SafeTeens Think First: A Driver's Education Program Evaluation

Background: In the United States (US), motor vehicle crashes (MVCs) represent the leading cause of death among youth 16-19 years of age. Although adolescents comprise only 14% of the US population, they are responsible for 30% ($19 billion) of motor vehicle crash (MVC) related injury costs incurred by hospitals and 28$7 billion) of MVC-related injury costs incurred by emergency departments. The number of teen MVC-related fatalities and the economic impact of teen MVCs demonstrate the need for effective programs aimed at reducing risky teen driving behaviors. SafeTeens Think First (SafeTeens) is a one time, three-hour safe driving educational program delivered to Cleveland County, North Carolina high school students that provides information on the risks and consequences of unsafe driving. Through a yearlong Capstone experience, a team of students from the UNC Gillings School of Global Public Health partnered with the UNC Department of Surgery and Cleveland Country Regional Medical Center to conduct the first process and outcome evaluation of the SafeTeens program. The purpose of the evaluations was to determine whether the SafeTeens program was being delivered as intended and whether it was reducing the number of adolescent MVCs and MVC-related deaths occurring in Cleveland County. Methods: Throughout the academic year, Capstone team members emphasized community engagement and incorporated feedback from stakeholders and experts. First, the Capstone team created an evidence table in order to explore the literature base on teen driving program evaluations that focus on long-term outcomes. Next, the Capstone team developed a process and outcome evaluation plan. Three process evaluation instruments were developed to measure implementation fidelity, dose delivered, dose received, and participant satisfaction, and a process evaluation user guide was created to standardize measurement across evaluators. Quantitative and qualitative methods were used to analyze primary data and conduct the process evaluation of the SafeTeens program. For the outcome evaluation, study design and secondary data sources were carefully considered when developing the outcome evaluation plan. MVC rates were calculated for Cleveland County and each of three comparison groups at pre- and post-implementation of SafeTeens. MVC rate differences computations with 95% confidence intervals were calculated for each group to determine if the decrease in teen MVCs in Cleveland County was significantly lower than the decrease observed in the comparison groups. A program evaluation report and PowerPoint presentation were created to present evaluation findings to stakeholders in April 2014, along with a comprehensive report sharing program recommendations. Results: Results suggested that the SafeTeens program was implemented with fidelity and students reported being satisfied with the program. However, student engagement with the program activities was low. Students reported interactive activities as program components that they like best, yet the majority of students recommended increasing the number of engaging activities in which they can participate. Statistical analysis of the long-term impact of SafeTeens suggested that the program did not lower the number of teen MVCs that occurred in Cleveland County since the program's implementation in 2005 (p = 0.05). Sample size was too small to evaluate impact of SafeTeens on teen driver fatalities. Discussion: This Capstone project not only provided Cleveland Regional Medical Center with a user-friendly toolkit to conduct future evaluations of the SafeTeens program, but it also included recommendations for improving the program's effectiveness. This evaluation contributed to the current body of knowledge surrounding evaluated drivers' education programs. The UNC Department of Surgery Capstone experience provided a setting in which parties engaged in a reciprocal relationship to foster a positive learning environment, enhance and develop skills, evaluate and present program findings, and promote principles of community engagement.Master of Public Healt