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Dubin, Julie Weingarden. "A DRUNK DRIVING TRAGEDY--WITH A SURPRISING TWIST." __Cosmopolitan__ 245.6 (Dec. 2008): 138-139. __MasterFILE Premier__. EBSCO. [Library name], [City], [State abbreviation]. 5 Mar. 2009 .

//A DRUNK DRIVING TRAGEDY--WITH A SURPRISING TWIST. By: Dubin, Julie Weingarden, Cosmopolitan, 00109541, Dec2008, Vol. 245, Issue 6 //**Database:**//MasterFILE Premier//

A DRUNK **//DRIVING//** TRAGEDY--WITH A SURPRISING TWIST
===Contents  **Section:** Real-Life Reads: THE COSMO POST === After hanging out with friends at a bar past closing time, Sarah Panzau, then 21, called it a night a little after 4 a.m. She'd been **//drinking//** for eight hours. She exited Highway 64 as she'd done many nights before, on an offramp whose posted speed limit was 25 mph. Only this time, she didn't slow down her '96 Saturn. Instead, Sarah began to take the sharp curve at 72 mph, then panicked and tried to swerve back onto the highway. Her car Hipped twice, slammed upside down onto a guardrail, and skidded 25 feet before flipping a third time. The hack windshield shattered, and Sarah was ejected from the car. She hadn't been wearing a seat belt, and her blood alcohol content was 0.308 — which is almost four times the legal limit in Illinois. By the time an ambulance arrived — one happened to be **//driving//** past the accident scene — Sarah was legally dead. Her heart had Stopped, and she had already lost so much blood that she was no longer even bleeding. Paramedics working to revive her looked at what they thought was a gruesome corpse and prepared to call the coroner when Sarah amazingly gasped for air.
 * A car accident that momentarily claimed 27-year-old Sarah Panzau's life ended up forever changing the way she lives**

At Saint Louis university Hospital, doctors had little hope she'd survive. She had massive bead injuries, lacerations all over her body, a severed left arm. a broken hip, a leg that had been completely twisted around, and crushed ribs. Sarah was put on a ventilator and into a drug-induced coma. "If she didn't die from all her injuries, doctors thought she'd very well die from infection," says Sarah's mother, Cindi, an army nurse who was forced to identify her mangled daughter in the hospital. "She was that bad. I didn't know if Sarah would be okay until she woke up from her coma two weeks later. One of the surgeons asked how she was doing, and she gave a thumbs-up." Over the next 12 months, Sarah endured more than 30 surgeries. "I was stitched and Stapled and poked and prodded on every inch of my body," she says. "But I was determined to make it." And she was determined to turn her life around. A year before the accident, the two-time All-American volleyball player had dropped out of college, giving up her full-ride Scholarship because she hadn't enjoyed her course work. She opted instead to tend bar and started abusing drugs and alcohol. "I didn't pay for medical or car insurance, but I paid for cocaine." Sarah recalls. "I didn't think I had to listen to any-body — I partied whenever I wanted and only cared about myself."

Now 27, Sarah says she suffers from chronic pain despite taking a massive dose of pain medication ever) day "I hurt so bad that some mornings, I don't want to get up," she says. "But I tell myself, Deal with it. because things could be worse — you could be dead." After Sarah had recovered From her surgeries, a high school guidance counselor read about her in a local paper and asked her to speak to Students about her ordeal. "Of course I was nervous, but I knew it was something I wanted — and had — to do," she says. It eventually became a full-time job, as Sarah traveled all over the country, giving talks and using horrific photos of herself at the accident scene and in the hospital. Beermaker AnheuserBusch even signed her to its national speakers bureau. "I give presentations dressed in a lank top and shorts, even though I'm self-conscious about the scars on my body," Sarah admits. "I do it because I know seeing them has a huge impact on people." "I HURT SO BAD THAT SOME DAYS, I DON'T WANT TO GET UP. BUT THINGS COULD BE WORSE — I COULD BE DEAD." PHOTO (COLOR): She turned her horrible accident into a teaching tool (inset). PHOTO (COLOR): In the midst of a two-week coma 12362646211236264621 By Julie Weingarden Dubin

"Preventing driving accidents involving teenagers." __Harvard Mental Health Letter__ 25.6 (Dec. 2008): 6-6. __MasterFILE Premier__. EBSCO. [Library name], [City], [State abbreviation]. 5 Mar. 2009 .

M otor vehicle accidents remain the leading cause of death for teenagers, accounting for nearly 41% of fatalities in 2004 among young people ages 13 to 19. Th is deadly toll results, to a large extent, from lack of driving experience, but it also refl ects the fact that the teenage brain is still a work in progress. Th e prefrontal cortex, which contains the neural mechanisms of self-control, is one of the last parts of the brain to mature. As a result, teenagers are prone to risk taking, impulsive behavior, and sensation seeking—all of which can cause trouble behind the wheel of a two- or three-ton vehicle hurtling down a highway. One possible solution is to increase the age requirement for driver’s licenses to 17 or 18. But there is no consensus that this will reduce crash rates. Th e Institute of Medicine recently convened a panel of experts to identify behavioral and cognitive strategies to prevent motor vehicle accidents involving teenagers. Th eir fi ndings were summarized in a special issue of the //American Journal of Preventive Medicine// published in September 2008. Some helpful tips for parents follow. Although driver’s education courses may be marketed for their safety, there is no proof that they reduce the rate of motor vehicle accidents involving teenagers. In fact, specialized classes that emphasize practice in skid control and other emergency maneuvers may actually increase risk of crashes, especially for young men, possibly because of excess confi dence or a desire to “show off ” skills for friends. Accumulating more hours of parentsupervised driving may not help either. Studies have found that teenagers whose parents spend a lot of time supervising their driving are no more likely than teenagers with less supervised driving to avoid motor vehicle crashes once licensed. It’s not clear why, but parents may be restricting practice time to relatively safe conditions, such as driving during the day on a side road, rather than exposing novice drivers to more complicated situations, such as driving at night or in snow. Parents may also inadvertently act as codrivers, by helping to watch for other cars and checking “blind spots”; as a result, teenagers may not acquire the skills they need to drive by themselves. The research conclusively shows that only by driving alone do teenagers develop the complex skills they need to be safe on the road. Many parents set limits on car trips, by asking where their teenagers are driving and when they will return home. But the research suggests that it may be better for parents to impose strict limits on particular risk conditions, even if it means going beyond what state law requires, because teenagers are then less likely to become risky drivers or get involved in a motor vehicle crash in the fi rst year aft er earning a license. may seem obvious, as the legal drinking age is 21. Still, many teenagers fi nd ways to obtain alcohol anyway. Teenagers (like adults) may not realize they don’t have to be legally drunk to become risky drivers; at all blood alcohol concentration levels, they are more likely to crash a motor vehicle or die in an accident. take place at night. Ask the teenager to return the car home by 9 p.m. or 10 p.m., regardless of what state law says, until age 18. passenger increases risk of a crash, but the risk increases with each additional passenger. (Teenage boys in particular may want to show off for friends or egg one another on.) Ask the teenager to drive alone or with no more than one other passenger at a time, until age 18. are less likely than people of other age groups to use seat belts while driving, with disastrous results. In 2004, nearly two-thirds of teenagers who died or were injured in crashes were not wearing a seat belt. National Sleep Foundation reported that 45% of adolescents said they did not get suffi cient sleep on school nights, with 28% saying they felt irritable and cranky as a result. Sleep deprivation in teenage drivers contributes to lack of attention, impaired judgment and greater risk taking, more susceptibility to alcohol intoxication, and increased aggression and impulsivity. Th is may explain why half of motor vehicle accidents in teenagers occur at night. Surveys have found that parents and teenagers may not agree about what rules are in place or what the consequences are for not following them. Although electronic monitoring devices are commercially available, they undermine the development of independence and trust—and few parents use them anyway. It may help to clarify rules, expectations, and conditions for earning increased driving privileges by writing them down. This may not only help teenagers abide by the established limits but also encourage better driving practices. Graham R, et al. “Preventing Teen Motor Crashes,” //American Journal of Preventive Medicine// (Sept. 2008): Vol. 35, No. 3S, pp. S253–57. Shope JT, et al. “Teen Driving: Motor-Vehicle Crashes and Factors that Contribute,” //American// //Journal of Preventive Medicine// (Sept. 2008): Vol. 35, No. 3S, pp. S261–71. For more references, please see www.health.harvard.edu/mentalextra.
 * Don’t count on driver’s ed**
 * Monitor behavior, not the trip**
 * //Stress dangers of drinking.//** This
 * //Restrict night driving.//** Many crashes
 * //Limit passengers.//** Even one teenage
 * //Encourage buckling up.//** Teenagers
 * //Monitor sleep.//** A 2006 poll by the
 * //Write down “rules of the road.”//**

Dean-Mooney, Laura. "A Lower Age Would Be Unsafe." __U.S. News & World Report__ 15 Sep. 2008: 10+. __MasterFILE Premier__. EBSCO. [Library name], [City], [State abbreviation]. 5 Mar. 2009 .

__A Lower Age Would Be Unsafe__
__**Section:**__ __THE FORUM: TWO TAKES__  As the fall semester begins at colleges across the country, campuses once again face the challenge of combating underage and binge **__//drinking//__**. This is a serious and difficult issue for colleges, for communities, and for parents like me who are preparing to send a son or daughter to college. Unfortunately, more than 100 college presidents have chosen to address the issue by signing on to a misguided initiative that ostensibly favors a debate but is supported by a group, Choose Responsibility, whose sole aim is lowering the **__//drinking//__** age from 21 to 18 years old. Mothers Against Drunk **__//Driving//__**is open to a discussion about solving the problems of underage and binge **__//drinking//__**. But the discussion must be based on facts, and, in this case, the facts are clear: 21 saves lives. Since states began setting the legal **__//drinking//__** age at 21, the law has been one of the most studied in our history. The evidence is overwhelming: More than 50 high-quality scientific studies all found the 21 law saves lives, both on and off the road. And the public agrees: 72 percent of adults think that lowering the**__//drinking//__** age would make alcohol more accessible to kids, and nearly half think that it would increase binge **__//drinking//__** among teens, according to a new Nationwide Insurance poll. This is why stakeholders from scientific, medical, and public health organizations have joined MADD to form the Support 21 Coalition: We believe in basing public health policy on sound medical research and are committed to highlighting the lifesaving impact of the 21 **__//drinking//__** age. Twenty-one isn't just an arbitrary number set by Congress--more than 20 states already had laws setting the **__//drinking//__** age there in 1984. And since the 21 law was widely enacted, the number of young people killed annually in crashes involving drunk drivers under 21 has been cut in half, from more than 5,000 individuals in the early 1980s to around 2,000 in 2005. By the end of 2005, the 21 **__//drinking//__** age had saved nearly 25,000 American lives--approximately 1,000 lives a year. The Support 21 Coalition stands behind the indisputable scientific research that demonstrates lowering the **__//drinking//__** age would make the difficult problems of underage and binge **__//drinking//__** far worse. Research indicates that when the minimum legal **__//drinking//__** age is 21, people under age 21 drink less overall and continue to do so through their early 20s. When the **__//drinking//__** age has been lowered, injury and death rates significantly increased. Lowering the age of those who have easy access to alcohol would shift responsibility for underage **__//drinking//__** to high school parents and educators. A neurotoxin. Research has shown that the harmful effects of alcohol abuse are magnified on a teenager's still-developing brain. The adolescent brain is a work in progress, marked by significant development in areas of the brain responsible for learning, memory, complex thinking, planning, inhibition, and emotional regulation. The neurotoxic effect of excessive alcohol use is a danger to these key regions of the maturing adolescent brain. A person's brain does not stop developing until their early to mid-20s. During this period, alcohol negatively affects all parts of the brain, including cognitive and decision-making abilities as well as coordination and memory. Adolescent drinkers not only do worse academically but are also at greater risk for social problems like depression, violence, and suicidal thoughts. Lowering the **__//drinking//__** age would have dangerous long-term consequences: Early teen drinkers are not only more susceptible to alcoholism but to developing the disease earlier and more quickly than others. The problem of binge **__//drinking//__** on college campuses needs to be addressed, but lowering the **__//drinking//__** age would be not only short-sighted but deadly. The simple fact is that the 21 law saves lives and is, therefore, nonnegotiable. PHOTO (COLOR) PHOTO (COLOR) 12362652501236265250 By Laura Dean-Mooney Edited by Robert Schlesinger Laura Dean-Mooney, the national president of Mothers Against Drunk **__//Driving//__**, has been involved with the organization for 15 years
 * __Pro__**
 * __Since the mid-1980s, U.S. citizens have had to be at least 21 to purchase or consume alcohol. But a group of college presidents have reignited the 21__** //__drinking__// **__age debate, arguing it has fostered a binge-__**//__drinking__// **__culture. Advocates argue the law has saved lives. Should the__** //__drinking__// **__age stay at 21?__**
 * __What do you think?__** Should the U.S. **__//drinking//__** age stay at 21? Or should it be changed? You can join the debate at [|www.usnews.com/drinkingage]. Or send your thoughts to viewpoint@usnews.com or to Viewpoint, U.S. News & World Report, 1050 Thomas Jefferson Street NW, Washington DC 20007. Selected responses will appear in the next issue.

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Dean, Aaron. "Every 15 Minutes. (cover story)." __Fire Engineering__ 161.2 (Feb. 2008): 85-94. __MasterFILE Premier__. EBSCO. [Library name], [City], [State abbreviation]. 5 Mar. 2009 .

E VERY SPRING BEFORE PROMS AND GRADUATIONS, high schools around the nation put on a drinking and driving awareness program called "Every 15 Minutes." The Every 15 Minutes (H15M) program is a two-day event targeting high school juniors and seniors that illustrates the lievastating effects of the poor choice to drink and drive. This nationwide program takes eight to 10 months to plan and incorporates many local agencies. The fire department plays program. The E15M program begins on Day 1 with students arriving to class as usual. Iieginning in first period and continuing throughout the school day, students are randomly pulled from class by the "Grim Keaper." dres.sed in a full black robe carrying a scythe. The "random" students art- .ictually preselected; they become part of the "Living Dead" and are sequestered from their peer group, friends, and family until the next day. This requires a parental consent form and the obtaining of signed notification of event forms beforehand. A team that may include chaplains, law enforcement personnel, and coroner representatives then notifies the parents of the "death" at their residence or place of employment. The scene is very emotional. Even though the parents' supervisors and coworkers have received prior notice, the tension affects all present. THE CRASH SCENE During the morning, a scheduled mock crash scenario is demonstrated in real time before the assembled students (photo 1). Usually, the crash scene is staged on a football field, which also allows for the safe preparation of a helicopter landing zone (LZ). Before the students assemble, a towing company delivers two damaged vehicles on the field. If possible, the use of a helicopter is suggested; its presence contributes greatly to the crash scene's realism (photo 2). This venue allows excellent scene visibility and acoustics. The scene is comprised of one or two vehicles strategically located. Four students are preselected as crash scene participants. Tlie injuries may vary, but one student must be the driver driving under the influence (DL'l) and one must be the dead-on-arrival (DOA) victim. The other two .students can be considered critical trauma cases and treated and transported appropriately. One of the two should be a paraplegic, and one should require extrication at the crash scene (photo 3). The four crash scene students are transported to appropriate respective destinations: The police take the DUi driver to jail for booking; the coroner takes the body of the DOA to the morgue; and the two injured patients go to the trauma center—one by ambulance and the other by helicopter. These students will be "processed" through the normal routine of events associated with each facility. 'Hie parents of the trauma patients go to the emergency room, which is one element of the program that really alTects the participants. On completion ofthe demonstration, the assembled students are released to continue with their normally scheduled classes. Students continue to be removed every 15 minutes by the Grim Reaper, accompanied by the sound of a heartbeat that is broadcast over the school's public address system. Tombstone.^ are erected on campus to symbolize the losses. The school day ends with the remaining student body being released in the normal manner. The Living Dead at this point now number approximately 30. They will be shuttled www.FireEngineering.com FIRE ENGINEERING February 2008 85 • EVERY 15 MINUTES to //dii// otl-L<iiupus loLdlioii, such a.-, an i:lks iodgc, where retreat facilities have been arranged. THE RETREAT The retreat is led by law enforcement personnel, firefighters, chaplains, counselors, teachers, or other designated persons. The crash scene students are retrieved from each of their respective locations (the morgue, the jail, and the hospital) and reunited with the Living Dead, Tlie goal is that these students reflect on the day's events and share those thoughts with their peer group. The entire group remains out of contact with their families. This a.spect of the program requires confidentiality and understanding by all in attendance. At the retreat, warm-up games and icebreakers are played. In bigger schools, .students may not know every student in the room. When the time is right, two activities are performed— letter writing and the passing ofa candle. Although others may be included, these two components are very effective. Each student writes a letter to his parents. The lener begins, "Every 15 minutes in the United States, someone dies or is seriously injured in an alcohol-related incident. Today, I died." Thf student continues writing from the heart. The parents of the Living Dead students in turn write letters to their children. One or two letters will be read during the assembly the following day. 1 he passing of the candle occurs when all persons are seated in a circle in a darkened room. No one speaks unless they have the candle. A quiet uneasiness settles on the room. One can speak for as long or as short as he would like. The candle is passed around the circle until all persons have had the opportunity to speak. Some very troubling stories may be shared during emotional times at the retreat. Not all .stories will revolve around alcohol. Emotional issues such as drug use, losing family members in a war, and abusive family situations are examples of what has been shared. If a student reveals that he or she is in danger or needs help, appropriate measures must be started. Having 30 teenagers sit quietly in a room is unner\'ing in itself. When you can hear a pin drop in a room full of otherwise active, high-spirited high school students, it is obvious the message is being received. The evening concludes with the students spending the night. Day 2 begins back on campus with an assembly for the seniors and juniors. The entire student body attends if .space permits, A funeral-type procession commences with a focus on yesterday's evenls. A casket is on stage. A video of the previous day's events produced by the students is shown. The student who was a paraplegic can finally get out of the wheelchair he has l>een using since he was released from the hospital. A guest speaker, such as a local TV news personality, speaks. Counselors should be available. Closure begins. In the Sacramento area, we like to close the assembly with Roll Call. Roll Call illustrates the ripple effect. You or someone you know will be affected by a drunk driver. The speaker asks specific groups of people to stand, such as those who responded to the crash scene or those who performed patient care. The questions broaden in nature until ultimately every person in the assembly is standing. Ihe point: Drunk driving affects us all. In California, the state Office of Traffic Safety (OTS) provides minigrants of $10,000 to develop the program. The California Highway Patrol (CHP) works closely with OTS, funding and coordinating each program. Outside of California, minigrants are available through the national E15M.' Local agencies assist where needed. For instance, fire department jurisdictions may differ from EMS response areas, local law enforcement boundaries may vary as to location, or helicopter and hospital capabilities may need to be addressed. Coordination is the key to a successful program. Tlie CHP has a great procedures manual available at www,chp.ca,gov/pdf/manLial.pdf. HISTORY Although there is some debate as to the origin of this program, it is reported the E15M program originated in Spokane. Washington,^ 1990, under the direction of then Sergeant Mark Sterk of the Spokane (WA) Police Department (SPD). The traffic unit of SPD assisted Gon/aga Prep High School in producing a skit revolving around a traffic collision resulting from drunk driving. This is believed to have been the .start of the E15M program. The first high school program was pnxluced in 1991, funded by a grant from Safeco Insurance for the pur- 86 February 2008 FIRE ENGINEERING www.FireEngineering.com • EVERY 15 MINUTES chase of a sound system. The program continued, and many agencies came to see what was happening in Spokane. Sterk was elected sheriff of Spokane County and continued to build the program, He named it "Every 15 Minutes," which represented the approximate frequency of drunk-driving related deaths.^ It has been reported that Canada was performing a similar program to the north around the same time. After attending a Problem Oriented Police (POP) conference, the Chico (CA) Department hosted a program in January 1996.'* Reportedly, the Chico Police Department also played an integral role in strengthening the program. Again, since very little documentation of these events was formally recorded, the exact history has been difficult to establish. One aspect is very clear—many dedicated people have contributed and continue to contribute to this powerful program. In 1997, the national Every 15 Minutes organization was formed. Dean Wilson of the Bethlehem Ibwnship (PA) Police Department is the training coordinator and has spent countless hours developing the program. "We want to further grow this [program! ••• il has come so far already over the years." he explains. Wilson says that an online format will be available at www,everyl5minutes,com early this year to help coordinators administer their local program.* Every 15 Minutes Duties and Checklist Preplanning • Determine the number of students participating in crash scene. Usually, there should be at least a DUI driver, a DOA, a head injury/comatose patient, and a paraplegic patient. • Establish the time of day at which the crash occurs and what type of crash scenario it will be: head-on, rollover, T-bone, etc, • Obtain tbe sciiedule of events from the planning committee. • Make it clear to the planning committee that the fire department has the final say on scene specifics regarding safety. //Do not compromise safety at any time!// Site Inspection • Determine the most appropriate locations for the the crash scene, the helicopter landing zone, and the audio setup, including AC power and a good visual aspect of the crash scene. • Ensure there is adequate entrance/egress to the crash scene and for all apparatus. " Ensure the safety of the entire scene, including the crash scene, the students, spectators, and fire and police personnel. Pay particular attention to the approach of apparatus, extrication, the landing zone, and video crew locations at ai! times, • Obtain towing company contact Information (contact person and phone number) and discuss the vehicles involved (color, make, model, year) and possible safety issues with vehicles: air bags, "stuff" left in vehicle when towed to site, removal of broken glass in seats prior to placing students in vehicles, etc. Company Assignments Contact/e-mail fire department superiors for assignment of the following personnel and vehicles: • a battalion chief on location for the event; • a truck for extrication and two engines for patient care and LZ support; • an EMS unit for transport, possibly a second unit if weather prevents helicopter participation; • a medicai evacuation helicopter; and • a dispatcher, • Remain in touch with the police department contact for upto- date information. One Week Before the Event E-mail all members of all companies assigned program information specifics, including site-specific information, program details, and any necessary miscellaneous information. Identify the personnel projected to participate in the program. The Day Before the Program Follow up witii the towing company to confirm: • the vehicles to be used, • that a hoie has been cut in the passenger side of the vehicle's windshield for the DOA patient and that the hole's edges have been taped, and • the arrival time ofthe vehicles. Confirm each participating fire department company's attendance and time of arrival. The Morning of the Event • Arrive at the site approximately three hours before the start of the program. • Position the vehicles on arrival of the towing company. • In the morning, obtain a tactical channel to use from the fire dispatch supervisor (usually D6), Cail and confirm the helicopter's availability. If unavailable because of logistics or weather, immed/ate/y request a second medic unit. • Meet with crash scene students to explain Incident events/ procedures. • Meet with audio/visua! crew—emphasize safety. • Get mic'd up, if needed, • Have a briefing with the fire companies and law enforcement arresting officers (bring doughnuts/snacks from the food committee to give to the companies during the briefing). Hold the briefing approximately 40 minutes prior to the time of the crash. • Get two handheld radios from a company for your use onscene, • Remind the police department arresting officer to leave the audio microphone behind prior to departing for jail. During the Event If there is no dispatcher on-scene, you will become the dispatcher. Dispatch the "incident" and fill the roie of fire dispatch or command as needed, using only the one tactical channel. After the Event • Thank the participating companies. • Determine if the companies want to continue to train on extrication after the audience has cleared the bleachers. • Return mics to the audio crew. • Call Fire Dispatch and release the TAC channel, • Call the tow company and request that the vehicles be returned to the towing yard. 88 February 2008 FIRE ENGINEERING wvvvtf.FireEngineering.com • EVERY 15 MINUTES In the years since, this interactive, preventive program has influenced numerous high school students, parents, and facult>- In 200S. the 16,885 alcohol-related crashes in the United States represent an average of one alcohol-related fatality every 31 minutes. DOES IT REALLY WORK? Two studies are worth noting regarding the effectiveness of the E15M program. The first, from Springfield, Missouri, was published in the //American fournal of Health Studies in 2000.''// Il was based on the Greene Count>' (MO) DWI Task Force, which presented the E15M program in 2000 for the third time to the 1,700-student Kickapoo High School. The Task Force wanted to determine the effectiveness of the program. The abstract reveals, through the use of a survey-ba.sed format, "The intervention program had a favorable impact on attitudes but not behavior. Survey and focus group data suggested there would be no sustained behavioral change without combining the intervention with stronger DWI law enforcement, communit>' support, and educational programs," Another study, published in the //California Journal of// //Health Promotion// in 2003, had as its focus group 1,651 students from 81 California high schools who participated in the E15M program as the Living Dead. Data were collected in the form of pre- and post-incident surveys. Results suggested lasting program effects were congruent with other drinking- and dri\ ing-prevention programs. The following was noted: "However, one of the goals of the program is to prevent alcoholrelated driving mishaps during prom and graduation months, so short-term intervention may l>e successful," Also, an indirect aspect emerged, Barents whose children participated as Living Dead ,.. were significantly different in their attitudes and behaviors about alcohol ase among their children. Following their participation in the program, parents also reported being more likely to discuss drinking and driving, more prepared to control or prevent alcohol problems, and more confident that their teenager would not drink and drive."" THE FIRE DEPARTMENT'S ROLE The fire department can play an integral role in the E15M program. As the fire department coordinator, your planning is critical. Depending on your local geographical area of 911 response, various forms of service delivery may be performed. If your fire department has ambulances and transports, continuity of care and coordination may assist in the logistics of the agencies involved. As we in the fire service know, the plan is ever dynamic. Therefore, it is imperative to give chief officers as much advance notice as possible so that resources can be scheduled. Send, as needed, follow-up e-mails to ensure everyone is informed. Since different personnel or actors may fill certain positions because of promotion or vacation, multiple notifications ensure companies wilt be where they need to be at the proper time. The worst scenario is telling a firefighter on
 * BY AARON DEAN**
 * i vital role in planning, coordinating, and implementing this

• Multiple on-board platforms. Fully compatible wtth all rescue toots. //*•// The only PTO that fits a Ford Super Duty 4WD, all Allison, and Caterpillar transmissions. • Expert system consultation - 8 0 0 - 3 4 3 - 0 4 8 0 //Power Sysiems// //WE GIVE RESCUE TOOLS THi POWER TO// SVIVE //I.IVFF// //.12 Tioga Way, Marblehead. MA 01945// I //781-631-3282// I //Fax: 781-639-1467// I //Email: info@xrtcombi.coin// I //Web: www.xrtcombi.com// Enter 161 at fireeng.hotims.com 90 February 2008 FIRE ENGINEERING www.FtreEngineering.com • EVERY 15 MINUTES arrival at the firehouse to get ready to go do a "dog and pony" show in 10 minutes. Also, consider alternative plans. For instance, the initial helicopter may not be able to attend because of a mission in progress. If a secondary' agency has not filed a flight safety plan of the high school prior to the event, a "no go" will result. Weather may also disrupt flights, requiring additional ground ambulances. Programs usually continue as planned regardless of the weather. The exact number of companies needed depends on your level of staffing and standard operating procedures. If particifor them to get tunnel vision when behind a camera; they must be accounted for at all times. Often, they will accompany the first-arriving company and the transporting medic to the hospital. However, the helicopter does not generally take the videographer because of weight restrictions. The fire department coordinator is responsible for the vicjeographers' safety. A safety briefing for all crash scene participants is imperative. High school students want the pn)gram to Ix" successful and will typically listen to your directions. Administrators and principals may be a problem; they must know that your word is final on all safety matters, including where they stand at the crash scene. From student participants to firefighters, everyone siiouid be safe and injury-free at tiie end of tiie demonstration. pation will require overtime, chief officers may be less likely to permit full involvement. Generally, this program will need one engine company for patient care, one truck company for extrication, one engine company for LZ support, and one medic company for ground transport. A second medic unit may be needed if weather prevents the use of a helicopter. Although a battalion chief and a dispatcher add to the realism of the event, they are not necessary. The fire department coordinator can assume those roles if necessary. The keys to the crash scene are choreography and safety. As the fire department coordinator, you are responsible for the trash .scene, ensuring all students can see al! action and that all action is timed appropriately. Remember, whatever happens was exactly what was supposed to happen. The because of game-time difficulties, such as a delayed helicopter arrival. In addition to extrication and transport, law enforcement wilt perform field .sobriety tests on the DUI driver when planned. The officer, the DLII driver, and generally one firefighter are wired for microphones. Radio traffic can be transmitted over the public address system for the audience to hear. Occasionally, the paramedic radio report to the trauma center will be broadcast to the audience. It provides a chilling effect. //Sajety is paramount/// As fire department coordinator, you also assume the role of safety officer on-scene. From student participants to firefighters, everyone should be safe and injurefree at the end ofthe demonstration. Don't overlook basic principles such as using all appropriate personal protective equipment, including eye protection and full turnouts with gloves during extrication; appropriate crash scene and LZ isolation; and entrance/egress of apparatus, for which a traffic plan is highly desirable. Typically, "patient" extrication goes well if normal safety precautions are taken, such as covering the patient with a salvage cover and keeping a firefighter with the patient during cutting operations. Videographers, usually students, will be present. It is easy Your fire department's involvement in this community event can be very rewarding and also serve as a training evolution for the incident command system (ICS), multiple casualty incident (MCI) protocols, EMS, and extrication tactics. Probationary firefighters can leam much from a simulated incident such as this one. Often, after the student body has exited the bleachers, fire companies can finish cutting up the vehicles l>efore the towing companies arrive.
 * iiidience will not know if you depart from the script slightly

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Salazar, Camerino I., et al. "EVALUATION OF AN UNDERAGE DRINKING AND DRIVING PREVENTION PROGRAM." __American Journal of Health Studies__ 21.1/2 (Mar. 2006): 49-56. __MasterFILE Premier__. EBSCO. [Library name], [City], [State abbreviation]. 5 Mar. 2009 .

**EVALUATION OF AN UNDERAGE** //DRINKING// //AND// //DRIVING// **PREVENTION PROGRAM**
Underage //drinking// //and// **its associated consequences, including** //driving// **after** //drinking// //and// **riding with a** //drinking//**driver, remain a major public health concern to this nation. Underage** //drinking// **is also a major contributor to motor-vehicle injuries** //and// **fatalities among persons age 15 to 20. School-based alcohol prevention programs are essential in helping to prevent** //drinking// //and// //driving// **among adolescents. This paper will present methods**//and// **results of a preliminary evaluation conducted on a school-based** //drinking// //and// //driving// **prevention program for high school students that simulates alcohol-related consequences** //and// **involves various community elements. Recent epidemiological studies suggest that alcohol remains the primary drug of choice among adolescents, with the average age of first use being 13.2 years (Arata, Stafford, & Tims, 2003; Harris, Jolly, Runge, & Knox, 2000; Maney, Higham-Gardill & Mahoney, 2002; Stewart, 1999). The National Center on Addiction** //and// **Substance Abuse (CASA) at Columbia University estimates that 20% of alcohol consumption occurs among persons less than 21 years of age (2003). According to the Centers for Disease Control** //and// **Prevention (CDC) (2004), approximately 75% of high school students nationwide reported using alcohol at least once during their lifetime (i.e. one more drinks on one or more occasions) while 45% reported being current alcohol users (one or more drinks on one or more occasions within the last 30 days). In regards to heavy alcohol use, 28% of high school students reported binge** //drinking// **(five or more drinks in a row on one or more occasions)** //and// **between 18%** //and// **31 % reported being drunk within the last 30 days (CDC, 2004; Johnston, O'Malley, Bachman, & Schulenberg, 2003). Alcohol also significantly contributes to motor vehicle crashes, which remain the leading cause of death for persons 15-20 years of age (CDC, 2004, Lazy, Wiliszowski, & Jones, 2004). According to the Office of Applied Studies at the Substance Abuse** //and// **Mental Health Services Administration (2004), in 2003, 21 % of persons aged 16 to 20 reported that they had driven within the past year while under the influence of alcohol or illicit drugs. The National Highway Traffic Safety Administration (NHTSA) reports that in 2003, a quarter of young drivers ages 15 to 20 years killed in motor vehicle crashes were intoxicated (NHTSA, 2004). Young male drivers are also at higher risk for being killed in an alcohol-related motor-vehicle crash. In 2003, 28% of the young male drivers involved in fatal crashes had been** //drinking// **at the time of the crash, compared with 13% of the young female drivers involved in fatal crashes (NHTSA). Exposure to alcohol-related injuries** //and// **fatalities among adolescents are also enhanced by a series of other** //driving// **risks which include limited** //driving// //and// **road experience, nighttime** //driving//**, speeding,** //and// **failure to use proper safety restraints. The objectives of this study are to (a) describe the process of an evaluation conducted on an underage** //drinking// //and////driving// **prevention program for high school students, (b) report whether participants expressed changes in expectancy scores regarding underage alcohol use,** //and// **(c) develop programmatic recommendations that will strengthen the future design, implementation,** //and// **evaluation of this experiential underage** //drinking// //and//**driving prevention program.**

In 1998, the Bexar County DWI Task Force Advisory Board on Underage** //Drinking//**, in response to an increase in alcohol-related motor vehicle fatalities, established a program that would enhance awareness** //and// **understanding of the relationship between alcohol use** //and// **the occurrence of motor vehicle-related injuries** //and// **fatalities among adolescents. Shattered Dreams was modeled after Every 15 Minutes, a similar program developed** //and// **implemented in 1996 by the Chico, California Police Department (Burandt et al., 1998). This programs tide symbolized the death of a person every 15 minutes as a result of an alcohol-related traffic crash (Burandt et al., 1998). The comprehensive nature of Shattered Dreams requires substantial community effort from the volunteers** //and// **planning committees involved in sponsorship. School personnel, parents,** //and// **community volunteers plan the event at least six months in advance** //and// **must organize** //and//**develop specific program teams to solicit participation** //and// **support from various local public safety** //and// **health care professionals (Beer, Price, Villarreal, & Salazar, 2002). Program teams include assembly, counseling, death notification, debriefing, historian, living dead, mock crash, retreat, scholarship, video production,** //and// **public information. This intensive two-day experiential program visually demonstrates the social, physical** //and// **emotional consequences that underage** //drinking// //and////driving// **can have both on a school** //and// **a community. The programs target audience includes high school juniors** //and// **seniors (a segment of the adolescent population in which a majority have fulfilled the legal requirements to operate a vehicle** //and// **a group that is at a higher risk to engage in alcohol-related risk behavior). This program requires participation from the various elements located within** //and// **outside the high school setting including students, educators,** //and// **counselors, as well as medical, law,** //and// **various other emergency service entities (Burandt et al., 1998). A significant portion of this simulation occurs on the campus of the participating high school to dramatize** //and// **reinforce among me student body the significance of an alcohol-related fatality. The first day begins with an enactment of an alcohol-related motor-vehicle crash involving direct participants (student volunteers) in various stages of trauma including deceased passengers** //and// **the injured drunk driver. Law enforcement** //and// **emergency response follows (i.e., paramedics, state** //and// **local law enforcement officers, air** //and// **fire rescue)** //and// **includes the transporting of surviving passengers via ground** //and// **air to a local medical facility for emergency treatment while the deceased are taken to a local funeral home. The intoxicated driver is given a field sobriety test, arrested,** //and// **men delivered to the local juvenile detention center to await arraignment. During this rime, local** //and// **state enforcement agents are dispatched to the participating students' homes to notify parents that their son or daughter has been killed in an alcohol-related crash. The loss of life as a result of underage** //drinking// //and// //driving// **is dramatized throughout the day as a student or adult volunteer dressed as a Grim Reaper enters selected classrooms** //and// **removes a student volunteer to symbolize the number of persons killed by alcohol within a designated time interval. The reading of a obituary to the entire class immediately follows the student's departure. The student volunteers return to their individual classrooms** //and// **are identified as, "Living Dead." Their faces are covered in white makeup to reinforce the notion of death** //and//**finality of a life cut short as a result of alcohol. The Living Dead do not speak nor make eye contact with fellow students for the remainder of the day. Direct student participants (usually numbering around twenty-five) attend an overnight retreat where the central focus is skill-building activities that promote**//and// **reinforce healthy behaviors** //and// **choices that reduce the likelihood of alcohol use. Other activities focus on team-building, task**//and// **goal completion, promoting alternative patterns of communication that include redirection, reinforcement of positive peer influence, leadership development** //and// **reflection,**//and// **reinforcement** //and// **strengthening of familial relationships. Retreat activities use a mixed-method approach of interactive, video** //and// **personal presentations by a series of community, medical,** //and// **law enforcement personnel. These presentations include personal experience or knowledge-based topics regarding underage** //drinking// //and// //driving//**. Additional retreat activities stimulate youth leadership development that incorporates group discussions regarding personal power, identity,** //and// **the impact of** //drinking// //and////driving// **on both friends** //and// **family (Beer et al., 2002; Burandt et al., 1998). On the second day, both direct participants** //and// **observers (students exposed to the living dead** //and// **mock crash) attend a school-wide assembly with a mock funeral** //and// **a series of presentations by various medical,** //and// **law enforcement personnel, students, parents,** //and// **educators. Supportive debriefing sessions are held afterwards for students, parents,** //and// **volunteers who are interested in talking about issues or topics that might have been raised as a result of their involvement in the program. An optional follow-up activity enacts a mock trial of the drunk driver involved in the simulated alcohol-related motor-vehicle crash (Burandt et al., 1998).**
 * Elemental to effective school-based alcohol prevention programs are integrated community wide initiatives to raise awareness of the consequences of underage alcohol use** //and// **to deter access through a combination of countermeasures including legal, enforcement, medical, media,** //and// **political entities. Shattered Dreams is a model of both school** //and//**community-based alcohol prevention that incorporates simulated alcohol-related consequences with 14 community elements that include students, parents, educators, school administrators, health systems,** //and//**law enforcement personnel (Burandt, Guerra, Villarreal, Ramirez, & Harding, 1998)


 * The current evaluation utilized a single-group pretest-posttest (Reflexive Control) design (Cook & Campbell, 1979; Rog, 1994). Within this specific design, information on individuals is collected** //and// **measured prior to** //and// **after participating in an intervention. The information collected at these two different time points then serves as a point of comparison (i.e., whether individuals exhibited change after participating in the intervention). Despite previously cited design limitations, this type of design was adopted** //and// **identified as a logistically efficient** //and// **cost-effective approach to evaluate this program.**

INSTRUMENT
Pre- //and// **post-program questionnaires were standardized, closed-ended,** //and// **composed of 24-matched items. Sixteen items measured perceptions, attitudes,**//and// **level of awareness of underage alcohol use (a) in social activities, (b) on behavior** //and// **relationships, (c) in the ability to communicate the consequences associated with** //drinking// //and// //driving// **to peers,** //and// **(d) the likelihood of negative consequences occurring as a result of** //drinking// //and// //driving// **including injury** //and// **death. Responses were based on a 4-point Likert-type scale** //and// **ranged from strongly agree to strongly disagree. Four Texas zero tolerance items were included in order measure student knowledge about the legal consequences associated with alcohol use for individuals less than 21 years of age including fines, suspension of license,** //and// **imprisonment. The final component of the pre-** //and// **post-program questionnaire incorporated four demographic (pre-program)** //and// **three items that asked participants about the perceived impact of Shattered Dreams (post-program). A unique identifier was created to ensure that responses at both time points corresponded to individuals who were exposed to Shattered Dreams** //and// **that respondents at both pre** //and// **post were similar with respect to characteristics that may otherwise cloud or confound conclusions.**

ADMINISTRATION
Permission was granted to administer student questionnaires upon review //and// **approval by the University of Texas Health Science Center's Institutional Review Board** //and// **school district administration. Pre-**//and// **post-program questionnaires were administered approximately four weeks before** //and// **four weeks after the Shattered Dreams program to seniors enrolled at a high school in northeast San Antonio. This high school volunteered to conduct the Shattered Dreams program in the fall of 2002. According to the Texas Education Agency (2003), approximately 75% of the senior class were white non-Hispanic, 17% Hispanic, 3% black** //and// **5% Asian/Pacific Islander/Native-American. In terms of campus characteristics, 4% of the student body was identified as economically disadvantaged** //and// **0.7% as having limited English proficiency with a student to teacher ratio of 16:1. Only students who participated in the Shattered Dreams program (direct** //and// **observers) were administered program questionnaires via their student advisory period. At both time points, questionnaires were collected by school faculty, placed in their assigned envelope** //and// **submitted to the evaluation team.**

SAMPLE CHARACTERISTICS
A total of 349 seniors completed the pre-program questionnaire, prior to Shattered Dreams, for an overall response rate of 60%. Table 1 indicates that slightly more than half of respondents were female (53%) //and// **white non-Hispanic (66%) with a mean age of 17.2 years (SD = .46). **

MALE/FEMALE DIFFERENCES REGARDING ALCOHOL EXPECTANCIES
Chi-square tests (c²) of statistical significance were calculated to assess whether differences existed between sex of respondent //and// **positive** //and//**negative alcohol expectancy items. An alpha level of .05 was used for all statistical tests. Table 2 shows statistically significant differences between attitudes expressed towards underage** //drinking// //and// //driving// **under the influence** //and// **respondent's sex in this sample. For example, when respondents were asked to state whether they agreed or disagreed that "having two to three drinks is a good way to relax," 79% of females disagreed with the statement compared to 57% percent of males c² ([|1],N = 349) = 19.99, p = .01, 1 =. 47. Similarly males were more likely to agree that "a parry was more fun when alcohol was being served"** //and// **that it was "okay to drive if you have only had two to three drinks," 48%**//and// **27% respectively compared to females; 27%** //and// **10% respectively. On "taking the issue of** //drinking// //and// //driving// **seriously," 81% of females agreed with this statement compared to 67% of males c² ([|1],N = 349) = 8.73, p = .01, 1 =.35. Females were also more likely to agree "that they could talk to their friends about** //drinking// //and// //driving//**" compared to males (87%**//and// **74% respectively; c² ([|1],N = 349) = 9.411, p = .01, 1 =.39. On whether it is "rare for people who drink** //and// **drive to cause injury or death to others," 18% of males agreed with the statement compared to 6% of females c² ([|1],N = 349) = 11.36, p = .01, 1 =.52. No significant differences in intensity of response by sex of respondent was identified for the statement regarding whether it was okay to "drink if you are underage, as long as you do not drive" with 55% of females reporting disagreement compared to 52% of males. Cramer's Contingency Coefficient (V) was utilized to assess strength of association between variables. Strength of association on these seven items ranged from low to moderate (Cramer's V = 0.14 to 0.23). Tests of significance were similarly utilized to assess if there were differences between attitudes towards underage** //drinking// //and// //driving// **under the influence** //and// **the race or ethnicity of respondent. Race was recoded into three categories (white non-Hispanic, Hispanic,** //and// **other). Only one item was identified as statistically significant. White non-Hispanics (36%) were more likely to agree with the statement, "having two to three drinks is a good way to relax," compared to Hispanics (24%)** //and// **other (17%) c² ([|1],N= 349) = 10.662, p = .01, n =.17. **

POST-PROGRAM QUESTIONNAIRE RESULTS
From the original sample of 349 seniors who participated in the pre-program questionnaire, a total of 191 or 33% completed the post-program questionnaire. Respondents were mostly female (63%), white non-Hispanic (63%) with a mean age of 17 years (SD = .458). To assess global change from pre- to post- in alcohol expectancy scores among respondents, a scale was created through principal component analysis, based on the 16 original items. Four internal consistency estimates of reliability were computed for both the pre- //and// **post- Positive Alcohol Expectancy Scale (PAES) (The coefficient alpha**//and// **a split-half coefficient expressed as a Spearman-Brown corrected correlation). Due to the odd number of items the unequal-length split-half coefficient is reported. In splitting the items, sequencing** //and// **whether the item indicated or measured alcohol as a relaxant or as a socially acceptable behavior were taken into account. Values for the alpha** //and// **the Spearman Brown coefficient for each of the respective pre-** //and// **post-program sub-scales measured .88** //and// **.84 respectively. The three items combined to form a scale of positive alcohol expectancy. Each item was coded 0 to 3 or (values ranged from 0 = Strongly Agree, 1 = Agree, 2 = Disagree, 3 = Strongly Disagree). These items combined to form an overall scale that ranged from 0 to 9. An individual who expressed an overall score of 0 would be more inclined to initiate alcohol use compared to an individual who scored a 9 (indicating less of an inclination to initiate alcohol use). **

REPEATED MEASURES ANOVA
To assess whether mean scores differ on the Positive Alcohol Expectancy Scale across two assessments, a repeated measures (One-Way Within-Subjects) ANOVA was conducted with the within-subjects factor being Time 1 mean score on the PAES //and// **Time 2 mean score on the PAES. Means**//and// **standard deviations are presented in Table 3. The results of the ANOVA indicate a significant time effect, Wilks' L = .70 ([|1],190) = 80.198, p = .000, multivariate n² = .30. A follow-up paired-samples t test indicated a significant linear effect. For example, the post-score on the PAES (M = 5.98, SD = 2.19) was significantly greater than the baseline score (M = 3.18, SD = 2.37), t (191) = 8.955, p = .000. The standardized effect six index, d, was .64, a moderate value. The mean difference was 2.8 points between the 9-point Likert pre** //and// **post rating scales. Results suggest that across two assessments individuals who participated in Shattered Dreams were less inclined to express agreement with positive expectations regarding alcohol use (specifically its utility as a relaxant** //and// **as socially acceptable behavior). **

DIFFERENCES BY SEX
Repeated measures (One-Way Within-Subjects) ANOVA were also conducted separately for both males //and// **females to assess whether scores differed across two assessments of the PAES. Results of the ANOVA demonstrated significant time effects for both males (Wilks' L = .76 ([|1],70) = 21.905, p = .001, multivariate n² = .24)** //and// **females (Wilks' L = .67 ([|1],118) = 60.607, p = .001, multivariate n² = .30). In addition, paired-samples t tests were also conducted to evaluate differences in scores between males** //and// **females prior to** //and// **after exposure to the intervention. Results also reported in table 3 demonstrate that the post-program mean for the PAES was significantly greater than the pre-program mean. For example, males expressed a post-program mean of 5.94 (SD = 2.32)** //and// **was significantly greater than the pre-program mean for the PAES (M = 3.37, SD = 2.62), t (70) = 4.680, p = 0.000. The standardized effect size index, d, was .55, a moderate value. The mean difference was 2.57 points between the 9-point Likert pre-** //and// **post-rating scales. Paired-samples t test results similarly suggested a significant change for females. The post-program mean the PAES of 6.01 (SD = 2.13) was greater than the pretest mean (M = 3.06, SD = 2.22), t (118) = 7.785, p = 0.000. The standardized effect size index, d, was .71, a substantial value. The mean difference was 3.20 points between the 9-point Likert pre-** //and// **post- rating scales. Sub-group results similarly suggest that across two assessments, both males** //and// **females exposed to Shattered Dreams were less likely express agreement with positive expectancies regarding alcohol use** //and// **were just as likely to report that as result of the program the would be more likely to speak to their friends about underage**//drinking//**,** //drinking// //and// //driving//**, the risks associated with** //drinking////and// //driving//**,** //and// **that their friends as a result of participating in the program would be less likely to drink** //and// **drive. There are however notable differences. For example males not only reported slightly higher baseline expectancy scores compared to females (3.37** //and// **3.06, respectively) but males also were less likely to show a decrease in intentions to use alcohol compared to females (2.57** //and// **3.20, respectively).  **[|DISCUSSION] For example, pre-program scores reported that females were more likely to demonstrate disagreement towards alcohol as a relaxant** //and// **as an element of planned social activities. Females were also more likely to express an awareness of the relational effect of alcohol related to both peer relationships** //and// **in causing injury or death to others** //and// **to acknowledge that they could speak with their friends about the effects of underage**//drinking// //and// //driving//**. Males on the other hand, were more likely to endorse alcohol as a relaxant (42%); as acceptable to drive drunk (26%),** //and// **to be in disagreement regarding the seriousness of underage** //drinking// //and// //driving// **(32%). Although promising, these results are far from conclusive** //and// **are subject to careful interpretation due to limitations including (a) the absence of a comparison group to more accurately assess whether changes in student responses were a result of being exposed to Shattered Dreams, (b) the absence of items to measure the prevalence of underage** //drinking// //and// //driving// **among participants prior to** //and// **after the program,** //and// **(c) the need to develop outcome measures based on precise programmatic assumptions of Shattered Dreams. First, the absence of a comparison group similar in characteristic to the group exposed to Shattered Dreams significantly limits conclusive statements regarding effectiveness or impact of this program. Therefore, to assess whether changes in participant responses are a direct result of being exposed to a program or treatment, a comparison group should be incorporated in the research design. Specifically, Weiss (1998)** //and//**Rog (1994) observe that such a design is strengthened by the inclusion of periodic measurements, which can be helpful in assessing programmatic change over time. Second, measures were not included to assess change in self-report** //drinking// //and// //driving// **among students prior to** //and// **after the program. A series of self-report items were initially included as part of the program questionnaires submitted for review to the participating school district. Amid the clarification that was made regarding data collections procedures, the specific purpose of the study, relevance of measures to evaluation outcomes,** //and// **the confidentiality of participant's school district; officials still requested that self-report measures be removed. Grube, Keefe,** //and//**Stewart (2002) observe that in studies involving schools, investigators must often make strenuous efforts to convince school authorities on the importance of participation. Such negotiations occur within the context of other school-related activities that can significantly diminish the participation of both administrators** //and// **educators. In addition, school administration** //and// **district officials may be concerned** //and// **or uneasy about dealing with study results affecting their students. It is important, therefore, to convey to school authorities the important programmatic assumptions that a study is attempting to identify** //and// **measure. Third, is the development of a limited number of outcome measures reflective of the programmatic assumptions of Shattered Dreams. For example, participants were measured on legal knowledge regarding specific situations involving underage** //drinking// //and// //driving//**. Results however demonstrated that student knowledge did not increase from pre-to post. One programmatic assumption of Shattered Dreams was that the students would increase their knowledge of Texas underage** //drinking// **laws otherwise known as zero-tolerance. While specific zero-tolerance information was provided to only a small number of students (direct participants who attended the overnight retreat), less intensive efforts were made to provide observers (students not directly involved in the program but who observed the mock crash** //and// **assembly) with information regarding zero-tolerance. Therefore, the unequal dissemination of zero-tolerance information perhaps limited most students from fully learning**//and// **comprehending state underage** //drinking// //and// //driving// **laws. Although results will serve to inform** //and// **guide the development of a zero-tolerance component in Shattered Dreams, future recommendations include clearly stating** //and// **defining the programmatic assumptions to be measured. For example in regards to zero-tolerance laws, it should clearly state the type of information that will be provided, the specific target audience** //and// **how it will be used. Clear** //and// **specific use of information should lead to the development of items that effectively measure zero-tolerance knowledge among participants. Amid the limitations involved in the current design, results also demonstrate the need to utilize background measures that report on pathways of risk or protection towards alcohol use by adolescents. Additionally, both programmatic** //and// **evaluative activities should not only address comprehensive alcohol prevention strategies to address the social intricacies that increase or decrease adolescent's awareness regarding underage** //drinking// //and// //driving// **but develop** //and// **utilize the disparities in sex regarding alcohol use** //and// **experimentation. Further, information gleaned from this study augments a previous evaluation conducted by Hover, Hover** //and// **Young (2000) on a similar school-based underage**//drinking// //and// //driving// **prevention program involving the community. In addition to recommendations offered in this previous study, we advise adoption of a more rigorous evaluation design, incorporation of standardized behavioral measures related to** //drinking// //and// //driving//**,** //and// **a more thorough understanding of the relationship between theoretical assumptions, programmatic objectives** //and// **outcome measures. Future efforts will also focus on strengthening the development** //and// **evaluation of this program. This will include the adoption and application of behavioral theory in order to enhance our understanding of the processes that foster behavioral change as a result of students participating in this program. A concerted effort will also be made to include more schools** //and// **communities diverse in regards to both social** //and// **community characteristics (i.e., urban, rural, economically underserved) as well as obtain a more representative sample of students to more thoroughly examine the multiple risks associated with underage** //and// //drinking//**. Qualitative examinations with both students** //and// **key stakeholders on norms regarding underage** //drinking// //and// //driving// **will be essential to measuring the overall impact of Shattered Dreams on both a school** //and// **community. These approaches should also be complimented by repeated measures** //and// **extended follow-up of program participants. These activities will help to strengthen the validity** //and// **reliability of results** //and// **help determine both the short-**//and//** long-term effects of this program. This study was supported by a grant from University Health System, Bexar County, Texas under contract 2201063-LS. This paper is based on the first author's thesis which was presented at the 99th annual meeting of the American Sociological Association in San Francisco, California, August 2004.
 * Preliminary evaluation demonstrates that this program reduced positive expectations towards** //drinking// //and// //driving// **among participants. Results also demonstrate a measurable difference in alcohol expectancy scores from pre-program to post-program assessment between males** //and//**females. This compliments other investigations into dissimilarities in** //drinking// **motivations** //and// **outcomes between adolescent males** //and// **females**//and// **the various social**//and// **environmental factors that promote these differences, which include social or cultural expectations, differential pathways of coping as well as familial** //and//**peer affiliation (Copeland & Shope, 1996; Piko, 2001, Metrik, Frissell, McCarthy, D'Amico, & Brown, 2003).