Introduction

Although materials prepared by the Department of Motor Vehicles (DMV) are professionally prepared and well-designed, more assurance of adequate safety literacy is needed. Considering nearly half of all American adults - 90 million people - have difficulty understanding and acting upon health information (IOM, 2004), by logical extension, a comparable number of individuals are challenged in processing and applying traffic and highway safety information. Using health literacy as a template (Ratzan and Parker, 2000), the safety counterpart would be the degree to which individuals have the capacity to obtain, process, and understand basic information and services needed to make appropriate safety decisions.

There are various kinds of literacy such as oral, print, text and numeracy. "Basic print literacy is the ability to read, write and understand written language that is familiar and for which one has the requisite amount of background knowledge" (IOM, 2004, p. 37). This kind of literacy is demonstrated when someone can decode letters, sound-out words, and understand the meaning of printed text. However, basic print literacy has familiarity and background knowledge requirements. The material should also be culturally relevant (USDHHS, 2000). For this study, safety literacy is a form of basic print literacy and operationalized as: the ability of a person to read safety information and provide a verbal explanation of its meaning.

An opportunity arose to contribute to the body of knowledge on safety literacy during a Virginia Department of Motor Vehicles communications audit of printed material. The investigator developed a procedure for measuring safety literacy at DMV customer service centers (CSCs) and applying the results to improving customer communications.

 

Procedure Pilot

The investigator field-tested a procedure for randomly approaching DMV customers and interviewing them with a safety literacy questionnaire. Customers were more approachable outside the knowledge automated testing system (KATS) area compared to the general seating and exiting areas of the customer service center (CSC). Since customers were involved in a transaction, the KATS area allowed about 10 minutes of interviewing. To pilot the interview, the investigator greeted (with name tag visible), explained briefly the purpose of the study, and asked if the customer would like to participate. Upon agreeing, the interview proceeded if the participant responded affirmatively to two verbally-posed screening questions: "Are you 18 years of age or older?" and "Do you read English while at the DMV?" Then, the investigator sat next to him/her, secured informed consent, and proceeded with the interview.

The original safety literacy questionnaire was composed of a rapid estimate of adult literacy in safety, an assessment of the subject’s ability to understand traffic safety-phrases spoken to him/her, and a solicitation of customer background information. After field-testing, the rapid estimate section was removed because all of the customers were familiar with the terminology regardless of its syllabication. The revised questionnaire retained customer background information items preceded by a section containing 25 sentences selected from the DMV Driver’s Manual (VA DMV, 2004) and online knowledge tests (VA DMV, 2005).

During the interview, the investigator perfected a "speed-writing" technique to adequately record the participant’s narrative responses to each question. Since the interview was limited to 10 minutes, the investigator was restricted to randomly selecting four or five sentences from the pool of 25 for each participant to respond. Participants read aloud and then explained the meaning of the selected sentence "as if you were talking to a friend."

 

The Study

Once piloted, the procedure was implemented at three CSCs. Customers were randomly selected as they sat outside the KATS testing area. Most participants had been photographed and awaited their call back to the customer service representative. Fifty of 64 customers agreed to participate (response rate .78). The investigator approached, greeted, screened, sat next to the participant, secured agreement/informed consent, and then proceeded with the interview.

During the interview, data were collected as participants read aloud and explained the meaning of four or five randomly selected sentences from the pool of 25 items on the questionnaire. Each selected sentence was pointed out to the participant as he/she held a copy of the questionnaire. While reading aloud, the participant’s safety literacy was scored by the investigator:

3 - Participant appears to have no difficulty reading aloud (each word in) the sentence
2 - Participant appears to have some difficulty in reading aloud (each word in) the sentence (e.g., hesitating, stopping, asking for help, requesting confirmation, etc.)
1 - Participant has difficulty reading the sentence aloud to the point inability to finish the sentence

After reading of a sentence aloud, the participant was asked to explain its meaning before proceeding to the next selected sentence. The investigator, a certified driver education instructor, recorded participants’ explanations as narrative data using the "speed-writing" technique. Each sentence explanation received a score by the investigator:

3 - Participant’s verbal explanation indicates a sufficient understanding of the sentence’s meaning
2 - Participant’s verbal explanation indicates a lack of some understanding of the sentence’s meaning ("parrots" the sentence by reading directly from the instrument, omits explaining parts of the sentence, etc.)
1 - Participant’s verbal explanation indicates lack of understanding of the sentence’s meaning (admits not understanding, provides incorrect explanation, declines to offer explanation, etc.)

Once the participant completed this section, he/she responded in writing to eight background information items on the questionnaire. At this point of the interview, if a participant asked for assistance while responding to background questions, the investigator provided clarifying information as required by informed consent protocol. It is noteworthy that 14 of the 50 participants stopped the interview to retrieve their processed license and all but two of these 14 participants returned to finish the interview.

Results For this study, safety literacy is the ability of a person to read safety information and provide a verbal explanation of its meaning. The investigator measured safety literacy by scoring participants’ ability to read aloud selected sentences as well as verbally explain the sentences’ meaning. Both numeric and narrative data were collected and analyzed. Afterward, the investigator revised selected sentences to improve their readability scores.

 

Safety Literacy - Reading

Mean safety literacy reading scores ranged from 2.0 to 3.0 with all selected sentences having a score of 2.0 or higher. The total mean score for all 25 selected sentences was 2.4. The investigator also calculated Flesch Reading Ease as well as Flesch-Kincaid grade level ratings (built-in spelling tools in Microsoft® Word) for each selected sentence. Sentence reading ease ratings ranged from 25.3 to 100 with sentence grade levels ranging from 1.0 to 12. The mean reading ease rating for sentences was 55.9 whereas the mean sentence reading level was 9.0. Ten of the 24 selected sentences met the minimum desired reading ease rating of 60 where as 9 of the 25 sentences had a reading level not exceeding the 7th grade level. From these numeric data, the investigator deduced: Generally, the 50 randomly selected participants demonstrated the first part of the safety literacy definition: being able to read aloud with minimal hesitation, stopping or asking for assistance. This ability was demonstrated consistently across the four or five sentences selected for them despite some of the sentences having less than desired reading ease and grade level ratings. The previous deduction has some qualifications, though. It was interesting how some sentences had higher safety literacy reading scores (2.6 or greater), but correspondingly, their reading ease and grade level ratings would qualify them as being challenging to read [e.g., "6. If you were convicted of two or more moving violations (one or more if under age 21) since your license was last issued, you must reapply for your license."] Contrarily, there were sentences with lower safety literacy reading scores (2.3 or lesser) yet they were rated as having high reading ease and desirable grade levels (e.g., "1. When approaching railroad tracks you should look, listen, slow down, and be prepared to stop."). These inconsistencies necessitated looking closer at the second part of the safety literacy definition--being able to explain the sentences’ meaning--both in terms of numeric scoring and narrative data.

 

Safety Literacy - Explaining

Mean safety literacy explaining scores ranged from 1.4 to 2.7 with 15 of the 25 selected sentences having a score of 2.0 or higher. The total mean score for all 25 selected sentences was 2.1. From these numeric data, the investigator deduced: Generally, the 50 randomly selected participants demonstrated the second part of the safety literacy definition: being able to verbally explain a sentence’s meaning as an indication of understanding the sentence. However, there were a number of sentences that challenged them in terms of providing a verbal meaning (mean score of less than 2.0). For example, "3. If you drive in Virginia without liability insurance coverage on your vehicle, you face a $500 fine.". To determine why these sentences were challenging, the investigator examined the participants’ verbalized explanations. The narrative data were scrutinized. From this effort, the investigator concluded some sentences needed modification to improve their readability.

 

Suggested Sentence Revisions

The investigator made suggested revisions to selected sentences (see Table 1). Sentences were restructured. Where appropriate, actual participant expressions where substituted. Although the intent was to reduce word count and syllabication, it was necessary at times to add qualifying terms and phrasing. Other suggested revisions: o Avoiding word series (e.g., ". . . look, listen, slow down, and be prepared to stop"). To correct this perhaps the sentence could be rewritten as two sentences.

1) Avoiding idiomatic wording (e.g., "reduce your speed by one-half"). This would be clarified through parenthetical phasing.

2) If legalese wording is necessary perhaps a trailing qualifying sentence could be included (e.g., retaining the expression "liability insurance" but following it with a concise definition sentence).

3) Using graphics to exhibit "a bed of a pick-up truck" or "a camper shell."

4) Whenever possible, using active rather than passive voice (e.g., "Bicycles are vehicles . . ." instead of "Bicycles are considered vehicles .. .")

 

Some figurative speech that challenged the participants was retained since it was consistent with state-approved driver education curriculum (e.g., "space cushion"). Other terminology was unchanged because it was meant to mirror statutory code. Still, other sentences were not revised because they were extracted directly from text. Hence, participants did not have the luxury of viewing the sentence in the context of its larger paragraph within the DMV Driver’s Manual.

 

Background Information

The primary reasoning for participants’ coming to the DMV was licensing. English was the language read by all but one of the respondents. Participants reportedly did not visit the DMV website regularly (perhaps once or twice yearly). Of the 23 participants suggesting improvements to DMV printed materials, "more pictures" was most commonly expressed. At least 16 participants revealed some college education. While describing race, ethnicity and/or cultural heritage: 11 White, 10 Black/African American, 9 Latino/Hispanic, 3 Asian, 3 Other (multiracial), and 14 did not specify. A majority of respondents considered themselves good drivers and justified this by being attentive, and following the rules and not committing traffic violations (tickets). Only 19 participants offered constructive responses for bettering DMV operations and most comments were positive in nature.

 

Conclusion, Discussion, and Recommendations

A majority of participants in this study were able to read sentences selected from the DMV Driver’s Manual and sample knowledge tests. This was despite some of the sentences having low reading ease and high grade level ratings. Accordingly, a majority of the participants verbalized adequate explanations of the sentences’ meaning. Still, there were some readable sentences that challenged participants’ ability to explain their meaning. Relying on numeric and narrative data provided by the participants, the investigator suggested revisions to many of the selected sentences to improve their readability.

The investigator acknowledges limitations in this study. One was the assumption that verbalizing an explanation equates to understanding the meaning of a sentence. Although the investigator scored each sentence explanation based on his professional competence in driver education, it is possible that he misinterpreted the participant’s attempted explanation. After all, the investigator was also trying to record the narrative data using a "speed writing" technique. Another limitation was the limited data gathering time. Perhaps future investigators will be able to arrange more in-depth interviews and possible focus groups. One last limitation was the generalizability of the findings. Although DMV customers were randomly selected by the investigator, a more valid approach would be randomly selected queue tickets after the customer has left the CSC Information counter. At best, this study’s results are applicable to the 50 customers who decided to participate.

In conclusion, the DMV reading materials (Driver’s Manual and sample knowledge tests) are professionally prepared and generally readable and meaningful to customers. A procedure for measuring safety literacy at the DMV has been developed and, in this initial effort, it has rendered suggestions for improving the reading materials.

 

Figure 1: Selected Sentences (Partial List)

Original Version Suggested Version
When approaching railroad tracks you should look, listen, slow down, and be prepared to stop. When you come to railroad tracks go slow. Look and listen for a train because you might have to stop.
When driving on packed snow, reduce your speed by one-half. When driving on packed snow, reduce your speed by one-half (if 40 mph go back to 20).
If you drive in Virginia without liability insurance coverage on your vehicle, you face a $500 fine. If you drive in Virginia without liability insurance coverage on your vehicle, you face a $500 fine. Liability insurance coverage helps pay costs if you cause a crash.
The speed limit in business zones is 25 mph. The speed limit in business zones (near office buildings) is 25 mph.
For your own protection, do not use a suspended or revoked driver's license, lend anyone your driver's license, or allow an unlicensed driver to operate your vehicle. For your own protection, do not use a suspended or revoked driver's license. Do not lend anyone your driver's license or allow an unlicensed driver to operate your vehicle.
U-turns are allowed in business districts, cities, and towns only at intersections. You can U-turn only at intersections if you are driving in towns and cities.
The most common mistake that drivers make when backing is failing to look both ways behind them. The most common mistake that drivers make when backing is not looking to the left or right sides behind them.
Alcohol causes slower reactions, poor judgment and loss of concentration. Alcohol causes slower reactions, poor judgment and loss of clear thinking.
The shape of a traffic sign communicates important information about the sign's message. The shape of a traffic sign tells important information about the sign's message.
Bicycles are considered vehicles and have the same rights-of-way as motor vehicles. Bicycles are vehicles and have the same right-of-way (rules of the road) as motor vehicles.
Motorists are conditioned to look for four-wheeled vehicles; but they don't expect to see two-wheeled vehicles. Motorists are used to look for four-wheeled vehicles; but they don't expect to see two-wheeled vehicles.
Securing a child in a correctly installed child safety seat can significantly reduce the possibility of death or injury. Securing a child in a properly installed child safety seat can significantly reduce the possibility of death or injury to the child.

 


Richard E. Miller, Ed.D. (Health, Fitness and Recreation Resources, George Mason University)