For the past year I have worked with fellow traffic safety researchers from CHOP and the University of Iowa as part of the Transportation Research Board Young Driver Subcommittee to complete a critical review of parent-focused interventions to improve teen driver safety. Our findings, published earlier this month in a special supplement of the Journal of Adolescent Health along with expert reviews of hazard anticipation training programs, cell phone bans, and peer passenger research, will help inform efforts to develop effective interventions to reduce teen crashes.
For our critical review, we focused on evaluated interventions targeting drivers under age 21 with a direct parent component and specific outcome goals. After conducting a comprehensive systematic search, we focused on 18 interventions. We concluded that interventions that involve one or two mailings and do not actively engage parents are not likely to be effective. Several interventions, however, did show promise in helping parents be more effective supervisors during the learner and intermediate phases of licensure -- in particular, those with a strong conceptual approach that actively engaged parents, and/or included an in-vehicle data recorder system.
My co-authors and I believe the following are essential characteristics of effective parent-focused teen driver interventions:
- theory-based: A clear logic model explains the rationale and evidence. Targets are related to key behaviors that can be changed through the intervention and have room to change.
- parent engagement: Parents are directly involved and interact with their teens.
- evidence-based and rigorously evaluated: Effective evaluation studies share certain characteristics:
- Formative research is conducted during the design process and before implementation to assess usability, acceptability, and fidelity (the extent to which the intervention is delivered as intended).
- Process and outcome levels are evaluated.
- Study conditions are randomly assigned to participants, if possible.
- Whenever possible, the use of objectively collected data, such as crash data, is prioritized.
- Results include reporting of measures of effect (e.g., risk ratios) and confidence intervals to allow for comparison across interventions.
- All randomized controlled trials are registered to avoid selective reporting of results and to adhere to standard guidelines, such as the Consolidated Standards of Reporting Trials (CONSORT) statement.
We highlight the critical importance of subjecting interventions to rigorous evaluation (and ideally peer review) prior to widespread dissemination; many state-level interventions have been widely implemented without being subject to such evaluation.
Future research is needed to help identify how interventions may fit together in a more comprehensive approach, such as guiding a family through the entire licensing process. Although none of the interventions we reviewed concretely demonstrated a reduction in teen crashes and resulting injuries and deaths, we’re optimistic that this long-term public health impact will follow.
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