Key points
- Proven strategies exist to reduce motor vehicle crashes, injuries, and deaths.
- Prevention strategies include car seat and booster seat use, seat belt use, and reducing impaired and distracted driving.
- These strategies can be successfully tailored to tribal communities.
Overview
Proven strategies to reduce motor vehicle crashes, injuries, and deaths are well established. Strategies to prevent crashes include graduated drivers licensing laws, blood alcohol concentration (BAC) laws, sobriety checkpoints, and ignition interlocks for those convicted of driving while intoxicated. Increasing car seat and booster seat use through child passenger restraint laws that require car seat and booster seat use for all children until at least age 9 years, increasing seat belt use through primary enforcement seat belt laws that cover all seating positions, and high visibility enforcement are proven ways to prevent crash-related injuries and deaths. These strategies can be successfully tailored to tribal communities.
Indigenous Knowledge
In evaluating strategies for tribal road safety, it is important to include Indigenous Knowledge, which is "a body of observations, oral and written knowledge, innovations, practices, and beliefs developed by Tribes and Indigenous Peoples through interaction and experience with the environment." Indigenous Knowledge is "applied to phenomena across biological, physical, social, cultural, and spiritual systems" and includes "extensive observations, lessons, and skills passed from generation to generation."
A Memorandum for Heads of Federal Departments and Agencies in November 2022 stated that "Indigenous Knowledge is a valid form of evidence for inclusion in Federal policy, research and decision making. Indigenous Knowledge and other forms of knowledge do not depend on each other for validation, and each system can support the insights of the other."
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Prevention steps and strategies
Car seat and booster seat use
- Car seat use reduces the risk for injury in a crash by 71–82% for children, when compared with seat belt use alone.12
- Booster seat use reduces the risk for serious injury by 45% for children ages 4–8 years, when compared with seat belt use alone.3
- Car seat and booster seat distribution plus education programs can increase restraint use.456 These programs help parents and caregivers get new, unused car seats or booster seats and learn how to properly install and use them.456 These programs often include hands-on demonstrations which can help increase proper installation and use.
- Child restraint laws require children riding in vehicles to be buckled up in approved restraints such as car seats, booster seats, or seat belts appropriate for their age, weight, and height. These laws are effective for increasing restraint use and reducing child deaths and injuries.478
- Strengthening current laws with booster seat provisions that require children who have outgrown car seats to use booster seats until at least age 9 helps reduce injuries and deaths.9101112131415
- Short-term, high-visibility enforcement programs can enhance the effectiveness of child restraint laws, especially if they include broad media coverage.47 These programs are often similar to or conducted in combination with seat belt use programs like ; however, they should be conducted in an equitable and culturally centered manner (see example below).
Safe Native American Passengers (SNAP) Course
Seat belt use
- Seat belt use reduces the risk for death and serious injury by about half for older children and adults.16
- There is strong evidence that primary enforcement seat belt laws that cover all seating positions and high visibility enforcement are effective at increasing seat belt use.717 Prior work has explored how to conduct this in a culturally centered manner in some tribal communities.
'Click-It for a Movie Ticket'
Reduce impaired driving
Proven measures to reduce alcohol-impaired driving include:
- Implementing supported strategies that can reduce binge drinking.18
- Enforcing blood alcohol concentration (BAC) laws, minimum legal drinking age laws, and zero tolerance laws for drivers younger than 21 years old.719 These should be conducted in an equitable and culturally centered manner.
- Using publicized sobriety checkpoints. Checkpoints can reduce alcohol-related crash deaths by 9%.20
- Requiring ignition interlock use for all people convicted of alcohol-impaired driving, starting with their first offense21. Additionally, incorporating alcohol use disorder assessment and treatment into interlock programs shows promise in reducing repeat offenses once interlocks are removed.22
- Providing Drug Recognition Expert or Advanced Roadside Impaired Driving Enforcement program training to law enforcement.7
Sobriety Checkpoints
Prevent teen crashes
- There are proven methods to help prevent teen crashes. Graduated driver licensing (GDL) systems enable new drivers to progressively gain driving experience and driving skills under lower risk conditions by granting driving privileges in 3 stages.
- Research indicates that GDL systems are associated with reductions of about 19% for injury crashes and 21% for fatal crashes for 16-year-olds.23 Best practice GDL systems often include the following components:24252627
- Stage 1: Learner's Permit
- Minimum age of 16 to obtain a learner's permit
- A requirement to have a learner's permit for at least 12 months
- At least 70 supervised practice hours
- Minimum age of 16 to obtain a learner's permit
- Stage 2: Intermediate/Provisional License
- No teen or young adult passengers
- Restrictions on nighttime driving (from 9 or 10 pm until 5 am, or sometimes longer)
- No teen or young adult passengers
- Stage 3: Full Licensure
- Minimum age of 18 to obtain a full license
- Minimum age of 18 to obtain a full license
- Stage 1: Learner's Permit
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- Glerum KM, Zonfrillo MR, Fleisher L, McDonald CC. . Traffic Inj Prev. 2019;20(8):866–872. doi:10.1080/15389588.2019.1666372
- Venkatraman V, Richard CM, Magee K, Johnson K. . Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration; 2021.
- Sartin EB, Lombardi LR, Mirman JH. . Inj Prev. 2021;27(6):577–581. doi:10.1136/injuryprev-2021-044196
- Shaw KM, West B, Kendi S, Zonfrillo MR, Sauber-Schatz E. . J Pediatr. 2022;250:93–99. doi:10.1016/j.jpeds.2022.07.001
- Benedetti M, Klinich KD, Manary MA, Flannagan CA. . Traffic Inj Prev. 2017;18(8):866–869. doi:10.1080/15389588.2017.1318209
- West BA, Dorigo LL, Mattick KA, Yellman MA, Sauber-Schatz EK. Booster Seat Planning Guide. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2021.
- Farmer P, Howard A, Rothman L, Macpherson A. . Inj Prev. 2009;15(5):348–350. doi:10.1136/ip.2008.021204
- Brixey SN, Corden TE, Guse CE, Layde PM. . Inj Prev. 2011;17(4):233–237. doi:10.1136/ip.2010.029835
- Mannix R, Fleegler E, Meehan WP III, Schutzman SA, Hennelly K, Nigrovic L, Lee LK. . Pediatrics. 2012;130(6):996–1002. doi:10.1542/peds.2012-1058
- Eichelberger AH, Chouinard AO, Jermakian JS. . Traffic Inj Prev. 2012;13(6):631–639. doi:10.1080/15389588.2012.660663
- Kahane CJ. National Highway Traffic Safety Administration (NHTSA). . Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration; 2015.
- Dinh-Zarr TB, Sleet DA, Shults RA, et al. . Am J Prev Med. 2001; 21(4 Suppl):48–65. doi:10.1016/s0749-3797(01)00378-6.
- Guide to Community Preventive Services. . 2023.
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- Bergen G, Pitan A, Qu S, Shults RA, Chattopadhyay SK, Elder RW, Sleet DA, Coleman HL, Compton RP, Nichols JL, Clymer JM, Calvert WB, Community Preventive Services Task Force. . Am J Prev Med. 2014;46(5):529–539. doi:10.1016/j.amepre.2014.01.018.
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- Voas RB, Tippetts AS, Bergen G, Grosz M, and Marques P. . Alcohol Clin Exp Res. 2016;40(9):1953–1960. doi:10.1111/acer.13149
- Masten SV, Thomas FD, Korbelak KT, Peck RC, Blomberg RD. . Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration. November 2015.
- Ouimet MC, Pradhan AK, Brooks-Russell A, Ehsani JP, Berbiche D, Simons-Morton BG. . J Adolesc Health. 2015;57(1 Suppl):S24–35.e6. doi:10.1016/j.jadohealth.2015.03.010
- Insurance Institute for Highway Safety (IIHS). . Arlington, VA: Insurance Institute for Highway Safety & Highway Loss Data Institute; 2022.
- Steadman M, Bush JK, Thygerson SM, Barnes MD. . Traffic Inj Prev. 2014;15(4):343–348. doi:10.1080/15389588.2013.822493
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