Key Messages

Who is Youthsafe?

Youthsafe partners to prevent unintentional injury of young people. We address youth injury on the roads, at work, while playing sport and when out socialising with friends.

Why are young people at risk?

Young people are at greater risk of injury than any other age group. In Australia:

• Injury is one of the leading causes of death and disability in young people, accounting for around 66% of all young people deaths. (AIHW, 2011)
• Over 71,000 young people aged 15 to 25 were hospitalised because of injuries between 2010 and 2011, with more than twice as many males hospitalised as females. (AIHW, 2013)

There are many reasons why young people may find it difficult to assess risk, make safer choices and react rationally, particularly in new or stressful situations. This includes the way the brain is still developing during adolescence, inexperience, peer or family influence as well as society’s expectations of how young people should and will behave.

Ultimately Youthsafe wants a world in which young lives are free from unintentional injury.

Our unique approach

We know that fear appeals and shock tactics are not effective in stopping young people from taking unsafe risks and won’t lead to positive behaviour change. In addition, using education in isolation of other structural or systemic improvements will not improve outcomes for individuals.

Youthsafe favours evidence-based approaches that create supportive, strong environments to address injury prevention in the context in which that injury occurs. This allows young people to take safe and calculated risks as well as build capacity and self-efficacy over time.

Our programs offer practical tools and provide strengths-based strategies to assist young people as well as those in a position of influence in their lives.

KEY MESSAGE 1: Negative judgments re young people’s behaviour without clear understanding of impact of brain development

Keywords: limbic system, prefrontal cortex, emotional response, planning, forethought, social environment, gender conditioning

Adolescence is a transitional developmental period where physical, psychological and social changes are occurring (Ernst, Pine & Hardin, 2006).

In particular during this time, the brain is going through some changes that may impact on a young person’s ability to assess risk and think things through rationally. While this developmental period is associated with an increase in risky behaviour, these important changes are taking place to help the brain become more efficient; redundant pathways are being cut off and new, more orderly pathways are being connected (Sercombe 2010).

The limbic system, located towards the back of the brain, is primarily responsible for memory, motivation and emotion. This part is one of the first areas to develop so becomes dominant during adolescence. The frontal lobes (or prefrontal cortex) responsible for planning/forethought, decision making, judgment, impulse control, delay of gratification and rational or logical thinking, is one of the last areas of the brain to develop in adolescents (Johnson et al, 2009).

Young people have some ability to make thoughtful decisions when they are calm. However when faced with making a quick decision on the spot, or in a stressful situation, the limbic system overrides the prefrontal cortex and this causes young people to respond emotionally and impulsively (Spear, 2000; Casey et al 2008; Bava & Tapert, 2010; Casey et al, 2011).

There are a lot of other factors that can impact on an individual’s behaviour, in any phase of development (Lubman et al, 2007; Casey et al, 2011). As individuals we all respond to situations differently depending on our physical and mental health, upbringing and other environmental and psychological factors. Stress is also shown to increase risk taking behaviour in young people in particular (Romer, 2010).

Because of these changes taking place, young people may have trouble:

• Interpreting written procedures (information flow is impacted)
• Understanding how to perform tasks explained but not demonstrated (difficulty in visualising potential outcomes)
• Translating general instructions into specific actions (ability to use information to make good decisions is inhibited) e.g. ‘be careful’ doesn’t have the same meaning to a young person as is does to an older adult
• Relating to something that they have not yet experienced (so cannot process critical information about dangerous situations or understand the harm potential of hazards once identified)

We may also need to consider that taking risks can be an important part of development and learning– it could be that taking risks is the very thing that helps us develop our brains and prepare us for adulthood (Spear, 2000; Sercombe, 2010; Casey et al, 2011). By allowing young people to take risks but with the support of older adults we could be helping young people learn how to assess and manage them (Sercombe, 2010).

References

Bava, S. & Tapert S.F. (2010). “Adolescent Brain Development and the Risk for Alcohol and Other Drug Problems”, Neuropsychological Review, 20(4): 398-413.

Casey, B.J., Jones, R.M. & Hare T.A. (2008). “The Adolescent Brain”, Annals of the New York Academy of Sciences, Vol. 1124: 111 – 126.

Casey, B.J., Jones, R.M. & Somerville, L.H. (2011). “Braking & accelerating of the adolescent brain”, Journal of Research on Adolescence, 21(1): 21-33.

Ernst, M., Pine, D.& Hardin, M. (2006). “Triadic model of the neurobiology of motivated behavior in adolescence”, Psychological Medicine, 36(3): 299-312.

Johnson, S.B., Blum, R.W. & Giedd, J.N. (2009). “Adolescent Maturity and the Brain: The promise and pitfalls of neuroscience research in adolescent health policy”, Journal of Adolescent Health, Vol. 45: 216-221

Lubman, D.I., Yucel, M. & Hall, W.D. (2007). “Substance use and the adolescent brain”, Journal of Psychopharmacology, 21(8): 792-794.

Romer, D. (2010). “Adolescent risk taking, impulsivity and brain development: implications for prevention”, Developmental Psychobiology, Vol. 52(3): 263 – 276.

Sercombe, H. (2010). “The ‘teen brain’ research: critical perspectives”, Youth & Policy, No. 105: 71- 80

Spear, L.P. (2000). “The adolescent brain and age-related behavioral manifestations”, Neuroscience and Biobehavioral Reviews Vol. 24: 417 – 463.

KEY MESSAGE 2: Shock tactics and their ineffectiveness in impact on long-term behaviour change

Keywords: ineffective, young males, no alternative offered, social threats may be better, behavioural change, fear appeals

Fear appeals or shock tactics are terms commonly used to describe messages that show graphic or extreme negative consequences of unsafe or risky behaviour (Lewis et al, 2007; Ruiter et al, 2014). Those who use fear appeals or shock tactics believe the target audience will be persuaded to change negative behaviour and act safely. So for example, showing images of a graphic car crash scene or pictures of gory crash victims to young novice drivers and expecting them to modify risky driving behaviour.

This approach has been popular over the years in trying to encourage young people in particular to modify or reduce risk-taking – so to stop smoking, drink alcohol to excess, speed, etc.

Research on the effectiveness of fear appeals appears to be inconsistent (Shanahan et al, 2000; Lewis et al, 2007), and many studies have shown that these approaches will not lead to positive behaviour change (VicRoads, n.d.).

In fact, some studies have shown that the undesirable or risky behaviour has actually increased (Job, 1988; Bird & Tapp, 2008; Algie & Rossiter, 2010; VicRoads, n.d.) or target audiences can switch off completely as the fear appeal messages don’t offer any solutions or alternative behaviours (Shanahan et al 2000: Algie & Rossiter, 2010).

Another worrying finding is that strong fear appeals appear to have the least impact on those who are more likely to engage in risk-taking behaviours, such as young males (Shanahan et al, 2000; Lewis et al, 2007; Bird & Tapp, 2008; Ruiter et al, 2014). Shock tactics have been shown to work better on older people (Geller, 2004) or to simply reinforce existing positive behaviours.

Shock tactics present the ‘worst-case scenario’, rather than offering alternatives or positive outcomes of safe behaviour (Job, 1988; Algie & Rossiter, 2010), so again are less effective than other approaches in reducing or eliminating risky behaviours.

Fear appeals may have some impact in some scenarios with some audiences, but they must be carefully researched and tested before implementation (Shanahan et al, 2000). Research suggests that social threats (loss of licence, embarrassment, missing out on a social event) rather than physical threats (severe injury, disfigurement or death) may be a more effective method in encouraging young people to be safe (Lewis et al, 2007; Bird & Tapp, 2008).

Approaches that equip the target audience with ways to develop their own practical strategies (‘ifthen’ plans) (Ruiter, 2014) help people develop decision-making skills which may be more effective than trying to scare people into positive behaviour change.

References

Algie, J. & Rossiter, J.R. (2010). “Fear patterns: A new approach to designing road safety advertisements”, Journal of Prevention & Intervention in the Community”, Vol. 38(4); 264-279.

Bird, S. & Tapp, A. (2008). “Encouraging road safety amongst young drivers: How can social marketing help?” Bristol Social Marketing Centre, Bristol Business School, UWE.

Geller, E.S. (2003). “Scared safe: How to use fear to motivate safety involvement” Occupational Health & Safety, Vol. 6(1): 6-9.

Job, S., (1988). “Effective & ineffective use of fear in health promotion campaigns”, American Journal of Public Health, Vol. 78 (2): 163-167.

Lewis, I. M., Watson, B., Tay, R. and White, K. M. (2007). “The Role of Fear Appeals in Improving Driver Safety: A Review of the Effectiveness of Fear-arousing (threat) Appeals in Road Safety Advertising.” International Journal of Behavioral and Consultation Therapy 3(2):pp. 203-222.

Ruiter, R.A.C., Kessels, L.T.E., Peters, G-J. Y. & Kok. G. (2014). “Sixty years of fear appeal research: Current state of the evidence”, International Journal of Psychology, Vol. 49(2): 63-70.

Shanahan, P., Elliot, B. & Dalhgren, N. (2000). “Review of public information campaigns addressing youth risk-taking”. A report to the National Youth Affairs Research Scheme, National Youth Affairs Research Scheme, Australian Clearinghouse for Youth Studies, Hobart, Tasmania.

VicRoads & Transport Accident Commission” (n.d.), Effective Community & School Based Road Safety for Young People. Updated 2014.

KEY MESSAGE 3: We shouldn’t just target young people and expect safer behaviour - a comprehensive whole-of-community approach to safety is needed.

Keywords: systemic rather than individual focus, complexity of injury, context, holistic approach

Research has established that the cause of unintentional injury is complex (Hanson et al 2005; Schwebel & Gaines 2007; Sleet et al, 2010; Allegrante et al 2010). What may lead a person to take risks and be at risk of serious injury is not just up to the actions of the individual but also exposure to risky situations, interaction with safe and healthy role models, actual or perceived barriers to safer behaviour as well as the existing norms and connections within their local environments (Allegrante et al 2010; Sleet et al 2010).

Neglecting to look at the ‘big picture’, that is, all the elements that may lead a young person to have incurred an injury and only addressing the issue on an individual level will then prove ineffective: “it is difficult to expect that people will change their behavior easily when many forces in the social, cultural, and physical environment conspire against such change” (Syme & Balfour in Allegrante et al, 2010: 26).

In addition, using education in isolation of other structural or systemic improvements will not improve outcomes for individuals within that system (McClure et al 2015; World Health Organization, 2014).

Approaches that create a supportive, strong environment that addresses injury prevention considering the contexts in which that injury occurs will lead to more effective interventions (Hanson et al, 2005; Johnston, 2010; McClure et al, 2015). There also needs to be a more widely accepted understanding that the individual’s ability to control injury risk is only one small part of a more multifaceted system that needs to be addressed more comprehensively (World Health Organization, 2014).

References

Allegrante, J.P, Hanson, D.W., Sleet, D.A. & Marks, R. (2010). “Ecological approaches to the prevention of unintentional injuries”, Italian Journal of Public Health, Vol. 7(2): 24-31. ‘

Hanson, D., Hanson, J., Vardon, P., McFarlane, K., Lloyd, J. Muller, R. & Durrheim, D. (2005). “The injury iceberg: An ecological approach to planning sustainable community safety interventions”. Health Promotion Journal of Australia, Vol. 16(1): 5-10.

Johnston, I. (2010). “Beyond ‘best practice’ road safety thinking and systems management – A case for culture change research”, Safety Science, Vol. 48 : 1175 – 1181.

Mason, M.J., Tanner, J.F., Piacentini, M., Freeman, D., Anastasia, T., Batat, W., Boland, W., Canbulut, M., Drenten, J., Hamby, A., Rangan, P. & Yang, Z (2011). ”Youth and risky consumption: Moving toward a transformative approach”, Journal of Research for Consumers, Vol. 19: 1 – 8.

McClure, R.J., Mack, K., Wilkins, N., & Davey, T.M. (2015). “Injury Prevention as Social Change”, Injury Prevention, Published Online First 9 December 2015, doi: 10.1136/injuryprev-2015-041838.

Schwebel, D.C. & Gaines, J. (2007). “Pediatric unintentional injury: Behavioral risk factors and implications for prevention”, Journal of Developmental & Behavioral Pediatrics, Vol. 28(3): 245 – 254.

Sleet, D.A., Gielen, A.C., Diekman, S. & Ikeda, R. (2010). “Preventing unintentional injury: A review of behavior change theories for primary care”, American Journal of Lifestyle Medicine, Vol. 4(1): 25-31.

World Health Organization (2014). “Health for the world’s adolescents: A second change in the second decade”, accessed 20 January 2016, www.who.int/adolescent/second-decade