U.S. Preventive Services Task Force
Release Date: August 2007
Summary of Recommendation 1 / Summary
of Recommendation 2 / Supporting Documents
Recommendation 1: Counseling about Proper Use of Motor Vehicle Occupant Restraints to Prevent Motor Vehicle Occupant Injuries (MVOIs)
- The USPSTF concludes that the current evidence is
insufficient to assess the incremental benefit, beyond the
efficacy of legislation and community-based interventions,
of counseling in the primary care setting, in improving rates
of proper use of motor vehicle occupant restraints (child
safety seats, booster seats, and lap-and-shoulder belts). (Go to Clinical Considerations for definitions of proper
use.)
Rating: "I" Recommendation
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Rationale:
Importance: Motor vehicle occupant injury is the leading
cause of death in U.S. children, adolescents, and young
adults age 3 to 33 years and of unintentional injury-related
deaths for persons of all ages. Proper use of motor vehicle occupant restraints (child safety seats, booster seats, and
lap-and-shoulder belts) is associated with a 45% to 70%
reduction of fatality risk. Improper use reduces the efficacy
of restraints substantially.
Recognition of behavior: Approximately 80% of adults
use seat belts. General use of child safety seats is 90%, and
booster seat use is rapidly increasing. However, proper use
of child safety seats and booster seats in infants and children
is low.
Effectiveness of counseling to change behavior: Legislation
and community-based interventions along with counseling
in primary care settings have dramatically increased the use
of motor vehicle occupant restraints and have reduced the
incidence of MVOIs in all populations. However, the incremental
benefit of primary care counseling for general
restraint use in the context of legislation and community
interventions is unknown. There is insufficient evidence
addressing the efficacy of counseling in the primary care
setting to increase the proper use of motor vehicle occupant
restraints in the current high-use environment. This
constitutes a critical gap in the evidence for counseling.
Harms of counseling: There is no evidence addressing
the harms of counseling; however, these potential harms
are estimated to be none or minimal in magnitude.
USPSTF assessment. The USPSTF concludes that current
evidence is insufficient to assess the net benefit of
counseling interventions in primary care settings to increase
proper use of motor vehicle occupant restraints to
reduce MVOIs in children, adolescents, and adults.
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Recommendation 2: Counseling to Prevent
Alcohol-Related MVOI in Adolescents and Adults
- The USPSTF concludes that the current evidence is
insufficient to assess the balance of benefits and harms of
routine counseling of all patients in the primary care setting
to reduce driving while under the influence of alcohol
or riding with drivers who are alcohol-impaired.
Rating: "I" Recommendation
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Rationale:
Importance: Alcohol use is involved in nearly 40% of
all traffic-related fatalities.
Effectiveness of counseling to change behavior: There is
evidence that screening for misuse of alcohol and targeted
counseling of those persons who screen positive reduce alcohol
consumption and alcohol-related MVOI. However,
there is a critical gap in the evidence of the efficacy of
behavioral counseling interventions directed to all patients
in the primary care setting to reduce driving while under
the influence of alcohol or riding with drivers who are
alcohol-impaired.
Harms of counseling: There is no evidence addressing
the harms of counseling to prevent alcohol-related MVOI;
however, these potential harms are estimated to be none or
minimal in magnitude.
USPSTF assessment: The USPSTF concludes that the
evidence is insufficient to assess the net benefit of universal
counseling in the primary care setting (in the absence of
screening and targeted counseling) to reduce the incidence
of alcohol-related MVOI.
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Supporting Documents
Counseling About Proper Use of Motor Vehicle Occupant Restraints and Avoidance of Alcohol Use While Driving, August 2007
Recommendation Statement (PDF File, 365 KB; PDF Help)
Clinical Summary
Article: Systematic Evidence Review (PDF File, 390 KB; PDF Help)
Evidence Synthesis (PDF File, 2 MB; PDF Help)
Top of Page
Current as of August 2007
Internet Citation:
Counseling About Proper Use of Motor Vehicle Occupant Restraints and Avoidance of Alcohol Use While Driving, Topic Page. August 2007. U.S. Preventive Services Task Force. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/uspstf/uspsmvin.htm