Published online September 28, 2009
PEDIATRICS Vol. 124 No. 4 October 2009, pp. 1069-1075 (doi:10.1542/peds.2008-3443)

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ARTICLE

Primary Access to Vehicles Increases Risky Teen Driving Behaviors and Crashes: National Perspective

J. Felipe García-España, PhD^a, Kenneth R. Ginsburg, MD, MSED^a,b, Dennis R. Durbin, MD, MSCE^a,c, Michael R. Elliott, PhD^d,e, Flaura K. Winston, MD, PhD^a,f,g,h

^a Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
Divisions of ^b Adolescent Medicine
^c Emergency Medicine
^f General Pediatrics, Department of Pediatrics, School of Medicine
^g Leonard Davis Institute for Health Economics
^h Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, Pennsylvania
^d Department of Biostatistics, School of Public Health
^e Survey Methodology Program, Institute for Social Research, University of Michigan, Ann Arbor, Michigan

OBJECTIVE: The goal was to explore teen driver vehicle access and its association with risky driving behaviors and crashes.

METHODS: A nationally representative, school-based survey of 2167 ninth-, 10th-, and 11th-graders examined patterns of vehicle access (primary access [ie, the teen is the main driver of the vehicle] versus shared access) and associated driving exposure, risky driving behaviors, and sociodemographic factors.

RESULTS: Seventy percent of drivers reported having primary access to vehicles. They were more likely to be white, to be in 11th grade, to attend schools with higher socioeconomic levels, to have mostly A/B grades, to have a job, to drive a pickup truck, and to drive more hours per week but were not more or less likely to consume alcohol or to wear seat belts while driving. Compared with drivers with shared access, drivers with primary access reported more than twice the crash risk (risk ratio [RR]: 2.05 [95% confidence interval [CI]: 1.41–2.99]) and higher likelihoods of using cellular telephones while driving (RR: 1.23 [95% CI: 1.12–1.35]) and speeding 10 mph above the posted limit (RR: 1.24 [95% CI: 1.11–1.40]).

CONCLUSIONS: Primary access of novice teen drivers to vehicles is highly prevalent in the United States. This practice is a dangerous norm, because primary access is associated with risky driving behaviors. Healthcare providers and schools should consider counseling parents to discourage giving novice teen drivers primary access to vehicles. In communities where teens require primary access (eg, due to limited public transportation options), greater efforts should be made to promote safe behaviors.

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Key Words: adolescent • motor vehicle crashes • accident prevention • injury prevention • survey • teenaged drivers • teenage vehicles • vehicle ownership

Abbreviations: GDL—graduated driver licensing • NYDS—National Young Driver Survey • RR—risk ratio • CI—confidence interval

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Accepted Feb 13, 2009.

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