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There is convincing evidence to suggest that older truck drivers are a highly valued cohort in the transportation industry. Thus, ensuring the safety, health and wellbeing of this workforce should be a priority so that transportation industry employers can develop strategies to keep them driving for as long as they are safe on the road. As a first step in achieving this goal, the aim of this study was to better understand the key factors associated with managing the safety, health and wellbeing of older drivers in the trucking industry. Two focus groups with safety managers (n = 15) trucking companies in the United States were conducted to gain an understanding of the barriers and facilitators in planning and managing the safety of older truck drivers. Data were analyzed using thematic analysis and involved a broad categorisation of all meaningful data into four key areas (i.e., advantages, concerns, current strategies and challenges). Themes were subsequently identified within each of the four key areas. The results confirmed that older truck drivers are valued in the workforce for their work ethic and safety attitudes; however, there are multiple and interrelated factors influencing the safety management of older truck drivers. It was also found that there are few interventions that are targeted to the specific needs of older truck drivers and aligned to the challenges in managing the safety risks. Overall, the findings of this study support recommendations to address the barriers associated with managing the safety of older truck drivers.

Studies over the past two decades have attempted to document and understand factors related to crashes involving older drivers to develop more effective countermeasures to reduce the frequency and severity of these crashes. Studies in which vehicle acceleration data can be recorded have begun to explore the relationship between rapid deceleration events (RDEs) and functional abilities among older drivers as a surrogate measure of unsafe driving. Recent naturalistic driving studies with older adults have found differing results using different thresholds to define an RDE. The present study examined the relationship among RDE rates, demographics, visual abilities, cognitive abilities, and driving comfort among a large cohort of older drivers, using two definitions of RDEs—longitudinal deceleration of 0.35 g or greater (RDE35) and longitudinal deceleration of 0.75 g or greater (RDE75). The study utilized objective driving, objective functioning, and reported driving comfort data from 2774 participants of the multi-site AAA Longitudinal Research on Aging Drivers (LongROAD) study. RDE rates for each threshold were calculated per 1000 miles driven. Multivariate regression models with backward elimination were developed to examine how outcome measures were related to RDE rates. Too few RDE75 events were found for meaningful analysis. RDE35 rates were significantly associated with several covariates. RDE35 rates were related to declining functional abilities, but many other factors also played a significant role in the rate of RDE35s among older drivers, diminishing the value of using RDE35 rates as a surrogate measure of driving safety. In addition, because the AAA LongROAD sample was relatively healthy and high functioning, other ability-related covariates may also be significantly related to RDE35s but the lack of variance in these measures in the current study prevented these effects from emerging.

Evidence suggests that older driver safety may be improved by good vehicle maintenance, in-vehicle advanced technologies, and proper vehicle adaptations. This study explored the prevalence of several measures of vehicle maintenance and damage among older drivers through inspection of their vehicles. We also investigated the prevalence of in-vehicle technologies and aftermarket adaptations. Vehicle inspections were conducted by trained research staff using an objective, standardized procedure. This procedure, developed by a multidisciplinary team of researchers, was based on a review of inspection checklists used by automobile dealerships and the project team's expertise. The study used baseline data from vehicles of 2988 participants in the multi-site Longitudinal Research on Aging Drivers (LongROAD) study. Among this cohort, vehicles were well maintained, had little damage, and contained a range of advanced technologies but few aftermarket adaptations. Implications of study findings for occupational therapy practice are discussed.

As people age, some of the commonly experienced psychomotor, visual, and cognitive declines can interfere with the ability to safely drive, often leading to situational avoidance of challenging driving situations. The effect of hearing impairment on these avoidance behaviors has not been comprehensively studied. Data from the American Automobile Association (AAA) Longitudinal Research on Aging Drivers (LongROAD) study were used to assess the effect of hearing impairment on driving avoidance, using three measures of hearing. Results indicated that hearing loss plays a complex role in driving avoidance, and that an objective hearing measure was a stronger predictor than hearing aid use and self-rated hearing. Greater hearing impairment was related to less nighttime and freeway driving, more trips farther than 15 mi from home, and lower odds of avoiding peak driving times. The moderating influence of hearing on both vision and cognition is also discussed, along with study implications and future research.

Vehicle automation offers promise for improving safe transportation, access to mobility, and quality of life. However, at least in the early stages of automation, human drivers remain an integral component of the system and their acceptance and use of the automated technology needs to be much better understood. One factor that has emerged as a strong influence on the acceptance and use of automated technology is trust. We used regression analyses to address two research questions. The first was: What factors are associated with the extent to which individuals report trust in automated technology after a simulated automated drive experience? The second research question was: How are trust in automated technology, control preferences (both preference for control specifically related to driving and more general preference for control), and experience with technology associated with objective measures intended to capture acceptance of automated technology? With regard to the first research question, we found that driving-specific control preferences were significantly related to reported trust. Specifically, after experiencing a simulated drive that required switching between manual and automated modes, the extent to which individuals reported that they trusted the automated technology was significantly higher among those who also reported being comfortable with other drivers behind the wheel. While specific results were mixed with regard to the second research question, we did find evidence that trust in automated driving, at least as reported after a simulated experience with the technology, was an important component of acceptance of the technology.

OBJECTIVE There are many unknowns regarding drivers' use and acceptance of advanced vehicle technologies. This research aimed to examine drivers' perceptions of advanced driver assistance systems (ADAS). METHODS This research was conducted using structured interviews and focus groups of owners of vehicles with advanced technologies. RESULTS Drivers' perceptions about ADAS were mixed, but generally safety was considered to be the greatest value of the systems. There was recognition that the systems may result in overreliance and thus encourage distraction behaviors or other bad driving habits, and participants generally expressed that they were ultimately responsible for the vehicle's operation and needed to be ready to override the system if it failed. CONCLUSIONS The findings indicate that driver characteristics and individual factors may influence perceptions, behaviors, and interactions with safety technology, and this research is a first step toward understanding any influences. Human factors issues related to automated vehicle technologies are critical for design and deployment, including those of trust, acceptance, and understanding of systems.

Motor vehicle crashes represent a significant public health problem. Efforts to improve driving safety are multifaceted, focusing on vehicles, roadways, and drivers with risky driving behaviors playing integral roles in each area. As part of a study to create guidelines for developing risky driving countermeasures, 480 drivers (118 young/18-25, 183 middle-aged/35-55, 179 older/65 and older) completed online surveys measuring driving history, risky driving (frequency of engaging in distracted [using cell phone, texting, eating/drinking, grooming, reaching/interacting] and reckless/aggressive [speeding, tailgating, failing to yield right-of-way, maneuvering unsafely, rolling stops] driving behaviors), and psychosocial characteristics. A cluster analysis using frequency of the risky behaviors and seat belt use identified five risky behavior-clusters: 1) rarely/never distracted-rarely/never reckless/aggressive (n=392); 2) sometimes distracted-rarely/never reckless/aggressive (n=33); 3) sometimes distracted-sometimes reckless/aggressive (n=40); 4) often/always distracted-often/always reckless/aggressive (n=11); 5) no pattern (n=4). Older drivers were more likely in the first/lowest cluster (93.8% of older versus 84.2% of middle-aged and 59.3% of young drivers; p

Better information is needed about how declines in sensory and cognitive function affect older drivers. This study assessed how hearing loss affects engagement in four challenging driving patterns. Data from the AAA Longitudinal Research on Aging Drivers study was used, including objectively-measured driving; three measures of hearing: reported hearing aid use, self-rated hearing, and the Whisper Test; visual acuity (Tumbling E); and cognition (Trail Making B). Failing the Whisper Test in both ears was related to significantly lower percentage of trips (%trips) at night, on freeways, and during rush hour, but a higher %trips >15 miles. Hearing aid use and self-rated hearing were not associated with any driving differences. Worse vision was related to a lower %trips >15 miles, while worse cognition was associated with a lower %trips at night, on freeways, and during rush hour. The Whisper Test interacted with cognition for rush hour trips.

INTRODUCTION: Driver distraction is an important contributor to crash risk. Teenage driver distraction can be influenced by the attitudes and behaviors of parents. This study examined teens' and their parents' engagement in distracting behavior while driving. METHOD: Survey data were collected from a national sample of 403 parent-teen dyads using random-digit dialing telephone interviews. RESULTS: Results demonstrated few parent or teen sex differences in distracting behavior engagement while driving, or in their perceptions of each others' behavior. Parents and teens' frequencies of distracting behavior engagement were positively correlated. Parents' and teens' perceptions of each others' distracting behavior engagement while driving exceeded their own selfreports. Finally, the likelihood that teens reported engaging in distracting behavior while driving was more strongly associated with their perceptions of their parents' distracting behavior than by parents' self reports of their own behavior. CONCLUSIONS: These results suggest that parents' examples of driving behavior are an important influence on teen driving behavior, but potentially more important are teens' perceptions of their parents' behaviors. Keywords: Driver distraction; Language: en

Objective: The aging of the population in the United States and elsewhere has brought increasing attention to the issue of safe driving and mobility among older adults. The overall objective of this research was to use naturalistic data collection to better understand driving exposure and driving patterns, 2 important contributors to crash risk. Methods: Data came from a study conducted at the University of Michigan Transportation Research Institute as part of the Integrated Vehicle-Based Safety System (IVBSS) program. A total of 108 randomly sampled drivers took part, with the sample stratified by age and sex. The age groups examined were 20 to 30 (younger), 40 to 50 (middle-aged), and 60 to 70 years old (older). Sixteen late-model Honda Accords were used as research vehicles and were driven by participants as their personal vehicles over the study period. Roughly the first 2 weeks of vehicle use comprised the baseline driving period, during which the IVBSS technologies were turned off (i.e., no warnings were presented to the drivers) but all onboard data were collected. For this article, only data from the baseline period were analyzed to limit any confounding effects that the safety technology may have had on driving behavior. Results: Results indicated that when looking at age independent of sex, older drivers (age 60–70) took fewer trips, drove fewer minutes, were less likely to drive at night, and had fewer high decelerations and speeding events than the youngest age group (20–30). They were also less likely to drive during peak morning traffic and on high-speed roads than their middle-age counterparts (40–50). Across all age groups, there were few differences by sex, with the exception that females drove fewer miles and fewer minutes and had fewer high decelerations than males. When both age and sex were taken into account, it was often the group of females age 60–70 that appeared to account for many of the age and sex differences found in driving exposure and patterns. Conclusions: Future research in this area would benefit from larger scale and longitudinal study designs so that changes in driving exposure and patterns over time among large samples of drivers could be examined.

Introduction: Teens beginning to drive independently are at significant increased risk of motor-vehicle crashes relative to their other life stages. There is, however, little guidance for parents as to how best to supervise learning to drive. Method: This study sought to undertake an informed approach to development and implementation of a Parent Guide. We included a multi-stage development process, using theory, findings from a Delphi-study of young driver traffic-safety experts, and parent focus groups. This process informed the development of a Guide that was then evaluated for feasibility and acceptability, comparing a group that received the Guide with a control group of parent and teen dyads. Both members of the dyads were surveyed at baseline, again at the approximate time teens would be licensed to drive independently (post-test), and again three months later. Results: We found no difference in the proportion of teens who became licensed between those given the new Guide and control teens (who received the state-developed booklet); that is the Guide did not appear to promote or delay licensure. Teens in the Guide group reported that their parents were more likely to use the provided resource compared with control teens. Responses indicated that the Parent Guide was favorably viewed, that it was easy to use, and that the logging of hours was a useful inclusion. Parents noted that the Guide helped them manage their stress, provided strategies to keep calm, and helped with planning practice. In contrast, control parents noted that their booklet helped explain rules. Among licensed teens there was no significant difference in self-reported risky driving at the three-month follow-up. We discuss the challenges in providing motivation for parents to move beyond a set number of practice hours to provide diversity of driving practice. (C) 2018 National Safety Council and Elsevier Ltd. All rights reserved.

The purpose of the present study was to gain a better understanding of the types of in-vehicle technologies being used by older drivers as well as older drivers' use, learning, and perceptions of safety related to these technologies among a large cohort of older drivers at multiple sites in the United States. A secondary purpose was to explore the prevalence of aftermarket vehicle adaptations and how older adults go about making adaptations and how they learn to use them. The study utilized baseline questionnaire data from 2990 participants from the Longitudinal Research on Aging Drivers (LongROAD) study. Fifteen in-vehicle technologies and 12 aftermarket vehicle adaptations were investigated. Overall, 57.2% of participants had at least one advanced technology in their primary vehicle. The number of technologies in a vehicle was significantly related to being male, having a higher income, and having a higher education level. The majority of respondents learned to use these technologies on their own, with "figured-it-out-myself" being reported by 25%–75% of respondents across the technologies. Overall, technologies were always used about 43% of the time, with wide variability among the technologies. Across all technologies, nearly 70% of respondents who had these technologies believed that they made them a safer driver. With regard to vehicle adaptations, less than 9% of respondents had at least one vehicle adaptation present, with the number of adaptations per vehicle ranging from 0 to 4. A large majority did not work with a professional to make or learn about the aftermarket vehicle adaptation.

Purpose Adolescent drivers are at elevated crash risk due to distracted driving behavior (DDB). Understanding parental and peer influences on adolescent DDB may aid future efforts to decrease crash risk. We examined the influence of risk perception, sensation seeking, as well as descriptive and injunctive social norms on adolescent DDB using the theory of normative social behavior. Methods 403 adolescents (aged 16–18 years) and their parents were surveyed by telephone. Survey instruments measured self-reported sociodemographics, DDB, sensation seeking, risk perception, descriptive norms (perceived parent DDB, parent self-reported DDB, and perceived peer DDB), and injunctive norms (parent approval of DDB and peer approval of DDB). Hierarchical multiple linear regression was used to predict the influence of descriptive and injunctive social norms, risk perception, and sensation seeking on adolescent DDB. Results 92% of adolescents reported regularly engaging in DDB. Adolescents perceived that their parents and peers participated in DDB more frequently than themselves. Adolescent risk perception, parent DDB, perceived parent DDB, and perceived peer DDB were predictive of adolescent DDB in the regression model, but parent approval and peer approval of DDB were not predictive. Risk perception and parental DDB were stronger predictors among males, whereas perceived parental DDB was stronger for female adolescents. Conclusions Adolescent risk perception and descriptive norms are important predictors of adolescent distracted driving. More study is needed to understand the role of injunctive normative influences on adolescent DDB. Effective public health interventions should address parental role modeling, parental monitoring of adolescent driving, and social marketing techniques that correct misconceptions of norms related to around driver distraction and crash risk.

Given the high current prevalence of dementia and expected increases in the coming years, it is increasingly important to understand and address the process of transitioning from driving to non-driving among older drivers with dementia and the potential role of self-regulation (e.g., avoiding challenging driving situations). The purpose of this Alzheimer’s Association-funded study was to examine differences in self-regulation between older drivers with and without dementia. Fifty-two active drivers age 65 or older (16 with dementia; 36 healthy controls), completed a validated self-regulation questionnaire and standardized assessment of cognition, vision, and psychomotor skills. The dementia group reported some awareness of cognitive challenges (lower driving-related abilities to remember things and concentrate on multiple things at a time than the comparison group). Similarly, the dementia group performed significantly worse on memory tasks and complex reaction time in the objective assessment. Both groups were confident they could drive safely where they needed to go. However, the dementia group reported being less comfortable driving in several situations (unprotected left turns, unfamiliar areas, alone, rush hour traffic, backing up). Despite lower driving comfort among the dementia group, there were few differences in self-regulation between the groups. The only statistically significant difference was that more of the dementia group had reduced their driving in the past year. There were no differences in self-regulation between groups for any of the specific driving situations for which the dementia group reported feeling less comfortable. Full study results will be presented along with implications for programs and future research.

Addressing teen driver crashes, this study adapted an effective CheckpointsTMprogram for parents of teen drivers for dissemination by primary care practitioners (PCPs) and the web; distributed the PCP/web program through pediatric practices; and examined dissemination to/implementation by parents. The website, youngDRIVERparenting.org , and brief intervention protocol were developed. PCPs delivered interventions and materials to parents, referred them to the website, and completed follow-up surveys. Google Analytics assessed parents’ website use. Most PCPs reported delivering interventions with fidelity, and thought the program important and feasible. Brief interventions/website referrals, averaging 4.4 minutes, were delivered to 3465 (87%) of 3990 eligible parents by 133 PCPs over an 18-week average. Website visits (1453) were made by 42% of parents, who spent on average 3:53 minutes viewing 4.2 topics. This program costs little (its website, training and promotional materials are available) and could be one component of a comprehensive approach to reducing teen driver crashes.

The purpose of this study was to test the efficacy of an adapted Checkpoints Program designed to increase parental limits on novice teen independent driving under high-risk conditions. Twenty-seven class sessions with a minimum of 5 dyads each were delivered in driver education to 231 parent-teen dyads. Entire driving school classes were randomized to Checkpoints Program or comparison group sessions, both led by a trained health educator. At licensure, compared with parents in the comparison group, treatment parents had increased awareness of teen driving risk and were more likely to have completed a parent-teen driving agreement and met Checkpoints recommendations for restrictions on teen driving in inclement weather and road types. They were also marginally more likely to have met Checkpoints restrictions on driving with teen passengers. This study indicates that it is feasible to implement the Checkpoints Program in driver education with positive effects on parent management practices. Language: en

This study examined the association between psychosocial maturation and problem driving behavior in young adulthood. Psychosocial maturation is the process of adopting adult roles, attitudes and behaviors and completing developmental tasks associated with becoming an adult. Past research has demonstrated that individuals' participation in health-risk behaviors decreases as psychosocial maturity increases. Not surprisingly, decreases in driving risk that occur over the first years of driving have often been assumed to result in large degree from general maturation; however, no research has tested this assumption. This study used data from a telephone survey of young adults to begin addressing this gap in the literature by testing three hypotheses: (1) indicators of higher psychosocial maturity are associated with lower problem driving behavior; (2) the association between the level of psychosocial maturity and problem driving behavior is cumulative; and, (3) these associations are moderated by sex. Problem driving behavior was evaluated by assessing three measures: high-risk driving, drink/driving, and drug/driving. Results supported all three hypotheses. Participants with greater psychosocial maturity had lower levels of problem driving behavior than participants who were less psychosocially mature. Second, problem driving behavior was lower with higher psychosocial maturity. Third, these associations between psychosocial maturity and problem driving behavior were moderated by sex. The primary contributions of this study are: (1) initial evidence that psychosocial maturation may play a role in improvements in the safety of young drivers; and (2) the generation of questions and hypotheses that provide direction for future research on the role of maturation in observed declines in risk among young drivers.

The objective of this study was to evaluate the utility of the Canadian Aerobic Fitness Test (CAFT), a field measure of cardiovascular fitness. After providing anthropometric measures, 31 subjects, ages 10 to 15, completed a maximal treadmill test and the CAFT, a 3-stage step test. Multiple regression analyses were conducted where maximal oxygen consumption from the treadmill test was estimated based on the oxygen cost of stepping, age and various combinations of body composition. For the total sample, the best model (R = 0.79, SEE = 6.7), obtained from the sum of 4 skinfolds, was the body composition estimate. This model was slightly more accurate for males (R = 0.83, SEE = 6.0) than for females (R = 0.77, SEE = 7.0). When the regression equation incorporated less time consuming indicators of body composition, the predictive power, albeit lower, was still satisfactory. It appears that the CAFT can be a useful option for measuring cardiovascular fitness for youth, with the decision dependent on the purpose of the test, the testing resources, the setting, and the motivation of the subjects.

Background Crashes among US novice young drivers remain too high. Addressing this problem, one effective program for parents is Checkpoints, which raises parents’ awareness of risks to their young drivers and offers ways to reduce those risks. But its most effective approach was in driver education classrooms and not widely available. A federally-funded study adapted Checkpoints to a website that could be promoted in several ways. This study promoted the Checkpoints website in brief interventions by Primary Care Practitioners (PCPs), and examined dissemination to/implementation by parents. Methods The website, youngdriverparenting.org (with an interactive parent-teen driving agreement, PTDA) , and brief intervention protocol were developed in collaboration with leadership of Paediatric Research in Office Settings at the American Academy of Paediatrics. PCPs delivered interventions and materials to parents, referred them to the website, and completed follow-up surveys. Google Analytics was used to assess parents’ website use. Results Focus groups of parents/teens determined the website adaptation successful. Most of the 133 PCPs from 16 states reported delivering interventions with fidelity, and thought the program important and feasible. Brief interventions/website referrals, averaging 4.4 minutes, were delivered to 3,465 (87%) of 3,990 eligible parents over an 18-week average in 2012–2013. Website visits (1,453) were made by 42% of parents exposed to the intervention, who spent on average 3.53 minutes viewing an average of 4.2 pages. The PTDA was viewed by 24%, and 10% registered for an interactive PTDA. Conclusions Translation of an evidence-based parent program to a PCP-promoted website was demonstrated. Delivering the brief intervention/website referral was feasible and acceptable to PCPs. This program costs little (its website, training and promotional materials are available) and could be one component of a comprehensive approach to reducing young driver crashes.

The Checkpoints program (Checkpoints) uses a Parent-Teen Driving Agreement (PTDA) to help parents monitor teens' driving, and has shown efficacy in increasing parental restrictions on teens' driving and decreasing teens' risky driving. In previous trials, research staff administered Checkpoints. This study examined the effectiveness of Checkpoints when delivered by driver educators. It was hypothesized that Checkpoints would result in more PTDA use, greater PTDA limits on higher risk driving situations, and less high-risk driving.Eight trained driving instructors were randomly assigned to intervention or control groups in a group randomized trial. Instructors enrolled 148 parent-teen dyads (intervention = 99, control = 49); 35% of those eligible. Intervention parents joined teens for a 30-minute Checkpoints session during driver education. The session included a video, persuasive messages, discussion, and PTDA initiation. Teens completed four surveys: baseline, licensure, and 3- and 6-months post-licensure.Intervention teens were more likely to report that they used a PTDA (OR= 15.92, p = .004) and had restrictions on driving with teen passengers (OR = 8.52, p = .009), on weekend nights (OR = 8.71, p = .021), on high-speed roads (OR = 3.56, p = .02), and in bad weather (b = .51, p = .05) during the first six months of licensure. There were no differences in offenses or crashes at six months, but intervention teens reported less high-risk driving (p = .04).Although challenges remain to encourage greater parent participation, Checkpoints conducted by driver education instructors resulted in more use of PTDAs, greater restrictions on high-risk driving, and less high-risk driving. Including Checkpoints in driver education parent meetings/classes has potential to enhance teen driver safety.

INTRODUCTION: Alcohol use, alcohol misuse, and risky driving from adolescence into young adulthood were compared by drinking onset age. Methods: Surveys were administered in Grades 5/6, 6/7, 7/8, 10, 12, and at approximately age 23. Participants were placed into Drinking Onset groups based on self-reported alcohol use frequency on the adolescent surveys. Driving records were examined in three age periods: under 21, 21-25, and 26+. Results: The earliest drinking initiators reported higher alcohol use and misuse on each survey, and were more likely to have risky driving offenses before age 21 and to have alcohol driving offenses in all three age periods. Discussion: The earliest drinking initiators engaged in risky drinking behavior and risky driving behavior that was consistently higher than those with later drinking initiation, beginning in adolescence and persisting well into young adulthood. Language: en

Study objective To determine whether an emergency department (ED)–based laptop computer intervention reduces the normative age-related increase in alcohol misuse compared with standard of care. Methods This was a randomized controlled trial conducted from October 11, 1999, to April 14, 2001, in a community teaching hospital and university medical center. Subjects were aged 14 to 18 years and with a minor injury. Controls and intervention participants completed a computer-based questionnaire. Intervention participants also completed a laptop-based interactive computer program to affect alcohol misuse. Main outcome measures were Alcohol Misuse Index (Amidx) and binge-drinking episodes. Follow-up occurred by telephone at 3 and 12 months. Analysis included repeated-measures analysis of variance (α=0.05; power 0.80; effect size 0.10). Results Three hundred twenty-nine participants were randomized to the intervention group, and 326 participants were randomized to the control group. Two hundred ninety-five (89.7%) intervention subjects and 285 (87.4%) control subjects completed 3- and 12-month follow-ups. For intervention and control groups, respectively, mean age was 16.0 and 15.9 years and men composed 66.8% and 66.3% of the groups; Amidx scores were 2.2 and 2.0; binge-drinking episodes were 1.2 and 1.0. Outcomes for intervention and control, respectively, were Amidx (3 months) 1.5 and 1.4; Amidx (12 months) 1.8 and 2.1; binge drinking (3 months) 0.9 and 0.8; and binge drinking (12 months) 1.4 and 1.2. Overall, there were no significant effects (effect size 0.04). No detrimental effects were noted. Subgroup analysis suggested that the intervention may have an effect among subjects with experience drinking and driving (5% of the sample). Conclusion The intervention was not effective in decreasing alcohol misuse among the study population. Further research will be required to determine effectiveness among the subgroup of adolescent minor injury patients who have experience drinking and driving.

Background Effective injury prevention programmes for teen drivers that can be broadly disseminated are needed. In this study, a university and a state department of community health partnered to translate an evidence-based, parent-oriented teen driving intervention to a website for state-wide dissemination. Aims/Objectives/Purpose Compare the effectiveness of website promotion efforts via paid or earned media. Methods Three, 4-month sequential phases of an incremental promotional strategy were evaluated using data from Google Analytics: Phase-1) links placed on partner websites only; Phase-2) active promotion by partners and earned media added; Phase-3) paid media added. Results/Outcome Each phase increased Website visits (2044; 3921; 9313), including a 137.5% increase due to paid media in Phase-3 ($10 000 Facebook, plus $20 000 various websites). Facebook was the leading source of Phase-3 traffic (2515 visits), but yielded average visits of only 15 s and 89.5% of visitors bounced (exited homepage without viewing other pages). In comparison, website visits increased 149.4% during a 2-week period in Phase-2 following a press release (379 visits), with average visits of 1 : 49 min and a bounce rate of 44.8%. Significance/Contribution to the Field Results demonstrated the potential of and revealed trade-offs inherent to paid and earned media for promoting a web-based injury prevention programme. Paid media had high costs and brought high traffic volume, but website use by visitors was limited. Earned media was free, increased website traffic less than paid media, but visitors used the website more. The success of earned media is encouraging for programmes that have limited financial resources.