title: Teen driving behaviors in a rural southern state.
abstract: OBJECTIVE
  Motor vehicle crashes are the leading cause of death for teenagers. Alabama ranks fourth in the United States for teen crash fatalities. We sought to describe risky driving behaviors among teens in the rural areas of the state's most populous county.
  
  
  METHODS
  A questionnaire was adapted from the Youth Risk Behavior Surveillance System. Each of the schools in Jefferson County, Alabama, participated in 2009 and 2010. Surveys were anonymous and data were entered into an Excel spreadsheet. Inclusion criteria were age 15 years and older.
  
  
  RESULTS
  A total of 1399 surveys met inclusion criteria. A total of 52% of respondents were boys; 64% were white, 29% were African American, and 3% were Hispanic. Respondents were 15 (38%), 16 (36%), 17 (21%), and 18 (5%) years old. When asked about behaviors during driving in the last 30 days, 41% reported texting and 11% reported driving after drinking. Teens reported being a passenger in a car with the driver texting (67%) or after the driver had been drinking (27%) in the last 30 days. Overall, 58% reported not wearing a seatbelt; 13% reported driving after using drugs; 60% reported routinely exceeding the speed limit; 80% reported having discussed safe driving with a parent, but only 16% with their doctor; 25% had signed a safe driving contract; and 63% had taken a driving class.
  
  
  CONCLUSIONS
  Many risky behaviors were identified for both teen drivers and passengers. A concerning number of teens are not receiving safe driving educational messages from parents, doctors, or driver's education classes. Some interventions have been instituted; however, more outreach efforts should be made to focus on strengthening driving laws and educating parents and teens.
authors.affiliation: From the Department of Pediatric Emergency Medicine and the Southeast Child Safety Unit, University of Alabama Hospital Systems, Children's of Alabama, Birmingham.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Irons
authors.affiliation: From the Department of Pediatric Emergency Medicine and the Southeast Child Safety Unit, University of Alabama Hospital Systems, Children's of Alabama, Birmingham.
authors.forename: Michele
authors.initials: M
authors.lastname: Nichols
authors.affiliation: From the Department of Pediatric Emergency Medicine and the Southeast Child Safety Unit, University of Alabama Hospital Systems, Children's of Alabama, Birmingham.
authors.forename: William D
authors.initials: WD
authors.lastname: King
authors.affiliation: From the Department of Pediatric Emergency Medicine and the Southeast Child Safety Unit, University of Alabama Hospital Systems, Children's of Alabama, Birmingham.
authors.forename: Marie
authors.initials: M
authors.lastname: Crew
authors.affiliation: From the Department of Pediatric Emergency Medicine and the Southeast Child Safety Unit, University of Alabama Hospital Systems, Children's of Alabama, Birmingham.
authors.forename: Kathy
authors.initials: K
authors.lastname: Monroe
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000407:Alabama; D001334:Automobile Driving / Q000523:psychology / Q000706:statistics & numerical data*; D003617:Dangerous Behavior; D005260:Female; D006801:Humans; D008297:Male; D012424:Rural Population; D057566:Self Report; D011795:Surveys and Questionnaires