Vanya C. Jones

Driving Cessation and Health Outcomes in Older Adults

To determine what effect driving cessation may have on subsequent health and well‐being in older adults.

Adolescent development and risk of injury: using developmental science to improve interventions

In adolescence, there is a complex interaction among physical, cognitive, and psychosocial developmental processes, culminating in greater risk-taking and novelty-seeking. Concurrently, adolescents face an increasingly demanding environment, which results in heightened vulnerability to injury. In this paper, we provide an overview of developmental considerations for adolescent injury interventions based on developmental science, including findings from behavioural neuroscience and psychology. We examine the role that typical developmental processes play in the way adolescents perceive and respond to risk and how this integrated body of developmental research adds to our understanding of how to do injury prevention with adolescents. We then highlight strategies to improve the translation of developmental research into adolescent injury prevention practice, calling on examples of existing interventions including graduated driver licensing.

Barriers and Facilitators to School-Based Parent Involvement for Parents of Urban Public Middle School Students

Using semistructured interviews, we explored barriers and facilitators to school-based parent involvement (SBPI) in a sample of predominately African American parents (N = 44) whose children attended urban public middle schools. Barriers to SBPI (e.g., perceptions of hostile parent–teacher interactions and aggressive, disrespectful students in the school) were more commonly reported than facilitators (e.g., child invitations for involvement). Findings suggest that parents’ motivations for engaging in SBPI may be undermined by a variety of barriers, resulting in low participation. Implications and tailored strategies for enhancing SBPI in this population are presented.

Enhancing fire department home visiting programs: results of a community intervention trial.

This study evaluates the impact of an enhanced fire department home visiting program on community participation and installation of smoke alarms, and describes the rate of fire and burn hazards observed in homes. Communities were randomly assigned to receive either a standard or enhanced home visiting program. Before implementing the program, 603 household surveys were completed to determine comparability between the communities. During a 1-year intervention period, 171 home visits took place with 8080 homes. At baseline, 60% of homes did not have working smoke alarms on every level, 44% had unsafe water temperatures, and 72% did not have carbon monoxide alarms. Residents in the enhanced community relative to those in the standard community were significantly more likely to let the fire fighters into their homes (75 vs 62%). Among entered homes, those in the enhanced community were significantly more likely to agree to have smoke alarms installed (95 vs 92%), to be left with a working smoke alarm on every level of the home (84 vs 78%), and to have more smoke alarms installed per home visited (1.89 vs 1.74). The high baseline rates of home hazards suggest that fire department home visiting programs should take an “all hazards” approach. Community health workers and community partnerships can be effective in promoting fire departments’ fire and life safety goals. Public health academic centers should partner with the fire service to help generate evidence on program effectiveness that can inform decision making about resource allocation for prevention.

A Glimpse Into Urban Middle Schools on Probation for “Persistently Dangerous” Status: Identifying Malleable Predictors of Fighting

The No Child Left Behind Act requires state boards of education to identify schools that are unsafe. Schools that are identified by measures such as suspension and expulsion rates are subsequently labeled “persistently dangerous.” To our knowledge there is no published research that attempts to characterize fighting behavior among youths who may attend schools designated as persistently dangerous. Two hundred thirteen sixth-grade African American boys and girls attending two urban middle schools on probation for persistently dangerous status were examined to investigate differences in demographic characteristics of gender and age and predictor factors of nonparental adult mentorship (NPAM), parental acceptance of fighting behavior, and peer fighting. These analyses suggest a relationship between being more likely to fight and number of peers who fight, youths who believed their parents endorse fighting, and youths without nonparental adult mentorship. This study also indicates that regardless of school status there are modifiable predictors associated with early adolescent fighting.

Promoting “Healthy Futures” to Reduce Risk Behaviors in Urban Youth: A Randomized Controlled Trial

There is increasing evidence of the interconnection between educational and health outcomes. Unfortunately wide disparities exist by both socioeconomic status and race/ethnicity in educational and vocational success. This study sought to promote urban youths’ career readiness as a way to reduce involvement in risk behaviors. Two hundred primarily African-American youth (ages 14–21) were recruited from a pediatric primary care clinic. Youth randomized to the intervention received three motivational interviewing sessions focused around expectations and planning for the future. Baseline and 6-month follow-up assessments included measures of career readiness and risk behavior involvement (i.e., physical fighting, alcohol and marijuana use). At 6-months, youth randomized to the intervention condition showed increased confidence in their ability to perform the behaviors needed to reach their college/career goals. Additionally, youth randomized to the intervention arm showed decreased fighting behavior (adjusted rate ratio: .27) and marijuana use (adjusted rate ratio: .61). Assisting urban youth in thinking and planning about their future holds promise as a way to reduce their involvement in risk behaviors. This study also demonstrated that motivational interviewing could be used to promote positive behaviors (i.e., career readiness).

Driving Habits and Risk Exposure in Older Drivers: Lessons Learned From the Implementation of a Self-Regulation Curriculum

Objective: This article describes the development and pilot testing of Seniors on the MOVE (Mature Operators Vehicular Education), a safe driving education program for older adults. The study aims are to describe driving experiences and habits of a community sample of older drivers and to determine whether the program reduces their driving risk exposures. Methods: A 2-group randomized design was used. Fifty-eight participants with an average age of 70 were randomly assigned to the MOVE program or a no treatment control group. MOVE is a 4-session program designed to help older drivers better understand and utilize self-regulation skills for safer driving. Baseline and 4-week follow-up questionnaires were completed by both groups, after which the control group received the MOVE program. Results: In the total sample, 14 percent reported having ever been in a traffic crash where someone was injured, and 10 percent reported having received a traffic citation in the past 6 months. Almost one half of the sample (47%) reported thinking about reducing the amount of driving done at night. Nearly one third were thinking about reducing the amount of driving done in unfamiliar places (32%) and the number of miles driven each week (30%). Participants reported most frequently driving between 2 to 10 miles from home, on local roadways, and between 9:00 am and 4:00 pm. Based on responses to items that measured such driving habits, a risk exposure score was created by combining driving exposure variables. Participants were categorized into lower and higher driving risk exposure groups at baseline and follow-up. There were no statistical differences in changes in higher or lower risk driving exposure variables when comparing the 2 groups. Conclusions: Although the impact of this program on reported driving behaviors yielded null results, descriptions of older drivers’ habits and plans are informative. Because many participants were thinking about making changes to their driving habits, and many already had, the need for more effective self-regulation driving safety programs to help with this process is clear.

One of my fears is that physically or mentally, the time will come where I'll be unable to drive anymore. and I'm not looking forward to that: a mixed methods feasibility study to assess older driver's risk impairment.

Sixty-seven older adults were assessed using multiple validated tools. The current study aimed to identify high-, medium-, and low-risk impairment among older drivers and to explore high-risk drivers’ reactions to being told their results. Of 67 adults screened from a convenience sample of older drivers, nine high-risk participants, four completed in-depth follow-up qualitative interviews. The quantitative assessment algorithm identified 13% as high risk, 30% as medium risk, and 57% as low risk, and only Trails B distinguished the medium- and high-risk impairment groups. Although the assessment tests did not predict future crash involvement over a 7-month period, four participants in the medium- and high-risk impairment categories had been involved in a crash during the 5 years prior to the study compared with none of those who screened low risk. Only three participants (1 high risk) voluntarily surrendered their driver’s licenses after the assessment, and one participant in the in-depth interviews reported that the assessment influenced the decision to stop driving. There may be some benefit in using driving record history and assessment results to determine driving risk impairment level. However, more research is needed to determine the best combination of tools to predict risk level. How to best communicate risk levels remains to be determined, although results from the older drivers in this study underscore the need for great sensitivity when identifying areas of concern about driving ability.

Changes in smoke alarm coverage following two fire department home visiting programs: what predicts success?

BackgroundDoor-to-door canvassing and installation of smoke alarms have been found to be effective at increasing the number of homes protected. This analysis reports on how smoke alarm coverage changes six months after a home visiting program in a large urban sample, and how this change varies by characteristics of the residents and characteristics of the services delivered during the home visit.MethodsFire department Standard and Enhanced home visiting programs were compared. During the home visit, fire fighters installed lithium battery smoke alarms. Residents in the Enhanced program received tailored education about fire safety. Six months after the home visit, participating residences were visited to complete a follow-up survey and to have the installed alarms checked.Results81% of the 672 homes that had a working smoke alarm on every level of the home at the end of the home visit remained safe at follow-up, and 87% of the residents found the home visit was very useful, and these rates did not differ between the Enhanced and Standard programs. The degree to which firefighters delivered their services varied, although households in which the resident’s engagement with the fire department team was rated as excellent were 3.96 times as likely to be safe at follow-up compared to those with poor or fair resident engagement (p=0.03).ConclusionsThere is a need to better understand how to maximize the time spent with residents during smoke alarm home visiting programs. This study helps with the development of methods needed for implementing and evaluating such programs in real-world settings.

Discrepant Perspectives on Conflict Situations Among Urban Parent–Adolescent Dyads

Parents influence urban youths’ violence-related behaviors. To provide effective guidance, parents should understand how youth perceive conflict, yet little empirical research has been conducted regarding parent and youth perceptions of conflict. The aims of this article are to (a) report on the nature of discrepancies in attribution of fault, (b) present qualitative data about the varying rationales for fault attribution, and (c) use quantitative data to identify correlates of discrepancy including report of attitudes toward violence, parental communication, and parents’ messages about retaliatory violence. Interviews were conducted with 101 parent/adolescent dyads. The study population consisted of African American female caretakers (n = 92; that is, mothers, grandmothers, aunts) and fathers (n = 9) and their early adolescents (mean age = 13.6). A total of 53 dyads were discrepant in identifying instigators in one or both videos. When discrepancy was present, the parent was more likely to identify the actor who reacted to the situation as at fault. In the logistic regression models, parental attitudes about retaliatory violence were a significant correlate of discrepancy, such that as parent attitudes supporting retaliatory violence increased, the odds of discrepancy decreased. The results suggest that parents and adolescents do not always view conflict situations similarly, which may inhibit effective parent–child communication, parental advice, and discipline. Individuals developing and implementing family-based violence prevention interventions need to be cognizant of the complexity of fault attribution and design strategies to promote conversations around attribution of fault and effective conflict management.