'Just Drive': An Employee-Based Intervention to Reduce Distracted Driving.

Distracted driving is a major danger on today's roadways. Employers play a critical role in developing distracted driving policies and promoting a culture of workplace driving safety. The purpose of this study was to evaluate the effectiveness of an in-person work-based class to reduce distracted driving in participating employees. The "Just Drive-Take Action Against Distraction" class was designed by the UC San Diego Training, Research and Education for Driving Safety (TREDS) program to increase awareness of the dangers of distracted driving and to encourage employees to be safe and responsible drivers, both on and off the job. Participants completed pre- and post-anonymous surveys and, in a subset of attendees, volunteers were contacted via email 3 months post-intervention to complete a driving-behavior survey on Surveymonkey.com. 115 classes for 6896 employees were delivered at 54 agencies in Southern California. A total of 4928 participants completed the pre- and post-survey; 2014 n = 2263 and 2015 n = 2665. The course was found useful (85%) and engaging (85.6%). For non-commercial drivers, 55.6% of participants reported an increase of 80-100% in awareness of the dangers of distracted driving, and 67.2% reported an increase of 80-100% in their motivation to change. For commercial drivers, 71.3% reported a motivation increase of 80-100%. There were significant increases in knowledge for both groups. In the three-month follow-up survey, participants identified multiple positive changes in distracted driving behavior. This 1-h employer-supported intervention demonstrated positive changes in short-term intention and medium-term behaviors.

Adaptation of the driver behaviour questionnaire and behavioural risk factors for traffic violation arrest and self-reported crash involvement among Nigerian drivers.

CONTEXT: Few studies have been conducted to investigate the driving behaviour of drivers in Africa. AIMS: This study aims to determine the behavioural risk factors for road crashes among Nigerian drivers. SETTINGS AND DESIGN: This is a case-control study. Cases were drivers who were booked for traffic violation or who had been involved in road crashes in the past, while the controls were drivers with no such histories. SUBJECTS AND METHODS: Both the cases and controls were administered the Driver Behaviour Questionnaire (DBQ). Principal component analysis with varimax rotation was run to examine the factor structure of the scale. Cronbach's alpha was used for assessing the internal consistency of the DBQ, and logistic regression was used to determine risk factors for crash involvement. RESULTS: Six hundred active drivers consisting of 300 cases and 300 controls were selected. The mean scores of all DBQ items, except one, were significantly higher among booked drivers compared to those who had never been booked. Consistent with many previous studies, factor analysis identified three factors in the DBQ (aggressive violation, ordinary violation and error). However, the factors were constructed differently with most ordinary violation items in the original DBQ loading as aggressive violation in the present study. Eight variables were predictive of being booked for traffic offences while only five variables were predictive of self-reported crash involvement. CONCLUSIONS: The most important variable associated with previous crash involvement was alcohol use. A major policy implication of this is the need for better attention to anti-drunk driving measures.

Challenges of enforcing cell phone use while driving laws among police: a qualitative study.

BACKGROUND: Cell phone use while driving laws do not appear to be heavily enforced in the USA. This study seeks to gain law enforcements' perspective and learn potential barriers to cell phone law enforcement. METHODS: Qualitative interviews (ie, focus groups) were conducted with officers (N=19) from five West Virginia law enforcement agencies. The officers who participated were >18 years of age, sworn into their departments and employed in law enforcement for >1 year. Focus group sessions lasted 45-60 min and followed a standardised, pilot-tested script. These sessions were audio recorded and transcribed. Qualitative content analysis was employed among three researchers to determine themes surrounding enforcement. RESULTS: Four themes emerged including current culture, the legal system, the nature of police work and issues with prevention. Specific barriers to enforcement included cultural norms, lack of perceived support from courts/judges, different laws between states, the need for a general distracted driving law, unclear legislation, officers' habits and perceived risk, wanting to maintain a positive relationship with the public, not being able to see the driver (impediments of vehicle design, time of day), phones having multiple functions and not knowing what drivers are actually doing, risk of crashing during traffic stops and lack of resources. Prevention activities were debated, and most felt that technological advancements implemented by cell phone manufacturers may deter use. CONCLUSIONS: Numerous barriers to cell phone law enforcement exist. Legislation could be amended to facilitate enforcement. Prevention opportunities exist to deter cell phone use while driving.

Falling asleep at the wheel and distracted driving. The High-Risk Professional Drivers study.

BACKGROUND: Sleepiness at the wheel and driving while engaged in other activities are well known risk factors for traffic accidents. This article estimates the prevalence of these factors among Italian Professional Drivers (PDs) and their impact on reported driving mistakes. METHODS: A cross-sectional study was conducted using anonymous questionnaires. PDs (n=497) were divided into two groups: high-risk PDs (HiRis_PDs) (those who self-reported more than one incident during the last 3 years and/or more than one mistake during the past year) and non-HiRis_PDs (subjects who did not meet the above-mentioned inclusion criteria). Logistic regression analyses were performed to assess the association of self-reported sleepiness and/or risky driving behaviour with the condition of being a high-risk driver. RESULTS: 161 (32.4%) subjects were defined as HiRis_PDs. Forty-one percent of the interviewees experienced at least one episode per month of sudden-onset sleep at the wheel. Twenty-eight point two percent reported a regular use of a hand-held cell phone. Predictive factors for being HiRis_PDs were: at least one self-reported episode per month of falling asleep at the wheel [odds ratio (OR) 5, 95% confidence interval (CI) 3.21-7.80, P<0.001], driving while regularly engaged in other activities (mainly hand-held cell phone use) (OR 6.11, 95% CI 2.90-12.84, P<0.001), and young age (OR 0.96, OR 1 year of age increase, 95% CI 0.94-0.98, P=0.001). CONCLUSIONS: Focusing prevention efforts on recognizing sleepiness at the wheel and on avoiding other distracting activities while driving can reduce the possibility of driving errors on the road by about 5-6 times.

Predictors of Cell Phone Use in Distracted Driving: Extending the Theory of Planned Behavior.

This study examines the predictors of six distracted driving behaviors, and the survey data partially support Ajzen's (1991) Theory of Planned Behavior (TPB). The data suggest that the attitude variable predicted intention to engage in all six distracted driving behaviors (reading and sending text messages, making and answering cell phone calls, reading/viewing social media, and posting on social media while driving). Extending the model to include past experience and the variable perceived safety of technology yielded an improvement in the prediction of the distraction variables. Specifically, past experience predicted all six distracted driving behaviors, and the variable perceived safety of technology predicted intentions to read/view social media and intention to post on social media while driving. The study provides evidence for the importance of incorporating expanded variables into the original TPB model to predict cell phone use behaviors while driving, and it suggests that it is essential to tailor campaign materials for each specific cell phone use behavior to reduce distracted driving.

Distracted Biking: An Observational Study.

Commuting via bicycle is a very popular mode of transportation in the Northeastern United States. Boston, MA, has seen a rapid increase in bicycle ridership over the past decade, which has raised concerns and awareness about bicycle safety. An emerging topic in this field is distracted bicycle riding. This study was conducted to provide descriptive data on the prevalence and type of distracted bicycling in Boston at different times of day. This was a cross-sectional study in which observers tallied bicyclists at 4 high traffic intersections in Boston during various peak commuting hours for 2 types of distractions: auditory (earbuds/phones in or on ears), and visual/tactile (electronic device or other object in hand). Nineteen hundred seventy-four bicyclists were observed and 615 (31.2%), 95% CI [29, 33%], were distracted. Of those observed, auditory distractions were the most common (N = 349; 17.7%), 95% CI [16, 19], p = .0003, followed by visual/tactile distractions (N = 266; 13.5%), 95% CI [12, 15]. The highest proportion (40.7%), 95% CI [35, 46], of distracted bicyclists was observed during the midday commute (between 13:30 and 15:00). Distracted bicycling is a prevalent safety concern in the city of Boston, as almost a third of all bicyclists exhibited distracted behavior. Education and public awareness campaigns should be designed to decrease distracted bicycling behaviors and promote bicycle safety in Boston. An awareness of the prevalence of distracted biking can be utilized to promote bicycle safety campaigns dedicated to decreasing distracted bicycling and to provide a baseline against which improvements can be measured.

Distracted Driving in Teens With and Without Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: This study is among the first to examine the effect of talking on a cell phone or text messaging while driving in teens with and without attention deficit/hyperactivity disorder (ADHD). METHOD: Teens (average age 17years) with a diagnosis of ADHD (N=16) were matched with typically developing controls (N=18). All participants operated a driving simulator while (1) conversing on a cell phone, (2) text messaging, and (3) with no distraction during a baseline condition. Six indicators of driving performance were recorded: (a) time to complete the drive; (b) lane deviations; (c) variability in lane position (i.e., root mean square [RMS]); (d) reaction time; (e) motor vehicle collisions; and, (f) speed fluctuation. RESULTS: Significantly greater variation in lane position occurred in the texting task compared to no task and the cell phone task. While texting, in particular, teens with ADHD took significantly less time to complete the scenario. No significant main effects of group were found. CONCLUSIONS: Generally, those with ADHD did not differ in regard to driving performance, when compared to controls, with the exception of one outcome: time to complete scenario. These findings suggest that distracted driving impairs driving performance of teen drivers, regardless of ADHD status. Texting while driving had the greatest negative impact on driving performance, particularly with regard to variability in lane position (i.e., RMS). This study sheds light on key issues regarding injury prevention, with the intent of providing pediatric care providers with the knowledge to inform teen drivers of risks associated with distracted driving which will ultimately result in reduced rates of motor vehicle crashes and concomitant injuries.

The utility of telematics data for estimating the prevalence of driver handheld cellphone use, 2019-2022.

INTRODUCTION: Driver distraction from handheld cellphone use contributes to fatal crashes every year but is underreported in terms of the proportion of crashes attributed to any distraction or cellphone use specifically. Existing methods to estimate the prevalence of cellphone distractions are also limited (e.g., observing drivers stopped at intersections, when crash risk is low). Our study used data from Cambridge Mobile Telematics to estimate the prevalence of drivers' handheld calls and cellphone manipulation while driving, with "cellphone motion" based on movement recorded by the phones' gyroscopes used as a surrogate for manipulation. METHOD: We compared the telematics measures with the National Highway Traffic Safety Administration's roadside observations of driver electronic device use, and logistic regression tested relationships between regional, legislative, and temporal factors and the odds of cellphone behaviors occurring on a trip or at a given point in time. RESULTS: Results showed 3.5% of trips included at least one handheld phone call and 33.3% included at least an instance of cellphone motion, with handheld calls occurring during 0.78% of overall trip duration and cellphone motion during 2.4% of trip duration. CONCLUSIONS: Correspondence between trends in cellphone distractions across regional, legislative, and temporal factors suggest telematics data have considerable utility and appear to complement existing datasets.

Assessing the determinants of crash propensity using structural equation modeling: Role of distractions caused by fellow drivers.

INTRODUCTION: Aggressive behavior of drivers is a source of crashes and high injury severity. Aggressive drivers are part of the driving environment, however, excessive aggressive driving by fellow drivers may take the attention of the recipient drivers away from the road resulting in distracted driving. Such external distractions caused by the aggressive and discourteous behavior of other road users have received limited attention. These distractions caused by fellow drivers (DFDs) may agitate recipient drivers and ultimately increase crash propensity. Aggressive driving behaviors are quite common in South Asia and, thus, it is necessary to determine their contribution to distractions and crash propensity. METHOD: Our study aimed to evaluate the effects of DFDs using primary data collected through a survey conducted in Lahore, Pakistan. A total of 801 complete responses were obtained. Various hypotheses were defined to explore the associations between the latent factors such as DFDs, anxiety/stress (AS), anxiety-based performance deficits (APD), hostile behavior (HB), acceptability of vehicle-related distractions (AVRD), and crash propensity (CP). Structural Equation Modeling (SEM) was employed as a multivariate statistical technique to test these hypotheses. RESULTS: The results supported the hypothesis that DFDs lead to AS among recipient drivers. DFDs and AS were further found to have positive associations with APDs. Whereas, there was a significant negative association between DFD, AS, and AVRD. As hypothesized, DFD and AS had positive associations with CP, indicating that distractions caused by aggressive behaviors leads to stress and consequently enhances crash propensity. PRACTICAL APPLICATIONS: The results of this study provide a statistically sound foundation for further exploration of the distractions caused by the aggressive behaviors of fellow drivers. Further, the results of this study can be utilized by the relevant authorities to alter aggressive driving behaviors and reduce DFDs.

Distracted on duty: A theory-based exploration of influences leading to mobile phone distracted riding among food delivery workers.

Using mobile phones while riding is a form of distracted riding that significantly elevates crash risk. Regrettably, the factors contributing to mobile phone use while riding (MPUWR) among food delivery riders remain under-researched. Addressing this literature gap, the current study employs the Job Demands-Resources (JD-R) model and various socio-economic factors to examine the determinants of MPUWR. The research incorporates data from 558 delivery workers in Hanoi and Ho Chi Minh City, Vietnam. The study utilizes two analytical methods to empirically test the hypotheses, considering non-linear relationships between variables: Partial Least Square Structural Equation Modelling (PLS-SEM) and Artificial Neural Network (ANN). The results reveal mixed impacts of factors connected to job resources. Although social support appears to deter MPUWR, work autonomy and rewards seemingly encourage it. Furthermore, a predisposition towards risk-taking behaviour significantly impacts the frequency of mobile phone usage among delivery riders. Interestingly, riders with higher incomes and those who have previously been fined by the police exhibit more frequent mobile phone use. The findings of this study present valuable insights into the crucial factors to be addressed when designing interventions aimed at reducing phone use among food delivery riders.

Demographic characteristics and trends of cell phone use while driving citations in selected states in the United States, 2010-2020.

OBJECTIVE: Distracted driving is a leading cause of motor vehicle crashes, and cell phone use is a major source of in-vehicle distraction. Many states in the United States have enacted cell phone use laws to regulate drivers' cell phone use behavior to enhance traffic safety. Numerous studies have examined the effects of such laws on drivers' cell phone use behavior based on self-reported and roadside observational data. However, little was known about who actually violated the laws at the enforcement level. This study sought to uncover the demographic characteristics of drivers cited for cell phone use while driving and whether these characteristics changed over time since the enactment of cell phone laws. METHODS: We acquired useable traffic citation data for 7 states in the United States from 2010 to 2020 and performed descriptive and regression analyses. RESULTS: Male drivers were cited more for cell phone use while driving. Handheld and texting bans were associated with a greater proportion of cited drivers aged 40 and above, compared to texting-only bans. Trends in the citations issued based on drivers' age group following the enactment of different cell phone laws were also uncovered. The proportion of citations issued to drivers aged 60 and above increased over time but the temporal trend remained insignificant when population effect was considered. CONCLUSIONS: This study examined the demographic characteristics of drivers cited for cell phone use while driving in selected states with texting-only bans or handheld and texting bans. The results reveal policy-based differences in trends in the proportion of citations issued to drivers in different age groups.

Influence of cannabis use history on the impact of acute cannabis smoking on simulated driving performance during a distraction task.

Objective: This research explores the driving performance of people who use cannabis daily or occasionally during distraction tasks performed following acute cannabis use.Methods: Healthy adults aged 25 to 45 years with different cannabis usage histories were recruited to participate in a within-subjects controlled experiment using a car-based driving simulator. Participants were classified as having daily use (n = 31), occasional use (1 or 2 times per week; n = 24), or no-use (n = 30). Participants completed a practice drive followed by four 5-10 minute driving scenarios during the baseline period. Participants then smoked self-procured cannabis flower ad libitum for up to 15 minutes. Thirty minutes later, they completed four additional 5-10 minute scenarios. Scenarios were paired according to difficulty and randomized across the baseline and post-use periods. Each scenario contained between 0 and 3 repetitions of a distraction task where the participant was prompted by an audio message to select an app from a 4 × 5 grid displayed on a mounted tablet, a step that would require briefly looking away from the roadway. Measures of driving performance (lane departures, standard deviation of lateral position) were assessed during the five-second period following the audio trigger and analyzed using generalized linear mixed models.Results: Those with a pattern of occasional use were significantly more likely to experience a lane departure during distraction periods after acute cannabis use relative to baseline (OR = 3.71, p = 0.04, CI = 1.04, 13.17), while those with daily use did not exhibit a similar increase (OR = 1.56, p = 0.43, CI = 0.52, 4.64). Changes in departure risk were significantly greater for the occasional use group compared to no-use (p = 0.02), but not for the daily use group compared to no-use (p = 0.18). However, following acute use, those who use daily exhibited decreases in speed relative to baseline in comparison to the changes observed in the no-use group (p = 0.02), while differences between occasional and no-use did not reach statistical significance (p = 0.052). Differences in standard deviation of lateral position were not statistically significant, likely due to the short duration of tasks.Conclusions: These results find the largest potential safety concerns associated with a pattern of occasional use, who displayed an increase in lane departures after acute cannabis smoking. Those in the daily use group decreased their speed, which may be interpreted as compensation for drug effects. Further research is needed to understand the effects during longer and more complex secondary tasks.

Psychosocial factors associated with the self-reported frequency of cell phone use while driving in Iran.

Cell phone use while driving is a common contributing factor in thousands of road traffic injuries every year globally. Despite extensive research investigating the risks associated with cell phone use while driving, social media campaigns to raise public awareness and a number of laws banning phone use while driving, this behaviour remains prevalent throughout the world. The current study was conducted in Iran, where road traffic injuries are the leading causes of death and disability, and where drivers continue to use their cell phones, despite legislative bans restricting this behaviour. A total of 255 drivers in the city of Mashhad (male = 66.3%; mean age = 30.73 years; SD = 9.89) completed either an online or a paper-based survey assessing the self-reported frequency of using a cell phone while driving. Psychosocial factors contributing to cell phone use while driving and support for legislation restricting this behaviour, as well as the Big Five personality traits, were also measured. Overall, the results showed that almost 93% of drivers use their cell phones while driving at least once a week, with 32.5% reporting they always use their cell phones while driving. Ordinal logistic regression revealed that the presence of a child passenger, age, perceived benefits and risks of using cell phones while driving, as well as the perceived ability to drive safely while using a cell phone, were strongly associated with the frequency of cell phone use while driving. As for personality traits-extraversion, agreeableness and conscientiousness significantly predicted the frequency of cell phone use in this sample of Iranian drivers.

Prevalence and trends of distracted driving in Canada.

INTRODUCTION: This study evaluates prevalence and trends in distracted driving in Canada based on multiple indicators collected from the Road Safety Monitor (RSM) and Canada's National Fatality Database maintained by the Traffic Injury Research Foundation (TIRF). METHOD: Data from the RSM on self-reported distracted driving behaviors were analyzed using multivariate techniques including logistic regression analysis in various years spanning from 2004 to 2019. Data from TIRF's National Fatality Database from 2000 to 2016 were also analyzed using piecewise regression analysis to evaluate trends and prevalence of driver distraction. RESULTS: Significantly more Canadians reported talking on their phone hands-free or handheld phone while driving in 2019 compared to 2010. There was a 102% increase in the percentage that reported texting while driving in 2019 (9.7%) compared to 2010 (4.8%). For every 10-year increase in age, drivers were 44% less likely to text, 38% less likely to use a handheld phone, and 28% less likely to use a hands-free phone. Males were 62% more likely to use a handheld phone and 50% more likely to use a hands-free phone than females. Findings related to drivers' perceived danger of distracted driving and attitudes are also presented. Although the number of distraction-related fatalities has not increased substantially from 2000 to 2016, the percentage of all fatalities where distraction was a contributing factor has increased. Unlike drinking drivers, distracted drivers more often kill other road users in crashes than kill themselves. CONCLUSIONS: In conclusion, while most Canadians appear to understand that one of the high-risk forms of distracted driving (i.e., texting while driving) is indeed dangerous, there is a minority who are unaware of, or resistant to, this fact. Practical Applications: Enforcement activities and education initiatives to combat distracted driving ought to be tailored to the target audience based on the patterns uncovered.

Characterizing phone usage while driving: Safety impact from road and operational perspectives using factor analysis.

Phone use while driving (PUWD) is one of the most crucial factors of distraction related traffic crashes. This study utilized an unsupervised learning method, known as factor analysis, on a unique distracted driving dataset to understand PUWD behavior from the roadway geometry and operational perspectives. The results indicate that the presence of a shoulder, median, and access control on the relatively higher functional class roadways could encourage more PUWD events. The roadways with relatively lower speed limits could have high PUWD event occurrences if the variation in operating speed is high. The results also confirm the correlations between the frequency of PUWD events and the frequency of distracted crashes. This relationship is strong on urban roadways. For rural roadways, this correlation is only strong on the roadways with a large amount of PUWD events. The findings could help transportation agencies to identify suitable countermeasures in reducing distraction related crashes. Moreover, this study provides researchers a new perspective to study PUWD behavior rather than only focus on drivers' personalities.

Mobile phone use while driving: Development and validation of knowledge, attitude, and practice survey instruments.

INTRODUCTION: Instruments that assess the knowledge, attitude, and practice (KAP) of mobile phone use serve as a primary assessment tool on which mobile phone distracted driving interventions can be designed. The objective of this study is to develop and validate KAP-modeled survey instruments that measure the knowledge of mobile phone hazards while driving (KMPHD), the attitude of drivers towards mobile phone use while driving (AMPUD), and the practice of mobile phone use while driving (PMPUD). METHOD: This study was a cross-sectional analytical survey conducted in Ibadan, Nigeria. Three instruments were designed to measure KMPHD, AMPUD, and PMPUD. Content validity, item analysis, exploratory factor analysis were conducted, and items were excluded based on the collective results of the analysis. The domains of the constructs and the reliability of the instruments are reported. A confirmatory factor analysis was used to assess the regression weights of each item and the model fit. RESULTS: From an original list of 13, 12, and 10 items in the KMPHD, AMPUD, and PMPUD instruments, a final list of 7, 5, and 7 items were generated in each survey instrument, respectively. Two domains of the knowledge of hazards and practice of mobile phone use were obtained, and attitude to phone use while driving was a single domain. The reliabilities (Cronbach alpha) of the KMPHD (0.881), AMPUD (0.954), and PMPUD (0.920) were sufficiently high. Also, all items in the three instruments had moderate-to-high regression coefficients, and the model fits of the instruments were good. CONCLUSIONS: This study provides KAP-modeled survey instruments that can be used to assess a population-based knowledge, attitude, and practice of mobile phone use while driving. Practical Applications: This survey instrument can be used in assessing baseline knowledge, attitude, and practice of phone use while driving and determine the focus and effectiveness of mobile phone-induced distracted driving interventions.

Is organized carpooling safer? Speeding and distracted driving behaviors from a naturalistic driving study in Brazil.

Carpooling consists of drivers and passengers sharing a journey and its costs. Nowadays, in the context of mobility as a service, organized carpooling encompasses a service and trust relationship between drivers and passengers, by matching common routes and splitting cost through mobile phone applications. Therefore, passengers expect a certain level of travel quality and safety. In this context, this research aims to verify the hypothesis that drivers in an organized carpooling situation (CP) show safer driving behavior in terms of speeding (SP) and mobile phone use while driving (MPU) in comparison with non-carpooling (NCP) drivers. The research is based on data from the Brazilian Naturalistic Driving Study (NDS-BR) conducted in the City of Curitiba, with 40.45 driving hours and a traveled distance of 895.87 km. Methodology included the selection of safety performance indicators on SP and MPU, use of nonparametric Wilcoxon signed rank test for safety performance indicator comparisons and Pearson Chi-Square to test the association between CP or NCP and low or high indicator values. Hypothesis test results point in the same direction and partially confirm the initial assumption that CP induces safer behavior in terms of speeding. The statistically sound results showed that CP drivers engaged in less speeding episodes and mobile phone use duration in comparison to NCP drivers, as well as lower speed while using a mobile phone. In addition, driver behavior in CP and NCP situations also differed in terms of the type of MPU, with the proportion of types of use that demand a higher level of visual and manual distraction being higher among NCP drivers. In summary, these results confirm the initial hypothesis of safer driving behavior during carpooling in terms of MPU while driving.

Evaluation of a population health strategy to reduce distracted driving: Examining all "Es" of injury prevention.

BACKGROUND: Cell phone use while driving (CPWD) increases the risk of crashing and is a major contributor to injuries and deaths. The objective of this study was to describe the evaluation of a multifaceted, evidence-based population health strategy for the reduction of distracted driving. METHODS: A multipronged campaign was undertaken from 2014 to 2016 for 16- to 44-year-olds, based on epidemiology, focused on personal stories and consequences, using the "Es" of injury prevention (epidemiology, education, environment, enforcement, and evaluation). Education consisted of distracted driving videos, informational cards, a social media AdTube campaign, and a movie theater trailer, which were evaluated with a questionnaire regarding CPWD attitudes, opinions, and behaviors. Spatial analysis of data within a geographic information system was used to target advertisements. A random sample telephone survey evaluated public awareness of the campaign. Increased CPWD enforcement was undertaken by police services and evaluated by ARIMA time series modeling. RESULTS: The AdTube campaign had a view rate of >10% (41,101 views), slightly higher for females. The top performing age group was 18- to 24-year-olds (49%). Our survey found 61% of respondents used handheld CPWD (14% all of the time) with 80% reporting our movie trailer made them think twice about future CPWD. A stakeholder survey and spatial analysis targeted our advertisements in areas of close proximity to high schools, universities, near intersections with previous motor vehicle collisions, high traffic volumes, and population density. A telephone survey revealed that 41% of the respondents were aware of our campaign, 17% from our print and movie theater ads and 3% from social media. Police enforcement campaign blitzes resulted in 160 tickets for CPWD. Following campaign implementation, there was a statistically significant mean decrease of 462 distracted driving citations annually (p = 0.001). CONCLUSION: A multifaceted, evidence-based population health strategy using the Es of injury prevention with interdisciplinary collaboration is a comprehensive method to be used for the reduction of distracted driving. LEVEL OF EVIDENCE: Therapeutic, level IV.

Distracted driving of a motor vehicle on Brazilian federal highways as a cause of traffic accidents. / Falta de atenção ao conduzir veículo automotor como causa de acidentes de trânsito nas rodovias federais brasileiras.

INTRODUCTION: Distracted driving (DD) of a motor vehicle is considered an increasing risk factor for land transport accidents. OBJECTIVE: To identify the tendency in the number of victims in DD accidents and in the number of offences due to cell phone use on Brazilian federal highways, as well as analyze the DD category in depth as it is being used in the country. METHOD: A time series study with data on accidents with victims, made available by the Federal Highway Police, whose cause was distracted driving, from 2007 to 2016 and data on offences for driving using a cell phone. RESULTS: There was a tendency towards a monthly increase in the number of distracted driving accident victims in the country up to mid-2011 (percentage monthly variation - PMV = 0.57%), followed by a significant decrease (PMV = -0.45%). Macro-regions showed similar behavior, except in the Southeast. There was a monthly increase in the number of offences caused by drivers using cell phones from 2007 to 2013. CONCLUSION: There was a tendency towards monthly increases in the number of victims of distracted driving in Brazil and in most macro-regions up to 2011, followed by a subsequent downward tendency. The inaccurate nature of the expression "distraction" compromises the quality of the data and, consequently, the adequate estimation of victims attributable to this risk factor. The cell phone-driving dyad could be the root cause of accidents with victims caused by distracted driving in the country.