination by primary care practitioners (PCPs) and the web; distributed the PCP/web program through pediatric practices; and examined dissemination to/implementation by parents. The website, youngDRIVERparenting.org, and brief intervention protocol were developed. PCPs delivered interventions and materials to parents, referred them to the website, and completed follow-up surveys. Google Analytics assessed parents' website use. Most PCPs reported delivering interventions with fidelity, and thought the program important and feasible. Brief interventions/website referrals, averaging 4.4 minutes, were delivered to 3465 (87%) of 3990 eligible parents by 133 PCPs over an 18-week average. Website visits (1453) were made by 42% of parents, who spent on average 3:53 minutes viewing 4.2 topics. This program costs little (its website, training and promotional materials are available) and could be one component of a comprehensive approach to reducing teen driver crashes.