Gerene Denning, of the University of Iowa Department of Emergency Medicine, presented this at CPSC’s ATV Safety Summit Oct. 11, 2012. The study objective was to determine the effectiveness of an in-classroom ATV safety education program that targets younger adolescents and highlights the 10 STARs --Safety Tips for ATV Riders. Methods: An audience response system was utilized to obtain data before and after the educational sessions. A one year follow-up written survey was administered. Results: About 2000 students in thirteen Iowa schools received the ATV safety program; 10 schools participated in the follow-up study. On the three knowledge questions, pre-intervention correct scores were 52%, 27% and 46% which rose to 93%, 80% and 79% on post-exam, respectively. Immediately after the program, 44% said they were likely or very likely to use the ATV safety tips, while 36% said they were unlikely or very unlikely to do so. One-year follow-up knowledge question scores were 77%, 45% and 58%. Lower percentages of students reported having ridden on an ATV with passengers or on a public road in the year following the education program. There were no differences in helmet use. Conclusion: Although it's unclear if ATV safety behavior definitely improved, the classroom educational intervention was able to increase short and long term safety knowledge. Repeated interventions may improve both knowledge retention and safety behaviors.

1. Safety Tips for ATV Riders
(STARs)
Increasing Adolescent ATV Safety Knowledge
Through an In-Classroom Educational Intervention
Gerene Denning, PhD Kristel Wetjen, RN
Charles Jennissen, MD Pamela Hoogerwerf
Karisa Harland, PhD Jeffrey Peck

2. ATV Deaths And Injuries:
Children are at Increased Risk
 ATV crashes disproportionately
affect the young:
• 1 in 4 deaths and 1 in 3
injuries involve children and
teens.
 Children and teens account for
the majority of passenger
deaths and injuries.
 ATV crashes kill more children each year than bicycle crashes.

3. Objective of Study
Develop, Implement, and Assess A
School-Based ATV Safety Program
Targeted to Adolescents

4. How do we get from here…
?
…to here?
?
?
?
?
?

5. STARs ATV Safety Program
 School-based format
 Target age range of
12-15 years old
 Interactive and
engaging
 Partner ATV safety
experts and injury
prevention experts
 Do evaluative
research

6. Program Design
Recruit schools and schedule times:
Invitation letters to principals
Personal contacts
School Nurse’s Conferences
10 Isolated 5 Urban
3 Rural (754)
Rural (1,227) (1,204)
Day of school visit
Welcome
Pre-program survey (Turning Point™)
40 min program
Post-program survey (Turning Point™)
1-year follow-up (9 schools)
Written follow-up survey

7. Pre-survey
Turning Point™
 Age
 Gender
 ATV use and frequency
 Riding and safety practices
• Riding with passengers
• Riding on public roads
• Helmet use
 Whether experienced a crash
 3 knowledge questions

8. Safety Tips for ATV Riders
(STARs) 1 Always wear your helmet
2 One person at a time
3 Ride the right size machine
4 Always wear your protective gear
5 Never ride on the road
6 Take a safety course
7 Tell someone where you are going
8 Respect private property
9 Never use alcohol or drugs
10 Always obey the rules

9. ATV Tilt Table
Jeffrey
Peck

10. Post-survey
Turning Point™ 1-Year Written
Follow-up Survey
 3 knowledge
questions
 Age
 Likelihood of  Gender
using the  Riding and safety practices
knowledge
gained
• Riding with passengers
• Riding on public roads
• Helmet use
 Experienced a crash
 3 knowledge questions

11. Results

12. Both Rural And Urban Youth
Were Represented In The Study.
 18 schools in Eastern and
Central Iowa (3,185 students).
39% 38%
 Rurality is based on zip codes
and the Rural Urban Commuting 24%
Codes (RUCA)
 Males and females were equally
represented. 10%
17%
21%
 74% were in our original target
age range of 12-15 years old. 53%

13. Baseline knowledge was
relatively low.
According to guidelines, what is the
Most ATVs are made to largest ATV engine size
carry how many people? recommended for use by 12-15 year
Correct answer = 1 olds?
Correct answer = 90 cc
26%
54%
According to Iowa law, when can 44%
someone ride an ATV on a public road?
Correct answer = For farming purposes

14. The program improved
short-term knowledge.
Most ATVs are made to carry how many people?
54%
92%
What is the largest ATV engine size recommended for use by 12-15 year olds?
26%
81%
According to Iowa law, when can someone ride an ATV on a public road?
44%
77%

15. Increased knowledge was
partially retained.
Values represent only students for whom short- and long-term follow-up data
were available (9 of 18 original schools, N = 1046).
Same Day Long-term
Question Baseline
Follow-up Follow-up
Most ATVs are made to carry how many
people? 53% 93% 78%
According to guidelines, what is the largest
ATV engine size recommended for use by 26% 79% 44%
12-15 year olds?
According to Iowa law, when can someone
ride an ATV on a public road? 47% 79% 58%

16. Some improvement in reported
behavior was observed.
Program Day
%
Use knowledge
Likely/Very Likely 47%
Undecided 20%
Not Likely/Unlikely 33%
Variable Program Day 1 Year
Riding with 95% *82%
Passengers
Riding on the roads 81% *54%
Never/Almost never 76% 60%
wear a helmet
N = 1,046 students; *p<0.001

17. Conclusions
 Over 3,000 students received training.
 Short-term knowledge was increased.
 Long-term knowledge was partially
retained.
 Some improvement in safety behaviors
was observed.
 Unsafe behaviors remain unacceptably
high.

18. Future Directions
 Develop, implement, and assess a multi-state school-
based ATV safety intervention.
 Develop and make accessible toolkits for teaching ATV
safety for teachers, scout leaders, 4-H, FFA, and
healthcare provider.

19. Deaths and Injuries from ATV
Crashes are Preventable!
 To prevent deaths and injuries and their accompanying
financial costs, we need:
• EDUCATION and Public Awareness
• ENGINEERING Safer Vehicles
• ENFORCEMENT of Evidence-Based Public Health
and Safety Laws
 It takes all stakeholders working together.

20. Why We Do What We Do
5 of 8 Iowa children killed by ATVs in 2011
When we have the power to save lives and health,
we have the responsibility to do so.