"A TIP From EMS"                                        WISCONSIN

PROBLEM IDENTIFICATION
   Youthful drivers, cyclists and pedestrians are
   disproportionately represented in roadway crashes, injuries
   and deaths.  Studies show that drivers under the age of 30
   account for more than one-half of all drinking drivers who are
   fatally injured in crashes. In Wisconsin in 1992, 115 drivers
   between ages 15 and 24 were killed in alcohol-related crashes,
   and such crashes caused serious injury to pedestrians,
   cyclists and others on the road.  Young people are also
   observed to use safety belts less and to take significantly
   more risks when driving, cycling and walking on state
   roadways.  Safety messages must be carefully targeted and
   delivered to reach this difficult audience.                    
              
   In response to this problem, Emergency Medical Services (EMS)
   personnel in Portage County, Wisconsin developed the "A TIP
   From EMS" Program.   
                                                                  
GOALS AND OBJECTIVES
   The "A TIP From EMS" (Trauma and Injury Prevention) Program
   was created to reduce injury and death among youth ages 16 to
   24 by increasing their perception of the risks and of
   acceptable ways to reduce them.

   The "A TIP From EMS" Program consists of a videotape divided
   into short segments addressing motor vehicle trauma, alcohol,
   head injury and helmet use.  It also includes a supporting
   brochure, poster and teacher guide.  Emergency service
   providers present the program, that can be tailored to fit
   each audience.  The presentation can convey the following
   messages to a young audience:  

    Trauma is the leading cause of disability and death among
     young people, but traumatic injury is preventable

    The effects of alcohol and other drug use and the role of
     substance abuse in the prevalence of traumatic injury

    The role of seat belts and airbags prevents or minimizes
     injury   
        
    The long-term effects of head injury and how the use of
     helmets when riding a motorcycle or bicycle can prevent or
     minimize these injuries
   
    The catastrophic emotional and economic costs of traumatic
     injuries

STRATEGIES AND ACTIVITIES
   The "A TIP From EMS" program was developed by emergency care
   providers, law enforcement professionals, coroners, television
   news staff and injured crash survivors. These individuals
   formed the committee to oversee all phases of the program's
   development.      
   
   The "TIP" Program has been presented to numerous audiences,
   including high school driver education classes, meetings of
   County Traffic Safety Commissions, the Wisconsin Emergency
   Nurses Association, the Coroners Association and the medical
   examiners.  

RESULTS
   Most of the students who have viewed the video rated the
   presentation as "good" or "excellent".  Their comments
   indicate that the "A TIP From EMS" program positively
   influences students perceptions of the need to use safety
   belts and to prevent drinking and driving.  

   A videotape in the same format is under development using
   Section 403 Bystander Care grant funds.  Another one targeting
   a younger audience is also under development, using Section 402 
   funds.          
                  
   

Community Occupant Protection Program                     INDIANA

PROBLEM IDENTIFICATION
   In an effort to reduce the risk to teens of injury and death
   from traffic crashes in Elkhart County, Indiana, the Elkhart
   County Safe Kids Coalition determined that a safety education
   plan targeting high school youth was needed.  A teen safety
   belt committee was formed, headed by a community volunteer for
   the American Red Cross.
   
GOALS AND OBJECTIVES
   The primary goal of the Community Occupant Protection project
   was to implement an initiative that would result in a
   significant increase in safety belt usage rates by teens. 
   This would reduce their risk of injury and death if they were
   involved in a traffic crash.
   
   The objectives were to:

    Raise the awareness level of seat belt safety
   
    Design and implement a student driven incentive program for
     five area high schools

    Form a committee of high school sponsors and students to
     develop the incentive program for their individual schools

    Provide leadership training for students/youth involved in
     the school-based programs

    Recruit and train volunteers to conduct safety belt usage
     surveys

    Achieve a minimum 70 percent safety belt usage rate by high
     school students

STRATEGIES AND ACTIVITIES
   In the Spring of 1991, members of the Elkhart County Safe Kids
Coalition formed the   
     Teen Safety Belt Committee.  The Committee developed the
strategies and objectives, and solicited area high schools to 
participate in the program. 
   Five high schools agreed to participate.  Leadership
   conferences were conducted and school committees were
   established.  Each school designed and implemented programs
   utilizing the "Buckle Your Bod" theme and logo.  A dance was
   held to kick-off the program and 3,000 students attended.

   Other program activities included:

       The development and distribution of promotional items,
        such as lifesavers candy, t-shirts and water bottles

       Dissemination of educational materials

       Announcements through the school public address system

       Contest drawings

   Four students and an adult volunteer attended the National
   Student Safety Program (NSSP) Conference in Texas.  This
   resulted in the establishment of the first NSSP chapter in the
   State of Indiana. 

RESULTS
   Evaluation methods consisted of observational surveys as well
   as feedback and follow-up sessions with participants.  Four
   out of five schools demonstrated increased safety belt use
   rates.  Two of the schools achieved a 69 percent usage rate,
   while overall increases ranged from 4 to 51 percent.

   Students continue to develop leadership and communication
   skills through networking with other students and
   organizations.  One additional high school has submitted a  
   request to participate in the program.

Elementary Education Initiative                             MAINE

PROBLEM IDENTIFICATION
   Comprehensive primary prevention programming in elementary
   schools is important because national surveys indicate that
   children are now beginning to use alcohol and other drugs at
   much younger ages than in the past.  Developing and fostering
   positive "no-use" attitudes at an early age can help to
   prevent people from eventually choosing to drive when under
   the influence of alcohol or other drugs.

   The Elementary Education Initiative educates school children
   about the risks of impaired driving, and it enhances awareness
   of these issues for school personnel and treatment providers
   in the community.

GOALS AND OBJECTIVES
   As part of a comprehensive prevention effort at each site, the
   program sought to:

     Increase awareness on the part of school staff of the issue
      of driving under the influence of alcohol or other drugs (DUI)

     Establish chemical health policy and procedures for
      employees and students

     Set up support groups for students and staff

     Plan and execute a student awareness plan

     Implement a curriculum model

     Provide alternative activities that are alcohol and other
     drug free

     Complete staff development activities

STRATEGIES AND ACTIVITIES
   In educating elementary school children about the risks of
   DUI, the Division of Alcohol and Drug Education Services
   provides leadership in the following areas:

    Assisting school administrators and treatment providers in
     the development and implementation of chemical dependency
     services for elementary school children, including support
     groups

    Designing and implementing substance abuse prevention
     programs and activities

    Providing consultation to school administrators and school
     boards in revising and adopting policy and procedures

    Providing instruction for elementary school personnel in
     primary prevention curricula

    Offering consultation on the design, implementation and
     evaluation of elementary school student awareness programs

    Facilitating inclusion of parents in comprehensive
     prevention programs

    Establishing the implementation of the DARE America program
     in schools statewide
   
RESULTS
   More than 30 school systems have been trained to implement the
   primary alcohol and other drug use prevention curriculum in
   elementary schools.  Schools adopting these curricula within a
   comprehensive program have reported a more positive climate in
   classrooms, greater student awareness of DUI risks, and
   enhanced abilities for teachers to intervene with children who
   are most at risk for early onset of chemical use.

   After the Elementary Education Initiative had received 3 years 
   of Section 402 grant funding from the National Highway Traffic
   Safety Administration (NHTSA), Maine lawmakers initiated a 5 
   cent tax on all bottle liquor sales for use in financing the
   program's continuation.

Missouri HEADS UP                                        MISSOURI

PROBLEM IDENTIFICATION
   The University of Missouri-Columbia School of Medicine
   conducted an incident study on traumatic spinal cord injury in
   central Missouri and found that young people between the ages
   of 15 and 25 years were consistently over-represented. 
   Traumatic head and spinal cord injuries result in permanent,
   life-altering disabilities which have no known cure.  Given
   the nature of these injuries and the baseline data, it became
   very clear that an intervention targeting adolescents and
   young adults was desperately needed. 

GOALS AND OBJECTIVES
   The primary goal of the Missouri HEADS UP program is to
   increase young peoples' knowledge and understanding of the
   causes and consequences of injuries to the head and spinal
   cord, and of measures to prevent these injuries.  Motor
   vehicle crashes are the leading cause of head and spinal cord
   injury, contributing to about half of all new cases each year. 
   This program emphasizes safety belt use, safe driving
   behavior, motorcycle and bicylce helmet use, proper bystander
   behavior and safety with all-terrain vehicles.  It also
   emphatically discourages drinking and driving.

STRATEGIES AND ACTIVITIES
   Staff members developed an educational assembly for junior and
   senior high school audiences across the state.  The program is
   presented in a manner that is suitable to adolescent
   audiences, and is designed to provide information in a non-
   threatening, non-authoritative manner.  

   Audiences are exposed to the following information through
   videos and a brief lecture:

    Their vulnerability to serious injury

    Specifics about the mechanisms of injury, especially as they
     pertain to motor vehicle injury

    Facts about the permanence of injury

    Details about the anatomy of the brain and spinal cord

   Additionally, a young person who has had a head or spinal cord
   injury then speaks to the audience about his or her personal
   experience with injury and all aspects of living with a
   disability.  This includes changes in urinary and bowel
   functions, sexual options and other elements that may not be
   readily apparent to those who have never had a spinal cord
   injury.  After the speaker's presentation, the floor is open
   to questions from the students.  
   
RESULTS
   Over the past 13 years, assemblies have been conducted in over
   500 schools, reaching nearly 182,000 students.  Similar HEADS
   UP programs have been established in St. Louis, Kansas City,
   Cape Girardeau, Springfield and Joplin.  These partner HEADS
   UP programs are supported and operated by hospitals and trauma
   centers. 

   The American Association of Neurological Surgeons (AANS) and
   Congress of Neurological Surgeons (CNS) provided a national
   budget which was used to found the National Head and Spinal
   Cord Injury Prevention Program office in Park Ridge, Illinois. 
   This allowed for the replication of Missouri HEADS UP in other
   states. 

   There are now approximately 100 programs in 49 states using
   the Missouri assembly model or a similar model from Pensacola,
   Florida. Most of the programs are referred to as THINK FIRST,
   the name of the recently established national office.  Former
   President Ronald Reagan and former US Surgeon General C.
   Everett Koop have both publicly endorsed this injury prevention 
   model initiated by the University of Missouri School of
   Medicine.

Northern Kentucky Rural Office of Traffic Safety         KENTUCKY

PROBLEM IDENTIFICATION
   According to the "Analysis of Traffic Data in Kentucky (1987-
   1991)," the rate of fatal crashes on the state's urban
   highways was less than one-half the fatal crash rate on its
   rural highways.  To address this major traffic safety concern
   in rural areas, the Northern Kentucky Rural Office of Traffic
   Safety (Northern KY ROOTS) developed a program targeting seven
   rural counties of Northern Kentucky whose populations ranged
   from 5,393 to 15,737.

GOALS AND OBJECTIVES
   One of the main objectives of this project was to establish
   safety committees in Gallatin, Grant, Owen, Carroll, Henry,
   Trimble and Pendleton counties.  Each committee was given a
   Traffic Crash Data Sheet to identify their county's main
   highway safety concerns.  The following areas were then
   targeted for the project:

    Safety belt and safety seat usage among youth

    Underage drinking and driving

STRATEGIES AND ACTIVITIES
   Northern KY ROOTS works with many organizations on this
   project, including the Department of Education, the Extension
   Service, the Farm Bureau, Students Against  Driving Drunk
   (SADD), Future Homemakers of America (FHA),  American
   Association of Retired Persons (AARP), and various religious,
   law enforcement and education committees in the communities.

   Each county committee planned and executed activities for
   special emphasis events such as Child Passenger Safety
   Awareness Week and Buckle Up America! Week.  The project
   provided materials and technical assistance for the
   activities.  The committees worked hand-in-hand with local
   school systems, health departments, law enforcement 
   agencies, ambulance services and administrative offices 
   of the courts.

   Most activities were conducted in high schools and included
   birthday parties for students turning 16, education on the
   dangers of drinking and driving, an annual seat belt use
   competition titled "Battle of the Belts", and distribution of
   new driver packets.  

   Other activities included media spots, church bulletin inserts
   and informational brochures included with paychecks.  Northern
   KY ROOTS also works with the Kentucky Early Childhood
   Association Conference by providing a highway safety exhibit
   and related materials for teachers of young children.
   
RESULTS
   According to surveys, four counties have shown increases in
   their safety belt usage rates since 1993. They include
   Gallatin County with an increase of 7 percent, Grant County
   with an increase of 16 percent, Owen County with an increase
   of 14.9 percent, and Pendleton County with an increase of 7
   percent.
        
   Additionally, no youth alcohol-related fatalities or injuries
   were reported in any of these four counties in 1993, compared
   to one fatality in Owen County in 1992.

Young Driver Deterrence Project                            HAWAII

PROBLEM IDENTIFICATION
   Across the nation, studies have concluded that alcohol-related
   traffic fatalities are still the number one killer of young
   people between the ages of 16 and 24.  In Hawaii, a December
   1989 report on drunk driving by the State Attorney General's
   Office found that Hawaii's alcohol-related teenage traffic
   fatalities were at a rate 38 percent above the national
   average.  Based on data from the 1991 Fatal Accident Reporting
   System, the Motor Vehicle Safety Office of the Hawaii
   Department of Transportation reported that 76 percent of
   traffic fatalities involving youth between the ages of 16 and
   24 were alcohol-related.
   
GOALS AND OBJECTIVES
   In an effort to deter young people from drinking and driving,
   the Young Drivers DUI Deterrence Project was established
   within the Maui Police Department.  The project initiated a
   Juvenile Alcohol Contact program designed to advise parents of
   situations involving the use of alcohol that may place their
   children in jeopardy. 

     The project objectives are to:

    Increase the DUI arrest rate of 16 to 21 year old drivers 

    Eliminate illegal liquor sales to minors

    Reduce alcohol-related violations, incidents and citizen
     complaints involving 16 to 21 years olds in Maui County

STRATEGIES AND ACTIVITIES
   The Maui Police Department established sobriety checkpoints in
   areas and at times where frequent rates of youth driving under
   the influence had been previously detected.  Roving
   patrol teams were also established in public areas where
   teenagers are known to congregate and consume alcohol.  

   On an overtime basis, police officers monitored alcohol
   establishments suspected of selling liquor to minors. 
   Appropriate enforcement action was taken in instances where
   warranted.  

   The Juvenile Alcohol Contact Program sought to increase
   parental awareness.  When a youth was found in a situation
   involving the use of alcohol, but was not in violation of the
   law, the officer sent the parents a letter advising them of
   the situation and the potential jeopardy for the child
   involved.

RESULTS
   The program has achieved positive results and has been
   received favorably.  A total of 382 labor-hours have been
   expended using teams of 2 to 3 officers on roving patrols.  As
   a result, they have made 39 arrests for alcohol or drug
   violations, of which 32 involved minors.  As a result of the
   deterrence projects high visibility in Maui County,
   particularly during the holiday season, patrol officers
   observed a substantial reduction in both public consumption of
   alcohol by juveniles, and illegal attempts to purchase
   alcohol.

   

Youthful DUI Offender                                    MISSOURI

PROBLEM IDENTIFICATION
   National traffic safety data for 1992 showed that drinking
   contributed to 38.3 percent of the fatal crashes involving
   drivers under the age of 21.  Drinking and driving crashes
   constitute 60.6 percent of single vehicle crashes during
   weekend and evening hours.  DUI enforcement is a critical
   component of every impaired driver control system. 

GOALS AND OBJECTIVES   
   The primary goal of the Youthful DUI Offender project is to
   detect and deter impaired driving, especially as it occurs
   among underage drinkers.  The objectives of the program are
   to:
   
    Use sobriety checkpoints to decrease by 20 percent the
     serious traffic crashes involving underage drinkers

    Reduce the number of safety belt violations

    Increase media coverage of underage drinking risks by
     inviting local media and school newspapers to each
     checkpoint

STRATEGIES AND ACTIVITIES
   The Missouri Division of Highway Safety (MDHS) utilized
   officers on an overtime basis to conduct sobriety checkpoints. 
   These checkpoints targeting underage drinking drivers were
   conducted in areas where minors were known to congregate and
   consume alcoholic beverages.  

   The department also responded to complaints from citizens
   concerning establishments that sold alcohol to minors.  When
   such a call was received, police officials deployed one of
   their civilian employees who was a minor to attempt to
   purchase alcohol at the establishment in question.  If the
   individual was successful, appropriate apprehensions  
   and arrests would be conducted.  

   The department's Vice Unit participated in this effort by also
   obtaining intelligence information, and by effecting the
   appropriate arrest of those employees of businesses found to
   sell alcoholic beverages to minors.  Enforcement efforts were
   coupled with appropriate public information releases aimed at
   escalating the perceived risk of arrest.

RESULTS
   The department was able to purchase an undercover vehicle for
   use in surveillance activities. Four sting operations and 11
   saturation patrols have been conducted between March and
   October of 1994 resulting in 17 minor and 96 adult arrests. 
   Funding to continue efforts through 1995 has been requested.