Research In Action

Cell phones and peer passengers can serve as major sources of distraction for adolescent drivers, contributing to over 20 percent of teen driver motor vehicle crashes. Engaging in handheld cell phone use increases the risk of a crash substantially, and peer passengers are also shown to increase the risk of being involved in a fatal crash. There’s a need for evidence-based, behavioral interventions grounded in theory that can address risk factors associated with driver inattention. I am developing a web-based intervention with my colleagues at CHOP and the University of Pennsylvania that shows promise in addressing this growing crash risk. We recently shared details of how we developed this intervention in the Journal of School Nursing.

We developed the intervention based on the Theory of Planned Behavior, which has been shown to work in other high-risk areas to change teen health behavior. As a first step in developing our intervention, we listened to adolescents tell us about their experiences with driver inattention: what they think contributed to cell phone use while driving and unsafe passenger interactions, as well as what they believe may work to help change unsafe behaviors.

What we found from these focus groups was extremely helpful in the development of our intervention:

• Although adolescent drivers know cell phone use in the car is unsafe, they do it anyway.
• Adolescents do not necessarily view peer passengers as dangerous; instead, they view having passengers in the car as both helpful (i.e., managing a cell phone) and harmful (i.e., showing the driver a picture on their phone).
• Adolescents believe we can change unsafe behaviors in positive ways.

Let’s Choose Ourselves

After talking to the adolescents, we developed an initial version of the web-based intervention “Let’s Choose Ourselves” and presented it to another group of adolescents. We wanted to gain their feedback on what we could do to improve it, including what they liked, didn’t like, and if they thought it would resonate with others their age. Although we couldn’t implement everything that they suggested, we were able to include plenty of examples and language adolescents could relate to, as well as an interface that they found acceptable.

Our systematic steps to developing the intervention were critical. From the beginning, we were able to use the voices of the adolescents and to integrate their suggestions. Decreasing cell phone use while driving and preventing unsafe peer passenger interactions in adolescents requires interventions that are feasible, acceptable and effective. We are excited to continue this research to encourage focused attention on driving in adolescents.