The study will translate an evidence-based approach to improve adolescent motor vehicle safety. Motor vehicle crashes are the leading cause of death among 16-19-year olds, and a major threat to teens'well being, yet are seldom addressed by Primary Care Providers (PCPs) as they advise families about health issues. This study's purpose is to evaluate the translation of Checkpoints, an evidence-based, parent program to set limits on and monitor teen driving, for delivery via a brief intervention by primary care providers (PCPs) of teens. Checkpoints can enhance adherence to Graduated Driver Licensing restrictions, and has been shown to increase the use of a parent/teen driving agreement, and to reduce teens'risky driving, violations, and crashes. The proposed brief PCP intervention will refer parents of teens to the Checkpoints Web Program, a sustainable and appealing delivery mode that could be widely adopted and institutionalized. There are four study aims.
Aim 1 : Adapt Checkpoints for dissemination by PCPs and over the Internet, and examine the PCP/Checkpoints Web Program's adaptability and fidelity. Checkpoints'effectiveness in reaching families through PCPs and over the Web has not been examined. The content of the effective Checkpoints program delivered previously to parents in driver education classes will be adapted, with part of it delivered by the PCPs in a brief intervention with parents and a more extensive part provided by the Checkpoints Web Program to which parents will be referred. Adaptation and fidelity will be evaluated.
Aim 2 : Distribute the PCP/Checkpoints Web Program through pediatric and family medicine offices. In collaboration with the American Academy of Pediatrics, practices will be recruited through two national networks, Pediatric Research in Office Settings (PROS) and the Electronic Primary Care Research Network (ePCRN), a """"""""network of networks"""""""" group of family medicine practitioners. Participating practice staff and PCPs will be trained to identify eligible families, deliver the brief intervention, assist families to access the Checkpoints Web Program on-line, and implement specific promotional and reminder activities.
Aim 3 : Identify practice, PCP, and parental factors related to the dissemination, implementation, institutionalization, adoption, and health outcomes of the PCP/Checkpoints Web Program. Variation in adoption, implementation, and institutionalization of the PCP/Checkpoints Web Program will be measured at three levels (practices, individual PCPs, and individual parents) for their association with parents'frequency of accessing the website, downloading materials, and using the program.
Aim 4 : Measure the feasibility and sustainability of the PCP/Checkpoints Web Program in terms of the economic costs associated with dissemination, implementation, institutionalization, and health outcomes. Feasibility of the approach taken to disseminate and implement the program will be evaluated, both in terms of monetary and opportunity costs. Costs related to website maintenance, as well as costs to PCPs, their practices, and parents will be assessed.
Motor vehicle crashes are the leading cause of death and injury among teenagers, with 4,544 deaths among those aged 16-19 and nearly 400,000 nonfatal injuries that required treatment in emergency departments in 2005. While Graduated Driver Licensing systems for teen drivers have led to crash reductions, other effective approaches are needed, especially to guide parents in keeping their teenagers safe as they gain driving experience in their first months of licensure. This study's purpose is to evaluate the translation of Checkpoints, an evidence-based, parent intervention to set limits on and monitor teen driving, for delivery via a brief intervention by primary care providers of teenagers with referral to an interactive web site, thus offering a sustainable and appealing delivery mode that could be widely adopted and institutionalized to reduce the high toll of traffic crashes on teenagers.