Examining the stability of transport behaviours for high-risk early adolescents 20th International Council on Alcohol, Drugs and Traffic Safety Conference Brisbane, August Kelly Dingli Lisa Buckley, Rebekah Chapman, Bianca Reveruzzi, Mary Sheehan

Presentation overview Introduction to the research 1. Research aim 2. Methodology 3. Results 4. Conclusions 5. Limitations and future directions 6.

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 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 years in in 2007 (AIHW, 2011) Leading cause of hospitalisation for persons aged 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 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 % Increase in engagement Risk category 4.7 % 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?

Increase in engagement in each risk category over 6 months Risk categoryHigh-risk N High-risk %Non High-risk N Non High-risk % Alcohol use Ridden bike without helmet Passenger of drink driver Driven car off-road Driven motorbike off-road Ridden with a dangerous driver

Change in engagement in each risk category over 6 months Risk category % Change in engagement

Change in engagement in each risk category over 6 months Risk CategoryHigh-risk N High-risk % Non high-risk N Non high-risk % χ² test Alcohol use χ²(1)22.43, p < 0.00* Ridden bike without helmet χ²(1)28.26, p < 0.00* Passenger with drink driver χ²(1)2.09, p = 0.14 Drive car off road χ²(1)5.12, p = 0.02* Driven Motorbike off road χ²(1)4.92, p = 0.02* Ridden with a dangerous driver χ²(1)11.20, p < 0.00* * Significant at < 0.05%