Examining the impact of interventions in reducing self-reported engagement in distracted driving: A systematic review.

Despite the implementation of legal countermeasures, distracted driving remains a prevalent concern for road safety. This systematic review (following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) summarised the literature on the impact of interventions targeting attitudes/intentions towards, and self-reported engagement in, distracted driving. Studies were eligible for this review if they examined self-reported behaviour/attitudes/intentions pertaining to distracted driving at baseline and post-intervention. Databases searched included PubMed, ProQuest, Scopus, and TRID. The review identified 19 articles/interventions, which were categorised into three intervention types. First, all program-based interventions (n = 6) reduced engagement in distracted driving. However, there were notable limitations to these studies, including a lack of control groups and difficulties implementing this intervention in a real-world setting. Second, active interventions (n = 9) were commonly utilised, yet a number of studies did not find any improvements in outcomes. Finally, four studies used a message-based intervention, with three studies reporting reduced intention and/or engagement in distracted driving. There is opportunity for message-based interventions to be communicated effortlessly online and target high-risk driving populations. However, further research is necessary to address limitations highlighted in the review, including follow-up testing and control groups. Implications are discussed with particular emphasis on areas where further research is needed.

Use of smartphone apps while driving: Variations on driving performances and perceived risks.

Distracted driving increases the crash frequencies on the road and subsequently leads to fatalities involved with crashes. As technology has evolved, drivers are continuously exposed to newer technology in their vehicles and applications in their phones, which has led to technology representing one of the main secondary tasks that distract drivers on the road. The impact of technology-involved distraction appears to be different by the type of distraction since a secondary task that can be exceedingly distracting to the driver causes more reckless and risky driving. Moreover, the impact of distracted driving may differ by roadway geometries since distracted drivers' performance may vary depending on how actively they interact with other vehicles or surrounding environments. This study aims to understand the impacts of smartphone application distractions, in particular social media activities (e.g., video, feed, message), on different road geometries using a mixed-method analysis consisting of a survey, a driving simulator experiment, and individual interview. Results from the interview and simulation experiments show that most social media activities cause unsafe lane changes regardless of road geometry. Among various social-media activities, watching reels (videos) represent an unintentional but deeper level of engagement that consequently causes a driver to deviate in their lane, make unintentional lane changes, suddenly change their speed and acceleration, and headway. The interview also revealed varying levels of risk perception about distracted driving, in particular the lower level of risk perception in using GPS and music applications. This study concludes that the distractions caused by smartphone applications and social media activities combined with lower awareness and risk perception could significantly elevate the crash risks.

Real-time monitoring of driver distraction: State-of-the-art and future insights.

Driver distraction and inattention have been found to be major contributors to a large number of serious road crashes. It is evident that distraction reduces to a great extent driver perception levels as well as their decision making capability and the ability of drivers to control the vehicle. An effective way to mitigate the effects of distraction on crash probability, would be through monitoring the mental state of drivers or their driving behaviour and alerting them when they are in a distracted state. Towards that end, in recent years, several inexpensive and effective detection systems have been developed in order to cope with driver inattention. This study endeavours to critically review and assess the state-of-the-art systems and platforms measuring driver distraction or inattention. A thorough literature review was carried out in order to compare and contrast technologies that can be used to detect, monitor or measure driver's distraction or inattention. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The results indicated that in most of the identified studies, driver distraction was measured with respect to its impact to driver behaviour. Real-time eye tracking systems, cardiac sensors on steering wheels, smartphone applications and cameras were found to be the most frequent devices to monitor and detect driver distraction. On the other hand, less frequent and effective approaches included electrodes, hand magnetic rings and glasses.

Evaluating the Impact of a Multifaceted Distracted Driving Prevention Program.

OBJECTIVE: The aim of this study is to evaluate undergraduate college students' attitude changes toward distracted driving after participating in a multifaceted distracted driving prevention program. METHODS: This study used a quasi-experimental, pre- post-test design. Participants were undergraduate college students who were aged 18 or older and had a valid driver's license. The Questionnaire Assessing Distracted Driving was used to measure participants' attitudes and behaviors. All participants completed the entire Questionnaire Assessing Distracted Driving survey and then participated in the distracted driving prevention program that consisted of a 10-minute narrated recorded PowerPoint lecture followed by a distracted driving simulation. Descriptive statistics were calculated to describe the study sample. The Questionnaire Assessing Distracted Driving data were analyzed to ascertain any statistically significant changes in responses from pre- to postintervention. RESULTS: From pre- to post-test, there were statistically significant increases in the number of participants who reported they would tell friends to stop texting and driving if they were a passenger, refrain from texting while driving, and wait until reaching home before retrieving their cell phones from the floor of the vehicle. Participants perceived a greater threat from drivers talking on phones or texting/emailing from pre- to post-test. Moreover, attitudes toward talking on a handheld device, talking on a hands-free phone, and texting/emailing became more negative from pre- to post-test. CONCLUSION: The intervention helped promote negative attitudes toward distracted driving in a sample of college students immediately after participating in a distracted driving prevention program.

Driver distraction and in-vehicle interventions: A driving simulator study on visual attention and driving performance.

Driving simulator studies are popular means to investigate driving behaviour in a controlled environment and test safety-critical events that would otherwise not be possible in real-world driving conditions. While several factors affect driving performance, driving distraction has been emphasised as a safety-critical issue across the globe. In this context, this study explores the impact of distraction imposed by mobile phone usage, i.e., writing and reading text messages, on driver behaviour. As part of the greater i-DREAMS project, this study uses a car driving simulator experimental design in Germany to investigate driver behaviour under various conditions: (I) monitoring scenario representing normal driving conditions, (II) intervention scenario in which drivers receive fixed timing in-vehicle intervention in case of unsafe driving manoeuvres, and (III) distraction scenario in which drivers receive in-vehicle interventions based on task completion capability, where mobile phone distraction is imposed. Besides, eye-tracking glasses are used to further explore drivers' attention allocation and eye movement behaviour. This research focuses on driver response to risky traffic events (i.e., potential pedestrian collisions, and tailgating) and the impact of distraction on driving performance, by analysing a set of eye movement and driving performance measures of 58 participants. The results reveal a significant change in drivers' gaze patterns during the distraction drives with significantly higher gaze points towards the i-DREAMS intervention display (the utilised advanced driver assistance systems in this study). The overall statistical analysis of driving performance measures suggests nearly similar impacts on driver behaviour during distraction drives; a higher deviation of lateral positioning was noted irrespective of the event risk levels and lower longitudinal acceleration rates were observed for pedestrian collisions and non-critical events during distracted driving.

An XGBoost approach to detect driver visual distraction based on vehicle dynamics.

OBJECTIVES: Distracted driving such as reading phone messages during driving is risky, as it increases the probability of severe crashes. This study proposes an XGBoost model for visual distraction detection based on vehicle dynamics data from a driving simulation study. METHODS: A simulated driving experiment involving thirty-six drivers was launched. We obtained the vehicle dynamics parameters required for the model using the time window and fast Fourier transform methods, totaling 26 items. Meanwhile, the effects of varied time window sizes (1-7 s) and amount of input indications on model performance were studied. RESULTS: By conducting a comparative analysis, it has been determined that the ideal time window size is 5 s. Additionally, the optimal number of input indicators was found to be 23. The XGBoost model for distinguishing distractions achieved an accuracy rate of 85.68%, a precision rate of 85.83%, a recall rate of 83.85%, an F1 score of 84.82%, and an AUC value of 0.9319, which were higher than SVM and RF. The gain-based feature rank demonstrated that the standard deviation of vehicle sideslip rate and the mean amplitude of the 0-1 Hz spectrum component of the steering wheel angle were more crucial than other features. CONCLUSIONS: The research results indicate that the steering wheel angle and vehicle sideslip angle may be more conducive to identifying distractions. This XGBoost model could potentially be applied in advanced driving assistant systems (ADAS) to warn driver and reduce cellphone involved distracted driving.

Modelling braking behaviour of distracted young drivers in car-following interactions: A grouped random parameters duration model with heterogeneity-in-means.

Braking is an important characteristic of driving behaviour that has a direct relationship with rear-end collisions in a car-following task. Braking becomes more crucial when drivers' cognitive workload increases because of using mobile phones whilst driving. This study, therefore, investigates and compares the effects of using mobile phones whilst driving on braking behaviour. Thirty-two young licenced drivers, evenly split by gender, faced a safety-critical event, that is, leader's hard braking, in a car-following situation. Each participant drove the CARRS-Q Advanced Driving Simulator and was required to respond to a braking event in the simulated environment in three phone conditions: baseline (no phone conversation), handheld, and hands-free. A random parameters duration modelling approach is employed to (i) model drivers' braking (or deceleration) times using a parametric survival model, (ii) capture unobserved heterogeneity associated with braking times, and (iii) account for repeated experiment design. The model identifies the handheld phone condition as a random parameter whilst vehicle dynamics variables, hands-free phone condition, and driver-specific variables are found as fixed parameters. The model suggests that most distracted drivers (in the handheld condition) reduce their initial speeds more slowly than undistracted drivers, reflecting their delayed initial braking that may lead to abrupt braking to avoid a rear-end collision. Further, another group of distracted drivers exhibits faster braking (in the handheld condition), recognising the risk associated with mobile phone usage and delayed initial braking. Provisional licence holders are found to be slower in reducing their initial speeds than open licence holders, indicating their risk-taking behaviour because of their less experience and more sensitivity to mobile phone distraction. Overall, mobile phone distraction appears to impair the braking behaviour of young drivers, which poses significant safety concerns for traffic streams.

Trial of Training to Reduce Driver Inattention in Teens with ADHD.

BACKGROUND: Teens with attention deficit-hyperactivity disorder (ADHD) are at increased risk for motor vehicle collisions. A computerized skills-training program to reduce long glances away from the roadway, a contributor to collision risk, may ameliorate driving risks among teens with ADHD. METHODS: We evaluated a computerized skills-training program designed to reduce long glances (lasting ≥2 seconds) away from the roadway in drivers 16 to 19 years of age with ADHD. Participants were randomly assigned in a 1:1 ratio to undergo either enhanced Focused Concentration and Attention Learning, a program that targets reduction in the number of long glances (intervention) or enhanced conventional driver's education (control). The primary outcomes were the number of long glances away from the roadway and the standard deviation of lane position, a measure of lateral movements away from the center of the lane, during two 15-minute simulated drives at baseline and at 1 month and 6 months after training. Secondary outcomes were the rates of long glances and collisions or near-collisions involving abrupt changes in vehicle momentum (g-force event), as assessed with in-vehicle recordings over the 1-year period after training. RESULTS: During simulated driving after training, participants in the intervention group had a mean of 16.5 long glances per drive at 1 month and 15.7 long glances per drive at 6 months, as compared with 28.0 and 27.0 long glances, respectively, in the control group (incidence rate ratio at 1 month, 0.64; 95% confidence interval [CI], 0.52 to 0.76; P<0.001; incidence rate ratio at 6 months, 0.64; 95% CI, 0.52 to 0.76; P<0.001). The standard deviation of lane position (in feet) was 0.98 SD at 1 month and 0.98 SD at 6 months in the intervention group, as compared with 1.20 SD and 1.20 SD, respectively, in the control group (difference at 1 month, -0.21 SD; 95% CI, -0.29 to -0.13; difference at 6 months, -0.22 SD; 95% CI, -0.31 to -0.13; P<0.001 for interaction for both comparisons). During real-world driving over the year after training, the rate of long glances per g-force event was 18.3% in the intervention group and 23.9% in the control group (relative risk, 0.76; 95% CI, 0.61 to 0.92); the rate of collision or near-collision per g-force event was 3.4% and 5.6%, respectively (relative risk, 0.60, 95% CI, 0.41 to 0.89). CONCLUSIONS: In teens with ADHD, a specially designed computerized simulated-driving program with feedback to reduce long glances away from the roadway reduced the frequency of long glances and lessened variation in lane position as compared with a control program. During real-world driving in the year after training, the rate of collisions and near-collisions was lower in the intervention group. (Funded by the National Institutes of Health; ClinicalTrials.gov number, NCT02848092.).

How do the type and duration of distraction affect speed selection and crash risk? An evaluation using naturalistic driving data.

Distracted driving is among the leading causes of roadway crashes worldwide. However, due to limitations of police-reported crash data, it is often challenging to understand the nature and magnitude of this problem. Distraction has also been shown to affect driver speed selection, which is important as both mean speed and speed variance have substantive impacts on crash risk. This study utilizes naturalistic driving data to investigate the relationship between the engagement in various secondary (non-driving) tasks and driver speed selection under different driving contexts. Separate analyses were conducted for low-speed and high-speed driving environments. Two-way random effects linear regression models were estimated for both speed regimes, while controlling for driver, roadway, and traffic characteristics. The differences were assessed based upon ten types of secondary tasks. In general, engagement in all tasks was found to decrease speeds in high-speed environments while the effects were mixed in low-speed settings. The changes in speeds were much pronounced for secondary tasks that include a combination of visual, manual, and cognitive distractions, such as cell phone use. Among all secondary tasks, an average episode of a driver talking on a handheld cellphone was associated with a 6-mph speed reduction in high-speed environments, but a 3.5-mph increase in low-speed settings. In addition to examining impacts on speed selection, the risk of involvement in crash and near-crash events was also evaluated in consideration of the type and duration of distraction. Interestingly, distractions tended to show similar relationships, in both direction and magnitude, with the risk of involvement in both crash and near-crash events. From a policy standpoint, this study provides further motivation for legislation and other programs aimed at curbing distracted driving.

Address inputting while driving: a comparison of four alternative text input methods on in-vehicle navigation displays usability and driver distraction.

OBJECTIVE: Efficient and safe address entry is crucial to in-vehicle navigation systems. Although various text input methods (TIMs) are commercially available, to date, the details of the driver's interactions with these TIMs in the vehicle are poorly understood. Therefore, the effect of four alternative TIMs conditions on in-vehicle navigation displays usability and driver distraction were directly compared. For reference, the baseline driving task (distraction-free) was also investigated. METHODS: A city expressway simulator experiment including 25 young drivers was launched. Under each condition, the driving task was lane-keeping with speed ranging between 40 and 60 km/h, and the navigation task was to enter a 14-characters Chinese address name. In the meantime, usability (text entry time, number of errors, and preference) and driver distraction (NASA-TLX, average speed, the standard deviation of lane position, total glance duration, number of glances, average glance duration, and number of glances exceeding 1.6 s) metrics were measured as dependent variables. A sequence of one-way repeated measure analyses of variance (ANOVA) was performed to examine which type of TIMs can maximize in-vehicle navigation displays usability and minimize driver distraction. RESULTS: Generally, lateral driving performance deteriorated with the addition of the address inputting task, and the four alternative TIMs might fall into three levels: Speech is optimal, Qwerty followed, Shape-writing and Handwriting ranked last. Specifically, word-based speech remains performed best on all observed metrics for Chinese address names. There was an insignificant difference in text entry time and total glance duration among Qwerty, Shape-writing, and Handwriting. However, Shape-writing and Handwriting are not suitable for young drivers since the nature of uninterruptible causes excessive errors, more considerable lane position variation, longer average glance duration, and more glances exceeding 1.6 s. CONCLUSIONS: This study provides valuable insights into young drivers' interactions with four alternative TIMs. Importantly, it is beneficial to the automotive user interfaces design of in-vehicle navigation displays and other sub-functions of in-vehicle information systems (IVISs), such as music playback and text messaging, which positively mitigate driver distraction and prevent traffic injuries.

Temporal analysis of cellphone-use-involved crash injury severities: Calling for preventing cellphone-use-involved distracted driving.

With the popularity of smartphones and the increasing dependence on cellphones, cellphone-use-involved distracted driving has become a global traffic safety concern. Calling, texting, or watching videos while driving could have harmful impacts on driving abilities and increase crash-injury severities. To investigate the temporal stability and the heterogeneity of cellphone-involved crash injury severity determinants, a series of likelihood ratio tests and random parameters logit models with heterogeneity in means and variances are estimated. Cellphone-involved single-vehicle crash datasets of Pennsylvania from 2004 to 2019 are utilized. Marginal effects are also applied to investigate the impact of explanatory variables on injury severity outcomes. The results indicate an overall temporal instability of cellphone-involved crashes across different periods. However, driving without seatbelts and overturns are observed to produce relatively stable and positive influence on the increased injury severities of cellphone-involved crashes. Besides, it is noteworthy that a combination of cellphone usage with risky driving behaviors (aggressive driving, alcohol- or drug-related driving, speeding, or fatigue driving) significantly increase driver injury-severities. This finding highlights the necessity of identifying drivers with multiple risk-taking behaviors and enacting laws to prohibit these drivers from using cellphones while driving. Applications of smartphones provide another feasible approach to prevent using cellphones while driving. Insights and suggestions of this study would be valuable to mitigate the negative outcomes of cellphone-involved crashes and prevent the crashes caused by cellphone-involved distracted driving in the future.

The use of risk homeostasis theory to reduce smartphone use during low-speed driving.

Driving while distracted by smartphones is an unsafe behavior and constitutes a serious worldwide road safety issue. In line with the risk homeostasis theory, during high-speed driving, drivers perceive smartphone usage as an unwarranted risk and in most cases refrain from doing so. During low-speed driving, however, drivers often use their smartphones, as they do not perceive this as inherently unsafe, even though it is. The goal of this study was to examine an intervention, based on the risk homeostasis theory, aimed at decreasing the use of smartphones while driving at low speeds. Thirty-seven young drivers participated in the research group that aimed to alter drivers' risk perceptions, decision making, and behavior. The study also included a control group of 33 young drivers. All of the participants' smartphone usage was monitored using a dedicated application that measured both the number of times drivers touched their smartphone screens while driving and the driving speed each time the screen was touched. The results indicate that drivers in the research group decreased their smartphone usage while driving, unlike the control group drivers who did not alter their behavior. In conclusion, a risk homeostasis-based intervention can decrease dangerous and unsafe driving behavior, even when such behavior is not perceived as significantly dangerous. Furthermore, additional types of risky and unsafe driving behaviors may be decreased using this type of intervention.

Dynamic is optimal: Effect of three alternative auto-complete on the usability of in-vehicle dialing displays and driver distraction.

OBJECTIVE: Auto-complete (AC) has become ubiquitous on domain-specific systems and is mainly divided into two types (static-AC and dynamic-AC). Specifically, static-AC only presents the possible completions not changing with user input in the suggestion list for users to select. Dynamic-AC constantly filters out inconsistent content with user input and shows the possible completions at the top of the suggestion list. However, the details of the driver's interactions with AC in the vehicle are poorly understood. Therefore, we investigated the effect of three alternative AC (non-AC, static-AC, and dynamic-AC) on the usability of in-vehicle dialing displays and driver distraction. As a reference, the baseline task (only driving) was also surveyed in each AC condition. METHODS: A simulated driving experiment consisting of 24 participants was conducted. The primary task was a lane-keeping task with speed ranging between 60 and 120 km/h over the stretch. The secondary task was dialing an 11-digit phone number. Usability metrics (task completion time and number of errors) and driver distraction metrics (NASA-reduced task load index (NASA-RTLX), mean speed, lateral position variation, total glance time, number of glances, mean glance time, and number of glances over 1.6 s) in each condition were measured. A series of one-way repeated measure analyses of variance was used to examine whether and which type of AC can maximize the usability of in-vehicle dialing displays and minimize driver distraction. RESULTS: Generally, the AC-based in-vehicle dialing display gains a more positive effect. Specifically, we observed that among the three alternative AC conditions, dynamic-AC performed optimally on usability metrics similar to previous studies and various driver distraction metrics, notwithstanding it is still not up to the level of the baseline condition. However, static-AC did not exhibit the advantages described in previous studies except for fewer errors and NASA-RTLX owing to the possibility of position bias and boundary effect. CONCLUSIONS: This study provides valuable insights into drivers' interactions with AC-based in-vehicle dialing displays and broadened its applications in safety-critical situations. More importantly, it informs the design of a more effective in-vehicle system, which positively contributes to mitigating driver distraction and preventing traffic accidents.

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.

Narrative persuasion and stigma: Using news accounts to denormalize texting while driving.

Despite nearly universal texting while driving bans in U.S. states, distracted driving still poses a major risk for American motorists and pedestrians on a daily basis. We argue texting while driving behavior, due to its cultural, social, and psychological motivations, may be addressed by cultivating a stigma to denormalize TWD much in the same way public health campaigns and bans did with tobacco use. While extant strategies may similarly stigmatize this risky behavior, we contend the stigmatizing effect of news narratives offers an untapped and unexamined resource. In this paper we draw on emergent findings in narrative persuasion work to present an exploratory analysis and evidence indicates news narratives, through narrative engagement, can both stigmatize TWD behavior and diminish attitudes toward distracted driving. These initial findings are then validated against an independent sample. If applied widely, this method may be applied to increase social pressure against distracted driving, leading to fewer people engaging in TWD behavior, and making roads safer.

What's it Worth?: The Costs and Benefits of an Initiative to Decrease Post-Call Fatigued Driving Among Surgery Residents.

BACKGROUND: In 2017 the ACGME enacted new regulations requiring sponsoring institutions to ensure "safe transportation options for residents who may be too fatigued to safely return home." We investigate here the impact of a pilot "Safe Ride" program designed to mitigate the risks of fatigued driving. METHODS: During a 2-month pilot period at a single university-affiliated general surgery residency with four urban clinical sites, all residents (n = 72) were encouraged to hire a rideshare (e.g., Uber, Lyft) to and from 24-h clinical shifts if they felt too fatigued to drive safely. The cost of the rideshare was fully reimbursed to the resident. The impact of this intervention was evaluated using utilization data and a post-intervention resident survey. RESULTS: A total of 16.6% of trainees utilized a rideshare at least one time. Sixty-three post-call rides were taken, predominantly by junior residents (92.4%) and for commutes greater than 15 miles (91%). The cost for the 60-day pilot was $3030. Comparing pre-intervention to post-intervention data, there was a significant improvement in the reported frequency of falling asleep or nearly asleep while driving (P < 0.001). Trainees nearly unanimously (98%) supported efforts to make the program permanent. DISCUSSION: Driving while fatigued is common among surgical residents, with increased risk among junior residents, during longer commutes and following longer shifts. A reimbursed rideshare program effectively targets these risk factors and was associated with a significant decrease in rates of self-reported fatigued driving. Future efforts should focus on strategies to promote use of reimbursed rideshare programs while remaining cost efficient.

Evaluation of smartphone interactions on drivers' brain function and vehicle control in an immersive simulated environment.

Smartphones and other modern technologies have introduced multiple new forms of distraction that color the modern driving experience. While many smartphone functions aim to improve driving by providing the driver with real-time navigation and traffic updates, others, such as texting, are not compatible with driving and are often the cause of accidents. Because both functions elicit driver attention, an outstanding question is the degree to which drivers' naturalistic interactions with navigation and texting applications differ in regard to brain and behavioral indices of distracted driving. Here, we employed functional near-infrared spectroscopy to examine the cortical activity that occurs under parametrically increasing levels of smartphone distraction during naturalistic driving. Our results highlight a significant increase in bilateral prefrontal and parietal cortical activity that occurs in response to increasingly greater levels of smartphone distraction that, in turn, predicts changes in common indices of vehicle control.

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.

Long-Term Effects of Driving Skill Training on Safe Driving in Older Adults with Mild Cognitive Impairment.

BACKGROUND/OBJECTIVE: A driving skill program had positive effects on safe driving performance in older adults, even those with cognitive impairment. However, the long-term effects of the program remain unclear. The purpose of this study was to examine whether such effects were maintained at 1 year after the intervention in older adults with cognitive impairment who had low driving skills. DESIGN: A secondary analysis of single-blind randomized controlled trial. SETTING: Community setting in Japan. PARTICIPANTS: Community-living adults, aged 65 years or older (n = 159), with mild cognitive impairment (MCI). INTERVENTION: The intervention group completed 10 classroom sessions of 1 hour and 10 on-road sessions of 50 minutes, focusing on common problem areas of older drivers. The control group received one education class about safety driving. MEASUREMENTS: On-road driving performance was assessed by certified driving school instructors in a driving school at preintervention and postintervention, and 1-year follow-up. RESULTS: A total of 159 community-living older drivers participated in this study and were randomized to either an intervention group (n = 71) or a control group (n = 88). One year after the intervention, 104 of 159 community-living older drivers completed the follow-up assessment (intervention group, n = 58). Regarding the safe driving skill score, there was a significant group × time interaction (P < .01), indicating benefits of the intervention over time. Although the intervention group showed a significant decline in the safe driving skill score from postintervention (score = 38.9 ± 46.1) to 1-year follow-up (score = -0.3 ± 55.2), there was a significant difference between the groups at 1-year follow-up (control group score = -148.5 ± 46.4) (P < .05), and between preintervention (score = -132.0 ± 54.6) and 1-year follow-up in the intervention group (P < .05). CONCLUSION: The driving skill program maintained safe driving performance that had been improved by the intervention in older adults with MCI.

Initial Testing of a Web-Based Intervention to Reduce Adolescent Driver Inattention: A Randomized Controlled Trial.

INTRODUCTION: Motor vehicle crashes are the leading cause of adolescent death. Inattention to the roadway contributes to crash risk. The objective of this study was to deploy an initial study of a web-based intervention (Let's Choose Ourselves) designed to improve adolescent driver attention to the roadway. METHODS: We used a randomized controlled trial design in a sample of adolescent drivers to test if a web-based intervention decreased cell phone engagement in driving simulation at 3 months as compared with controls. As secondary hypotheses, we tested if the intervention increased the use of peer passengers to manage distractions and decreased eyes off the forward roadway in driving simulation and decreased self-reported risky driving behaviors. Adolescents, aged 16-17 years, licensed for ≤90 days were randomized to Let's Choose Ourselves with distractions in the simulator protocol at baseline, Let's Choose Ourselves with no distractions, an attention control intervention on healthy eating with distractions, or attention control with no distractions. We used Poisson regression modeling to test the primary and secondary hypotheses. RESULTS: The trial included 60 adolescents (66.7% female, 78.3% non-Hispanic white subjects, mean age 16.8 years, licensed 50.8 days). In Poisson regression, controlling for sex, we found no significant effects of Let's Choose Ourselves on primary or secondary outcomes. However, there was a significant effect of visit on self-report outcomes, with self-reported distracted driving behaviors increasing over time. DISCUSSION: Although there were no significant effects of Let's Choose Ourselves, self-reported risky driving behaviors increased over time. Further investigation of the relationship between driving experience and increasing inattention to the road in adolescents is warranted.