Through this critical review of the literature and evaluation of warning letter contents, the foundation has been set for the development of an enhanced negligent-operator treatment and evaluation system (ENOTES) for California. Criteria to evaluate the treatment letters were developed from the 16 components of the Transtheoretical Model (TTM) of behavior change that, incidentally, incorporates the majority of the recommendations made by traffic safety researchers over the past 50 years. The evaluated studies were tabulated by the strenght of the evidence supporting each treatment in terms of the quality of the research and the validity of the methods as defined by the degree to which they reflected components of the TTM. Overall, the research designs were outstanding. However, the warning letters themselves were weaker, and generally not strongly tied to a theory of behavior change. On average, 2.5 of the six General Stage, 1.8 of the five Early Stage, and 0.29 of the five Late Stage TTM elements were utilized. No balanced treatment letters were identified that incorporated the majority of the TTM elements available from all three stages. A definite opportunity exists to strengthen the effectiveness of letter treatments through intelligent use of the TTM. (Author/publisher)
Abstract