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Safe driving education programs at school: Lessons from New Zealand

Safe driving education programs at school: Lessons from New Zealand Abstract The self-reported driving and passenger behaviours of senior high school students in njuries from road crashes remain a leading cause of death and hospitalisation for teenagers. Young men appear to be especially at risk. There is a need to develop and evaluate public health programs that aim to reduce the incidence of road injuries among young people. Motorist associations continue to support the expansion and improvement of safe-driving education programs for senior high school students.’ While training programs aimed at teaching driving skills have yielded mixed results, evaluations of ‘drinking and driving’ education programs in America have indicated that such educational approaches have promise.*.’ However, it is hard t.o find published evaluations of classroom-only driver education programs in New Zealand or Australia. In NZ high schools, it is feasible to include safe driving and passenger education in the existing health education syllabus. It was decided to take advantage of this to evaluate a 10-lesson driver education program for senior high school students that was more broadly based than previously evaluated programs, which have focused on drinking and driving. The main aim of the present work was to determine whether such a schoolbased program had at least a short-term influence on the students’ self-reported behaviours and attitudes related to safe driving. This study began with the pre-testing of students early inYear 12 of high school. The driving safety behaviours of the students in this pre-treatment sample have been described in an earlier paper.4 The present paper reports the outcome of a follow-up assessment on these students about four months after they either had, or had not, experienced a program on safe driving. schools in a low to middle income area of Auckland. The control and intervention schools were matched to provide demographic profiles of a similar nature. At the outset of the study, the participants’ mean age was 15.8 years. The sampling was biased toward students performing below the academic average for Auckland schools, as the most highly achieving students often do not participate in health studies programs. The intervention and control groups did not differ on any major demographic characteristic except sex distribution; there were fewer females than males in the intervention group. Sex was therefore included as a variable in all analyses. The ethnic composition of the sample was representative ofAuckland high school students: 57% Caucasian, 10%Maori, 15% Pacific Islanders and 18% described themselves as some combination of these categories or ‘other’.At the study’s pre-treatment phase, 45% and 38% of the intervention and control groups, respectively, were drivers. At the follow-up phase, 54% of both groups were drivers. The remainder of students described themselves as non-drivers or learner drivers. Auckland, New Zealand, were assessed prior to and about four months after a school-based program for driver education. The intervention group (n=176) received a program of 10, one-hour sessions dealing with knowledge, attitudes and judgements relating to safe driving . A control group (n=146) did not receive any formal driving safety education. Analyses of pre-treatment and follow-up questionnaire responses revealed that both the intervention and control groups showed significant improvements in knowledge about safe driving over time. Males reported more risky attitudes and behaviours than females throughout the study. There were no significant differences between the intervention and control groups on any measures. In discussing these findings, particular attention is paid to the program content and the social context in which such interventions are carried out. (Aust N Z J Public Health 1998; 22: 447-50) Program and procedure The program consisted of 10 one-hour lessons based on Bandura’s social learning theory and his concept of self-efficacy. l4 The program had the following characteristics: 1. It targeted all students, whether or not they were drivers. Passenger behaviour was discussed and each exercise carefully structured to include those without driving experience. 2. The lessons were very interactive and used a wide variety of teaching techniques, such as discussions, group work and self-assessment. 3. Students were provided with detailed information. Fearful, highly arousing methods were avoided. Personal choice was emphasised, on the assumption that informed choices will tend to be safe choices. Method Participants The study comprised an intervention group of 176 and a control group of 146 Year 12 students, drawn from six state high VOL. Correspondenceto: Dr Niki Harre, Faculty o Science, The f University o Auckland, Private Bag 92019, f Auckland 1, New Zealand. 22 NO. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH Harre and Field 4. The students' perception of their personal risk of injury was strongly targeted with information on injury statistics, the effects of alcohol and a session on risk perception. 5. Students were given opportunities to practise the skills related to safe behaviours through role play. Peer resistance skills (such as refusing a drink when driving) were emphasised. 6 . There was a session on how to avoid making poor judgements associated with conforming to unsafe driving, impulsivity, feeling invulnerable, macho tendencies and lack of respect for road rules and authority figures. 7. Teachers were encouraged to invite a crash victim of the students' own age to talk about his or her experiences. A training day was held for the health teachers involved and they were presented with detailed written descriptions of lesson plans and all the necessary worksheets. Near the beginning of the academic year, a pre-treatment questionnaire concerning safe driving attitudes and behaviour was distributed to participating students. Between three and five months after the initial survey, the intervention group received the program. Immediately upon its completion, two of the three intervention school groups were surveyed. Approximately four months later, all the students in both the intervention and control groups received a follow-up survey to see if the program had lead to positive changes in the attitudes and behaviour of the intervention group. phase.4 Checks were also made on possible differences between schools in the occurrence of critical incidents regarding road safety during the course of the study. No such differences were found and no major incidences were reported. Results Initial analysis indicated that there were no significant differences between schools in the measures used in each phase of the study. There were also no significant differences between the selfreported driving and passenger behaviours of the intervention group before and immediately after intervention. Results of analyses of the full sample (drivers and non-drivers) before the intervention and at follow-up are reported first, and then the results pertaining specifically to those who were drivers. Due to the number of analyses being camed out, an alpha level of .01 was used. All participants Univariate ANOVAs were performed on the items pertaining to both drivers and non-drivers to test for pre/follow-up, male/female and intervention/control group differences. The measures analysed were reported attitudes and behaviours relating to drinking and driving, seat-belt wearing and an overall score for knowledge of safe driving. A significant difference was revealed between the subjects' pre-test and follow-up results on the knowledge score, with subjects in both groups showing significant improvements in knowledge about safe driving over time, F( 1,305)=24.41,p<O.OOOI. There was no interaction between time and group, suggesting that subjects in both the intervention and control group changed in similar ways. There were no significant effects for any other comparisons. Table 1 shows the means and standard deviations for each of the subgroups in the study on these measures. The apparent reduction in frequency of being the passenger of a drinking driver shown in Table 1 was probably artefactual, since the timeframe given in the relevant question had to be shortened from the pre-treatment to the follow-up phase. Measures The questionnaires measured risky behaviours and intentions with regard to driving and being driven. Recent studies have found a positive correlation between this type of behaviour and crashes and violation^.^,^ The following areas were assessed for the purposes of this study: drinking and driving attitudes and behaviours, compliance with traffic laws such as speed limits and seat belt wearing, a 13-item 6-point Likert scale which asked about frequency of engaging in illegal and unsafe actions, such as dangerous passing and going through red lights (Unsafe Driving Behaviours Scale), a 10-item test on knowledge about safe driving, and a 5-point Likert scale consisting of 27 items which asked about tendencies towards the unsafe judgements outlined in item 5 in the description of the study (Dangerous Thought Patterns Scale). Further details about the scales used in these assessments appear in a report of this study's first Driver-only measures Table 2 shows the means and standard deviations for the subgroups on the 10 measures that pertained to only those who were drivers. Univariate ANOVA's tested for pre/follow-up, malelfemale Table 1:Self-reported behaviours and attitudes of all participantsat pre-test and follow-up. Intervention (n=176) pre-test follow-up male female male female Control (1-1446) pre-test follow-up male female male female Attitude towards drink drivinga Intention to be passenger of drinking driverb Frequency of being passenger of drinking driverC Seat belt wearingd Knowledge scoree mean SD mean SD mean SD mean SD mean SD (a) Scale: 1 to 4. The lower the score the fewer drinks believed accemable bebre drivfna. (6)Scale: 1 to 3. The lower the score the greater the intention. (c) Scale: 1 to 4. The lower the score the lesser the frequency (d) Scale: 1 to 4. The lower the score the greafer the frequency (e) Scale: 1 to 10. The higher the score the greater the knowledge. Note: n's for individual variables varied slightly from the maximum due to missing responses. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH VOL. 22 NO. 4 Safe driving education programs at school: Lessons from NZ and interventionkontrol group differences. The only significant effects were for gender. All the gender differences revealed showed the males to have more risky attitudes or to engage in more unsafe driving practices than the females. Males were more likely than females to engage in the behaviours on the Unsafe Driving Behaviours Scale: F( 1,138)=8.88,p<O.O1. Males scored significantly more highly than females on four out of the five sub-scales on the Dangerous Thought Palterns Scale. They were more likely to report thinking that was categorised as invulnerable, impulsive, conforming to anti-social behaviours and macho in style. Discussion These results appear to show that the education program had no impact on the way the students responded in the follow-up survey. Males reported more risky attitudes and behaviours than females, as has been discussed elsewhere4 However, there was no evidence that the program itself affected the male and female students differently. The implications of the findings are discussed below. In particular, the possible problems with the approach of the present intervention and general issues concerning the delivery of driver education programs in schools are looked at. Strategies for overcoming these problems are also examined. The viability of the reasoned argument approach It is possible that some aspects of the approach and content of the program were not ideal, although there was a strong element of skills training, which is probably the most effective form of health education.’. * The program’s unemotional, low fear approach and its emphasis on reasoned argument may have reduced its effectiveness. The current opinion on the use of fear as a motivator for change is mixed.’,1° Teenagers themselves seem to approve of high fear methods.” It may be that high fear and arousal methods are more effective than those based on reasoned argument, as long as the young people are given strategies that they believe would be effective in avoiding the negative outcome. In light of the finding that some high school drug abuse prevention programs based on a liberal, non-emotional approach appear to increase experimentation with drugs, it has been pointed out that ‘the facts’, in the absence of highly emotional content, may result in removing excessive anxiety concerning the behaviour in question and therefore lead to an increase in experimentation.12 The current program presented ‘the facts’ in a way that was intended to be interesting but not fearful. It also encouraged a sense of individual choice and responsibility. Is it therefore possible that it paved the way for increased experimentation with risky driving? While there was no direct evidence for this, the program may have had mixed effects which effectively cancelled each other out. It has been suggested that school students exposed to liberal programs may become more honest in their responses to a post-test due to having openly discussed their behaviour.6J2This could have concealed any possible effects of the intervention on the self-report measure. A further feature of the current program was that instead of directing students to specific alternatives to unsafe behaviours, it encouraged them to explore a range of options. As noted in a survey of NZ public health and safety campaigns, the need to define the target behaviour and provide the audience with a reasonable and practical alternative is p a r a m ~ u n t .On similar lines, the health belief ’~ model suggests that the subject of an intervention must believe that the ‘safe’ behaviour presented would be greatly effective in reducing the risk of injury. A belief in the effectiveness of the ‘safe’ behaviour, along with a belief that the subject can perform the behaviour, is essential for a sense of self-efficacy with regard to a behaviour.I4 It is possible that there was insufficient clarity in the pro- Table 2: Self-reported behaviours and attitudes of drivers at pre-test and follow-up. Intervention In=78) pre-test follow-up male female male female Control (n=67) pre-test follow-up male female male female Intention to drink and drivea Frequency of drinking and drivingb Fastest meed - oDen roadC mean SD mean SD mean SO SD Fastest speed - around townd mean Unsafe Driving Behaviours Scalee Anti-authoritarianthinkino‘ . , mean so mean SD Invulnerable thinking‘ Impulsive thinking’ Conforming t o anti-social thinking‘ Macho thinking‘ mean SD mean SD mean SD mean so 2.92 0.29 1 .oo 0.00 2.75 0.62 2.17 1 .oo 1.49 0.33 3.57 0.66 3.51 0.49 3.78 0.35 3.8 0.63 3.27 0.55 2.85 0.37 1.08 0.27 2.50 0.91 2.07 1 .oo 1.49 0.40 3.79 0.58 3.40 0.55 3.70 0.51 4.03 0.76 3.31 0.63 (a) Scale: 1 to 3 The lower the score the greater the intention. . (b) Scale: 1 to 4. The lower the score the lesser the frequency (c) Scale: 1 = 80 km to 4 = 120+ km. (d) Scale: 1 = 50 km to 4 = 80+ km. (el Scale: 1 to 6. The lower the score the lesser the amount of unsafe driving. (f) Scale: 1 to 5. The lower the score the stronger the thought pattern. Note: n’s for individual variables wried slightly from the maximum due to missing responses. VOL. 22 NO. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH Harre and Field gram about the nature of safe versus unsafe driving and passenger behaviours and how to reduce them. Finally, this program emphasised peer resistance skills, in accord with current thinking that these are a primary cause of risk behaviour in adolescence. However, there is a mounting number of studies which suggest that direct peer pressure is not a major cause of drinking or drinking and driving.l’ This may have meant the program was not placing sufficient emphasis on more important determinants of risky driving behaviour. Can driving attitudes be changed through school programs? To be widely adopted, school driver education programs must be able to be effectively delivered by school teachers. While the current program was positively viewed by teachers, they described a number of interruptions to the teaching of it, including ‘urgent’ school activities that sometimes took priority over a lesson. Their final estimates of how well they followed the program ranged from 70% to 90%. The reality is that in New Zealand schools, ‘health’or ‘lifeskills’ teaching is not subject to the same scrutiny as academic subjects in which there are tests and exams. This can compromise the effectiveness with which driver education and other healthrelated programs are delivered. The literature on health education has suggested two further drawbacks associated with the school context. One of these is that many young people who are at the highest risk for various problematic behaviours do not attend school regularly and so may not be exposed to all the message^.^^.^^ The other is that the school environment is representative of adult authority and so is not conducive to encouraging adolescents to change their behaviour.16 The effectiveness of school-based health education may be very limited if it is not part of a larger campaign to develop safer driving behaviours.’ Driving behaviour is social not just in the sense that it, in common with other health and safety behaviours, is learnt primarily by modelling significant others, but it also takes place in a social context. It has been suggested that there may be a critical level of the driving public who have to be persuaded before a safety innovation is adopted.l71f we accept the concept of a ‘critical level’ (said to be in the region of 20-30%). then we must also accept the need for programs that promote safety strategies to be run on a large scale. It is not difficult to imagine how the newly educated driver, initially attempting to be conscientious is quickly corrupted by the poor safety habits of other drivers on the road. Another important element in the social context of driving is the effective detection of violations and unsafe driving by policing agencies. The high levels of speeding and other violations reported in the first phase of this study suggest that current policing levels in urban environments in New Zealand are not a d e q ~ a t e . ~ In conclusion, it would certainly be unwise to deduce from evaluations of this and other ‘unsuccessful’ programs that driver education should be abandoned. Instead, it could be argued that such programs should be retained and refined in conjunction with other safety campaigns. Comprehensive safety campaigns, that include an educational component have been run in Japan and Norway with One possible strategy may be for a high degree of success.IR.IY schools themselves to try and affect community norms. This type of approach has successfully been trialed in the US, where in an attempt to reduce adolescents’ involvement in problem areas such as drug and alcohol abuse, inter-personal violence, teenage pregnancy and HIV infection, the students worked for social change to reduce these problems for the entire community.20This kind of approach could be readily translated to the driver education area, where it would be possible to get students designing traffic safety campaigns (perhaps aimed at young children), and investigating and making submissions concerning traffic laws. It should also be possible for the students to work with the traffic safety co-ordinator of local councils in designing interventions aimed at their local communities. The various problems associated with the implementation and evaluation of this program are common problems faced by many programs for driving safety. Nevertheless, it is desirable that driving for safety is retained and integrated into school health programs, as it is a health issue that needs widespread attention. Acknowledgments Dr Barry Kirkwood’s key role in the development and implementation of this study is gratefully acknowledged. This research was funded by the Accident Rehabilitation and Compensation Insurance Corporation of New Zealand. John Gribben and Michael Corballis are thanked for their advice and help with data analyses. Finally, thanks are due to the students and teachers who took part in the study. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

Safe driving education programs at school: Lessons from New Zealand

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Publisher
Wiley
Copyright
Copyright © 1998 Wiley Subscription Services, Inc., A Wiley Company
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/j.1467-842X.1998.tb01412.x
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Abstract

Abstract The self-reported driving and passenger behaviours of senior high school students in njuries from road crashes remain a leading cause of death and hospitalisation for teenagers. Young men appear to be especially at risk. There is a need to develop and evaluate public health programs that aim to reduce the incidence of road injuries among young people. Motorist associations continue to support the expansion and improvement of safe-driving education programs for senior high school students.’ While training programs aimed at teaching driving skills have yielded mixed results, evaluations of ‘drinking and driving’ education programs in America have indicated that such educational approaches have promise.*.’ However, it is hard t.o find published evaluations of classroom-only driver education programs in New Zealand or Australia. In NZ high schools, it is feasible to include safe driving and passenger education in the existing health education syllabus. It was decided to take advantage of this to evaluate a 10-lesson driver education program for senior high school students that was more broadly based than previously evaluated programs, which have focused on drinking and driving. The main aim of the present work was to determine whether such a schoolbased program had at least a short-term influence on the students’ self-reported behaviours and attitudes related to safe driving. This study began with the pre-testing of students early inYear 12 of high school. The driving safety behaviours of the students in this pre-treatment sample have been described in an earlier paper.4 The present paper reports the outcome of a follow-up assessment on these students about four months after they either had, or had not, experienced a program on safe driving. schools in a low to middle income area of Auckland. The control and intervention schools were matched to provide demographic profiles of a similar nature. At the outset of the study, the participants’ mean age was 15.8 years. The sampling was biased toward students performing below the academic average for Auckland schools, as the most highly achieving students often do not participate in health studies programs. The intervention and control groups did not differ on any major demographic characteristic except sex distribution; there were fewer females than males in the intervention group. Sex was therefore included as a variable in all analyses. The ethnic composition of the sample was representative ofAuckland high school students: 57% Caucasian, 10%Maori, 15% Pacific Islanders and 18% described themselves as some combination of these categories or ‘other’.At the study’s pre-treatment phase, 45% and 38% of the intervention and control groups, respectively, were drivers. At the follow-up phase, 54% of both groups were drivers. The remainder of students described themselves as non-drivers or learner drivers. Auckland, New Zealand, were assessed prior to and about four months after a school-based program for driver education. The intervention group (n=176) received a program of 10, one-hour sessions dealing with knowledge, attitudes and judgements relating to safe driving . A control group (n=146) did not receive any formal driving safety education. Analyses of pre-treatment and follow-up questionnaire responses revealed that both the intervention and control groups showed significant improvements in knowledge about safe driving over time. Males reported more risky attitudes and behaviours than females throughout the study. There were no significant differences between the intervention and control groups on any measures. In discussing these findings, particular attention is paid to the program content and the social context in which such interventions are carried out. (Aust N Z J Public Health 1998; 22: 447-50) Program and procedure The program consisted of 10 one-hour lessons based on Bandura’s social learning theory and his concept of self-efficacy. l4 The program had the following characteristics: 1. It targeted all students, whether or not they were drivers. Passenger behaviour was discussed and each exercise carefully structured to include those without driving experience. 2. The lessons were very interactive and used a wide variety of teaching techniques, such as discussions, group work and self-assessment. 3. Students were provided with detailed information. Fearful, highly arousing methods were avoided. Personal choice was emphasised, on the assumption that informed choices will tend to be safe choices. Method Participants The study comprised an intervention group of 176 and a control group of 146 Year 12 students, drawn from six state high VOL. Correspondenceto: Dr Niki Harre, Faculty o Science, The f University o Auckland, Private Bag 92019, f Auckland 1, New Zealand. 22 NO. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH Harre and Field 4. The students' perception of their personal risk of injury was strongly targeted with information on injury statistics, the effects of alcohol and a session on risk perception. 5. Students were given opportunities to practise the skills related to safe behaviours through role play. Peer resistance skills (such as refusing a drink when driving) were emphasised. 6 . There was a session on how to avoid making poor judgements associated with conforming to unsafe driving, impulsivity, feeling invulnerable, macho tendencies and lack of respect for road rules and authority figures. 7. Teachers were encouraged to invite a crash victim of the students' own age to talk about his or her experiences. A training day was held for the health teachers involved and they were presented with detailed written descriptions of lesson plans and all the necessary worksheets. Near the beginning of the academic year, a pre-treatment questionnaire concerning safe driving attitudes and behaviour was distributed to participating students. Between three and five months after the initial survey, the intervention group received the program. Immediately upon its completion, two of the three intervention school groups were surveyed. Approximately four months later, all the students in both the intervention and control groups received a follow-up survey to see if the program had lead to positive changes in the attitudes and behaviour of the intervention group. phase.4 Checks were also made on possible differences between schools in the occurrence of critical incidents regarding road safety during the course of the study. No such differences were found and no major incidences were reported. Results Initial analysis indicated that there were no significant differences between schools in the measures used in each phase of the study. There were also no significant differences between the selfreported driving and passenger behaviours of the intervention group before and immediately after intervention. Results of analyses of the full sample (drivers and non-drivers) before the intervention and at follow-up are reported first, and then the results pertaining specifically to those who were drivers. Due to the number of analyses being camed out, an alpha level of .01 was used. All participants Univariate ANOVAs were performed on the items pertaining to both drivers and non-drivers to test for pre/follow-up, male/female and intervention/control group differences. The measures analysed were reported attitudes and behaviours relating to drinking and driving, seat-belt wearing and an overall score for knowledge of safe driving. A significant difference was revealed between the subjects' pre-test and follow-up results on the knowledge score, with subjects in both groups showing significant improvements in knowledge about safe driving over time, F( 1,305)=24.41,p<O.OOOI. There was no interaction between time and group, suggesting that subjects in both the intervention and control group changed in similar ways. There were no significant effects for any other comparisons. Table 1 shows the means and standard deviations for each of the subgroups in the study on these measures. The apparent reduction in frequency of being the passenger of a drinking driver shown in Table 1 was probably artefactual, since the timeframe given in the relevant question had to be shortened from the pre-treatment to the follow-up phase. Measures The questionnaires measured risky behaviours and intentions with regard to driving and being driven. Recent studies have found a positive correlation between this type of behaviour and crashes and violation^.^,^ The following areas were assessed for the purposes of this study: drinking and driving attitudes and behaviours, compliance with traffic laws such as speed limits and seat belt wearing, a 13-item 6-point Likert scale which asked about frequency of engaging in illegal and unsafe actions, such as dangerous passing and going through red lights (Unsafe Driving Behaviours Scale), a 10-item test on knowledge about safe driving, and a 5-point Likert scale consisting of 27 items which asked about tendencies towards the unsafe judgements outlined in item 5 in the description of the study (Dangerous Thought Patterns Scale). Further details about the scales used in these assessments appear in a report of this study's first Driver-only measures Table 2 shows the means and standard deviations for the subgroups on the 10 measures that pertained to only those who were drivers. Univariate ANOVA's tested for pre/follow-up, malelfemale Table 1:Self-reported behaviours and attitudes of all participantsat pre-test and follow-up. Intervention (n=176) pre-test follow-up male female male female Control (1-1446) pre-test follow-up male female male female Attitude towards drink drivinga Intention to be passenger of drinking driverb Frequency of being passenger of drinking driverC Seat belt wearingd Knowledge scoree mean SD mean SD mean SD mean SD mean SD (a) Scale: 1 to 4. The lower the score the fewer drinks believed accemable bebre drivfna. (6)Scale: 1 to 3. The lower the score the greater the intention. (c) Scale: 1 to 4. The lower the score the lesser the frequency (d) Scale: 1 to 4. The lower the score the greafer the frequency (e) Scale: 1 to 10. The higher the score the greater the knowledge. Note: n's for individual variables varied slightly from the maximum due to missing responses. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH VOL. 22 NO. 4 Safe driving education programs at school: Lessons from NZ and interventionkontrol group differences. The only significant effects were for gender. All the gender differences revealed showed the males to have more risky attitudes or to engage in more unsafe driving practices than the females. Males were more likely than females to engage in the behaviours on the Unsafe Driving Behaviours Scale: F( 1,138)=8.88,p<O.O1. Males scored significantly more highly than females on four out of the five sub-scales on the Dangerous Thought Palterns Scale. They were more likely to report thinking that was categorised as invulnerable, impulsive, conforming to anti-social behaviours and macho in style. Discussion These results appear to show that the education program had no impact on the way the students responded in the follow-up survey. Males reported more risky attitudes and behaviours than females, as has been discussed elsewhere4 However, there was no evidence that the program itself affected the male and female students differently. The implications of the findings are discussed below. In particular, the possible problems with the approach of the present intervention and general issues concerning the delivery of driver education programs in schools are looked at. Strategies for overcoming these problems are also examined. The viability of the reasoned argument approach It is possible that some aspects of the approach and content of the program were not ideal, although there was a strong element of skills training, which is probably the most effective form of health education.’. * The program’s unemotional, low fear approach and its emphasis on reasoned argument may have reduced its effectiveness. The current opinion on the use of fear as a motivator for change is mixed.’,1° Teenagers themselves seem to approve of high fear methods.” It may be that high fear and arousal methods are more effective than those based on reasoned argument, as long as the young people are given strategies that they believe would be effective in avoiding the negative outcome. In light of the finding that some high school drug abuse prevention programs based on a liberal, non-emotional approach appear to increase experimentation with drugs, it has been pointed out that ‘the facts’, in the absence of highly emotional content, may result in removing excessive anxiety concerning the behaviour in question and therefore lead to an increase in experimentation.12 The current program presented ‘the facts’ in a way that was intended to be interesting but not fearful. It also encouraged a sense of individual choice and responsibility. Is it therefore possible that it paved the way for increased experimentation with risky driving? While there was no direct evidence for this, the program may have had mixed effects which effectively cancelled each other out. It has been suggested that school students exposed to liberal programs may become more honest in their responses to a post-test due to having openly discussed their behaviour.6J2This could have concealed any possible effects of the intervention on the self-report measure. A further feature of the current program was that instead of directing students to specific alternatives to unsafe behaviours, it encouraged them to explore a range of options. As noted in a survey of NZ public health and safety campaigns, the need to define the target behaviour and provide the audience with a reasonable and practical alternative is p a r a m ~ u n t .On similar lines, the health belief ’~ model suggests that the subject of an intervention must believe that the ‘safe’ behaviour presented would be greatly effective in reducing the risk of injury. A belief in the effectiveness of the ‘safe’ behaviour, along with a belief that the subject can perform the behaviour, is essential for a sense of self-efficacy with regard to a behaviour.I4 It is possible that there was insufficient clarity in the pro- Table 2: Self-reported behaviours and attitudes of drivers at pre-test and follow-up. Intervention In=78) pre-test follow-up male female male female Control (n=67) pre-test follow-up male female male female Intention to drink and drivea Frequency of drinking and drivingb Fastest meed - oDen roadC mean SD mean SD mean SO SD Fastest speed - around townd mean Unsafe Driving Behaviours Scalee Anti-authoritarianthinkino‘ . , mean so mean SD Invulnerable thinking‘ Impulsive thinking’ Conforming t o anti-social thinking‘ Macho thinking‘ mean SD mean SD mean SD mean so 2.92 0.29 1 .oo 0.00 2.75 0.62 2.17 1 .oo 1.49 0.33 3.57 0.66 3.51 0.49 3.78 0.35 3.8 0.63 3.27 0.55 2.85 0.37 1.08 0.27 2.50 0.91 2.07 1 .oo 1.49 0.40 3.79 0.58 3.40 0.55 3.70 0.51 4.03 0.76 3.31 0.63 (a) Scale: 1 to 3 The lower the score the greater the intention. . (b) Scale: 1 to 4. The lower the score the lesser the frequency (c) Scale: 1 = 80 km to 4 = 120+ km. (d) Scale: 1 = 50 km to 4 = 80+ km. (el Scale: 1 to 6. The lower the score the lesser the amount of unsafe driving. (f) Scale: 1 to 5. The lower the score the stronger the thought pattern. Note: n’s for individual variables wried slightly from the maximum due to missing responses. VOL. 22 NO. 4 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH Harre and Field gram about the nature of safe versus unsafe driving and passenger behaviours and how to reduce them. Finally, this program emphasised peer resistance skills, in accord with current thinking that these are a primary cause of risk behaviour in adolescence. However, there is a mounting number of studies which suggest that direct peer pressure is not a major cause of drinking or drinking and driving.l’ This may have meant the program was not placing sufficient emphasis on more important determinants of risky driving behaviour. Can driving attitudes be changed through school programs? To be widely adopted, school driver education programs must be able to be effectively delivered by school teachers. While the current program was positively viewed by teachers, they described a number of interruptions to the teaching of it, including ‘urgent’ school activities that sometimes took priority over a lesson. Their final estimates of how well they followed the program ranged from 70% to 90%. The reality is that in New Zealand schools, ‘health’or ‘lifeskills’ teaching is not subject to the same scrutiny as academic subjects in which there are tests and exams. This can compromise the effectiveness with which driver education and other healthrelated programs are delivered. The literature on health education has suggested two further drawbacks associated with the school context. One of these is that many young people who are at the highest risk for various problematic behaviours do not attend school regularly and so may not be exposed to all the message^.^^.^^ The other is that the school environment is representative of adult authority and so is not conducive to encouraging adolescents to change their behaviour.16 The effectiveness of school-based health education may be very limited if it is not part of a larger campaign to develop safer driving behaviours.’ Driving behaviour is social not just in the sense that it, in common with other health and safety behaviours, is learnt primarily by modelling significant others, but it also takes place in a social context. It has been suggested that there may be a critical level of the driving public who have to be persuaded before a safety innovation is adopted.l71f we accept the concept of a ‘critical level’ (said to be in the region of 20-30%). then we must also accept the need for programs that promote safety strategies to be run on a large scale. It is not difficult to imagine how the newly educated driver, initially attempting to be conscientious is quickly corrupted by the poor safety habits of other drivers on the road. Another important element in the social context of driving is the effective detection of violations and unsafe driving by policing agencies. The high levels of speeding and other violations reported in the first phase of this study suggest that current policing levels in urban environments in New Zealand are not a d e q ~ a t e . ~ In conclusion, it would certainly be unwise to deduce from evaluations of this and other ‘unsuccessful’ programs that driver education should be abandoned. Instead, it could be argued that such programs should be retained and refined in conjunction with other safety campaigns. Comprehensive safety campaigns, that include an educational component have been run in Japan and Norway with One possible strategy may be for a high degree of success.IR.IY schools themselves to try and affect community norms. This type of approach has successfully been trialed in the US, where in an attempt to reduce adolescents’ involvement in problem areas such as drug and alcohol abuse, inter-personal violence, teenage pregnancy and HIV infection, the students worked for social change to reduce these problems for the entire community.20This kind of approach could be readily translated to the driver education area, where it would be possible to get students designing traffic safety campaigns (perhaps aimed at young children), and investigating and making submissions concerning traffic laws. It should also be possible for the students to work with the traffic safety co-ordinator of local councils in designing interventions aimed at their local communities. The various problems associated with the implementation and evaluation of this program are common problems faced by many programs for driving safety. Nevertheless, it is desirable that driving for safety is retained and integrated into school health programs, as it is a health issue that needs widespread attention. Acknowledgments Dr Barry Kirkwood’s key role in the development and implementation of this study is gratefully acknowledged. This research was funded by the Accident Rehabilitation and Compensation Insurance Corporation of New Zealand. John Gribben and Michael Corballis are thanked for their advice and help with data analyses. Finally, thanks are due to the students and teachers who took part in the study.

Journal

Australian and New Zealand Journal of Public Health – Wiley

Published: Aug 1, 1998

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