Examining the stability of transport behaviours for high-risk early adolescents

20th International Council on Alcohol, Drugs and Traffic Safety ConferenceBrisbane, August 27 2013

Kelly Dingli Lisa Buckley, Rebekah Chapman, Bianca Reveruzzi, Mary Sheehan

Presentation overview

•Introduction to the research1.

•Research aim2.

•Methodology3.•Results4.

•Conclusions5.

•Limitations and future directions6.

Introduction to the research

• Injury is a leading cause of death and disability for adolescents (CDC, 2010)

• Transport related injuries are the leading cause of death and disability for persons aged 15-29 years worldwide (WHO, 2013)

• Adolescents have increased risk of harm due to the co-existence of increasing alcohol use and engagement in risky transport behaviours

Transport related injuries in Australia

• 35% of all deaths for persons aged 15-24 years in in 2007 (AIHW, 2011)

• Leading cause of hospitalisation for persons aged 12-14 years in 2008/9 (AIHW, 2011)

• 53% of adolescents (13-14 years) reported at least one transport related injury in six month period (Chapman & Sheehan, 2005)

The relationship between adolescent transport injuries and risky behaviour

• There is an association between adolescent injury experiences and engagement in risk taking behaviour (Buckley et al., 2012)

• Potential for harm increases as co-occurrence of other risky behaviours (e.g. alcohol use) appears to increase over time

Adolescent risk taking indicators• Risk taking indicators are positively related to

engagement in risky behaviour (Jelalian et al., 1997)

• Adolescents who report at least one transport related injury were more likely to report engagement in other risk taking behaviours (Chapman & Sheehan, 2005)

High-risk adolescents and transport related injuries

• High-risk adolescents are at increased risk of harm than non high-risk adolescents due to greater engagement in risky transport behaviours

• There is a need to understand more about the difference between high-risk and non high-risk adolescents to target school interventions

Defining high-risk adolescents

• Participants were classified as high-risk during post-hoc analyses if they had reported seeking medical treatment for one or more injury during the preceding 6 month period (baseline)

Research aim

• To examine change in alcohol use, anger management and transport risk taking behaviours for early high-risk adolescents and non high-risk adolescents over a six month period

Participants and Procedure

• Year 9 students (N=1,005, 65% female), aged 13-14 years

• 20 high schools (13 State; 5 Catholic; 2 Independent)

• Paper based survey• Matched data (anonymous)

Measures

• Demographic characteristics• Risk taking: Mak’s adolescent delinquency

scale (1987), including five transport related items• Alcohol use: Self-reports of alcohol use for

preceding 6 month period• Anger management: Temper subscale of the

Measures of Self-Control (Grasmick, Tittle, Bursick & Arneklev, 1993)

Analyses• Analyses examined differences in high-risk

adolescent (n=264; 28.82%) and non high-risk adolescent (n=652; 71.18%) populations:

- Demographic characteristics (chi-square test)- Change in risk taking indicators and alcohol

use over 6 month period (chi-square test)- Self management of anger over 6 month

period (independent t-test)

Results

• High-risk adolescents reported a greater increase of engagement in each risk category over time compared with non high-risk adolescents

Increase in engagement in each risk category over 6 months

Alcohol u

se

Ridden bike w

ithout h

elmet

Passenger o

f drin

k driv

er

Driven ca

r off-ro

ad

Ridden motorbike

off-road

Ridden with

dangerous driv

er0

5

10

15

20

25

High-riskNon High-risk

% In

crea

se in

eng

agem

ent

Risk category4.7% 2.6

%

Results continued

• Engagement in risk taking behaviours increases at greater levels for high-risk compared with non high-risk adolescents over time

• Differences were identified in the stability of a sample of risk taking indicators for high-risk adolescents and non high-risk adolescents

Results: Demographic characteristics and anger management

• Demographics were not related to the stability of risk taking behaviours

• No significant difference in self-management of anger for either group over the six month period

Conclusions

• The dynamic change in risk taking behaviours by high-risk adolescents over time supports the positive relationship between aging and increased risk taking in adolescence (Pickett et al., 2002)

• The findings suggest that there is a greater need to target change in risk taking behaviour of high-risk adolescents

Conclusions continued

• High-risk adolescents have a different trajectory of engagement in risk taking

• Any program evaluation measuring change should examine findings for high-risk adolescents separately

• The findings contribute to bridging the gap in literature about the application of school based injury prevention interventions to high-risk adolescents (Dent et al., 2001)

Limitations and future directions

• Self-reported data• Data matching problems

• Future directions: Currently involved in outcome evaluation of injury prevention intervention comparing change in risk taking behaviour of high-risk and non high-risk adolescents

Questions?

K2.dunstan@qut.edu.au

Increase in engagement in each risk category over 6 months

Risk category High-riskN

High-risk % Non High-risk N

Non High-risk %

Alcohol use 9 4.7 13 2.6

Ridden bike without helmet

31 16.0 50 9.7

Passenger of drink driver

16 8.3 25 4.8

Driven car off-road 11 5.7 20 3.9

Driven motorbike off-road

9 4.7 12 2.3

Ridden with a dangerous driver

20 10.3 27 5.2

Change in engagement in each risk category over 6 months

Alcohol u

se*

Ridden bike with

out helm

et*

Passenge

r drin

k driv

er

Driven

car o

ff-road*

Driven

motorbike o

ff-road*

Ridden with

dangero

us driv

er *0

20

40

60

80

100

High-risk

* Significant at <0.05%

Risk category

% C

hang

e in

eng

agem

ent

Change in engagement in each risk category over 6 months

Risk Category High-riskN

High-risk%

Non high-riskN

Non high-risk%

χ² test

Alcohol use 76 29.00 99 15.33 χ²(1)22.43, p < 0.00*

Ridden bike without helmet

134 51.15 210 32.31 χ²(1)28.26, p < 0.00*

Passenger with drink driver

30 15.38 59 11.37 χ²(1)2.09, p = 0.14

Drive car off road 42 16.03 69 10.62 χ²(1)5.12, p = 0.02*

Driven Motorbike off road

26 13.33 41 7.90 χ²(1)4.92, p = 0.02*

Ridden with a dangerous driver

59 22.52 88 13.52 χ²(1)11.20, p < 0.00*

* Significant at < 0.05%