A qualitative study of teens' and parents' perceptions of preventing teen drinking and driving.

OBJECTIVE: In the U.S., motor vehicle crashes are the leading cause of death for adolescents ages 15 - 18, and alcohol use increases the risk of crashes. There is a need for greater clarity regarding the factors most effective for behavior change in preventing teen driving after drinking. Given the centrality of teen-parent relationships in influencing teen behavior, understanding the relational dynamics in this context is vital to prevention. To inform the development of more effective prevention programs for teens and parents, this study examines teen drivers' and parents of teen drivers' perspectives on drinking and driving behaviors, prevention, and parental involvement. METHODS: Surveys and focus groups were conducted among 41 teens (ages 15 - 18) and 27 parents (of teens ages 15 - 18) residing in 11 cities in Orange County, California. Participants completed an online survey assessing demographic information, driving behaviors, family relationships, physical and mental health, and substance use history. Participants then attended a one-hour in-person focus group, held separately for teens (5 focus groups; 7-13 participants per group) and parents (4 focus groups; 5-8 participants per group). During these sessions, participants engaged in open discussions about imagined scenarios involving riding with or driving while impaired, as well as imaginal scenarios designed to explore perspectives, decision-making, and prevention strategies. Focus group transcripts were coded by a multidisciplinary team using a deductive approach to explore and summarize themes. RESULTS: Teens reported varying experiences with alcohol, yet overall described a strong safety orientation, awareness of consequences, openness to parental limits, and interest in having explicit safety conversations related to driving after drinking. Although teens differed in their preferences for the timing and duration of these discussions, most expressed a desire for genuine parental understanding. Parents similarly described differing perceptions of teen alcohol use, with some expressing trust in their teens not using alcohol and others acknowledging alcohol use as common and driving after drinking as a notable concern. Parenting approaches regarding drinking ranged from expectations of strict alcohol abstinence from their teens to more permissive practices, including permitting supervised and social drinking. Parents reported a preference that their teens first turn to them for support and, when necessary, seek help from other trusted, practical sources, including family, friends, or rideshare services. CONCLUSIONS: Findings emphasized the need for proactive prevention strategies targeting driving after drinking. Teens suggested that prevention efforts should collaboratively engage both teens and parents to improve safety outcomes. Parents highlighted that comprehensive prevention efforts should extend beyond the home to multiple contexts and be adaptable to diverse family structures. These study findings present directions for future research, prevention activities, and programs.