atv safety summit: training the next generation - barriers and facilitators of education and...
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Robin D. Schier, Assistant Professor of Nursing at the University of Texas Health Science Center at Houston, presented this at CPSC’s ATV Safety Summit Oct. 11, 2012. ATV rider safety training, education and danger awareness has become the major focus on reducing the incidents of injuries and deaths in children under the age of 16 years. My doctoral project (currently in press with Journal of Trauma) at Vanderbilt University was dedicated to understanding what the barriers and facilitators were to youth under 16 years of age and ATV safety education and training. The aim of this project was to develop and implement a pilot-version, parent survey assessing barriers against and facilitators for youth under 16 years of age attending the ASI RiderCourse in Tennessee. This project examined the only national ATV safety course given by ASI to determine the low enrollment in this course. No previously validated survey instrument for parents was found, therefore, survey development for this project was based on injury prevention and survey development literature, and personal experience during the attendance of a RiderCourse. The knowledge gained from survey results will help guide the development of future projects that are needed to contribute to the body of knowledge concerning ATV safety and children. Many questions remain unanswered: Are there sufficient ATV safety training courses? Are there direct barriers to enrollment in these courses? Does the public feel the need for formal ATV education? Are the available classes effective for children? Is the RiderCourse student handbook written so children of all ages can understand and comprehend the material? Is it even appropriate to train and educate children on ATV use? Can ATV use ever become a safe, recreational activity for children under the age of 16 years?TRANSCRIPT
Barriers and Facilitators of All-Terrain Vehicle Education and Safety Training
for Youth Under 16 Years of Age
Robin D. Schier, DNP, APRN, CPNP AC/PCThe University of Texas Health Science Center
Purpose
The purpose of this project was to identify the barriers and facilitators of enrollment
in the ASI ATV Safety RiderCoursesm
Copyright 2011 Robin D. Schier
Background and Significance
Children under 16 years of age are using ATVs for high-adventure thrill and fun, sporting, and family-oriented activities
ATV operators under the age of 16 are nearly four times more likely than older ATV operators to experience injuries requiring emergency treatment
The escalating popularity is associated with increasing morbidity and mortality
Copyright 2011 Robin D. Schier
Background and Significance
From 1982 to 2006, the number of children killed in ATV crashes was equivalent to…
Five 747 jumbo jets full of children
Copyright 2011 Robin D. Schier
Background and Significance
In 2008… There were 135,100 ATV-related ER visits
across the United States 37,000 (28%) were children under 16
years of age This is the equivalent of 2 school buses
full of children that are injured or killed every day while riding an ATV
Copyright 2011 Robin D. Schier
Background and Significance
Children under 16 years of age lack the strength, physical motor skills,
coordination and judgment to safely maneuver these high-powered vehicles
Copyright 2011 Robin D. Schier
Background and Significance
Voluntary standards agreed to by the industry have not worked
Legislative efforts have not proven successful
ATV danger awareness, education, and rider safety training has become the major focus on reducing the incidents of injuries and deaths in children under the age of 16 years
Copyright 2011 Robin D. Schier
Review of Literature
Historically, there is only a 4-7 % participation in ATV education and safety training courses, including the ASI RiderCoursesm
Numerous studies and organizations have recommended an increase in ATV safety training and education for children
To date, no studies have identified what effective ATV education and safety training looks like or why there is such a low attendance and involvement in these classes
Copyright 2011 Robin D. Schier
Review of Literature
The 4-H ATV Safety and ASI ATV RiderCoursesm grants are offered to 4-H communities to increase ASI’s ATV RiderCoursesm participation
Tennessee was challenged to educate 150 persons (adults and youth) in the ASI ATV RiderCoursesm
Only 62 youth completed the course
Copyright 2011 Robin D. Schier
Copyright 2011 Robin D. Schier
Data Collection
A 26 – question multiple choice and short answer pilot survey was distributed to 180 parents of youth associated with the Tennessee 4-H Extension residing in one of the top 9 Central Region Tennessee counties with the highest ATV morbidity and mortality identified by the trauma database at Monroe Carell Jr. Children’s Hospital at Vanderbilt
22.2% of the surveys were returned
Copyright 2011 Robin D. Schier
The Socio-Ecological Model and Approach to Public Health Initiatives
Copyright 2011 Robin D. Schier
Copyright 2011 Robin D. Schier
Results
70% of the parents in this sample do not feel that ATVs are dangerous
for children under 16 to ride and
consider their child a “good” or “expert” driver
Copyright 2011 Robin D. Schier
Results
Only 3% of parents report that a medical professional has talked to
them about ATV safety
100% of parents feel that the Tennessee 4-H Extension is
trustworthy
Copyright 2011 Robin D. Schier
Results
92% percent of the children in this study would not be able to attend a
RiderCoursesm because they ride vehicles exceeding course and
manufacturer engine size recommendations of 90 cc or less
Copyright 2011 Robin D. Schier
Results
50% of parents state they WILL NOT have their child take the RiderCoursesm in the future because they have never heard of
the program
Of the parents who purchased their vehicle new through an authorized ATV dealership,
only 7% received any information on hands-on safety training
Copyright 2011 Robin D. Schier
Results
93% of parents feel ATV training will reduce ATV related injuries and deaths
AND96% of parents feel that ATV training
is NOT a waste of time HOWEVER
More than 80% of these parents said they would not enroll their child in the
RiderCoursesm
Copyright 2011 Robin D. Schier
Results
Over 85% of parents who were self-taught or learned to drive ATVs from a friend or family member also had
used this method with their own children creating
a cross-generational pattern
Copyright 2011 Robin D. Schier
Results
Only 7% of parents said their children completed the
RiderCoursesm
Copyright 2011 Robin D. Schier
Copyright 2011 Robin D. Schier
Identified Facilitators to Course Enrollment
Free cost Belief ATV training will reduce
injuries “Not a waste of time” Parents’ concern for child’s safety Parents want children to learn
something new about ATV safety and driving skills
Previous ATV-related accident Trust in the TN 4-H Extension and
community Copyright 2011 Robin D. Schier
Identified Barriers to Course Enrollment
Lack of awareness of RiderCoursesm
Lack of ATV safety training information given at time of vehicle purchase (New and Used)
Large market for previously-owned ATVs
Parents’ desire to teach their own children
Copyright 2011 Robin D. Schier
Indentified Barriers to Course Enrollment
Parents’ scheduling conflicts with time/day courses are offered
Parents’ uncertainty of who teaches the course
Parents’ belief that child is an experienced driver
Not having the correct-sized ATV to attend training courses
Copyright 2011 Robin D. Schier
Copyright 2011 Robin D. Schier
Future Research
Explore and identify beliefs and attitudes about the dangers of operating ATVs and about safety training to both parents and youth
Revise survey instrument or conduct focus groups with parents and youth
Increase awareness and anticipatory guidance related to the dangers of ATVs and children by medical professionals
Copyright 2011 Robin D. Schier
Future Research
Further explore trust/distrust issues with parents and youth about ATV safety information
Promote health policy legislative efforts in conjunction with educational and training opportunities
Explore vehicle loaner program for youth who need correct-sized ATVs for course enrollment
Copyright 2011 Robin D. Schier
Future Research
Evaluate RiderCoursesm course handbook and materials for age appropriateness and reading comprehension level
Evaluate ASI’s ATV booklet “Parents, Youngsters and All-Terrain Vehicles” for reliability in determining rider “readiness” for children
Investigate opportunities to increase parental involvement in ATV safety training courses and consider a “train your child how to ride” course for parents
Copyright 2011 Robin D. Schier
Future Research
Further investigate and encourage increased distribution of ATV safety information from new and used dealers, as well as to those who sell vehicles privately
Develop collaborative/interdisciplinary partnerships to promote ATV safety within community settings Copyright 2011 Robin D. Schier
Copyright 2011 Robin D. Schier
Conclusion
This pilot survey can serve as a catalyst for developing theory-driven interventions and research questions
addressing the problem of low enrollment and participation in ATV
safety training for children
Copyright 2011 Robin D. Schier
If no one attends the classes, the ASI RiderCoursesm is an ineffective solution
to preventing ATV-associated injuries and deaths
Copyright 2011 Robin D. Schier
References
Aitken, M.E. Graham, C.J., Killingsworth, J.B., Mullins, S.H., Parnell, D.N. & Dick, R.M. (2004). All-terrain vehicle injury in children: Strategies for prevention. Injury Prevention, 303-307. doi: 10.1136/ip.2003.004176
Allegrante, J.P., Marks, R. & Hanson, D.W. (2006). Ecological models for the prevention and control of unintentional injury. In A.S. Gielen, Injury and Violence Prevention (pp.105-126). San Francisco: Jossey-Bass.
ATV Safety Institute (2009). ATV RiderCourse Student Handbook. Irvine: Specialty Vehicle Institute of America.ATV Safety Institute (2009). Parents, Youngsters & All-Terrain Vehicles. Irvine: Specialty Vehicle Institute of America.Bowman, S.M. & Aitken, M.E. (2010). Still unsafe, still in use: Ongoing epidemic of all-terrain vehicle injury hospitalizations among children. The Journal of Trauma,
Injury, Infection, and Critical Care, 20 (20), 1-6. doi:10.1097/TA.0b013e3181ea283d.Bronfenbrenner, U. (1993). Ecological models of human development. In M. Gauvain & M. Cole, Readings on the Development of Children, (pp. 37-43). New York:
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124 (3), 409-418. doi: 10.1080/10599240902751047.Burr, J.F. Jamnik, V.K., Shaw, J.A. & Gledhill, N. (2010). Physical demands of off-road vehicle riding. American College of Sports Medicine, 42(7), 1345-1354.
doi:10.1249/MSS.0b013e3181cd3.Collins, C.L., Smith, G.A. & Comstock, R.D. (2007). Children plus all nonautomobile motorized vehicles (not just all-terrain vehicles) equals injuries. Pediatrics, 120 (1),
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Surgery, 40 (6), 929-935. doi: 10.1016/j.jpedsurg.2005.03.007.Kellum, E., Creek, A., Dawking, R., Bernard, M. &Sawyer, J.R. 2008). Age-related patterns of injury in children involved in all-terrain vehicle accidents. Journal of Pediatric
Orthopedics, 28 (8), 854-858.Murphy, N. & Yanchar, N.L. (2004). Yet more pediatric injuries associated with all-terrain vehicles:: Should kids be using them? The Journal of Trauma, Injury, Infection
and Critical Care, 56 (6), 1185-1190. doi 10.1097/01. T.A. 0000123038.94864.E2.Scutchfield, S. (2003). All-terrain vehicles: Injuries and prevention. Clinical Orthopaedics and Related Research, 409, 61-72. doi:10.1097/01.glo.0000060441.40507.3e.Specialty Vehicle Institute of America. (2010). About the ATV Safety Institute. Retrieved October, 2010, from ATV Safety Institute:
http://www.atvsafety.org/infosheets/about_ASI.pdf. Specialty Vehicle Institute of America (2010). State all-terrain vehicle requirements. Retrieved October 28, 2010, from ATV Safety Institution: http://
www.atvsafety.org./infosheets/summary_chart_August _2010.pdf.Stolz, U., McKenzie, L.B., Mehan, T.J. & Smith, G.A. (2009). Assessing public opinion regarding potential ATV-related policies. Journal of Safety Research, 40, 149-155. doi:
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doi:10.1016/j.jpedsurg.2006.01.011.Testerman, G. (2009). 300 all-terrain vehicles crashes: An east Tennessee trauma center’s experience. Tennessee Medicine, 108 (8), 45-7. United States Consumer Product Safety Commission (2010). 2008 Annual Report of ATV-Related Deaths and Injuries. Bethesda: Division of Hazard Analysis. United States Government Accountability Office Reports to Congressional Committee. (2010). All-terrain vehicles: How they are used, crashes, and sales of all-sized
vehicles for children’s use. Washington, D.C.Upperman, J.S.. Shulz, B. Gaines, B.A. Hackam, D., Cassidy, L.D., Ford, H.R. & Helkemp, J.. (2003). All-terrain vehicle rules and regulations: Impact on pediatric mortality.
Journal of Pediatrics, 38 (9), 1284-1286. doi: 10.1016/s0022-3468(03)00383-x.Williams, R. S., Graham, J. Helmkamp, J.C., Dick, R., Thompson, T. & Aitken, M.E. (2010). A trial of all-terrain vehicle safety education video in a community-based hunter
education program. The Journal of Rural Health, 00, 1-8. doi: 101111/j.1748-0361.2010.00327.x.
Copyright 2011 Robin D. Schier
Special acknowledgement and appreciation for offering their time and expertise with this project to…
Dr. Tom Cook
Vanderbilt University School of Nursing Dr. Patti Scott
Arkansas Department of HealthDr. Mary Aitken
Arkansas Children’s HospitalMartin Koon
TN 4-H Extension Hope Mullins
Arkansas Children’s HospitalPurnima Unni
Monroe Carell Jr. Children’s Hospital at Vanderbilt
Copyright 2011 Robin D. Schier
For additional information, please contact:
Robin D. Schier, DNP, APRN, CPNP AC/PCAssistant Professor of Nursing
The University of Texas Health Science Center
(832) 434 - 7426
Copyright 2011 Robin D. Schier