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regulations, citing the importance of advocating on this issue as a health care system with a Level I trauma facility.
Gathering the Stakeholders
and Creating the Coalition
The State Trauma Committee, which includes trauma system hospitals, county emergency medical services, public health,
the nucleus of the ATV Safety Coalition. for participation in the Coalition included state agencies with functions relevant to ATV safety, injury prevention coalitions, convening of the ATV Safety Coalition,
it was apparent that ATV industry and
law enforcement representation were
also important to ensure incorporation of diverse perspectives.
Nemours facilitated a process
to engage Coalition members in identifying education, outreach, and policy strategies to impact pediatric ATV-related injuries. Many Coalition members immediately voiced their support for establishment of a hands-on ATV safety training program within the state. Securing agreement on a policy
A series of meetings were hosted to identify a consensus policy position. Nemours shared national and state data on ATV injuries and fatalities, provided examples of stronger regulations in
other states, and offered policy options feasible within the political environment. Law enforcement was consulted to gauge the enforceability of regulations on private land.
Simultaneous with identifying a consensus policy position, the Coalition developed educational materials to raise awareness of the risks associated with
child ATV use and promote safe ATV riding behaviors, and in the process build momentum for an eventual legislative push. Coalition members reviewed and provided input on an ATV safety tip card, developed a co-branded ATV safety tips poster, and developed cell phone cleaners depicting a safety message.
Advocating for Policy Change
By early 2015, the ATV Safety Coalition coalesced around a consensus policy of 15 Coalition member agencies.
The position statement articulated
the Coalition’s support for legislation requiring that: ATV operators under age 18 wear a motorcycle or other motorized sports helmet; ATV operators under
age 18 drive without passengers; and youth under age 18 not be passengers
on an ATV, regardless of the age of the driver, unless the ATV is intended by
the manufacturer to carry passengers.
A policy brief was developed to educate on the risks associated with child and adolescent use of ATVs, present injury and fatality statistics, underscore the need for stronger regulations, and recommend a change to state policy to better safeguard minor ATV operators.
Nemours worked with the Delaware Division of Motor Vehicles (DMV) to draft legislation advancing the ATV Safety Coalition’s policy position, secured legislative sponsors on the House and Senate sides of the General Assembly, and worked to secure support for the policy change within all four caucuses. generate support among other stakeholder groups not actively engaged in the ATV Safety Coalition.
Senate Bill 69 was introduced on April 23, 2015 and assigned to the Senate Public Safety Committee. The legislation
in the ATV Safety Coalition’s position statement. The bill progressed through the legislative process in just two months with ATV Safety Coalition members lending their support by calling and meeting
with legislators, attending committee
at Senate and House committee hearings. Legislators were impressed with the diverse base of support for the legislation, which included ATV industry and law enforcement representation. Several lawmakers who expressed their support cited personal experiences of ATV-related injuries and fatalities among family and friends. During the legislative process, it was necessary to amend the bill to address landowner liability concerns and an outdated helmet standard in statute.
RESULTS
Senate Bill 69 was signed into law by Governor Jack A. Markell on July 30,
2015, with the strengthened regulations becoming effective immediately upon the Governor’s signature. The venue for the bill signing was the Delaware State Fair, which provided an opportunity to raise awareness of the new regulations among agricultural constituencies. Delaware is now among the 35 states with helmet requirements and 22 states with passenger restrictions.22 It will take time to evaluate if the new regulations decrease the number of pediatric patients presenting with ATV-related injuries and increase rates of helmet use.
DISCUSSION
Nemours clinicians, including trauma surgeons, neurosurgeons, and nurses, among others, endorse the AAP policy position and as a result, supported a policy change that encompassed an age
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Del Med J | March 2017 | Vol. 89 | No. 3
