Rebekah L. Chapman

Young driver distraction: state of the evidence and directions for behavior change programs.

Adolescent drivers are overrepresented in distraction-related motor vehicle crashes. A number of potential reasons for such an elevated risk include driving inexperience, high adoption of communication technology, increased peer involvement, and tendency to take risks, which render young drivers particularly vulnerable. Major legislative efforts in Graduated Licensing Systems that include passenger restrictions have shown positive effects. Restrictions on cell phone use are also being introduced; however, it is challenging to enforce such regulations. This article argues that such contextual, legislative interventions are an essential prevention strategy, but there is an unfilled need to introduce behavior change programs that may target adolescents, parents, and friends. A theoretical framework is applied in which risk and protective factors are identified from research within the contexts of community and jurisdiction. In the literature on distraction, social context and normative influences are key elements used to inform program design for adolescent drivers, with parental monitoring informing interventions targeting parents. Following from this assessment of the message content assessment, the design of strategies to deliver the messages is reviewed. In the current literature, school-based programs, simulations, and Web-delivered programs have been evaluated with supplementary strategies delivered by physicians and parents. Such developments are still at an early stage of development, and ultimately will need controlled implementation and evaluation studies. Of course, there is no likely single approach to prevent adolescent driver distraction. Complementary approaches such as the further development of technological interventions to manage phone use are needed.

Adolescent involvement in anti-social and delinquent behaviours: Predicting future injury risk

The purpose of this study was to challenge the broadly based focus of injury prevention strategies towards concern with the needs of young adolescents who engage in multiple anti-social and delinquent behaviours. Five hundred and forty 13-14-year olds reported on injuries and truancy, violence, illegal road behaviours, drug, and alcohol use. Engagement in these behaviours was found to contribute to the likelihood of an injury. Those engaging in the most anti-social and delinquent behaviours were around five times more likely to report medically-treated injuries in the past three months. Their likelihood of future injury was 1.8 times more likely when they were followed up three months later. The engagement in multiple delinquent and illegal behaviours thus significantly increased the likelihood of injury and identifies a particularly vulnerable group. The findings also suggest that reaching these young people represents a key target for change strategies in injury prevention programs.

Keeping friends safe: a prospective study examining early adolescent's confidence and support networks

There is a continued need to consider ways to prevent early adolescent engagement in a variety of harmful risk-taking behaviours for example, violence, road-related risks and alcohol use. The current prospective study examined adolescents’ reports of intervening to try and stop friends’ engagement in such behaviours among 207 early adolescents (mean age = 13.51 years, 50.1% females). Findings showed that intervening behaviour after three months was predicted by the confidence to intervene which in turn was predicted by student and teacher support although not parental support. The findings suggest that the benefits of positive relationship experiences might extend to the safety of early adolescent friendship groups particularly through the development of confidence to try and stop friends’ risky and dangerous behaviours. Findings from the study support the important role of the school in creating a culture of positive adolescent behaviour whereby young people take social responsibility.

In Their Own Words: Adolescents Strategies to Prevent Friend's Risk Taking.

Injury is a significant public health problem among youth. A primary cause of adolescent injury is risk-taking behavior, including alcohol use, interpersonal violence and road-related risks. A novel approach to prevention is building on friendships by encouraging adolescents to intervene into their friends’ risk taking. Fifty-one early adolescents (13-14 years) and 44 older adolescents (16-17 years) from two Australian schools participated in focus groups, aiming to explore stories of intervening. Findings showed preference for talking to friends; however, participants also spoke to adults, monitored friends’ behavior and planned ahead. Close friendships, perceived harm, and self-efficacy influenced the likelihood of intervening. These findings have implications for the design of risk and injury prevention programs, by suggesting strategies to promote adolescents’ communicative ability for risk reduction. The findings also highlight the language and dialogue of adolescents and suggest that methods for increasing intervening behavior should focus on building social connectedness and increasing self-efficacy.

Towards an integration of the theory of planned behaviour and cognitive behavioural strategies: an example from a school-based injury prevention programme

Adolescent risk-taking behaviour has potentially serious injury consequences and school-based behaviour change programmes provide potential for reducing such harm. A well-designed programme is likely to be theory-based and ecologically valid; however, it is rare that the operationalisation process of theories is described. The aim of this paper is to outline how the theory of planned behaviour and cognitive behavioural therapy informed intervention design in a school setting. Teacher interviews provided insights into strategies that might be implemented within the curriculum and provided detail used to operationalise theory constructs. Benefits and challenges in applying both theories are described with examples from an injury prevention programme, Skills for Preventing Injury in Youth.

Teachers’ perceptions of school connectedness and risk-taking in adolescence

School connectedness has been shown to be an important protective factor in adolescent development, which is associated with reduced risk-taking behavior. Interventions to increase students’ connectedness to school commonly incorporate aspects of teacher training. To date, however, research on connectedness has largely been based on student survey data, with no reported research addressing teachers’ perceptions of students’ connectedness and its association with student behavior. This research attempted to address this gap in the literature through in-depth interviews with 14 school teachers and staff from two Australian high schools. Findings showed that teachers perceived students’ connectedness to be important in regard to reducing problem behavior, and discussed aspects of connectedness, including fairness and discipline, feeling valued, belonging and having teacher support, and being successfully engaged in school, as being particularly important. This research enables the development of school-based intervention programs that are based on both student- and teacher-focused research.

Reaching high-risk young adolescents: a process evaluation of a school based injury prevention programme

Background Adolescent injury is a serious public health concern. Adolescents classified as high-risk are a population most vulnerable to harm from injury due to increased engagement in risk-taking behaviour. Aims/Objectives/Purpose The aim of this research is to evaluate responsiveness of high-risk young Australian adolescents (13–14 years) to a curriculum based injury prevention programme. Methods Fifteen schools implemented the Skills for Preventing Injury in Youth (SPIY) programme in April to June 2012. Focus groups were conducted with a random sample of teachers after the conclusion of SPIY in July 2012.Teachers classified the risk-level of students based on perceptions of student engagement in risk-taking behaviour (eg, alcohol, violence, transport risks) and reported on dose, adherence, quality of process and participant responsiveness. Results/Outcomes The findings of teacher focus groups are presented regarding perceptions of the implementation of the curriculum based injury prevention programme and perceived responsiveness for high-risk young adolescents. Programme strengths and weaknesses are reported in the context of meeting the needs of high-risk young adolescents and the amount of material high-risk young adolescents received in line with the SPIY curriculum. Significance/Contribution to the Field Teachers provide insight into responsiveness of high-risk young adolescents for a curriculum based injury prevention programme as well as the way it is implemented for high-risk young adolescents. Findings of this research have the potential to enhance implementation of school based interventions for high-risk young adolescents who are still participating in mainstream schooling and maximise programme effect and sustainability.

A Systematic Review of Intervening to Prevent Driving While Intoxicated: The Problem of Driving While Intoxicated (DWI)

ABSTRACT Background: Driving while intoxicated (DWI) is a significant public health issue. The likelihood someone will intervene to prevent DWI is affected by the characteristics of the individuals and the context of the potential driving scenario. Understanding such contexts may help tailor public health messages to promote intervening from those who are nearby to an intoxicated driver. Objective: This systematic review investigates the behavior of those close to an intoxicated driver and factors associated with increasing the likelihood they will intervene in situations where driving while impaired may be likely. The review of the literature is guided by an orienting framework, namely the classic social psychology theory of decision-making proposed by Latané and Darley. Results: Drawing upon this framework, the review examines the extent to which research has focused on factors which influence whether or not an individual identifies a need to intervene and identifies a seriously dangerous situation. In addition, consideration is given to perceived personal responsibility. The final two components of the model are then discussed; the perceived skill an individual who may intervene has (in their ability to intervene) and their actual enactment of the intervening behavior. Conclusions and Importance: Drawing upon such a well-considered theoretical framework, this review provides guidance on key components likely to assist in the development of targeted, more effective public education messages and campaigns that dissuade individuals from drinking and then driving.

The Challenge of Normative Influences for Program Design for Youth in Detention

Young people in detention are at greater risk of death and disability from injury sustained while not in custody. Injury prevention and mental health programs have been designed for this group but their theoretical basis is rarely discussed. The present study investigates whether the conceptual basis of the Theory of Planned Behavior (TPB) is relevant to youth in a detention center. Focus group and observational data were collected. A thematic analysis supported central theoretical constructs and emphasized “Subjective Norms.” The challenge of normative influences must be actively addressed in the design of health interventions for youth in detention.

Challenges for Teaching Injury Prevention in a Juvenile Detention Center

ABSTRACT This case study explored the injury related experiences and perceptions of youth in detention and the delivery of first aid education in youth detention contexts. It aimed to develop an understanding of how a mainstream injury prevention intervention could be modified for youth detention populations. Teacher and student reactions to the program were examined and injury checklists, focus groups, and staff interviews were conducted. Analysis revealed serious injuries related to criminal behaviors, violence, dangerous driving, and substance use. Recommendations for youth detention interventions include lesson flexibility, discussions, role-plays, visual materials, peer support strategies, student-teacher relationships, and positive reinforcement.