Reducing Injury and Death in Teen Drivers

Journal of Trauma Nursing
Volume 8, Number 1,
January-March 2001

Society of Trauma Nurses
2743 South Veterans Parkway, PMB 193
Springfield, Il. 62704

Guest Editorial
by Gary Direnfeld, MSW, Executive Director of the I Promise Program

Given that automobile crashes are the leading cause of injury and death in teens, you can pretty much say that teens drive themselves to trauma centers. And, they do this in record numbers.

Car crashes account for approximately 6,000 deaths annually of American teens. While 15 to 20 year olds only account for 6.7% of the total driving population, they account for a whopping 14% of all fatal crashes. Up to 60% of fatally injured teen drivers were not wearing a seat belt, 65% of teen passenger deaths occur at the hands of a teen driver, about 50% of the crashes involving 16-year-old drivers are single vehicle crashes and 41% of fatal crashes occur at nighttime.

While a single jet plane crash involving a few hundred lives will make and maintain headline news for months and years, the epidemic of teen deaths due to driver behavior is difficult to maintain on any political agenda. Rather, it is an issue that is fought in the trenches mainly by grass roots organizations often founded by surviving family members of crash victims. The crusade to reduce and prevent teen driver crashes goes on several fronts and includes many groups whose intention is to change rules and regulations with respect to obtaining a drivers license, to increasing penalties for driving infractions. Perhaps three fronts symbolize the crusade to prevent or reduce teen driver fatalities: reduction of the legal limit for blood alcohol content, increase penalties for impaired driving and graduated licensing.

Driver education has been a mainstay of the process to obtaining a license. However, this has been largely unregulated with no nationally enforced standard. Notwithstanding, there has been a long held belief that education will determine performance and on this basis, the automobile insurance industry has generally offered premium discounts to those young drivers who attended some form of driver education. It seems that some insurers now bemoan having ever entered into this quagmire believing now that the evidence supporting a reduction of claims, based upon attendance at driver education is slim - at best. In other words, education in and of itself is not enough.

Graduated licensing is the natural progression from driver education. Recognizing that new drivers need far more than information, graduated licensing recognizes that driving is a complex learned skill that can only occur with practice, over time. Graduated licensing provides a process whereby new drivers must practice and master certain abilities before obtaining increased driver privileges. Generally the process demands that the driver must master minimum driving skills for daytime driving on city roads before being allowed to enter specified major highways. The driver then must obtain another level of proficiency before nighttime driving is permitted. Throughout these stages, the driver is required to have differing levels of supervision and has greater restrictions on blood alcohol content. Graduated licensing is shown to reduce car crashes in novice drivers.

At some point however, the young leaves the nest and the novice driver flies solo. From a human developmental point of view, this couldn't happen at a worse time. Most novice drivers flying solo are adolescents. Adolescence is a time of spreading wings, risk taking and the belief of invincibility. Independence from parents is paramount, yet without resources for true independence teens are caught in the developmental bind of relying on parental resources to paradoxically flex their own might.

It is at this point in the journey where most teen injuries and deaths occur.

To meet this next challenge a new initiative is taking the stage, set to provide a process to take over where graduated licensing leaves off and provide a new mechanism to reduce the risk associated with novice teen drivers. Dubbed the I Promise Program, the particulars include a parent-teen contract and a rear window decal with a clearly visible toll free number. The decal identifies the driver as novice and invites the community to make reports, positive or critical on driver behavior. The calls are taken by a call center and a call report is delivered to the parent (owner) of the vehicle. Critical to the success of the program is the contract. Parent and teen sit down and complete a 9-page document that sets out mutual expectation with respect to driving behavior, car maintenance, rewards and consequences (as negotiated).

This exciting new program was developed by myself after years of working in brain injury rehabilitation. The program is still in development and in clearly in order for it to be successful, the program must reach the greatest number of novice teen drivers at the lowest cost possible. To that end we have identified the automobile insurance industry as the most significant partner in the success of the program as this industry reaches literally every novice driver and had a vested interest in reducing the cost of claims associated with the carnage of teen driver error. Interestingly, the I Promise Program is already garnering international attention. A web site, developed to introduce the initiative to the automobile insurance industry has letters of support posted from the US, UK, Canada, Australia, Korea, Poland, Austria and Romania.

These letters have been actively solicited knowing that in order to move the insurance industry, you first must show tremendous support and acceptance of the program. We identified that each letter is crucial to the development of the program where the cumulative effect will be the influence they can have on the insurance industry. In addition to the letters of support, the program has obtained offers to collaborate on research from Harvard University - School of Public Health, University of Alabama -Computing and Information Division - Engineering Research Laboratory and from Plan-It Safe, a program of Children's Hospital of Eastern Region in affiliation with the University of Ottawa, Ontario, Canada.

All traumas are serious. Traumas involving young persons are particularly troublesome. Graduated licensing and then the I Promise Program are two significant initiatives that can considerably reduce the number of teen fatalities. As the largest professional organization of nurses specializing in trauma care this program will be of interest to you and your colleagues.

Where Can I Get More Information?

For more information, to view the parent-teen mutual safe driving contract and to view the letters of support, go to: www.ipromiseprogram.com

Gary Direnfeld and Jan Lowther can be reached at:

I Promise Program
20 Suter Crescent
Dundas, Ontario, Canada
L9H 6R5

Gary123@sympatico.ca
www.ipromiseprogram.com
(905) 628-4847