6.5 Youth Programs
Overall Effectiveness Concerns: This countermeasure has been examined in several research studies. Despite some positive research findings, the balance of evidence regarding countermeasure effectiveness remains inconclusive.
States, communities, nonprofit organizations, and schools have conducted extensive youth drinking-and-driving-prevention programs over the past 25 years. These programs seek to motivate youth not to drink, not to drink and drive, and not to ride with drivers who have been drinking. Although some programs use scare tactics, many employ positive messages and methods: providing positive role models that discourage alcohol use, promoting positive norms that do not involve alcohol, and encouraging youth activities that do not involve or lead to alcohol use.
Research has shown that teens’ behavior is influenced by their parents first and foremost, but also by their peers. As a result, peer-to-peer programs have been widely used. Students Against Destructive Decisions (SADD), founded in 1981 as Students Against Driving Drunk, employs a peer-to-peer education model in chapters across the country to raise awareness about the dangers of underage drinking and driving. Some States conduct similar activities under different names, such as Students Taking a New Direction (STAND) in Colorado and Teens in the Driver Seat in Texas. Many programs are targeted at celebratory times of the year, including prom and graduation season; the summer, when young people are out of school and more likely to be involved in a crash; and the winter holiday season. One specific activity, operated either by a youth program or independently, is Project Graduation, which provides alcohol-free prom and graduation parties for high school students. See Fisher (2019) and Hedlund et al. (2001) for brief examples of State programs.
A recent study found that young adults who are convicted of DWI 1 year post high school may have been influenced by prevalent substance-use norms among their five closest high-school friends (Li et al., 2016). NHTSA and the Ad Council published an online and social media campaign, “Ultimate Party Foul,” about the dangers and consequences of underage drinking and driving (www.multivu.com/players/English/7662551-ad-council-ultimate-party-foul/). The campaign also provided tips on how young adults can resist peer and social pressure related to drunk driving.
Another type of approach focuses on “social norms” or “normative feedback.” Social norms programs are based on studies showing that students often overestimate alcohol use among their peers. By providing students with accurate information about drinking, social norms programs reduce the pressure that light- or non-drinkers feel to drink, and help heavier drinkers realize their drinking is atypical (Perkins, 2002, 2003). Although many social norms programs focus on alcohol or other substance use, a few have addressed drinking and driving. Examples of social norms programs can be found at the National Social Norms Institute (www.socialnorms.org).
Other initiatives focus on brief interventions that involve the use of therapeutic components for a short duration to potentially reduce DWI, or driving after drinking in young adults and adolescents. An example intervention might include a discussion of the perceived costs and assumed benefits of alcohol consumption, a review of the legal consequences of drinking alcohol underage and driving or riding in a car with someone who has been drinking, providing opportunities to discuss options for moderating alcohol consumption, and providing personalized BAC charts based on the participant’s height and weight. For more information on brief interventions, see the Alcohol- and Drug Impaired Driving chapter, Section 5.1.
Use: Youth programs of some type are conducted in most, if not all, States.
Effectiveness: CDC’s systematic review found there was insufficient evidence to determine the effectiveness of youth programs (Elder et al., 2005). Two studies have attempted to evaluate SADD’s activities and effects. One study in two schools in California and New Mexico, found that neither school implemented the model SADD program well and found no evidence of effects on any drinking and driving measure (Klitzner et al., 1994). The second study in 6 schools with strong SADD programs located in Arizona, Ohio, and Wisconsin were matched with similar schools without programs (Leaf & Preusser, 1995). Results reported that students in schools with SADD programs were more likely to hold attitudes opposed to drinking and driving and self-reported drinking and driving was slightly lower.
Goodwin (2004) examined the long-term effects of a social norms program on drinking and driving. Breath samples were taken from students at a large public university as they returned home late at night. Following the social norms program, there was a marginally significant decrease in drivers who registered positive BACs, from 15.3% to 10.8%. Among drivers who had been drinking, self-reported number of drinks consumed and measured BACs decreased, as did the number of drinking drivers who reported having five or more drinks at one sitting on the night of the survey. Reducing this type of binge drinking may have safety benefits. Evans-Polce et al. (2017) examined the relationship between 12th grade drinking intensity and driving-related consequences at 19 and 20 years old and found that 12th grade binge drinkers were more likely to experience negative driving-related consequences at 19 and 20, compared to 12th grade non-binge drinkers. Overall, education programs that train young adults on how to resist peer pressure and enhance informed decision-making skills may be the most successful approaches (Kelly-Weeder et al., 2011; Botvin & Griffin, 2007).
Costs: Youth program costs can vary substantially depending on the size and nature of the individual activities. States have spent substantial funds, both Federal and non-Federal, on youth drinking-and-driving programs. These funds have been used for a variety of youth education, enforcement, and programs.
Time to implement: With model programs available from organizations such as SADD and MADD, youth programs can be started easily in 3 to 6 months.
- Other programs aimed at youths: A variety of programs are directed at youth. To increase the perceived risks of drinking and driving, many schools have employed “fatal vision goggles,” peer-to-peer programs, role plays, or drunk-driving crash reenactments (e.g., “Every 15 Minutes”). Although popular, the vast majority of these programs have not been evaluated. The few existing studies suggest these types of programs may produce changes in knowledge or attitudes, but have little or no effect on behaviors (Hover et al., 2000; Jewell & Hupp, 2005). Broader community-based programs have had much greater success at reducing drinking and driving among youth than standard education programs (see the Alcohol- and Drug Impaired Driving chapter, Section 6.4).
- Mandatory education for young offenders: Young people who violate zero-tolerance or MLDA-21 laws are often required to attend alcohol or traffic safety education programs. Unfortunately, these programs often fail to produce positive outcomes. For example, Rhode Island’s Reducing Youthful Dangerous Driving program was mandated for youths 16- to 20 years old who received driving citations or who had substance-related offenses. The 20-hour program consisted of four group sessions and two emergency department visits. Twelve months following the program, there was no difference between program participants and a comparison group in terms of high-risk driving behaviors and traffic citation recidivism (Baird et al., 2013).
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