DUIResearch on Prevention in Adolescents
Drunk driving is a major social problem. Estimates suggest that between 30% and 50% of all fatal crashes are alcohol related. These estimates translate into approximately 15,000 to 25,000 deaths annually involving the irresponsible use of alcohol. The financial costs associated with alcohol related crashes in the United States have been estimated in terms of billions of dollars annually in lost wages, medical expenses, property damage, legal fees, and insurance costs. Of course, there is no way of estimating the emotional costs to individuals who have lost members of their families and friends in alcohol related accidents.
It is well known that younger drivers are over-represented in driving fatalities due to drunk driving. My research focuses on changing older adolescent behavior with respect to drunk driving. Adolescents represent an important target group for several reasons. First, there is evidence indicating that the leading cause of death among young Americans is alcohol-related traffic accidents. Second, adolescents represent new drivers who are just embarking on a life behind the wheel of an automobile. The establishment of safe practices and orientations vis-a-vis drunk driving at this time is critical. Although it is the case that high school aged adolescents are under the legal age for alcohol consumption, estimates suggest that between 70% to 90% of all senior high school students experiment with alcohol. Thus, the reduction of drunk driving among this demographic group seems important.
My previous NIAAA funded research (with colleagues from the University at Albany, SUNY) has identified empirically the kinds of information that needs to be conveyed to teenagers in order to reduce drunk driving. Such information potentially could be conveyed to the teen by schools, peers (SADD), the media, parents . A review of school based treatments of drunk driving indicates that such treatments are limited in scope. Education about drunk driving typically occurs in mandatory health classes in which there is tremendous competition between topics (e.g., nutrition, alcohol consumption, drugs, sex) in terms of class coverage and class time. Drunk driving is typically addressed only superficially and in the context of more general lectures on alcohol. It seems unlikely that schools will devote large amounts of class time to a specialized topic such as drunk driving. Without special efforts on the part of schools to incorporate the kinds of educational materials that our previous research suggests is most effective, it is evident that other sources of information need to be developed.
One of the lines research I have been conducting will develop educational materials for parents of adolescents. It will teach parents how to develop good communication patterns with their teenager. It will teach them how to initiate communication with their adolescent about drunk driving, even when the family history is one of minimal parent-adolescent communication. The materials will teach parents what information will be most effective in convincing their teenager not to drive drunk and will teach parents the most effective ways of presenting this information to their teen. We will then examine the impact of this intervention on adolescent drunk driving behavior. There are several advantages to this approach. First, it will have the general effect of improving communication patterns between parents and teens. Second, it will permit parents to make value judgments about the kinds of information that their teen should be given. For example, most research on determinants of drunk driving focuses on the act of drunk driving per se (e.g., the increased risk of getting in a serious accident). Our research suggests that an important set of variables that impinge on drunk driving is how an individual construes alternative courses of action to driving drunk as well. When faced with a situation where he or she has consumed too much alcohol, an individual can drive drunk or pursue some other course of action (e.g., call a taxi, stay overnight, ask a friend for a ride home). If none of these alternatives appear viable or desirable, the individual is more likely to drive drunk, everything else being equal. It is possible to educate adolescents about what alternatives to driving drunk might exist and how to most effectively pursue these alternatives. However, our discussions with school administrators has indicated a reluctance to incorporate such information into school based programs. The primary objection is that by providing effective alternatives, one might be unwittingly encouraging adolescents to drink alcohol. This viewpoint holds that the risk to one's life by driving drunk is a deterrent to drinking alcohol and that by removing this deterrent, it is more likely that the teenager will drink alcohol, which is both illegal and undesirable. Administrators fear the controversy that might ensue from parents of students if such an approach is taken. With a parent based education approach, parents can be appraised of the potential relevance of alternatives to driving drunk and then make their own decisions about whether to address this issue and the kinds of alternatives that are acceptable to them.
The traditional stereotype among many lay persons and social scientists alike is that adolescence is a time when parents lose their influence on their children and that adolescent behavior is primarily a function of peer influences. This viewpoint is being increasingly challenged across a wide range of research domains. In addition to my research program on drunk driving, my colleagues at the University at Albany, Drs. James Jaccard and Patricia Dittus, have been actively studying parental influences on teenagers in the context of premarital sex and unintended pregnancy. Their research efforts have clearly shown that characterizations of minimal parental influence are based on data that are conceptually weak and methodologically suspect and that when approached from more compelling theoretical frameworks, parental influence on teen behavior can be substantial.
There is a growing body of social science literature on parent education programs in general and their effectiveness in influencing parental behavior. Much of this research is summarized in the recent Handbook on Parent Education. The forms of parent based interventions are varied, including school based programs, parenting conferences, written brochures on effective parenting, video-based programs of parenting, and parent teacher interactions, to name a few. Programs have been aimed at influencing such diverse child behaviors as school performance, sexual behavior, health behaviors, and physical development, to name only a few. It is evident from this literature that parenting education programs can be effective, but that they are not always so. I hope to contribute to this general body of knowledge by developing an approach to designing parent education programs aimed at changing specific adolescent problem behaviors. To the extent that we can show our approach produces tangible results in an area such as drunk driving, then this will encourage researchers to use the approach in other research domains to determine if it can form the skeleton for programs in other domains.
Only a few published accounts of the use of parent education program as a means of influencing drunk driving behavior in adolescence have been published in the scientific literature. Atkin reports a parent intervention program that led to increased concern on the part of parents for teen drunk driving and which increased communication between parents and teens about this topic. However, the program did not show evidence of effects on teen drunk driving behavior. McPherson developed a program to increase support networks for parents to discuss alcohol issues with their teens and to convey information about drunk driving and alcohol consumption. The results showed that parents tended to become more assertive about talking to teens and were more likely to monitor their teen's behavior with regard to drunk driving. These studies suggest that parent education programs can be effective in altering parental behavior, but there is little evidence that these effects filter through to the drunk driving behavior of adolescents. The focusof my research is distinct from previous parenting interventions in several ways. First, I have conducted extensive empirical research on our target adolescents focusing on cognitive, attitudinal, and personality variables that are likely to influence teen drunk driving. I have applied (and modified) a well developed theoretical framework based on over 15 years of decision theoretic work by Jaccard to the empirical analyses. This research has provided a list of variables that, if changed, are likely to impact on teen drunk driving behavior. It is these variables that will be the focus parental education efforts. Thus, the content of the research has a strong theoretical and empirical base that is directly tied to determinants of drunk driving of the adolescent target population. By contrast, past intervention efforts have not had this kind of empirical and theoretical base. Second, the educational materials will carefully take into account issues of adolescent development in the context of social, emotional, cognitive, moral, and physical development. Parents will be educated about adolescent development in each of these domains and given specific behavioral strategies for educating their teens about drunk driving in the context of basic adolescent development issues.
Although there are only a few studies focused on parent interventions and adolescent drunk driving, there are numerous studies that have used correlational paradigms to study the relationship between parental behaviors and teen drunk driving. For example, Beck observed that parents are more likely to attribute deviant behavior to friends of their children rather than their children themselves and that parents generally are not aware of the full extent of their teens' drinking habits and practices. Most parents admitted that they never talk to other parents about teen drinking and driving. Beck and Lockhart reviewed factors that can influence parent effectiveness in attempts to control adolescent drunk driving and present a theoretical framework for analyzing parental effectiveness. According to these authors, barriers that diminish the impact of parents include perceptions of low levels of empowerment and control, disaffiliation and lack of skills to communicate with their children, low levels of awareness, a lack of social support from other parents, and an increasing psychological distance from their children as they grow older. Beck and Lockhart review research from other research domains that suggest the importance of these variables. Beck, Summons, and Matthews report the results of focus groups with parents aimed at understanding issues related to adolescent alcohol consumption and drunk driving. They found that parents tend to be unaware of the extent of teen drinking, that many parents feel powerless to affect their teen's drinking behavior, that many parents feel a sense of isolation from other parents dealing with similar problems, and that parents are uncommitted to devoting large amounts of time to the problem in the context of formal workshops. DiBlaso applied social learning theory to the analysis of adolescent drunk driving behavior, examining the relationship between peer variables, parental variables, and self reports of drunk driving. He found support for a statistically significant association between numerous parental variables (e.g., disapproval of drunk driving and alcohol consumption, parental discipline strategies) and teen behavior. Jessor analyzed risky driving behavior in adolescents and found that such behavior was significantly related to parent-friend compatibility and the number of parental models for health reinforcing behavior. Klepp and Perry applied Problem Behavior Theory to the analysis of adolescent drunk driving and observed little utility of parent based variables in predicting drunk driving behavior. These studies, as well as others not reviewed here, generally point to the potential relevance of parents in influencing adolescent drunk driving behavior. Although there are some negative findings and evidence to suggest that parent communications with their teens are not frequent enough or satisfactory in quality, there does seem to be sufficient evidence to indicate that what a parent does and the type of relationship that a parent has with his or her teen can and does impact on drunk driving behavior.
As noted, parent intervention programs are relatively rare in the drunk driving domain. However, there is a much more substantial literature on the impact of parents and parent-based interventions focused on adolescent alcohol consumption, adolescent drug use, and adolescent sexual behavior. There is also a substantial body of literature on family systems approaches to the analysis of these behaviors. Space constraints do not permit a review of these literatures here, although overall, they affirm the promise of parent based education efforts.
In sum, there exists sufficient empirical data both in the area of drunk driving and related areas of adolescent problem behaviors to suggest that parents can play an important role in influencing drunk driving behavior. Based on data that I have collected, I believe that parental impact will be even greater if parent-teen communication can be encouraged and directed at the appropriate target variables identified by our empirical and theoretical analyses. The proposed research is significant in that it will be an important addition to the almost non-existent literature on parent interventions aimed at reducing adolescent drunk driving. It has the features of using a strong theoretical base, a strong empirical base that has already been collected and evaluated on the target populations, and it will present information taking into consideration developmental theory on adolescence.
Last Revised: 10/10/95
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