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Teens underestimate risk, overestimate vehicle, highway safety in motor vehicle accidents

August 15, 2008

Most teens' attitudes regarding trauma-related injuries, particularly those due to motor vehicle crashes, reflect an sense of invincibility and focus on fate rather than choice, according to new research published in the August issue of the Journal of the American College of Surgeons.

Teenage drivers have the highest motor vehicle crash and fatality rate of any demographic group. Injury prevention programs, which educate the public about the link between injury and high risk behaviors such as infrequent seatbelt use, impairment because of alcohol abuse, and speeding, are a requirement for accredited trauma centers. However, researchers say existing injury prevention initiatives often fall short of countering flawed beliefs and must better demonstrate - especially to teens - how and why their young age puts them at greater risk for injury.

"Students need to comprehend that it is lack of judgment, not only lack of skill, that increases the risk of injury to one's self and others. 'Not wanting something bad to happen' is simply not enough," said Najma Ahmed, MD, PhD, FACS, assistant trauma director, St. Michael's Hospital, University of Toronto. "In addition to giving teens the knowledge and teaching them the technical skills, injury prevention programs must also address teens' attitudes about being immune to illness and death as a means of changing high-risk behaviors, such as driving while impaired."

To study the effect of injury-prevention programs on injury-related knowledge and risk assessment, researchers evaluated 262 high school students participating in a one-day injury prevention program sponsored by the Toronto District School Board and St. Michael's Hospital's injury prevention program. In addition to didactic sessions, the program included a tour of an intensive care unit, where students met a young person who had either suffered a mild traumatic brain or a spinal cord injury. Students were divided into three groups: participants who completed a questionnaire eight days after participating in the program (n=85); participants who completed the questionnaire 30 days after attending the program (n=81) and a control group of students who completed a questionnaire prior to the program (n=96). One-third of the students were randomly selected to participate in a second qualitative phase four to six months after participation in the program.

The study found that teenagers consistently underestimate risk in motor vehicle situations and believe that vehicle and highway design are more likely to cause crashes than human error does. Study participants thought that because of their age and agility, they were better able to overcome the effects of poor driving conditions or intoxicants compared with more experienced drivers. Additionally, teens participating in the study believed strongly that medical care, particularly in young people, is virtually always effective.

Program participation was associated with increased ability to identify safer options (p < 0.05). However, acquired knowledge decayed substantially by day 30, with participants who completed the questionnaire on day eight performing significantly better than those on day 30 (p < 0.05). This finding stresses the need for repeated participation in injury prevention initiatives. Risk perception scores improved considerably among program participants, and this improvement was more durable over time than the acquisition of didactic knowledge. Researchers attributed this outcome to the strong emotional responses evoked during the visit to the trauma center, engagement with an injured peer, and an active reflection component embedded into the study design.

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