Wednesday, December 19, 2012

Preventing Teenage – Using Social and Behavioral Theory to critique MADD - Leah Forman

Drunk driving is a major cause of fatal car accidents, leading to the death of about 30 people daily in the United States.  According to the CDC, nearly 1/3 of all traffic related deaths from 2010 involved a driver impaired by alcohol (1).  Importantly, the risks of drunk driving do not only impact the drunken person who climbs behind the wheel.  Rather, the risks extend to the other passengers in the car, to all other people who are on the road, and to the families and friends of any potential victims.  Given just the very basic statistics cited above, combined with the legality and general accessibility of alcohol, it is clear the drunk driving is a problem that will not disappear in the near future.  As such, effective interventions and prevention strategies are desperately needed.
MADD, which stands for “Mothers against Drunk Driving”, is one such campaign.  According to its website, MADD’s mission is broken into three separate goals: “stop drunk driving, support the victims of this violent crime, and prevent underage drinking” (2).  For the purposes of this critique, I will focus on the first part of their mission statement, which is the prevention of drunk driving.  In order to eliminate drunk driving, MADD takes a three-pronged approach: supporting law enforcement efforts, requiring in-car breathalyzers for all drunk drivers, and “supporting the development of technology to determine automatically whether or not the driver is above the legal limit” (3).
MADD clearly recognizes that drunk driving is a serious problem.  It sets out to find solutions with the best intentions.   Unfortunately, however, intentions don’t always lead to effective interventions.  MADD’s failure to invoke strong core values, its focus on individual level interventions, and its inducement of psychological reactance through the use of messengers to whom its audience cannot relate, all serve to undermine the goals they are trying to achieve.  Throughout the course of this critique, I will show that MADD would do well to learn from social and behavioral theories so as to better tailor their campaign and more effectively prevent drunk driving.

Critique #1:  Failure to invoke strong core values

            Effective interventions and campaigns are those that tailor their message to the audience they are trying to reach.  This is done through framing – presenting the intended message in a way that directly references the audience’s core values.  In fact, “it is not necessarily the relative merits of various arguments for and against a proposal that most influences its legislative fate. Rather, it is the relative success of proponents and opponents in framing the overall terms of the debate” (4).  A major part of the reason that tobacco lobbyists have been so successful is that they understand the concept of framing and have “successfully framed the debate in terms of a rights issue rather than a health issue” (5) The core values upon which frames are built are not esoteric; they are beliefs and ideals commonly held by people across all different cultures, and all different life circumstances.  These universal core values include ideals such as autonomy, freedom, equality, loyalty, and independence.  If a population believes their core values are met, they are much more likely to agree with a campaign’s message, and are therefore more likely to follow its advice. 
            A visitor to MADD’s website is immediately inundated with statistics on drunk driving – how many people are killed in drunken driving accidents, how many are injured, and how often someone is killed in a drunk driving crash (once every 53 minutes) (6). The main goal of MADD’s campaign is clear from the outset – preventing people who are drunk from getting behind the wheel and driving their car.  Through even a cursory perusal of MADD’s website, it is clear why, according to MADD, these actions need to be prevented: drunken driving often leads to fatal accidents.
            There are a number of problems with MADD’s presentation of drunk driving, and ideas for its prevention.  Through its focus on fatalities and negative consequences, MADD loses an opportunity to tie strong core values such as independence and autonomy with its recommendations and interventions.  Instead, the negative focus of its website and statistics invoke relatively weak, less compelling core values, such as safety and health.  While it is likely true that the majority of people see health as a value to which they should aspire, it is not the driving force behind most of their actions.  This is especially true for teenagers, who, for the most part, are relatively healthy, and for whom health is far from an immediate concern.  The same is true for safety.  Humans do unsafe things on a daily basis.  In fact, safety is low on the scale of factors we consider before taking action.  In addition, for the majority of drivers, health and safety, while very real concerns, are still abstract ones.  Any driver who has not yet been in an accident is, until the moment of their first accident, a relatively healthy and safe driver.  They are therefore not immediately concerned with health and safety every time they get into their car. 
            Not only does this negative focus associate MADD’s campaign with weak core values, it also prevents them from connecting with the strong core values already held by its audience. Teenagers in general, and especially those who are new drivers, share a clear set of core values. Driving is the first real opportunity they have to fully assert their own independence away from the confines of home and parental guidance.  This assertion of independence is a fundamental character trait the majority of teens share. While they are aware of the potential threat to their safety posed by driving, this feeling is not immediate, nor is it tangible. Freedom and independence, however, are tangible feelings to which all teens can relate. Because of this, a message such as MADD’s that focuses on safety instead of on independence, will fail to connect with teens.
In fact, MADD’s insistence on highlighting the negative not only fails to invoke strong core values, it presents them as opposed to the goals of its campaign. The effect of not offering alternative, positive models of behavior is that the entire campaign appears opposed to freedom, autonomy, and personal choice.  Instead of focusing entirely on the negative, MADD would do well to tailor its campaign so that through listening to its message, teens find ways to assert their independence, not to restrict it.

Critique #2  - MADD’s campaign is focused on the individual level, and ignores group dynamics

            MADD’s campaign is built on three main pillars, two of which involve passing measures that would prevent individual drunk drivers from  getting behind the wheel.  The first goal is a technological development that would require previously convicted drunk drivers to have a device in their car which would require them to pass a Breathalyzer test before  turning on their ignition. The second would create a device that automatically measures a driver’s blood alcohol content before the car is able to start (7). While these measures may prevent individual drunk drivers from actually driving while drunk, it does little to prevent teens that have not yet been caught for drunk driving, from getting behind the wheel.  First, the focus on individual drivers allows much of the intended audience to remove themselves from the dangers of drunk driving, and makes the message inapplicable to their specific situation.  Second, the focus on drivers who have already driven drunk not only further alienates those who have not yet driven drunk, but also shifts the focus from a goal of avoiding drunk driving altogether, to avoiding getting caught for driving drunk.
            For most teens reading MADD’s website, drunk driving is not an immediately relevant concern.  This is not to say that it can’t or shouldn’t be. Depending on its presentation, drunken driving could, and should be, placed at the forefront of teenage consciousness.  However, MADD’s presentation does the opposite – it makes it easy for the majority of teens to decide that the issue of drunk driving is not relevant to them, because they have never driven drunk, or at the very least, not been caught driving drunk.  Once a group of teens decides that the issue is irrelevant to their individual situation; their friends are likely to follow: “When the appropriate behavior is unclear, we tend to rely on ‘social reality’ as displayed by others” (8).  Through failing to connect with a large segment of its target population, MADD effectively creates a social reality where drunken driving issues are unimportant.  The result is that teens will not think of the issues ahead of time, and will therefore not be aware of alternative options should they find themselves in a dangerous situation.
            This focus on individuals who have already been caught driving drunk re-focuses MADD’s attention from its stated goal of avoiding drunk driving, to avoiding getting caught for driving drunk.  In so doing, the MADD campaign loses yet another opportunity to connect with its audience as a whole.  These interventions are entirely inapplicable to an individual that has not yet been caught for drunk driving.  In fact, a driver who drives drunk and has not yet been caught, may even be encouraged to continue to do so.  After all, as long as she is not caught, she has nothing to worry about, and these interventions will not apply to her.  Through its focus on individual offenders, the MADD campaign inadvertently narrows the scope and reach of its message, effectively excluding much of the population it is trying to reach. 

Critique #3 – The MADD campaign’s authoritative tone lends itself to psychological reactance, a problem that is exacerbated by its unrelatable messengers
            The premise of the Mothers against Drunk Driving campaign is to get teenagers and other young drivers not to do a particular action, namely – not to drive drunk.  However, most people, and especially teens, do not like being told what not to do.  In fact, telling someone not to do something often leads to the exact opposite result – the person doing exactly what you did not want them to.  “When people think that a freedom is threatened they experience reactance, a motivational state aimed at restoring the threatened freedom” (9).   This is especially true when the person receiving the message cannot relate to the person delivering the message (10).  The MADD campaign suffers greatly from the fact that its messenger is a parent – the very definition of which is someone to whom a teenager does not directly relate.
            More often than not, teenagers feel misunderstood by the adults in their lives.  This is especially true for today’s teens, who are all too aware that with recent astronomical advances in technology – smartphones, personal computers, social media – they are leading lives entirely removed from the worlds in which their parents grew up.  As a result, teenagers are likely to believe that parents cannot possibly understand the situations in which they are placed, nor can parents understand why teens make the decisions they do.  The result is that teenagers do not see mothers as people who have been in their position before, but rather as authority figures that not only control their lives, but do so even though they cannot understand them. 
Teens who are exposed to the messages of the MADD campaign will not relate to the campaigns messengers, namely, as the MADD acronym implies – mothers.  Instead, teens will continue to see these messengers as authority figures who are consistently telling them what to do and how to live their lives.  The result is that instead of listening to the message and adhering to its advice, many teenagers will instead want to do the exact opposite of what they are told.  In other words, it will lead to psychological reactance.  By telling teens what not to do, MADD effectively threatens to eliminate their freedom and autonomy.  This threat to freedom in turn awakens teens, who are then impelled “to restore the particular freedom that was threatened” (11).  The end result is the exact opposite of what the MADD campaign intended, because telling teens not to do something only serves as a catalyst for their desire to engage in that very behavior.  Combining this with an authoritative, unrelatable messenger, only serves to exacerbate the problem, and increase the likelihood that psychological reactance will come into play. 

An Alternative Intervention – the designated driver movement

            The Designated Driver Movement is an alternative public health campaign with the same stated goal as MADD – preventing drunken driving.  It will center on a pledge signed by teenagers.  The pledge will not ask teens to promise never to drink and drive, but rather will accept the fact that even teens who are not drinking, will likely be around alcohol – whether it be through their peers or through other adults in their lives.  By signing the pledge, teens will join a movement – the Designated Driver Movement. Signing the pledge will result in two concrete actions: first, they will receive a wallet-sized membership ID card acknowledging them as a member of the movement.  Second, they will immediately be sent a password to log onto restricted, members only sections of the Designated Driver Movement’s website.
This website will shift the focus from the negative consequences of drunk driving, to the positive results of making smarter choices. The premise is that teens will acknowledge that it is important to always have a designated driver, or plans for alternate transportation if impaired driving will be a concern.  To that effect, it will create a network of teens that are willing to sign up as designated drivers.  These teens will take shifts, one or two nights a month, where they dedicate themselves to being on-call, and available.  The idea is not for these “on call” teens to be the first resort, but should a teen find themselves with no other options, they can call the designated driver on-call center, and they will be provided a ride home, no questions asked.
It is important that a drunken driving website dedicated toward teens not simply assume that all teens drink, or want to drink. To that end, the website will also include alternative options for those teens that choose not to drink, or not to drink on a particular night out.  Additionally, so as not to encourage bad habits, the second part of the Designated Driver Movement website will be a public teen forum whereby teens can earn “points” by reporting good behavior, such as assigning their own designated driver for the night, or taking away a drunken friend’s keys.  Once a teen has amassed a certain number of points, they can trade them in for a number of prizes, such as movie tickets, or electronics accessories. 
 Additionally, the website will be devoid of adult influence.  All messages will be written by teens, and all pictures and videos will be of teens that have already joined “the movement”.  The videos will explain the importance of the movement, the potential dangers of drunk driving, and the available options for avoiding unsafe situations.

Addressing Critique #1: How the Designated Driver Movement invokes core values that are important to teens   
It is certainly true that no two teenagers are alike – each teenager has his own preferences, interests, likes and dislikes.  However, that does not mean that there are not core elements that all teens share.  This is especially true when it comes to core values.  The core values that are important to one teenager, are important to his peers as well.  These core values are not a mystery, they are rather clear: at their core, teens want independence and autonomy, and they value rebellion.  Not only are these core values relevant to all teens generally, they are especially represented by driving.  To any teen, driving represents freedom and autonomy as it gives them control over their lives that they never had before.
            The Designated Driver Movement, DDM for short, is built around many of the core values that are most important to teens: freedom, independence, autonomy, and rebellion.  The MADD campaign restricts freedom because it is focused only on preventing those who are drunk from driving at all, without providing alternatives.  DDM, on the other hand, recognizes that teen driving is one of the most fundamental expressions of teen independence and autonomy.  Teens that join DDM join a peer community that promises to act responsibly, while at the same time remaining independent from the adults in their lives.
It is for that reason that peers, not adults, serve as designated drivers for the DDM movement.  The result of DDM is that teens are able to rely on one another and remain an independent, autonomous peer group. In fact, by providing an alternative option for teens in unsafe situations, DDM effectively increases teen independence.  Expanding the options available to teens allows them to reach decisions on their own terms.  This act of making their own decisions will be, for teens, a fundamental expression of both their freedom and their independence.
            The third core value addressed by the Designated Driver Movement is rebellion.  Joining a movement, and identifying as part of that movement is an expression of rebellion against the status quo. Teens that join DDM are rebelling against the unsafe situations in which they often find themselves. Many young people are often embarrassed to speak up when a situation gets worrisome, because they fear how they will be viewed by their peers.  Joining the movement is also a rebellion against that fear.  It is a declaration that they will not be paralyzed by what others think of them, and will not put themselves in danger.  Instead, they will take accountability for their actions, and refuse to accept already established social norms.

Addressing critique #2: DDM is a group-level intervention

            While the MADD campaign focuses entirely on individual drunken drivers, DDM turns the focus away from the individual level and brings it back to the group level.   DDM does this by creating a community.  Individuals who sign the pledge or become members of DDM are not simply deciding to change their own, individual behavior.  Rather, they are committing to sharing these changes in behavior with a virtual community of teens who have all made the same pledge.  Importantly, the community aspect of DDM does not end when teens sign up. Once they have joined the DDM community, the public forum keeps them active and involved, while providing incentives for those that do.  Signing the DDM pledge means identifying as part of a wider peer circle.  The Designated Driver Movement, therefore, aims not to change the attitude of individual teens one at a time, but rather to create a community that pledges to change its attitude as a group. 
            Importantly, this attitude change won’t affect just the individual members of the DDM community, but rather will spread – creating a wholesale attitude change for teens in general.  This is similar to the rise in popularity of Hush Puppies as described in Malcolm Gladwell’s book, The Tipping Point.  These shoes suddenly became hip around 1994/1995 when they had previously been going out of style. This happened even though no one was deliberately trying to make them a trend. Rather, the first few kids who started wearing Hush Puppies again, “simple wore the shoes when they went to clubs or cafes . . . and in so doing exposed other people to their fashion sense. They infected them with the Hush Puppies ‘virus’ (12).  The goal of DDM is similar, it aims to infect teens with an attitude against drinking and driving – an anti-drunk driving ‘virus’.  Changing the attitude of the group at this level, will lead to individual attitude shifts as well.  Just as other kids starting wearing Hush Puppies, other teens will want to join the Designated Driver Movement.

Addressing Critique #3: The use of relatable messengers reduces psychological reactance
            There are very few things that teens like less than being told what to do. This is especially true when the people telling them what to do are those that have already been doing it their whole lives.  Therefore, telling teens not to do something will only make them want to do it more.  As cited above, this theory is termed psychological reactance.  DDM is built with these principles in mind. Although the basic, fundamental idea behind DDM is to prevent teens from driving drunk or from being in a car with a drunk driver, it does not do this by explicitly stating “don’t drink and drive”.  Instead, it provides safer options for teens that are placed in unsafe situations.  By providing options instead of mandating certain actions, DDM avoids inducing psychological reactance, because it avoids telling teens how not to act.  In addition, DDM teens are able to maintain their own personal agency because it is they themselves that decide to sign the pledge and become part of the DDM community.
            Removing all adult influence from the website and having teens as its visual face, also serves to reduce psychological reactance.  This is because the messages of DDM will be delivered by people with whom new members can relate.  Teens feel that parents, such as those involved in MADD, are out of touch with their world and don’t understand where teens are coming from.  The teen messengers who are visible on DDM’s website are part of the exact audience that DDM is trying to reach.  Psychological reactance is reduced because teens joining DDM see themselves as similar to the messengers presenting the ideals of the movement, and because   “similarity increase[s] the force toward persuasion by increasing liking” (10).     In other words, DDM’s message is more likely to be accepted than MADD’s because through their similarities, its messengers become more likable and therefore are more persuasive. 

            The approach to any public health campaign requires an understanding of how messages are presented, and how target audiences receive those messages.  MADD fails to do this in a number of ways.   If, instead of focusing on negative consequences MADD focused on positive alternative options, as DDM does, it would present its goals as increasing freedom and autonomy, rather than restricting it.  MADD also falls short because it fails to recognize that teens identify as part of peer groups, with common ideals and goals.  Was MADD to treat them as a group, and create a community of like-minded teens, like DDM, it could change the attitude toward drunk driving as a whole.  Individual attitude changes will surely follow.  Finally, the use of likable, relatable messengers increases the effectiveness of any campaign.  If the messages are delivered by people with whom the audience can identify, the audience is more likely to apply those messages to their particular situation.  MADD would do well to take an approach more like DDMs – have peers deliver the message to the intended audience.  While MADD’s goal is noble, its approach is flawed.  It would do well to learn from social and behavioral theory so as to build a more effective campaign against drunk driving.  


1.       Centers for Disease Control and Prevention. Injury Prevention and Control: Motor Vehicle Safety. Atlanta, GA: Centers for Disease Control and Prevention.
2.      Mothers against Drunk Driving. Mission Statement.  Mothers against Drunk Driving.
3.      Mothers against Drunk Driving. Goals and Strategies. Mothers against Drunk Driving.
4.      Menashe CL, Siegel M. The power of a frame: an analysis of newspaper coverage of tobacco issues – United States, 1985—1996. Journal of Health Communication 1998; 3(4):307-325.
5.      Jacobson P. D., Wasserman, J., & Raube, K. The politics of antismoking legislation. 1993. Journal of Health Politics, Policy, and Law, 18, 787­ 819.
6.      Mothers against Drunk Driving. Drunk Driving. Mothers against Drunk Driving.
7.      Mothers against Drunk Driving. Campaign to Eliminate Drunk Driving. Mothers against Drunk Driving.
8.     Cialdini R, Trost M. Social influence: social norms, conformity, and compliance.  In: Gardner L, Gilbert D, Fiske S, eds. The Handbook of Social Psychology, Vol. 2. Oxford University Press, 1998.
9.      Brehm, J. W. A theory of psychological reactance. New York: Academic Press, 1996
10.  Silvia, P. J. Deflecting reactance: The role of similarity in increasing compliance and reducing
resistance. Basic and Applied Social Psychology 2005; 27, 277-284.
11.   Brehm Jack W. Psychological Reactance: Theory and Applications.  In: Srull T, ed.  Advances in Consumer Research Volume 16: Association for Consumer Research, Pages 72-75.
12.  Introduction. In: Gladwell M. The Tipping Point: How Little Things Can Make a Big Difference. Boston: Little, Brown and Company, 2000, pp3-14.

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