title: Primary access to vehicles increases risky teen driving behaviors and crashes: national perspective.
abstract: 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> or =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.
authors.affiliation: Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. garciajf@email.chop.edu
authors.forename: J Felipe
authors.initials: JF
authors.lastname: García-España
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Ginsburg
authors.forename: Dennis R
authors.initials: DR
authors.lastname: Durbin
authors.forename: Michael R
authors.initials: MR
authors.lastname: Elliott
authors.forename: Flaura K
authors.initials: FK
authors.lastname: Winston
mesh_terms: D000063:Accidents, Traffic / Q000401:mortality / Q000517:prevention & control* / Q000706:statistics & numerical data; D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D001333:Automobile Driver Examination; D001334:Automobile Driving / Q000193:education / Q000706:statistics & numerical data*; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D018986:Motor Vehicles / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011336:Probability; D018570:Risk Assessment; D012309:Risk-Taking; D012622:Seat Belts / Q000706:statistics & numerical data; D016019:Survival Analysis; D014481:United States