Pre-program survey

You have been asked to participate in this study because you are a provider who serves Children’s Hospital of Wisconsin patients and families. The purpose of this study is to learn more about provider use of anticipatory guidance on traffic safety issues with teens and their parents in the clinical setting. If you have questions about this study you may contact Deena Liska at (414) 231-4893 or Jane Howard at (414) 231-4884.
Can we ask them to create an identifier? 

Question Title

1. Please tell us how often you discuss these topics with caregivers of patients at or near driving age:

  Always/almost always Often Ocassionally Rarely/never
Seat belt use
Alcohol/drug use while driving
Distractions/cell phone use while driving
Speeding and/reckless driving
Driving with teen passengers
Being a passenger with a teen driver
Effects of inexperience on driving
Driving while fatigued
The need for caregivers to clarify consequences of violating driving limits
Night driving
State Graduated Driver Licensing law
Selecting a safer car
Driver education programs
Parent role modeling
Parent-teen written contract

Question Title

2. How often do you use these resources with caregivers of patients at or near driving age:

  Always/almost always Often Occassionally Rarely/never
Fact sheets
Brochures
Parent-teen written contracts
Posters
Videos
Computer-based/electronic

Question Title

3. When you provide counseling on teen driving safety, is it usually delivered to: 

Question Title

4. Please indicate your level of agreement with each statement: 

  Strongly agree Agree Neutral Disagree Strongly disagree
The risk of crashes among teen drivers increases with the number of passengers
Graduated Driver License legislation helps to reduce risk of injury or death to adolescents
Most fatal night-time crashes among teen drivers occur from 9 p.m. to midnight
Young age, independent of experience, is the primary risk factor in teen driving
Pediatricians should support state efforts to include night-time and passenger restrictions in Graduated Driver License legislation
Including parents in teen driving counselling increases its effectiveness
Anticipatory guidance on safe driving provided by pediatricians will help to reduce risk of injury or death to adolescents
Parents appreciate advice on teen driving from pediatricians
It is the role of pediatricians to counsel teens about their driving behavior
I have confidence in discussing teen driving issues with teens and parents
I am effective in discussing teen driving issues with teens and parents
I intend to institute counseling for teen driving safety but I have not done so
I am not trained to deal with the problem of teen driving safety
I do not have time to counsel teens and parents on teen driving safety
I feel frustrated because I cannot do anything about teen car crashes
Teen crashes and injuries are not a problem in my patient population
Thank you for your time.
Survey adapted from: 

Campbell, B., Borrup, K., Corsi, J., Kelliher, K., Saleheen, H., Banco, L., & Lapidus, G. (2009). Pediatrician attitudes, knowledge, and practice behavior regarding teen driver safety. Journal of Safety Research, 40, pp. 121-124.

Weiss, J., O’Neil, J., Shope, J., & O’Connor, K. (2012). Paediatrician knowledge, attitudes, and counselling patterns on teen driving. Injury Prevention, 18, 10-15. Retrieved November 21, 2016, from http://injuryprevention.bmj.com/

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