Family communication patterns and teen drivers' attitudes toward driving safety

Factors Influencing Participation and Engagement in a Teen Safe Driving Intervention: A Qualitative Study

(1) Background: Few teen driving safety programs focus on increasing parental engagement with high-risk teen drivers, specifically those with a traffic violation. This study explored parents'/guardians' ('parents') experiences with a teen driving safety program, ProjectDRIVE, including facilitators and barriers to program engagement. (2) Methods: We conducted virtual, semi-structured interviews with parents who completed ProjectDRIVE, which included in-vehicle driving feedback technology and individualized virtual training with parents on effective parent-teen communication. (3) Results: Twenty interviews (with 17 females and three males) were transcribed verbatim and independently coded by three coders using systematic, open, and focused coding. Three major themes were identified: factors influencing a parent's initial decision to participate, factors influencing continued engagement, and perceived benefits of participation. The decision to participate was influenced by these subthemes: parental motivation to help their teen, perceived program usefulness, program endorsement, program incentives, parents' busy schedules, and lack of access to a car/internet. Subthemes impacting continued engagement included enhanced communication skills, teen willingness to engage, strong parental engagement, and teens' other priorities. Perceived benefits included greater self-efficacy in communication, improved communication patterns and frequency, and enhanced parent-teen relationships. (4) Conclusions: These findings may set the foundation for developing and implementing future court-ordered parent-based teen safe driving programs for teens with traffic citations.

ProjectDRIVE: study protocol for a randomized controlled trial to improve driving practices of high-risk teen drivers with a traffic violation

BACKGROUND

Teen drivers with a traffic violation are at increased risk for crashes and crash-related injuries; however, most parent-focused interventions target teen drivers with supervised learner's permits. Very few interventions are implemented at the probationary driver's license stage or target high-risk teen drivers, such as those with traffic violations. This paper describes the protocol of ProjectDRIVE, A Randomized Controlled Trial to Improve Driving Practices of High-Risk Teen Drivers with a Traffic Violation, which targets improving parent-teen communication about safe driving practices to reduce unsafe driving behaviors and traffic violation recidivism of teen drivers cited for traffic violation.

METHODS

Teen drivers (ages 16 or 17) cited for a moving violation and the parent/legal guardian most involved with the teen's driving are recruited from juvenile traffic courts following their required court hearing. After completing informed consent/assent, enrolled dyads are randomized into one of three groups using stratified block randomization: control, device feedback only, or device feedback plus parent communication training. Participating dyads are followed for 6 months with 3 months of active intervention. Using in-vehicle device and smartphone application technology, the study provides real-time and cumulative driving feedback to intervention teens and collects continually recorded, objectively measured driving outcome data throughout the teen's study participation. Primary outcomes include rates of risky driving events and unsafe driving behaviors per 1000 miles driven. Secondary outcomes include traffic violation recidivism up to 12 months following study completion and frequency and quality of parent-teen communication about safe driving practices.

DISCUSSION

Through partnership with the local juvenile traffic courts, this study integrates recruitment and randomization into existing court practices. Successfully completing this study will significantly impact juvenile traffic court's practices and policies by informing judges' decisions regarding the driving safety programs they refer to teens to prevent motor vehicle crashes and crash-related injuries and deaths. Trial registration The study was registered on ClinicalTrials.gov Registry (NCT04317664) on March 19, 2020, https://clinicaltrials.gov/study/NCT04317664 and updated on April 27, 2021. This protocol was developed per the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) Checklist.

Parenting in the context of driving: Spanish adaptation of the Family Climate for Road Safety (FCRSS) for parents and children

The Family Climate for Road Safety Scale (FCRSS; Taubman - Ben-Ari & Katz - Ben-Ami, 2013) is a comprehensive measure originally developed in Israel to assess parent-children relations in the specific context of driving. The scale consists of seven dimensions: Modelling, Feedback, Communication, Monitoring, Messages, Limits, and Non-commitment to Safety. While the original FCRSS examines the young drivers' perception across the seven domains, a version applicable to parents has also been developed by the same authors. The current study investigates the validity and reliability of the FCRSS-Spain for both parents and young drivers. A total of 377 parents (199 fathers and 178 mothers) and 243 of their children (143 daughters and 100 sons) responded to the FCRSS-Spain versions and provided sociodemographic data. In addition, the young drivers completed the Spanish version of the Multidimensional Driving Style Inventory (MDSI-Spain). Results from exploratory structural equation modelling (ESEM) indicate that six out of the seven FCRSS domains were replicable among Spanish drivers. The Messages dimension did not emerge as a consistent factor in the FCRSS for either parents or young drivers. All six factors demonstrated good internal consistency reliability (ordinal alpha coefficients exceeding 0.70), except for Non-commitment to safety. Significant differences were found between mothers and fathers in various FCRSS dimensions in the predicted direction, whereas no significant differences in FCRSS scores were found between young men and young women. As expected, associations were found between parents' scores in various FCRSS dimensions and the reckless, angry, dissociative, anxious, and careful driving styles reported by the young drivers, as well as between young drivers' FCRSS scores and their self-reported reckless, angry, dissociative, anxious, and careful driving styles.

Provider Facilitation of Parent-Adolescent Health Communication: Findings From a National Survey

INTRODUCTION

Primary care providers are well-positioned to facilitate parent-adolescent health communication. We examined provider-facilitated parent-adolescent health communication prevalence and associations with parent-adolescent health communication.

METHOD

Using data from a national survey of parent-adolescent dyads (n = 853), we calculated the prevalence of provider-facilitated parent-adolescent health communication about 11 topics as a result of adolescent's last preventive visit. We examined correlates of of provider-facilitatedparent-adolescent communication and associations with with parent-adolescent communication.

RESULTS

Eighteen percent of adolescents reported that a provider helped them talk with their parent about a health concern, with little variability by adolescent, parent, or provider characteristics. Prevalence of parent-adolescent communication because of an adolescent's last preventive visit ranged between 38.4% and 79.5%. Provider facilitation was positively associated with parent-adolescent communication for all topics.

DISCUSSION

Given the low prevalence of provider-facilitated-parent-adolescent health communication and positive associations between provider facilitation and parent-adolescent communication about multiple important health-related topics, efforts to improve this practice could be beneficial.

A Systematic Review of Parent-Child Communication Measures: Instruments and Their Psychometric Properties

Parent-child communication represents an important variable in clinical child and family psychology due to its association with a variety of psychosocial outcomes. To give an overview of instruments designed to measure the quality of parent-child communication from the child's (8-21 years) perspective and to assess the psychometric quality of these instruments, we performed a systematic literature search in Medline and PsycInfo (last: February 25, 2022). Peer-reviewed journal articles published in English with a child-rated instrument measuring the quality of parent-child communication were included. Initial screening for eligibility and inclusion, subsequent data extraction, and quality assessment were conducted by couples of review team members. Based on the screening of 5115 articles, 106 studies reported in 126 papers were included. We identified 12 parent-child communication instruments across the studies. The Parent-Adolescent Communication Scale (PACS) was used in 75% of the studies. On average, the evidence for psychometric quality of the instruments was low. Few instruments were used in clinical and at-risk samples. Several instruments are available to rate parent-child communication from the child's perspective. However, their psychometric evidence is limited and the theoretical foundation is largely undocumented. This review has limitations with regard to selection criteria and language bias.Registration PROSPERO: CRD42021255264.

Steering Teens Safe: translation to a workplace wellness program in the USA

Parent-based teen driving interventions have been shown to increase safe teen driving but few have been translated beyond the research setting. As employers focus more on total worker health, the workplace offers a unique opportunity to implement a safe teen driving program into a workplace wellness program. The aim of this study was to adapt the evidence-based, parent-focused teen safe driving program Steering Teens Safe (STS) into workplace wellness programs, and to evaluate the implementation process and effect on parent-teen communication. The Replicating Effective Programs framework was used to modify STS to fit the workplace setting. The implementation process of the STS workplace wellness program was measured using direct observation and recordings of parent communication trainings while the effectiveness was measured by parent questionnaires. Forty-five parent employees across three businesses participated in the study. STS trainers were skilled in training parents in effective communication, including using open-ended questions and reflections. Parents reported increased success in conversations with their teens regarding safe driving through increased affection, receptivity, trust and equality in conversations. Workplaces may play a key role in assisting parents with teaching their children about safe driving.

Factor structure of the family climate for road safety scale in emerging adults in the United States

The Family Climate for Road Safety Scale (FCRSS) was developed to measure parenting behaviors specific to the driving context. The original validation study found a scale structure composed of seven factors. However, this structure has not been consistently replicated. Two- and six-factor structures have also been identified. Further, this measure has not been validated in the U.S. and has not been subjected to measurement invariance testing to determine the factor structure's suitability across sex. Additionally, its ability to predict the driving style of emerging adults with varied driving experience has not been directly examined. The current study utilized exploratory and confirmatory factor analytic procedures to identify the factor structure of the FCRSS in a sample of emerging adults in the U.S. The sample consisted of 4392 students recruited from six universities. The sample was predominantly female (68.8 %), and was 83.5 % White, 6.1 % Black or African American, 5.1 % Asian American, 4.6 % biracial or multiracial, 0.4 % American Indian or Alaskan Native, and 0.2 % Pacific Islander or Hawaiian. Results indicated that a five-factor model of the FCRSS provided the best fit to the data compared to one-, two-, six-, and seven-factor models. The five factors identified for the model were: Noncommitment, Monitoring, Feedback, Communication, and Modeling. Further, invariance testing revealed that the five-factor model fit equally well for males and females. Some factors of the FCRSS predicted driving outcomes and driving styles in the expected directions. These findings have implications for family/parenting-based driving interventions for adolescents and young adults.

Family Communication Patterns and Teen Driving Intervention Effectiveness

Objectives: Teen drivers are at increased crash risk, largely due to lack of experience. Parents play a key role in influencing teen behaviors and attitudes around driving safety. Parent-involved interventions may improve teen driving safety but tend to be resource intensive and have limited scalability. In this study, we examined how family communication patterns (FCPs) impact teen risky driving and the effectiveness of a parent-focused teen driving intervention. Methods: Our data came from a large randomized controlled teen driving intervention trial. We randomized parent-teen dyads into one of 3 groups: parent communication intervention plus in-vehicle event recorder feedback; in-vehicle event recorder feedback only ; or control. The primary outcome variable was teen risky driving (self-reports and triggered events); the primary exposure variables were FCPs and intervention group. We used generalized linear models to calculate effect estimates. Results: Teens' baseline risky driving did not vary by family communication pattern. The impact of the parent-focused intervention was stronger in families with a laissez-faire FCP. The laissez-faire FCP focuses little on child conformity and downplays communication. Conclusions: These results provide a framework for targeting high-resource teen driving interventions (event recorder feedback and parent-communication training) to families with laissez-faire communication patterns to attain the greatest risk reductions.

Talking with teens about traffic safety: Initial feasibility, acceptability, and efficacy of a parent-targeted intervention for primary care settings

INTRODUCTION

The aims of the current pilot study were to evaluate the feasibility, acceptability, and preliminary efficacy of the Talking with Teens about Traffic Safety Program. The program consists of a clinic-based health coaching session with parents of adolescents at their annual well-child visit to promote parent-teen communication about teen driver safety including: a Parent Handbook that is designed to serve as a primer on teen driver safety and facilitate parent-teen communication on a variety of teen driver topics; an interactive practice driving toolset; and an endorsement of the materials by the primary care provider.

METHOD

Fifty-four parent-teen dyads (n = 108 total) were recruited from a primary care practice. Dyads were randomized (1:1) into a treatment group or a usual care group. Implementation fidelity was assessed using checklists completed by health coaches and parent interviews. After 6 months, parents reported how often they talked with their teen about 12 safe driving topics (e.g., state graduated driver licensing laws).

RESULTS

Parents in the treatment group reported more frequent discussions than parents in the control group on 7 out of the 12 topics. Fidelity data indicate that 100% of sessions were implemented as designed and were acceptable to parents.

CONCLUSIONS

The program was feasible to administer and there was evidence for preliminary efficacy. Generally, effects were larger for more infrequently discussed topics, which is to be expected due to the potential for ceiling effects on more commonly discussed topics (e.g., distracted driving). A larger multi-site study is warranted.

PRACTICAL APPLICATIONS

The results from this pilot study provide support for implementation fidelity and establish a proof-of-concept for the Talking with Teens about Traffic Safety Program. The results provide guidance for developing partnerships with pediatricians and parents to develop parent-teen communication interventions on injury prevention topics.

Steering teens safe: a randomized trial of a parent-based intervention to improve safe teen driving

BACKGROUND

Crashes are the leading cause of death for teens, and parent-based interventions are a promising approach. We assess the effectiveness of Steering Teens Safe, a parent-focused program to increase safe teen driving.

METHODS

Steering Teens Safe aimed to improve parental communication with teens about safe driving using motivational interviewing techniques in conjunction with 19 safe driving lessons. A randomized controlled trial involved 145 parent-teen dyads (70 intervention and 75 control). Intervention parents received a 45-minute session to learn the program with four follow-up phone sessions, a DVD, and a workbook. Control parents received a standard brochure about safe driving. Scores were developed to measure teen-reported quantity and quality of parental communication about safe driving. The main outcome measure was a previously validated Risky Driving Score reported by teens. Because the Score was highly skewed, a generalized linear model based on a gamma distribution was used for analysis.

RESULTS

Intervention teens ranked their parent's success in talking about driving safety higher than control teens (p = 0.035) and reported that their parents talked about more topics (non-significant difference). The Risky Driving Score was 21% lower in intervention compared to control teens (85% CI = 0.60, 1.00). Interaction between communication quantity and the intervention was examined. Intervention teens who reported more successful communication had a 42% lower Risky Driving Score (95% CI = 0.37, 0.94) than control parents with less successful communication.

CONCLUSIONS

This program had a positive although not strong effect, and it may hold the most promise in partnership with other programs, such as Driver's Education or Graduated Driver's License policies.

TRIAL REGISTRATION

ClinicalTrials.gov NCT01014923. Registered Nov. 16, 2009.