In this latest opinion piece, Dr Elizabeth Box, research director at the RAC Foundation, explains why it’s time to move beyond traditional methods and embrace strategies that truly make a difference in promoting safe and healthy behaviours among young drivers.
It’s easy to get the wrong end of the stick when reading the results of studies presented in academic papers, and many have done so when it comes to fear-based interventions in PSHE education. The recently published independent review of the effectiveness of Safe Drive Stay Alive (SDSA), commissioned by Greater Manchester Fire and Rescue Service, underscores this point.
While it’s commendable to see evaluations being conducted, the results are, unfortunately, predictable: SDSA shows immediate, small beneficial effects that quickly dissipate. This finding aligns with existing literature on similar interventions over the years. However, the study’s lack of a control group undermines its robustness. It is also surprising that the paper doesn’t reference established good practices for PSHE education or consider potential unintended consequences. Moreover, it overlooks how behavioural change techniques, implementation intentions, and behavioural models could be further integrated into the intervention’s design.
The process evaluation conducted reveals that participants perceive the intervention as impactful. Sadly, perceptions are rarely accurate indicators of actual effectiveness. One notable comment highlights a crucial gap: “I think more focus on exactly what you need to do as a driver and passenger to be safe on the roads [is needed]”, which recent developments like DriveFit have sought to address. The paper recommends incorporating positive messaging alongside fear appeals. While some studies suggest that self-efficacy statements following a threat appeal can enhance effectiveness, this approach is not universally supported by the evidence. Overall, the existing literature suggests avoiding fear or threat appeals due to their inconsistent impact.
Overall the study found that SDSA can produce short-term improvements in knowledge, attitudes, and willingness to engage in risky driving and passenger behaviours. However, this raises a critical challenge: are the potential unintended negative outcomes worth the short-term effects, especially when other approaches can achieve similar but longer-lasting impacts using trauma-informed methods? Trauma-informed approaches create a supportive environment that promotes safety and empowerment, which can lead to more sustained behavioural changes.
Evidence from a recent meta-analysis
A new meta-analysis from Nature Reviews on determinants of behaviour change interventions provides valuable insights. It concluded that focusing on changing habits and modifying access to behaviours is more effective than targeting knowledge, general attitudes, and beliefs. These findings align with the principles of a systems approach, advocating for structural changes to support desired behaviours.
The review highlights that emotions, prominently featured in behavioural change models like the Health Belief Model, have limited effectiveness. For instance, the correlation between anxiety about COVID-19 and protective behaviours is small, and the association between perceived climate change risk and past adaptation behaviour is negligible. This pattern holds true for other perceived threats, such as HIV risk and condom use.
Recommendations for future interventions
To improve the efficacy of PSHE education, what should our future interventions look like? Well, a good start would be to:
- Adopt trauma-informed approaches, which provide a supportive environment that promotes long-term behavioural change.
- Focus on habit formation and structural changes to create conditions that facilitate desired behaviours, such as modifying access and providing consistent cues to support positive behaviours.
- Limit fear appeals due to their limited and inconsistent effectiveness. Instead, interventions should focus on positive, empowering strategies, especially when addressing a teenage audience.
- Incorporate action planning and Behaviour Change Techniques (BCTs). Utilising implementation intentions and other BCTs can bridge the well-known intention-behaviour gap.
In conclusion…
This latest set of SDSA study findings reiterate the need for evidence-based practices in PSHE education related to driving. While fear-based interventions may offer short-term gains, their long-term efficacy remains questionable. By adopting trauma-informed approaches and focusing on habit formation and structural changes, we have the opportunity to support people to achieve more sustainable and meaningful behavioural changes. As the recent Nature Reviews meta-analysis suggests, it’s time to move beyond traditional methods and embrace strategies that truly make a difference in promoting safe and healthy behaviours.
Dr Elizabeth Box
Research Director, RAC Foundation
Fully agree>>>
Communication processes should prioritise empowerment as a key
goal, with clear presentation of facts. The ethical issues associated with
the use of ‘shock, horror’ methods, or creating fear or shame should
be recognised and these should not be adopted.
Watson M C, Tilford S, Neil K E (2022) IHPE Position Statement:
Ethics and Health Promotion. Altrincham: Institute of Health Promotion
and Education.
https://ihpe.org.uk/wp-content/uploads/2022/11/IHPE-Position-Statement-Ethics-and-Health-Promotion-20th-Nov-2022.pdf
Dr Michael Craig Watson, Lincoln
+1