Car accidents lead to extensive physical pain and premature death the world over (CDCP, 2001).
Motor vehicle accidents remain as the main cause of death for 16- to 20-year-olds, accounting for approximately 5,500 occupant fatalities annually (NHTSA, 2005a). Each year, around 450,000 teenagers are injured, and 27,000 of them require hospitalization (NHTSA, 2005b). Of those killed, approximately 63% are drivers, 37% are passengers and 66% of teenagers who die in automobile crashes are male (NHTSA, 2005a). Among 16- to 24-year olds, only 77% wear seat belts (NHTSA & NCSA, 2005).One study suggests that teenagers do not wear seat belts because: it is not ‘cool’; due to peer pressure; their usage wrinkles clothes and causes discomfort; the short distance to be traveled; and, the feeling that ‘nothing will happen to me’ (Volkswagen of America, n.d.
). Boyle et al. (2004) found that almost half of teenagers (47%) say that seat belts are ‘as likely to cause harm as to help,’ while others report that wearing a seat belt makes them ‘worry more about being in an accident’ (27%), and that they would feel ‘self-conscious if they were going against the group norm in wearing safety belts’ (30%).Laws on seat belt use is present in most developed world—with the U.
S. seeking to increase seat belt use to 92% (US DoH, 2000), which is similar to how other countries prioritize its use (UK DoH, 1999). Aside from legal mechanisms, driver’s education plays a great part in disseminating the value of seat belts among teenage drivers. The Graduated Driver Licensing system has imposed adolescents some restrictions in driving.
School-based and media promotions reached every individual driving adolescent in the awareness of car accidents related to non-use of seat belts (Grossman & Garcia, 1999).Estimated to save 9,500 lives yearly, seat belts have proven to be the most effective safety devices in vehicles at present (NHTSA, 2000). However, only 68% of motor vehicle occupants use seat belts. If 90% of Americans buckle-up, more than 5,500 deaths and 132,000 injuries can be prevented per year. On the average, inpatient hospital care costs for non-seat belted vehicular victim are 50% more compared to seat belted victims. The victims do not pay for these costs; society does, assuming 85% of the costs (Dinh-Zarr et al., 2001).
An annual savings of $8.8 billion will be made if the 90% seat belt usage will be reached (NHSTA, 2005a). The medical costs, lost future work and reduced quality of life are not enough exchange for not wearing seat belts. The cost of lost lives from the recklessness behavior of non-use of seat belt is too much to call for imposing health promotion on belt safety (NHTSA, 2000).This paper seeks to utilize the promotion approach to achieve higher compliance of seat belt use among adolescents.
Indubitably, the seat belt problem raises important questions about the extent to which people will act voluntarily to reduce their risks. Existing levels of seat belt use suggest that the motivation to protect one’s self against certain hazards is very weak, even for risks that are very real (Williams ; Shabanova, 2002). This paper argues that the promotion of seat belt safety in adolescents, if done effectively and efficiently with strict compliance, can prove to be pivotal in helping reduce risks to fatal and not fatal injuries from vehicular accidents.Role of the NursePreventive Approach.
The nurse as the educator plays a vital role in educating adolescents on the value of seat belt safety. This provides a solid foundation for the teens’ driving throughout their lives, preparing them to become safe and responsible drivers. Driver’s education about seat belt safety can be disseminated through community health program, driver licensing procedures and school-based curriculum on health and safety. The nurse as an adviser attends to the anticipatory guidelines for driving teenagers which can be initiated through driver’s screening and education.Promotion Approach. The nurse as the endorser, role model and manager on promotion and public awareness can be done by means of media and advertising such as through radio, television, cellular phones, billboards, newspapers, books, stickers and pamphlets.Curative Approach.
The nurse as a health care provider to victims of car accidents due to non-use of seat belts. Promotion on Seat belt Safety can be included as part of the nurse’s health teachings and discharge teaching instructions.Rehabilitative Approach. The nurse as the counselor can promote seat belt safety through counseling with behavior modification among delinquent teenage drivers. The nurse as a researcher can take a vital part in the search to unravel the solutions on seat belt safety programs and effective strategies to increase seat belt use.Care Management ProcessNursing AssessmentAdolescence seat belt compliance problems are purely associated with the teenager’s health behaviors and attitudes.
A strong need for peer approval, coupled with the myths of adolescence, may entice a young person to attempt hazardous feats, or participate in a variety of risk-taking behaviors like the non-use of seat belt when driving; neither injury nor death is strong enough to motivate this hard-to-reach group. They love to play with fire—excitement and experience are the chicken soups for the teenage soul.Nursing GoalsShort term goal: To construct an effective and efficient promotion of seat belt safety among adolescents. Long term goal: To promote compliance and habitual use of seat belt for safety purposes, thus eliminating car accidents related to non-wearing of seat belt.Nursing PlanTo construct a promotion mechanism on seat belt safety among adolescents by utilizing the nursing processes of family health nursing, community health nursing, and health education. In the field of media and advertising, to create a talk-of-the-town trend and fashion statement in promoting seat belt use.Nursing Strategy and ImplementationsPreventive Approach. Formulate an effective health education for driver licensing procedure.
Health education will focus on the physiologic importance of seat belts (how does seat belt protect us during the crash), demonstrate the proper ways of using the seat belt, the function of the seat belt (what will happen to our body during crashes without the seat belt) and the possible injuries that can be sustained during the accident without wearing seat belt. In school-based curriculum, safety driving can be integrated as part of Health and safety subject by simply teaching the proper use of seat belt and the importance of it. It is better to start teaching safety driving to grade school students—the younger the child, the easier to inculcate a habit. Generate a seat belt campaign, seat belt rally or a vigil headed by the community health program as part of the government’s health and safety program. For example, declaring January as the Seat belt Month or scheduling a Seat belt Consciousness Week. Distribution of educational health materials about seat belt safety or home visits by designated health care personnel as part of the community health program. Incentives programs with rewards and prizes for strict compliance of teenage drivers. Formulate a driver’s screening program focused on the psychological readiness of the applicant for safe driving among adolescents.
Counseling on anticipatory guidelines together with the parents of teenage applicants. Support groups for the victims of accidents related to non-use of seat belt will help the counseling to be more effective.Promotion Approach: A trendy seat belt advertisement featuring popular teenage role models (such as teen or sports celebrities) who will advocate the use of seat belts—a young icon who will be the ‘ambassador of seat belt safety’. Launch a fashionable and trend-setting seat belt brand with varieties of designs and colors that address the taste and style of teenagers with both male and female motifs (in collaboration with local seat belt manufacturers). Remember that adolescence is the time of expression, imitations, idolizing celebrities, peer trends and fashion and creativity. Improve the seat belt designs to reduce discomforts.Curative Approach. Formulate a comprehensive health education in patient teaching program and discharge instructions for the injured adolescent confined in a hospital focused on safety driving and seat belt use.
Rehabilitative Approach. Counseling and behavior modification for the victims of accidents related to non-use of seat belt and delinquent teenage drivers. A support group for the victims of accidents due to non-use of seat belt will also help (akin to Alcoholics Anonymous).Expected OutcomesEvaluation Techniques. Survey, road traffic and safety compliance reports, observations, interviews, focus group discussions, community diagnosis, document analysis and statistical analysis regarding seat belt use and accidents related to the non-use of seat belts.Short term Outcomes.
Strict screening for adolescents driver licensing program focused on psychological readiness will be followed; positive feedbacks on driver education about seat belt safety from adolescents; large number of adolescents groups joining the seat belt campaign; home visits reported large number of awardees for seat belt compliance; formation of advocacy groups for seat belt use; reading health/safety materials are provided for every adolescents; a movie or sports celebrity becoming more popular for his/her seat belt advocacy; a popularized jingle about seat belt; wide-use of fashionable seat belts; in a hospital or rehabilitation set up, there will be a decrease number of participants due to the decrease in accidents related to seat belt and decrease seat belt use violators.Long term. Inculcating a habit-forming behavior of wearing seat belt among adolescents results in the decrease in the number of seat belts usage violators and decrease in the number of car accidents related to seat belts non-use.
SummaryAdolescence is the time when the brain creates the “wiring” for perspectives and judgments. Thus, opportunities for promoting seat belt safety education present themselves in every aspect of an adolescent’s life: in the home, school, community and workplace. Teachable moments exist every time an adolescent learns a new skill, such as when behind the steering wheel—habitually buckling-up before or immediately after inserting the key to start the engine. Seat belt safety promotion strategies can be embedded in a myriad of avenues, such as in education, law enforcement, parental modelling and the media.
Health and protection promotion behaviors are multidimensional and need to be considered separately.Parents have a key role in seat belt promotion. They provide the transportation, financial and emotional support, and are in control of the car keys and insurance. They provide role modelling with their own behavior and set boundaries with appropriate consequences. Privileges associated with driving cars should depend upon the adolescent’s ability to demonstrate an adequate knowledge base on the safe use of such machines.Schools have the responsibility to disseminate information and proper education regarding seat belt safety, and rests primarily on the school nurse.
Community health nursing can integrate and tailor strategies to meet the youth’s unique needs and opportunities for seat belt use. It is important to involve relevant stakeholders in planning and implementation of safety plans to increase commitment and involvement in carrying out solutions.Finally, it is recommended that further studies must be made on the following: on the efficacies of the various methods used to promote regular seat belt use; on the usage of seat belts among pregnant adolescents; on the extent of involvement of parents in adolescents’ licensing procedure; and regarding the expanded role of the nurse in seat belt promotion from school, community, organization, among others.