Effect of North Carolina's restriction on teenage driver cell phone use two years after implementation

Investigating the factors behind cellphone-distracted crashes: Assessing injury severity among distracted drivers in states with and without cell phone bans

INTRODUCTION

Distracted driving, particularly due to cellphone usage, poses a serious threat to road safety by diverting drivers' attention from the road to activities like calling, talking, and texting. This not only jeopardizes the safety of the drivers themselves but also puts other road users at risk. To address this issue, many states have enacted laws prohibiting cellphone use while driving. This study investigates the impact of such laws on the severity of driver injuries, focusing on a comparison between Connecticut and Florida.

METHOD

The study examines four years of crash data, during which Connecticut banned handheld phone use while driving, while Florida allowed hands-free use and treated handheld phone use as a secondary offense. Using random parameter logit models with heterogeneity in means and variances, the analysis identified differences in risk factors contributing to driver injury severity in both states with and without a cellphone ban.

RESULTS

Despite variations in data collection methods and variables across states, the study aligns and compares commonly defined and measured variables from crash incidents. The analysis identified 26 statistically significant variables in both models, with only four variables consistently affecting all levels of driver injury severity. These common risk factors include the involvement of newer vehicles (less than five years old from the crash involvement), incidents involving shoulders, young drivers (under 30 years old), and seat belt usage. Conclusions/Practical Applications: The findings emphasize the importance of modern safety features in newer vehicles, improved roadside design, driver training, and law enforcement measures targeting younger drivers to promote seat belt usage and mitigate distracted driving risks.

Opioid-limiting legislation and prescribing habits of otolaryngologists among Medicare beneficiaries

Objectives

To identify changes in otolaryngologists' opioid prescribing trends for Medicare beneficiaries associated with the enactment of state laws that limit the duration of prescriptions to 3-7 days in the years 2016 and 2017 in the United States.

Methods

Through the Centers for Medicare and Medicaid Services (CMS) database, we retrieved data on Medicare enrollment and on the total days prescribed and total number of beneficiaries for the drugs codeine/acetaminophen, hydrocodone/acetaminophen, oxycodone HCl, oxycodone/acetaminophen, and tramadol HCl, by each otolaryngologist prescriber in 13 states from January 2013 to December 2019. We modeled trends using linear spline regression models that controlled for Medicare beneficiaries' state-level socio-demographic characteristics' fixed effects.

Results

Across the 13 states, the number of days of all five opioids prescribed per beneficiary declined by 8.35 (SD = 12.61). The most commonly prescribed opioid type by otolaryngologists during the 5-year study period was tramadol HCl (28.72 days/beneficiary) followed by oxycodone HCl (19.99 days/beneficiary). All opioids had declines in prescription days over this time window and higher rates of decline in the years following law passage. Four states experienced statistically significant declines in the prescriptions of all opioids after the year of legislation passage (p < .05). Some states that had the greatest inclines in opioid prescriptions in the years prior to law enactment also experienced the greatest reductions in the time after legislation enactment.

Conclusions

Opioid prescribing practices of otolaryngologists may have been affected by opioid prescription duration limiting laws passed in 13 states in 2016 and 2017.

Level of Evidence

Level 4.

Short-term impacts of all-driver handheld cellphone bans on high-schoolers' texting while driving: quasi-experimental analyses of Illinois and Georgia

Teen drivers are more likely than their older counterparts to engage in distracted driving. Many states prohibit cellphone use for teen drivers, but only prohibit texting for all drivers. Evidence that these laws have been effective is mixed. We hypothesize that recent policy changes in Georgia and Illinois from teen cellphone bans with all-driver texting bans to all-driver handheld phone bans yielded short-term reductions in teen texting while driving. We analyzed Youth Risk Behavior Surveys in Georgia, Illinois, and control states North Carolina and Michigan. We estimated the reduction in texting while driving associated with policy changes via difference-in-differences models. In Illinois, 45.4 % of high school drivers texted while driving in 2013. After a 2014 policy change to an all-driver handheld ban, the percentage decreased in 2015 to 41.8 %, and decreased further in 2017 to 37.7 %. The adjusted DID estimate comparing Illinois to Michigan from 2013 to 2017 was -8.3 % (95 % CI: -15.5 % 1.1 %; p-value = 0.025). In Georgia, the percentage decreased from 37.5 % before the law to 30.8 % after, and the adjusted DID estimate comparing Georgia to North Carolina was -10.8 % (95 % CI: -19.0 %, -2.5 %; p-value = 0.011) than in North Carolina. Results support all-driver handheld phone bans to improve traffic safety for high school drivers.

Investigating speed-safety association: Considering the unobserved heterogeneity and human factors mediation effects

The relationship between mean speed and crash likelihood is unclear in the literature. The contradictory findings can be attributed to the masking effects of the confounding variables in this association. Moreover, the unobserved heterogeneity has almost been criticized as a reason behind the current inconclusive results. This research provides an effort to develop a model that analyzes the mean speed-crash frequency relationship by crash severity and type. Also, the confounding and mediation effects of the environment, driver, and traffic-related attributes have been considered. To this end, the loop detector and crash data were aggregated daily for rural multilane highways of Tehran province, Iran, covering two years, 2020-2021. The partial least squares path modeling (PLS-PM) was employed for crash causal analysis along with the finite mixture partial least squares (FIMIX-PLS) segmentation to account for potential unobserved heterogeneity between observations. The mean speed was negatively and positively associated with the frequency of property damage-only (PDO) and severe accidents, respectively. Moreover, driver-related variables, including tailgating, distracted driving, and speeding, played key mediation roles in associating traffic and environmental factors with the crash risk. The higher the mean speed and the lower the traffic volume, the higher odds of distracted driving. Distracted driving was, in turn, associated with the higher vulnerable road users (VRU) accidents and single-vehicle accidents, triggering a higher frequency of severe accidents. Moreover, lower mean speed and higher traffic volume were positively correlated with the percentage of tailgating violations, which, in turn, predicted multi-vehicle accidents as the main predictor of PDO crash frequency. In conclusion, the mean speed effects on the crash risk are entirely different for each crash type through distinct crash mechanisms. Hence, the distinct distribution of crash types in different datasets might have led to current inconsistent results in the literature.

"Does that mean I can't use my phone to pay when I'm in the Maccas drive thru?": Younger drivers' uncertainty and attitude toward smartphone law and punishment

This study employed a mixed methods approach (a survey [n = 2,774] and focus groups [n = 16]) to understand the perceptions of younger drivers (18-25) on current smartphone laws in the Australian state of Victoria. First, by analysing quantitative data gathered from an online survey regarding smartphone laws, perceptions of punishment when breaking the law, and attitudes to both the law and fines, this study found younger drivers were less likely to understand the law around phone use while driving, even after direct or indirect experience with police. Additionally, the severity and impact of fines were perceived as more impactful and severe among younger drivers, women, and those on lower incomes, and the most common types of illegal use younger drivers engaged with were navigation, music applications, and hands-free calling, mostly facilitated through Bluetooth with their device placed out of sight. Consequently, focus groups were conducted with a subset of these younger drivers to explore these findings in more depth. It was revealed that smartphone laws were perceived to be ambiguous, at times unreasonable, and difficult to access conclusive information regarding the law or receive information throughout the Graduated Licencing Program. Additionally, of full licenced drivers breaking smartphone laws (n = 807), 61.7 percent never used a cradle. Among probationary drivers breaking the law (n = 209), 76.1 percent never used a cradle. This suggests rampant surreptitious illegal use. As such, younger drivers learning to drive are also learning methods to avoid punishment while breaking smartphone laws. This included not using a cradle and opting instead for Bluetooth connectivity or engaging in hand-held use, a choice that continued into Full Licensed driving. The severity of punishment was not common knowledge and was perceived to be incommensurate to the risks associated with certain types of use. In their opinion all of these factors reduced the legitimacy of the law. Addressing these factors with evidence-based countermeasures may increase compliance and road safety.

The use of mobile phone while driving: Behavior and determinant analysis in one of the largest metropolitan area of Italy

The use of mobile phones while driving is one of the main causes of road accidents and it is a phenomenon in continuous growth. The key aim of this study is to analyse simultaneously knowledge, attitudes, and behavior toward the use of mobile phones while driving in one of the largest and populous metropolitan areas of Italy, Naples. The data acquired from 774 questionnaires - administered to subjects evenly divided by gender and with an average age of 39 years - revealed that 69 % have used their mobile phone while driving at least once in their lifetime. Among those who used the phone, 63.6 % use it to make phone calls while 75.2 % only to answer them; 49.1 % read messages and only 33.3 % write them. It is also notable that 34.1 % do not stop to answer a call and only 10 % do not value the use of headsets while driving as fundamental. The results indicate that cell phone usage while driving is common in the study population, despite many having university-level education and satisfactory risks awareness. The multiple linear regression analysis shows how knowledge is not correlated to the behavior held. On the contrary, attitudes are strongly correlated to knowledge and behavior, meaning that good attitudes bring forth positive behavior. According to the collected data and statistical analysis, it is possible to identify factors that can greatly affect the use of mobile phone while driving and establish targeted prevention programs.

Can't text, I'm driving - Factors influencing intentions to text while driving in the UK

There is clear research evidence that using a mobile phone while driving is dangerous. However, although drivers generally know this is a risky behaviour, many continue to use a handheld mobile phone while driving. The present research used the Theory of Planned Behaviour (TPB) to explore the psychological reasons underpinning intentions to use a mobile phone while driving in general, as well as to send and read text messages while driving across four different scenarios. Convenience sampling was used to obtain data from 314 participants who held a valid licence to drive in the UK, had driven at least once in the last six months and owned a mobile phone. General intentions to use a mobile phone while driving were predicted by positive Attitudes towards the behaviour and higher Perceived Behavioural Control. Moreover, when predicting intentions to send and read text messages, it was positive Attitudes that was the most consistent and significant predictor. Surprisingly, neither Perceived Behavioural Control nor Subjective Norms were significant predictors of intentions to send or read text messages. Furthermore, perceptions of risk (crashing and being apprehended by the police) were significant predictors of intentions to send and read texts over and above that provided by the TPB variables. The present research highlights the need for interventions to target attitudinal change and to increase risk perceptions in order to reduce the prevalence of these risky behaviours.

Factors affecting behavior of mobile phone use while driving and effect of mobile phone use on driving performance

This study analyzed factors affecting behavior of mobile phone use while driving and its effects on driving performance, in terms of speed, lateral position, steer deviation, steer speed, following distance, perception-reaction time, and occurrence of a near miss situation. To investigate the factors affecting behavior of mobile phone use while driving, 1106 respondents from four different regions in Thailand participated in the questionnaire survey study. Theory of Planned Behavior (TPB) was used to explain these factors including two additional extended factors which are risk perception and law enforcement knowledge. The outcome of this part shows that attitude, norm, and law enforcement knowledge significantly affect the intention and behavior of the drivers. Even though approximately 90 percent of drivers realized that using a mobile phone while driving was dangerous and against the law, they have reported that they still use mobile phone while driving. To determine the effect of mobile phone use on driving performance, a 2-lane, straight rural highway, with a leading vehicle and an unexpected "STOP" sign, were simulated in order to examine the driving performance of drivers "without a phone", "talking on a phone call", and "texting a message" conditions. The results found that using mobile phone while driving can reduce speed and following distance, but increase lateral deviation, steer deviation, steer speed, perception-reaction time, and number of near misses leading to higher risks for road crashes.

At what stages of licensing do graduated driver licensing systems reduce crashes? Example from Queensland, Australia

Evaluations of new graduated licensing systems (GLS) commonly examine pre-post young driver crash rates relative to another driver group. This comparison approach is important to account for other influences on crashes over time, but has limited ability to determine which GLS components are most effective and at what stage during the licensing process. We previously identified declines in young driver crashes in Queensland, Australia, following introduction of a new GLS in 2007. The objective of the current research was to conduct complementary modelling to identify at what points through the licensing process had particular GLS policies contributed to reductions. Crash trends were explored for learner and provisional drivers under the new GLS versus previous system for three time periods relative to the month of acquiring a provisional licence: the preceding learner period, the first month of provisional licensure (when crashes typically peak), and the overall provisional period. Interrupted time series analyses were conducted for the log ratio of crashes per 10,000 licensed (learner and provisional) drivers with the total number of licensed drivers as an offset. The greatest declines were found in the first month of licensure, with indications that a longer learner period, higher supervised driving hours, and a new provisional night-passenger restriction were key contributors to provisional crash reductions. There was also some indication that a restriction on all phone use reduced crashes during the learner period. We conclude that time series analysis focusing on licensing stage, rather than calendar time only, offers a complementary approach to analysing GLS effectiveness by better identifying where and how changes impact crashes.

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.

Cellphone laws and teens' calling while driving: analysis of repeated cross-sectional surveys in 2013, 2015, 2017, and 2019

BACKGROUND

Distracted driving among teens is a public health and safety concern. Most states in the U.S. have sought to restrict cellphone use while driving by enacting laws. This study examines the difference in prevalence of self-reported calling while driving (CWD) between states with different cellphone bans.

METHODS

Demographics and CWD data were extracted from state Youth Risk Behavior Surveys (YRBS) from 14 states in 2013, 2015, 2017, and 2019. The state YRBS is conducted every 2 years with a representative sample of 9th through 12th grade students attending public school. States were grouped by type of cellphone law(s): no ban (the absence of both handheld calling ban and young driver ban), young driver ban (a ban on all forms of cellphone use while driving, for young drivers only), or concurrent ban (a young driver ban plus a ban on handheld calling for all drivers irrespective of age). Poisson regression models with robust variance were used to estimate prevalence ratios comparing CWD prevalence across ban types.

RESULTS

In total, 157,423 high school students participated in the surveys, and 65,044 (45%) participants reached the minimum age to obtain an intermediate license and drove during the 30 days prior the survey. Approximately 53% of participants reported CWD at least once during the previous 30 days, and the percentages varied widely by states (range: 51-55%). Compared to students from states with no ban, those from states with concurrent bans were 19%(95% CI: 14-24%) less likely to engage in CWD. Students in states with concurrent bans were 23% less likely to engage in CWD compared to students in states with young driver bans (95% CI:17-27%).

CONCLUSIONS

Engaging in CWD is common among teen drivers. The concurrent implementation of a handheld calling ban and a young driver ban was associated with a lower prevalence of CWD.

Traffic campaigns and overconfidence: An experimental approach

We use a controlled experiment to analyze the impact of watching different types of educational traffic campaign videos on overconfidence of undergraduate university students in Brazil. The videos have the same underlying traffic educational content but differ in the form of exhibition. We find that videos with shocking content (Australian school) are more effective in reducing drivers' overconfidence, followed by those with punitive content (American school). We do not find empirical evidence that videos with technical content (European school) change overconfidence. Since several works point to a strong association between overconfidence and road safety, our study can support the conduit of driving safety measures by identifying efficient ways of reducing drivers' overconfidence. Finally, this paper also introduces how to use machine learning techniques to mitigate the usual subjectivity in the design of the econometric specification that is commonly faced in many researches in experimental economics.

Evaluating the impact of penalising the use of mobile phones while driving on road traffic fatalities, serious injuries and mobile phone use: a systematic review

BACKGROUND

A vast literature has demonstrated that using mobile phones while driving increases the risk of road traffic crashes. In response, policy-makers have introduced bans and harsher penalties on using mobile phones while driving. Even though emerging evidence suggests that such measures may reduce mobile phone use and crashes, the literature has not been systematically reviewed and synthesised.

OBJECTIVE

To evaluate the impact of penalising mobile phone use while driving on road traffic fatalities, serious injuries and the prevalence of mobile phone use while driving.

METHODS

We employed a comprehensive search strategy using electronic databases, websites, handsearching and other sources to locate studies evaluating legislation on mobile phone use while driving. Randomised controlled trials, interrupted time series', controlled before-after studies with control(s) not exposed to harsher sanctions and panel data designs were included if they measured the outcomes of fatalities, serious injuries or the prevalence of mobile phone use while driving. Eligible studies were critically appraised. Due to substantial heterogeneity, the results were synthesised narratively. The synthesis structured studies according to the type of legislation and outcome measure.

RESULTS

Of the 7420 studies retrieved, 32 were included. The evidence on the effects of penalising mobile phone use while driving was weak, and somewhat inconsistent, but pointed to a potential decrease in the prevalence of mobile phone use and fatalities for all-driver primary enforcement hand-held bans and texting bans.

CONCLUSIONS

Preventing fatalities from risky driving practices may be helped by implementing harsher laws that penalise mobile phone use while driving.

Assessing the impact of the 2015 introduction of increased penalties and enhanced public awareness and enforcement activities on texting while driving among adults in Ontario, Canada

Objective: Texting while driving (TWD) is considered a particularly hazardous form of distracted driving. It is highly prevalent among young drivers, but fewer studies of TWD among adult drivers exist and these prevalence rates may approach those of younger drivers. The effectiveness of measures to prevent distracted driving, and TWD specifically, is unclear. On September 1, 2015, Ontario introduced increased penalties for distracted driving accompanied by public education programs to increase public awareness of the new regulations. Provincial police also introduced enhanced enforcement efforts. The current study examined self-reported TWD in a representative sample of Ontario adults before and after introduction of the new legislation and the enhanced public education and enforcement efforts.Methods: Data were based on telephone interviews with 1,846 respondents who reported having driven in the past year. Data were derived from the 2015-2016 cycles of the Centre for Addiction and Mental Health (CAMH) Monitor, an ongoing cross-sectional telephone survey of adults aged 18+ years in Ontario, Canada. A binary logistic regression analysis of TWD in the previous 30 days was conducted, adjusting for demographic characteristics (sex, age), driving exposure, and introduction of the legislation (before versus after).Results: The proportion of the sample reporting TWD declined significantly from 37.6% before the law was introduced to 24.2% after the law was introduced. The impact appeared to be most pronounced among drivers who reported TWD more frequently. Adjusted odds of TWD declined 42% following introduction of the legislation and associated enhanced public education and enforcement.Conclusions: These results identify a decrease in TWD following the introduction of enhanced penalties with corresponding public education and enforcement efforts, adding to the existing evaluative evidence base to inform transportation safety policy. These results also support the need to examine TWD and its determinants among all age groups.

"It is frustrating to not have control even though I know it's not legal!": A mixed-methods investigation on applications to prevent mobile phone use while driving

Mobile phone distracted driving is a major risk factor for crashes. However, this behaviour has been increasing in recent years. Effective enforcement of mobile phone bans while driving faces several obstacles; as such, it is important to consider additional countermeasures. Applications designed to prevent distracted driving are a promising solution, yet more research is needed that examines their effectiveness in reducing dangerous phone use while driving behaviours. Additionally, these applications are voluntary in nature; therefore, an understanding of drivers' perceptions of the applications is necessary to determine how to improve uptake. A mixed methods design was utilised to examine these factors in a comprehensive manner. A total of 40 participants used the smartphone application "Do Not Disturb While Driving" for iOS phone operating systems or "Android Auto" for Android phone operating systems for approximately one week and completed three diary entries reporting on their experience. Two questionnaires that examined phone use while driving behaviours were also administered to participants; one before and one after completing the study. The quantitative results found that engagement in 1) visual-manual, 2) cognitive-auditory and 3) music mobile phone interactions significantly decreased while using the application. Distraction engagement and mental workload while driving also significantly decreased while using the application. The qualitative results identified a number of areas of improvement that need to be addressed, e.g. activation of the application and Bluetooth connection reliability. The features that required improvement presented an obstacle for effective use of the applications, and in some cases resulted in drivers deciding to stop using the application. Positive perceptions of the application were associated with the experiences of the application functioning appropriately and activating automatically. These results show that applications designed for voluntary use to prevent mobile phone distracted driving are a promising countermeasure, although current applications require several improvements.

"I Snapchat and Drive!" A mixed methods approach examining snapchat use while driving and deterrent perceptions among young adults

This research utilised a qualitative and quantitative study to examine a sample of young drivers' perceptions of deterrent forces, both legal and non-legal, for the behaviour of phone use while driving. First, focus groups were conducted with 60 drivers between the ages of 17 and 25 years who resided in Queensland, Australia. This qualitative study utilised an inductive approach to elicit participants' perceptions without omitting important ideas. Legal sanctions were associated with low perceptions of enforcement certainty. Meanwhile, the only non-legal sanction to emerge was the concept of "safety"; many participants were deterred from using their phone while driving for fear of injury or death to themselves or others. The types of social media most likely to be engaged in were explored and sending videos or photos via the application Snapchat emerged as the most common social media application used among the sample. Consequently, the subsequent quantitative study focused on deterrent forces associated with Snapchat use while driving. A survey was utilised with a separate sample of young drivers aged 17-25 years (n = 503). The impact of the threat of legal sanctions on Snapchat use while driving was examined through classical deterrence theory and Stafford and Warr's (1993) reconceptualised deterrence theory. The non-legal factor of perceived safety was also included in the quantitative study. None of the classical deterrence variables (e.g., certainty, severity and swiftness) reached significance while all the reconceptualised deterrence variables (e.g., direct and indirect punishment and punishment avoidance), as well as perceived safety, were significant predictors of Snapchat use while driving. It is suggested that perceptions of certainty of apprehension need to be increased for phone use while driving. The findings show the current impact of deterrent initiatives for phone use while driving as well as provide the first examination of deterrents for the specific mobile phone behaviour of Snapchat use while driving.

A Behavioral Economic Analysis of Demand for Texting while Driving

The overarching goal of the present study was to determine whether a behavioral economic framework of demand analysis is applicable to texting while driving. To this end, we developed a novel hypothetical task designed to quantify the intensity and elasticity of the demand for social interaction from texting while driving. This task involved a scenario in which participants receive a text message while driving, and they rated the likelihood of replying to a text message immediately versus waiting to reply until arriving at a destination when the amounts of a fine for texting while driving ranged from $1 to $300. To assess the construct validity of the task, the scenario presented two delays to a destination (15 min and 60 min). The demand for social interaction from texting was more intense (greater at the lowest amount of the fine) and less elastic (less sensitive to the increase in the amounts of the fine) for drivers who self-reported a higher frequency of texting while driving than for those who self-reported a lower frequency of texting while driving. Demand was also more intense and less elastic under the 60-min delay condition than under the 15-min condition. The results of this proof-of-concept study suggest that behavioral economic demand analyses are potentially useful for understanding and predicting texting while driving.

Association between cellphone use while driving legislation and self-reported behaviour among adult drivers in USA: a cross-sectional study

OBJECTIVES

Cellphone use behaviours can vary demographically in the USA. This study examined whether legislation restricting cellphone use while driving was associated with lower self-reported hand-held cellphone conversations or texting behaviours among adult drivers of different ages (19-24, 25-39, 40-59,≥60 years), sex, race/ethnicity (white non-Hispanic, black non-Hispanic, Hispanic, Other) or rurality (urban, rural).

DESIGN

Cross-sectional study.

SETTING

USA.

PARTICIPANTS

Individuals ≥19 years of age who indicated they were a current driver and participated in the 2011-2014 Traffic Safety Culture Index Surveys (n=9706).

PRIMARY OUTCOME

The exposure was the presence of a hand-held calling or texting ban applicable to all drivers (ie, universal) at time of survey. Modified Poisson regression with robust SE was used to estimate the risk of engaging in these self-reported behaviours.

RESULTS

In fully adjusted models, universal texting bans were not associated with lower texting behaviours (adjusted risk ratio [aRR]=0.92; 95% CI 0.84, 1.01). In stratified, fully adjusted models, men and those of other racial/ethnic origin were 13% and 33% less likely, respectively (aRR=0.87; 95% CI 0.77, 0.98; aRR=0.67; 95% CI 0.46, 0.97), to engage in texting behaviours if a universal texting ban was effective in their state. Conversely, universal hand-held calling bans were associated with lower self-reported hand-held cellphone conversations across every sub-group. In fully adjusted models, the presence of a hand-held calling ban was associated with 40% lower (aRR=0.60, 95% CI 0.54, 0.67) self-reported hand-held cellphone conversations while driving.

CONCLUSIONS

Universal hand-held calling bans were associated with lower self-reported cellphone conversations for adult drivers. More interventional work targeting adult drivers may be needed to reduce texting while driving.

The Teen Driver

For many teenagers, obtaining a driver's license is a rite of passage, conferring the ability to independently travel to school, work, or social events. However, immaturity, inexperience, and risky behavior put newly licensed teen drivers at risk. Motor vehicle crashes are the most common cause of mortality and injury for adolescents and young adults in developed countries. Teen drivers (15-19 years of age) have the highest rate of motor vehicle crashes among all age groups in the United States and contribute disproportionately to traffic fatalities. In addition to the deaths of teen drivers, more than half of 8- to 17-year-old children who die in car crashes are killed as passengers of drivers younger than 20 years of age. This policy statement, in which we update the previous 2006 iteration of this policy statement, is used to reflect new research on the risks faced by teen drivers and offer advice for pediatricians counseling teen drivers and their families.

Cellphone Legislation and Self-Reported Behaviors Among Subgroups of Adolescent U.S. Drivers

PURPOSE

The relationship between cellphone use while driving legislation and self-reported adolescent driver behavior is poorly understood, especially across demographic subgroups. This study investigated the relationship between statewide cellphone legislation and cellphone use behaviors across adolescent driver subgroups, including age (16/17 vs. 18), sex, race/ethnicity (white non-Hispanic and others), and rurality (urban or rural).

METHODS

Data from the 2011-2014 Traffic Safety Culture Index Surveys were combined with state legislation. The outcomes were self-reported texting and handheld cellphone conversations. The exposure was the presence of a texting or handheld cellphone ban applicable to all drivers (i.e., universal) in the drivers' state of residence. A multilevel, modified Poisson regression model was used to estimate the risk of engaging in these behaviors.

RESULTS

Approximately 34% of respondents reported to have driven while conversing, and 37% texted and drove in the 30 days before the survey. Universal handheld calling bans were associated with lower occurrences of cellphone conversations across all groups except rural drivers. Overall, handheld cellphone bans were associated with 55% lower (adjusted risk ratio .45, 95% confidence interval .32-.63) occurrences of cellphone conversations. However, universal texting bans were not associated with fewer texting behaviors in any subgroup.

CONCLUSIONS

Universal handheld calling bans may discourage adolescents from engaging in handheld phone conversations, whereas universal texting bans may not fully discourage texting behaviors. More interventional or educational work is necessary, particularly addressing texting while driving.

Multivariate dynamic Tobit models with lagged observed dependent variables: An effectiveness analysis of highway safety laws

Highway safety laws aim to influence driver behaviors so as to reduce the frequency and severity of crashes, and their outcomes. For one specific highway safety law, it would have different effects on the crashes across severities. Understanding such effects can help policy makers upgrade current laws and hence improve traffic safety. To investigate the effects of highway safety laws on crashes across severities, multivariate models are needed to account for the interdependency issues in crash counts across severities. Based on the characteristics of the dependent variables, multivariate dynamic Tobit (MVDT) models are proposed to analyze crash counts that are aggregated at the state level. Lagged observed dependent variables are incorporated into the MVDT models to account for potential temporal correlation issues in crash data. The state highway safety law related factors are used as the explanatory variables and socio-demographic and traffic factors are used as the control variables. Three models, a MVDT model with lagged observed dependent variables, a MVDT model with unobserved random variables, and a multivariate static Tobit (MVST) model are developed and compared. The results show that among the investigated models, the MVDT models with lagged observed dependent variables have the best goodness-of-fit. The findings indicate that, compared to the MVST, the MVDT models have better explanatory power and prediction accuracy. The MVDT model with lagged observed variables can better handle the stochasticity and dependency in the temporal evolution of the crash counts and the estimated values from the model are closer to the observed values. The results show that more lives could be saved if law enforcement agencies can make a sustained effort to educate the public about the importance of motorcyclists wearing helmets. Motor vehicle crash-related deaths, injuries, and property damages could be reduced if states enact laws for stricter text messaging rules, higher speeding fines, older licensing age, and stronger graduated licensing provisions. Injury and PDO crashes would be significantly reduced with stricter laws prohibiting the use of hand-held communication devices and higher fines for drunk driving.

The effectiveness of child restraint and seat belt legislation in reducing child injuries: The case of Serbia

OBJECTIVE

The objective of this study is to determine the short- and long-term impacts of Serbia's 2009 update of child restraint and seat belt legislation on the incidence of pediatric motor vehicle-related injury. With this new law, the use of child restraints in children age 0-3 became mandatory, and children 4-12 had to wear seat belts in the rear seats.

METHODS

A unique data set with assembled information from public institutions of the Republic of Serbia from January 2004 to December 2014 and analyses based on interrupted time series were carried out. Eight outcome variables were assessed: monthly rate of injured children for 2 age groups 0-3 and 4-12 per child population, number of registered motor vehicles, number of passengers transported, and number of passengers' kilometers traveled. Independent variables were short- and long-term impacts of Serbia's legislation update (June 2009). Data on injuries were obtained from Serbia's Road Traffic Safety Agency. Child population and other transport-related data were obtained from the Statistical Office of the Republic of Serbia. We excluded fatalities from the analysis.

RESULTS

In the first year of the updated legislation there was a reduction of 2.0% (confidence interval [CI], 0.1; 3.9) of injured children aged 0-3 and a reduction of 2.5% (CI, 0.6; 4.3) of injured children aged 4-12. Six years after enactment of the legislation, a significant reduction of 8.2% (CI, 3.5; 13.0) of injured children aged 4-12 was observed, but a nonsignificant reduction of 1.1% (CI, -5.8; 3.5) was found for injured children aged 0-3. By December 2014, 369 (CI, 186; 555) injuries among children aged 4-12 were avoided.

CONCLUSIONS

The case of Serbia suggests that the new law was effective in reducing injuries among children aged 0-3 in the short term and injuries among children aged 4-12 in both the short term and long term. To understand these results, we suggest 2 hypotheses. First, low proper usage of child restraint and weak police enforcement were likely to explain the short-term effect among children aged 0-3. Second, access to seat belts in rear seats was probably a condition that facilitated the use of these devices among children aged 4-12, protecting them during the period of the study.

It can W8: A community intervention to decrease distracted driving

Researchers tested an intervention to decrease cell-phone use while driving on a university campus. A total of 3,827 driving observations were recorded on a campus roadway over a three-week period. The campus intervention, consisting of fear appeals, pledges, and behavioral prompts, was tested using an ABA reversal design (Baseline-Intervention-Baseline) with observed cell-phone use as the dependent measure. A Chi-Square test of independence indicated the percentage of drivers talking on a cell phone decreased significantly from 8.5% of 945 drivers at Baseline to 5.5% of 1,428 drivers following the Intervention. In contrast, the percentage of drivers observed texting increased significantly from 4% of 945 drivers at Baseline to 6.2% of 1,428 drivers following the Intervention. Additionally, safety-belt use was associated with the type of phone use observed. Findings were significantly different for women versus men. Results are discussed in the context of behavioral community intervention and gender differences in traffic-safety behavior.

Does Talking on a Cell Phone, With a Passenger, or Dialing Affect Driving Performance? An Updated Systematic Review and Meta-Analysis of Experimental Studies

Objective An up-to-date meta-analysis of experimental research on talking and driving is needed to provide a comprehensive, empirical, and credible basis for policy, legislation, countermeasures, and future research. Background The effects of cell, mobile, and smart phone use on driving safety continues to be a contentious societal issue. Method All available studies that measured the effects of cell phone use on driving were identified through a variety of search methods and databases. A total of 93 studies containing 106 experiments met the inclusion criteria. Coded independent variables included conversation target (handheld, hands-free, and passenger), setting (laboratory, simulation, or on road), and conversation type (natural, cognitive task, and dialing). Coded dependent variables included reaction time, stimulus detection, lane positioning, speed, headway, eye movements, and collisions. Results The overall sample had 4,382 participants, with driver ages ranging from 14 to 84 years ( M = 25.5, SD = 5.2). Conversation on a handheld or hands-free phone resulted in performance costs when compared with baseline driving for reaction time, stimulus detection, and collisions. Passenger conversation had a similar pattern of effect sizes. Dialing while driving had large performance costs for many variables. Conclusion This meta-analysis found that cell phone and passenger conversation produced moderate performance costs. Drivers minimally compensated while conversing on a cell phone by increasing headway or reducing speed. A number of additional meta-analytic questions are discussed. Application The results can be used to guide legislation, policy, countermeasures, and future research.

Graduated driver licensing (GDL) in the United States in 2016: A literature review and commentary

This is the sixth in a series of reviews of research on graduated driver licensing (GDL) published in the Journal of Safety Research, the present review covering the period mid-2012 through 2016. In the two decades since GDL programs began to be introduced on a widespread basis in the United States, a vast amount of research has been published. The current review discusses recent research and the present state of knowledge on the following topics: characteristics of the novice driver population; effects of GDL on crashes for ages 16-19; the learner and intermediate periods; night and passenger restrictions; cellphone laws; GDL for older novices; enforcement of GDL rules; and programs attempting to influence GDL compliance and safe driving practices in general. GDL stands out as a successful policy for reducing teen driver crashes and is worth building on to extend its benefits. Strengthening existing GDL programs has the most potential for producing further crash reductions.

Hand-held cell phone use while driving legislation and observed driver behavior among population sub-groups in the United States

Background

Cell phone use behaviors are known to vary across demographic sub-groups and geographic locations. This study examined whether universal hand-held calling while driving bans were associated with lower road-side observed hand-held cell phone conversations across drivers of different ages (16–24, 25–59, ≥60 years), sexes, races (White, African American, or other), ruralities (suburban, rural, or urban), and regions (Northeast, Midwest, South, and West).

Methods

Data from the 2008–2013 National Occupant Protection Use Survey were merged with states’ cell phone use while driving legislation. The exposure was presence of a universal hand-held cell phone ban at time of observation. Logistic regression was used to assess the odds of drivers having a hand-held cell phone conversation. Sub-groups differences were assessed using models with interaction terms.

Results

When universal hand-held cell phone bans were effective, hand-held cell phone conversations were lower across all driver demographic sub-groups and regions. Sub-group differences existed among the sexes (p-value, <0.0001) and regions (p-value, 0.0003). Compared to states without universal hand-held cell phone bans, the adjusted odds ratio (aOR) of a driver hand-held phone conversation was 0.34 [95% confidence interval (CI): 0.28, 0.41] for females versus 0.47 (CI 0.40, 0.55) for males and 0.31 (CI 0.25, 0.38) for drivers in Western states compared to 0.47 (CI 0.30, 0.72) in the Northeast and 0.50 (CI 0.38, 0.66) in the South.

Conclusions

The presence of universal hand-held cell phone bans were associated lower hand-held cell phone conversations across all driver sub-groups and regions. Hand-held phone conversations were particularly lower among female drivers and those from Western states when these bans were in effect. Public health interventions concerning hand-held cell phone use while driving could reasonably target all drivers.

Exploring the effects of state highway safety laws and sociocultural characteristics on fatal crashes

OBJECTIVE

Distinguished from the traditional perspectives in crash analyses, which examined the effects of geometric design features, traffic factors, and other relevant attributes on the crash frequencies of roadway entities, our study focuses on exploring the effects of highway safety laws, as well as sociocultural characteristics, on fatal crashes across states.

METHODS

Law and regulation related data were collected from the Insurance Institute for Highway Safety, State Highway Safety Offices, and Governors Highway Safety Association. A variety of sociodemographic characteristics were obtained from the U.S. Census Bureau. In addition, cultural factors and other attributes from a variety of resources are considered and incorporated in the modeling process. These data and fatal crash counts were collected for the 50 U.S. states and the District of Columbia and were analyzed using zero-truncated negative binomial (ZTNB) regression models.

RESULTS

The results show that, in law and regulation-related factors, the use of speed cameras, no handheld cell phone ban, limited handheld cell phone ban, and no text messaging ban are found to have significant effects on fatal crashes. Regarding sociocultural characteristics, married couples with both husband and wife in the labor force are found to be associated with lower crash frequencies, the ratios of workers traveling to work by carpool, those driving alone, workers working outside the county of residence, language other than English and limited English fluency, and the number of licensed drivers are found to be associated with higher crash frequencies.

CONCLUSIONS

Through reviewing and modeling existing state highway safety laws and sociocultural characteristics, the results reveal new insights that could influence policy making. In addition, the results would benefit amending existing laws and regulations and provide testimony about highway safety issues before lawmakers consider new legislation.

Measuring a conceptual model of the relationship between compulsive cell phone use, in-vehicle cell phone use, and motor vehicle crash

OBJECTIVES

Previous research suggests that anticipation of incoming phone calls or messages and impulsivity are significantly associated with motor vehicle crash. We took a more explanative approach to investigate a conceptual model regarding the direct and indirect effect of compulsive cell phone use and impulsive personality traits on crash risk.

METHODS

We recruited a sample of 307 undergraduate college students to complete an online survey that included measures of cell phone use, impulsivity, and history of motor vehicle crash. Using a structural equation model, we examined the direct and indirect relationships between factors of the Cell Phone Overuse Scale-II (CPOS-II), impulsivity, in-vehicle phone use, and severity and frequency of previous motor vehicle crash. Self-reported miles driven per week and year in college were included as covariates in the model.

RESULTS

Our findings suggest that anticipation of incoming communication has a direct association with greater in-vehicle phone use, but was not directly or indirectly associated with increasing risk of previous motor vehicle crash. Of the three latent factors comprising the CPOS-II, only anticipation was significantly associated with elevated cell phone use while driving. Greater impulsivity and use of in-vehicle cell phone use while driving were directly and significantly associated with greater risk of motor vehicle crash.

CONCLUSIONS

Anticipation of incoming cellular contacts (calls or texts) is associated with greater in-vehicle phone use, while greater in-vehicle cell phone use and impulsive traits are associated with elevated risk of motor vehicle crashes.

The association between handheld phone bans and the prevalence of handheld phone conversations among young drivers in the United States

PURPOSE

Fourteen US states and the District of Columbia have banned handheld phone use for all drivers. We examined whether such legislation was associated with reduced handheld phone conversations among drivers aged younger than 25 years.

METHODS

Data from the 2008 to 2013 National Occupant Protection Use Survey were merged with states' legislation. The outcome was roadside-observed handheld phone conversation at stop signs or lights. Logistic regression was used.

RESULTS

A total of 32,784 young drivers were observed. Relative to drivers who were observed in states without a universal handheld phone ban, the adjusted odds ratio of phone conversation was 0.42 (95% confidence interval, 0.33-0.53) for drivers who were observed in states with bans. The relative reduction in phone conversation was 46% (23%, 61%) for laws that were effective less than 1 year, 55% (32%, 70%) for 1-2 years, 63% (51%, 72%) for 2 years or more, relative to no laws.

CONCLUSIONS

Universal handheld phone bans may be effective at reducing handheld phone use among young drivers.

A behavioral economic analysis of texting while driving: Delay discounting processes

The purpose of the present study was to examine an impulsive decision-making process underlying texting while driving from a behavioral economic perspective. A sample of 108 college students completed a novel discounting task that presented participants with a hypothetical scenario in which, after receiving a text message while driving, they rated the likelihood of replying to a text message immediately versus waiting to reply for a specific period of time. Participants also completed a delay discounting task in which they made repeated hypothetical choices between obtaining a larger amount of money available after a delay and an equal or lesser amount of money available immediately. The results show that the duration of the delay is a critical variable that strongly determines whether participants choose to wait to reply to a text message, and that the decrease in the likelihood of waiting as a function of delay is best described by a hyperbolic delay discounting function. The results also show that participants who self-reported higher frequency of texting while driving discounted the opportunity to reply to a text message at greater rates, whereas there was no relation between the rates of discounting of hypothetical monetary rewards and the frequency of texting while driving. The results support the conclusion that texting while driving is fundamentally an impulsive choice.

Student motorcyclists' mobile phone use while driving in Vientiane, Laos

To investigate mobile phone use while driving among student motorcyclists in Laos, we conducted a school-based questionnaire survey in central Vientiane in May 2014. Of the 883 high school students who reported to drive motorcycles at least once a week, 40% have ever used phones while driving motorcycles in both sexes. Those phone users had longer driving exposures than non-users, with about half engaging in phone use while driving at least 2 days a week and 70% engaging for 1 min or longer on an average day. They reported not just talking on the phone while driving but operating the phone such as dialling and text-messaging. In some instances, phone use was reportedly involved in their past crash experiences. To formulate a sound policy on this emerging distracting behaviour among motorcyclists, its contribution to the occurrence of overall crashes among motorcyclists should be investigated.

History and current status of state graduated driver licensing (GDL) laws in the United States

INTRODUCTION

The objective of this study is to describe changes in teenage driver licensing policies in the United States during the past two decades with the introduction of graduated driver licensing (GDL) programs, assess GDL laws currently in place, and discuss the possibilities and likely consequences of further changes.

METHODS

The history of laws introducing and amending GDL programs was tracked, based on records maintained by the Insurance Institute for Highway Safety (IIHS). Counts of states included the District of Columbia.

RESULTS

A few states had elements of GDL prior to the mid-1990s, and between 1996 and 2006 all other states adopted a learner period of 2 months or more, a minimum supervised practice hours requirement for the learner period, or a night or passenger restriction once initially licensed. All but seven states have upgraded their original laws one or more times. Very few states weakened their laws, usually in minor ways. In 158 instances, minimum learner periods, minimum practice hour requirements, or night or passenger restrictions were added or strengthened. Fifteen states raised the minimum age for a license allowing any unsupervised driving.

CONCLUSION

GDL policies have reduced teenage driver crashes. Most states now have at least minimum requirements for basic GDL features, although there is substantial opportunity for strengthening existing policies. Additional upgrades would result in further crash reductions, but very few have been made in recent years.

PRACTICAL APPLICATIONS

Guidelines for maximizing the crash reduction potential of GDL programs are available, based on the experience of U.S. states, other countries with GDL programs, and the evaluation literature in regard to GDL components.

Do as I say, not as I do: Distracted driving behavior of teens and their parents

INTRODUCTION

Driver distraction is an important contributor to crash risk. Teenage driver distraction can be influenced by the attitudes and behaviors of parents. This study examined teens' and their parents' engagement in distracting behavior while driving.

METHOD

Survey data were collected from a national sample of 403 parent-teen dyads using random-digit dialing telephone interviews.

RESULTS

Results demonstrated few parent or teen sex differences in distracting behavior engagement while driving, or in their perceptions of each others' behavior. Parents and teens' frequencies of distracting behavior engagement were positively correlated. Parents' and teens' perceptions of each others' distracting behavior engagement while driving exceeded their own selfreports. Finally, the likelihood that teens reported engaging in distracting behavior while driving was more strongly associated with their perceptions of their parents' distracting behavior than by parents' self reports of their own behavior.

CONCLUSIONS

These results suggest that parents' examples of driving behavior are an important influence on teen driving behavior, but potentially more important are teens' perceptions of their parents' behaviors.

Effects of a Driver Cellphone Ban on Overall, Handheld, and Hands-Free Cellphone Use While Driving: New Evidence from Canada

We provide new evidence on the effects of increasingly common driver cellphone bans on self-reported overall, handheld, and hands-free cellphone use while driving by studying Ontario, Canada, which instituted a 3-month education campaign in November 2009 followed by a binding driver cellphone ban in February 2010. Using residents of Alberta as a control group in a difference-in-differences framework, we find visual and regression-based evidence that Ontario's cellphone ban significantly reduced overall and handheld cellphone use. We also find that the policies significantly increased hands-free cellphone use. The reductions in overall and handheld use are driven exclusively by women, whereas the increases in hands-free use are much larger for men. Our results provide the first direct evidence that cellphone bans have the unintended effect of inducing substitution to hands-free devices.

Texting while driving as impulsive choice: A behavioral economic analysis

The goal of the present study was to examine the utility of a behavioral economic analysis to investigate the role of delay discounting in texting while driving. A sample of 147 college students completed a survey to assess how frequently they send and read text messages while driving. Based on this information, students were assigned to one of two groups: 19 students who frequently text while driving and 19 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they discounted, or devalued, delayed hypothetical monetary rewards using a delay-discounting task. In this task, students made repeated choices between $1000 available after a delay (ranging from 1 week to 10 years) and an equal or lesser amount of money available immediately. The results show that the students who frequently text while driving discounted delayed rewards at a greater rate than the matched control students. The study supports the conclusions that texting while driving is fundamentally an impulsive choice made by drivers, and that a behavioral economic approach may be a useful research tool for investigating the decision-making processes underlying risky behaviors.

The association between states' texting regulations and the prevalence of texting while driving among U.S. high school students

PURPOSE

To determine which distracted driving laws were associated with decreased texting while driving among U.S. teenage drivers.

METHODS

Data from the 2013 Youth Risk Behavior Surveillance System survey were merged with states' distracted driving legislation. The prevalence of texting while driving was assessed for different laws using log-binomial regression.

RESULTS

Approximately 39.0% of students reported texting while driving at least once in the 30 days before survey. Compared to states with universal texting bans along with young driver all cellphone bans, the adjusted ratio of texting while driving was 0.94 (95% confidence interval [CI], 0.77-1.16) in states with no bans, 1.33 (95% CI, 1.11-1.58) for young driver bans only, 1.24 (95% CI, 1.00-1.52) in states with bans for young drivers but no young driver all cellphone bans, and 0.89 (95% CI, 0.66-1.19) in states with universal texting bans. The prevalence of texting was 28% less in states with delays of full licensure for texting offenses (prevalence ratio = 0.72; 95% CI, 0.59-0.88).

CONCLUSIONS

Universal texting bans along with young driver all cellphone bans may be more effective in reducing texting while driving. Delays of full licensure may dissuade young drivers from texting and driving.

Are cellular phone blocking applications effective for novice teen drivers?

PROBLEM

Distracted driving is a significant concern for novice teen drivers. Although cellular phone bans are applied in many jurisdictions to restrict cellular phone use, teen drivers often report making calls and texts while driving.

METHOD

The Minnesota Teen Driver Study incorporated cellular phone blocking functions via a software application for 182 novice teen drivers in two treatment conditions. The first condition included 92 teens who ran a driver support application on a smartphone that also blocked phone usage. The second condition included 90 teens who ran the same application with phone blocking but which also reported back to parents about monitored risky behaviors (e.g., speeding). A third control group consisting of 92 novice teen drivers had the application and phone-based software installed on the phones to record cellular phone (but not block it) use while driving.

RESULTS

The two treatment groups made significantly fewer calls and texts per mile driven compared to the control group. The control group data also demonstrated a higher propensity to text while driving rather than making calls.

DISCUSSION

Software that blocks cellular phone use (except 911) while driving can be effective at mitigating calling and texting for novice teen drivers. However, subjective data indicates that some teens were motivated to find ways around the software, as well as to use another teen's phone while driving when they were unable to use theirs.

PRACTICAL APPLICATIONS

Cellular phone bans for calling and texting are the first step to changing behaviors associated with texting and driving, particularly among novice teen drivers. Blocking software has the additional potential to reduce impulsive calling and texting while driving among novice teen drivers who might logically know the risks, but for whom it is difficult to ignore calling or texting while driving.

State all-driver distracted driving laws and high school students' texting while driving behavior

OBJECTIVE

Texting while driving is highly prevalent among adolescents and young adults in the United States. Texting while driving can significantly increase the risk of road crashes and is associated with other risky driving behaviors. Most states have enacted distracted driving laws to prohibit texting while driving. This study examines effects of different all-driver distracted driving laws on texting while driving among high school students.

METHODS

High school student data were extracted from the 2013 National Youth Risk Behavior Survey. Distracted driving law information was collected from the National Conference of State Legislatures. The final sample included 6,168 high school students above the restricted driving age in their states and with access to a vehicle. Logistic regression was applied to estimate odds ratios of laws on texting while driving.

RESULTS

All-driver text messaging bans with primary enforcement were associated with a significant reduction in odds of texting while driving among high school students (odds ratio = 0.703; 95% confidence interval, 0.513-0.964), whereas all-driver phone use bans with primary enforcement did not have a significant association with texting while driving (odds ratio = 0.846; 95% confidence interval, 0.501-1.429).

CONCLUSIONS

The findings indicate that all-driver distracted driving laws that specifically target texting while driving as opposed to all types of phone use are effective in reducing the behavior among high school students.

Teen Drivers' Perceptions of Inattention and Cell Phone Use While Driving

OBJECTIVE

Inattention to the roadway, including cell phone use while driving (cell phone calls, sending and reading texts, mobile app use, and Internet use), is a critical problem for teen drivers and increases risk for crashes. Effective behavioral interventions for teens are needed in order to decrease teen driver inattention related to cell phone use while driving. However, teens' perceptions of mobile device use while driving is a necessary component for theoretically driven behavior change interventions. The purpose of this study was to describe teen drivers' perceptions of cell phone use while driving in order to inform future interventions to reduce risky driving.

METHODS

We conducted 7 focus groups with a total of 30 teen drivers, ages 16-18, licensed for ≤ 1 year in Pennsylvania. The focus group interview guide and analysis were based on the Theory of Planned Behavior, identifying the attitudes, perceived behavioral control, and norms about inattention to the roadway. Directed descriptive content analysis was used to analyze the focus group interviews. All focus groups were coded by 2 research team members and discrepancies were reconciled. Themes were developed based on the data.

RESULTS

Teens had a mean age of 17.39 (SD = 0.52), mean length of licensure of 173.7 days (SD = 109.2; range 4-364), were 50% male and predominately white (90%) and non-Hispanic (97%). From the focus group data, 3 major themes emerged: (1) Recognizing the danger but still engaging; (2) Considering context; and (3) Formulating safer behaviors that might reduce risk. Despite recognizing that handheld cell phone use, texting, and social media app use are dangerous and distracting while driving, teens and their peers often engaged in these behaviors. Teens described how the context of the situation contributed to whether a teen would place or answer a call, write or respond to a text, or use a social media app. Teens identified ways in which they controlled their behaviors, although some still drew attention away from the roadway.

CONCLUSIONS

Cell phone use while driving is a contributor to motor vehicle crashes in teens, and effective interventions to decrease risks are needed. Teens viewed some types of cell phone use as unsafe and describe methods in which they control their behaviors. However, some of their methods still take attention off the primary task of driving. Teens could benefit from behavior change interventions that propose strategies to promote focused attention on the roadway at all times during the driving trip.

Preventing texting while driving: a statement of the American College of Preventive Medicine

The American College of Preventive Medicine (ACPM) is providing a set of recommendations designed to reduce the morbidity and mortality associated with distractions due to texting while driving. According to the National Highway Traffic Safety Administration, 12% of all fatal crashes involving at least one distracted driver are estimated to be related to cell phone use while driving. Given the combination of visual, manual, and cognitive distractions posed by texting, this is an issue of major public health concern for communities. Therefore, the ACPM feels it is timely to discuss this issue and provide the following recommendations: 1. Encourage state legislatures to develop and pass legislation banning texting while driving, while simultaneously implementing comprehensive and dedicated law enforcement strategies including penalties for these violations. Legislatures should establish a public awareness campaign regarding the dangers of texting while driving as an integral part of this legislation. 2. Promote further research into the design and evaluation of educational tools regarding texting while driving that can be incorporated into the issuance of driver’s licenses. 3. Provide primary care providers with the appropriate tools to educate patients of all ages. 4. Conduct additional studies investigating the risks associated with cell phone usage while driving, particularly texting, with motor vehicle crashes.

A meta-analysis of the effects of texting on driving

Text messaging while driving is considered dangerous and known to produce injuries and fatalities. However, the effects of text messaging on driving performance have not been synthesized or summarily estimated. All available experimental studies that measured the effects of text messaging on driving were identified through database searches using variants of "driving" and "texting" without restriction on year of publication through March 2014. Of the 1476 abstracts reviewed, 82 met general inclusion criteria. Of these, 28 studies were found to sufficiently compare reading or typing text messages while driving with a control or baseline condition. Independent variables (text-messaging tasks) were coded as typing, reading, or a combination of both. Dependent variables included eye movements, stimulus detection, reaction time, collisions, lane positioning, speed and headway. Statistics were extracted from studies to compute effect sizes (rc). A total sample of 977 participants from 28 experimental studies yielded 234 effect size estimates of the relationships among independent and dependent variables. Typing and reading text messages while driving adversely affected eye movements, stimulus detection, reaction time, collisions, lane positioning, speed and headway. Typing text messages alone produced similar decrements as typing and reading, whereas reading alone had smaller decrements over fewer dependent variables. Typing and reading text messages affects drivers' capability to adequately direct attention to the roadway, respond to important traffic events, control a vehicle within a lane and maintain speed and headway. This meta-analysis provides convergent evidence that texting compromises the safety of the driver, passengers and other road users. Combined efforts, including legislation, enforcement, blocking technologies, parent modeling, social media, social norms and education, will be required to prevent continued deaths and injuries from texting and driving.

Objective assessment of the effects of texting while driving: a simulator study

Recent advances in electronic communication technology led to many drivers opting to send and receive text messages while driving. This, inevitably, has a potential to distract drivers, impair driving performance and lead to crashes. This study aims to assess the risk involved in texting while driving through assessing the distraction caused and determining the change in key driving performance indicators. Twenty-one paid young male volunteers were recruited to participate in this study. Each participant drove a driving simulator on four different scenarios involving driving while texting and without texting on highways and town roads. Results showed that texting while driving led, on average, to five times more crashes than driving without texting. Due to distraction also, participants unnecessarily crossed lane boundaries and road boundaries more often while texting as compared to driving without texting. Moreover, distraction due to texting led to participants deviating their eyes off the road while texting 15 times per session, on average, more than without texting. Results demonstrated a high-risk level of distraction and clear impairment in drivers' ability to drive safely due to texting. Based on the results, practical recommendations to combat this phenomenon are given.

Assessing characteristics related to the use of seatbelts and cell phones by drivers: application of a bivariate probit model

INTRODUCTION

The effects of cell phone use and safety belt use have been an important focus of research related to driver safety. Cell phone use has been shown to be a significant source of driver distraction contributing to substantial degradations in driver performance, while safety belts have been demonstrated to play a vital role in mitigating injuries to crash-involved occupants.

METHOD

This study examines the prevalence of cell phone use and safety belt non-use among the driving population through direct observation surveys. A bivariate probit model is developed to simultaneously examine the factors that affect cell phone and safety belt use among motor vehicle drivers.

RESULTS

The results show that several factors may influence drivers' decision to use cell phones and safety belts, and that these decisions are correlated.

PRACTICAL APPLICATIONS

Understanding the factors that affect both cell phone use and safety belt non-use is essential to targeting policy and programs that reduce such behavior.

The impact of Michigan's text messaging restriction on motor vehicle crashes

PURPOSE

The purpose of this study was to determine the effects of Michigan's universal text messaging restriction (effective July 2010) across different age groups of drivers and crash severities.

METHODS

Changes in monthly crash rates and crash trends per 10,000 licensed drivers aged 16, 17, 18, 19, 20-24, and 25-50 years were estimated using time series analysis for three levels of crash severity: (1) fatal/disabling injury; (2) nondisabling injury; and (3) possible injury/property damage only (PDO) crashes for the period 2005-2012. Analyses were adjusted for crash rates of drivers' aged 65-99 years, Michigan's unemployment rate, and gasoline prices.

RESULTS

After the introduction of the texting restriction, significant increases were observed in crash rates and monthly trends in fatal/disabling injury crashes and nondisabling injury crashes, and significant decreases in possible injury/PDO crashes. The magnitude of the effects where significant changes were observed was small.

CONCLUSIONS

The introduction of the texting restriction was not associated with a reduction in crash rates or trends in severe crash types. On the contrary, small increases in the most severe crash types (fatal/disabling and nondisabling injury) and small decreases in the least severe crash types (possible injury/PDO) were observed. These findings extend the literature on the effects of cell phone restrictions by examining the effects of the restriction on newly licensed adolescent drivers and adult drivers separately by crash severity.

Young driver distraction: state of the evidence and directions for behavior change programs

Adolescent drivers are overrepresented in distraction-related motor vehicle crashes. A number of potential reasons for such an elevated risk include driving inexperience, high adoption of communication technology, increased peer involvement, and tendency to take risks, which render young drivers particularly vulnerable. Major legislative efforts in Graduated Licensing Systems that include passenger restrictions have shown positive effects. Restrictions on cell phone use are also being introduced; however, it is challenging to enforce such regulations. This article argues that such contextual, legislative interventions are an essential prevention strategy, but there is an unfilled need to introduce behavior change programs that may target adolescents, parents, and friends. A theoretical framework is applied in which risk and protective factors are identified from research within the contexts of community and jurisdiction. In the literature on distraction, social context and normative influences are key elements used to inform program design for adolescent drivers, with parental monitoring informing interventions targeting parents. Following from this assessment of the message content assessment, the design of strategies to deliver the messages is reviewed. In the current literature, school-based programs, simulations, and Web-delivered programs have been evaluated with supplementary strategies delivered by physicians and parents. Such developments are still at an early stage of development, and ultimately will need controlled implementation and evaluation studies. Of course, there is no likely single approach to prevent adolescent driver distraction. Complementary approaches such as the further development of technological interventions to manage phone use are needed.

Distracted driver behaviors and distracting conditions among adolescent drivers: findings from a naturalistic driving study

PURPOSE

The proliferation of new communication technologies and capabilities has prompted concern about driving safety. This concern is particularly acute for inexperienced adolescent drivers. In addition to being early adopters of technology, many adolescents have not achieved the degree of automaticity in driving that characterizes experienced adults. Consequently, distractions may be more problematic in this group. Yet little is known about the nature or prevalence of distracted driving behaviors or distracting conditions among adolescent drivers.

METHOD

Vehicles of 52 high-school age drivers (N=38 beginners and N=14 more experienced) were equipped for 6 months with unobtrusive event-triggered data recorders that obtain 20-second clips of video, audio, and vehicle kinematic information when triggered. A low recording trigger threshold was set to obtain a sample of essentially random driving segments along with those indicating rough driving behaviors.

RESULTS

Electronic device use (6.7%) was the most common single type of distracted behavior, followed by adjusting vehicle controls (6.2%) and grooming (3.8%). Most distracted driver behaviors were less frequent when passengers were present. However, loud conversation and horseplay were quite common in the presence of multiple peer passengers. These conditions were associated with looking away from the road, the occurrence of serious events, and, to a lesser extent, rough driving (high g-force events).

CONCLUSIONS

Common assumptions about adolescent driver distraction are only partially borne out by in-vehicle measurement. The association of passengers with distraction appears more complex than previously realized. The relationship between distractions and serious events differed from the association with rough driving.