Background on Supportive Relationships
What are supportive relationship strategies?
- Supportive relationship interventions are programs or activities designed to increase social support to decrease motor vehicle injuries through involvement with individuals, organizations and communities.
- These interventions may focus on increasing the information individuals have about motor vehicle injury (e.g., risk factors and prevention) [informational support], provide a venue for sharing experiences and feelings [emotional and appraisal support], or provide tangible support (e.g., driver’s education classes). In addition, such interventions provide opportunities to identify and address challenges collectively rather than individually (e.g., collective problem solving or advocacy).
- This support may be provided through involvement from a variety of individuals or individuals as part of groups, organizations, or communities including:
- school nurses
- community health advisors
How do supportive relationships successfully impact motor vehicle injury related behaviors?
- Supportive relationships interventions may help to change behaviors in order to prevent an injury from occurring (primary prevention), or identify individuals who should not be driving through sobriety check points or other enforcement activities (secondary prevention).
- Supportive relationships interventions are successful for many reasons, such as: individuals can ask questions or clarify what they have been told, those providing support can also provide referrals and resources to assist the individual, and longer-term relationships can help to sustain behavior change over time, among others.
How can I use supportive relationship strategies in motor vehicle injury interventions?
- Supportive relationship intervention strategies may be designed to discuss challenges, benefits and advice for decreasing motor vehicle injuries. Supportive relationships may be provided in the form of face-to-face interactions, telephone calls, or through interactive web-based systems. These interventions may include specific information as part of each call or face-to-face session, or may be more open ended and responsive to the specific needs of the individual.
Why is it important to considering tailoring in supportive relationship strategies?
- These interventions can be very successful when the support is tailored to the individual’s needs. In order to provide tailored advice to the individual, the person providing the support has to determine the specific challenges the individual is facing. Supportive relationships interventions may include an assessment of existing behaviors or the environment as well as a discussion of challenges, benefits and advice for creating and maintaining change over time.
- Supportive relationship interventions work best when the advice also takes into account the person’s gender, age, language, race or ethnicity, and other cultural factors.
How do supportive relationship strategies deal with relapse?
- Often, individual change their behaviors and then relapse, or go back to previous behaviors. Supportive relationships, therefore, include information to help individuals to recognize that this is not unusual and to work with individuals to develop strategies to help prevent relapse in the future.
- It can be helpful to recognize that changes in behaviors may happen in small steps. For example, decreasing aggressive driving may happen first in response to certain conditions (e.g., avoiding slow drivers) and slowly generalize to other driving conditions (e.g., obeying traffic signals, disregarding hostile behavior by other drivers, or using caution around road obstructions). Every individual will have preferences for what steps may be the easiest to take first, and these preferences may depend to a large extent on the support of others for these changes (e.g., family, roommate, friends, co-workers).
How have supportive relationships been used in past motor vehicle injury interventions?
- Increase health care provider support for car or booster seat use. For example, a physician, nurse or health educator may provide support to new parents by helping them learn proper installation and use of car or booster seats. Health care provider support may be offered through face-to-face interactions, letters, home visits or telephone calls. These supportive efforts may be initiated by the health care provider or the client (e.g., counseling during an office visit, questions raised by the patient or client during a visit).
- Increase school-based support for avoiding drinking and driving. For example, peer educators can be trained to provide support through school-based activities such as athletic programs; teachers, school nurses and coaches can be trained to provide formal structured support (e.g., class sessions covering these topics) or less formal support (e.g., advice or encouragement) and family members can be encouraged to provide support through letters, newsletters or videos sent home with the students. These cues to action can describe or illustrate the challenges in avoiding drinking and driving (e.g., showing peer models making decisions not to drink and drive, building alcohol refusal skills, or demonstrating how to refuse a ride with someone who has been drinking) and instigate discussion between school representatives, family members and students about these struggles and strategies to address them.
- Increase support from drinking establishments (e.g., bars and clubs) for avoiding drinking and driving. Alcohol servers can provide support to patrons by sharing information regarding the harmful effects of drinking and driving and help provide an atmosphere that is supportive of drinking without becoming intoxicated. Drinking establishments (e.g., bars and clubs) are an ideal setting because this is an opportunity to provide support before a problem occurs.
- Increase community support for decreasing drinking and driving. For example, informational, emotional and appraisal support can be provided through peer support groups or telephone hot lines (e.g., program initiated calls to individuals, a call line that is made available for people to call). Individuals staffing these support groups and telephone lines may be trained professionals (e.g., alcohol treatment counselors, nurses) or trained peer or lay health advisors. Other examples of community support include the use of community role models who can speak to community members about the risks of certain drinking and driving and the benefits of change (i.e., local celebrities who have motor vehicle injuries related to drinking). In addition, these interventions may include contracts or a pledge to not drink and drive that is made between the driver and either peers, parents, or community members.
- Increase community support for decreasing aggressive driving. For example, informational, emotional and appraisal support can be provided through peer support groups or telephone hot lines (e.g., program initiated calls to individuals, a call line that is made available for people to call). Individuals staffing these support groups and telephone lines may be trained professionals (e.g., stress management instructors, health educators) or trained peer or lay health advisors. Other examples of community support include the use of community role models who can speak to community members about the risks of aggressive driving and the benefits of change (i.e., local celebrities who have motor vehicle injuries as a result of aggressive driving).
- Increase peer support to improve driving. Peer support programs may be conducted with specific populations (e.g., teens, older drivers, drivers with visual impairments) or certain types of drivers (e.g., commercial drivers). These programs may provide informational support on driving techniques or how to reduce fatigue or how to drive in hazardous conditions, tangible support in terms of resources to aid in driving, or appraisal support to encourage positive driving behaviors.