Effectiveness of a Text Message Intervention to Reduce Texting While Driving Among Targeted Young Adults: A Randomized Controlled Trial

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.

Exploring the Behaviour Change Wheel and the Theoretical Domains Framework in interventions for mobile phone driver distraction: A scoping review

Mobile phone use while driving remains a significant traffic safety concern. Although numerous interventions have been developed to address it, there is a gap in the synthesis of relevant information through a comprehensive behaviour change lens. This scoping review uses the Behaviour Change Wheel (BCW) and the Theoretical Domains Framework (TDF) to examine the literature to (a) identify behavioural constructs targeted in interventions for mobile phone use while driving, (b) determine if the intervention success varied by sociodemographic group (e.g., age, gender, driving experience), and (c) map interventions to TDF domains to highlight areas for future research. Following the PRISMA extension for scoping reviews, we searched seven databases and identified 5,202 articles. After screening, 50 articles detailing 56 studies met the following inclusion criteria: (a) intervention studies, (b) providing details on methods and results, (c) written in English, and (d) targeting any driver behaviour related to mobile phone use while driving with a bottom-up approach, using not regulation or law enforcement, but individuals' psychological processes, such as cognitive, behavioural, and emotional. Findings show that most interventions targeted young drivers and were typically effective. Except for a few studies, the effectiveness of interventions targeting different sociodemographic groups either remained untested or revealed nonsignificant differences. This finding points to a gap in the literature, indicating a need for further investigation into the efficacy of interventions for different groups, and for tailoring and testing them accordingly. The interventions also often targeted multiple TDF domains, complicating the interpretation of the relative efficacy of specific domains. Most frequently targeted domains included beliefs and consequences, emotions, knowledge, social influence, social/professional role and identity, and behavioural regulation. Physical skills and optimism domains were not targeted in any intervention. Further, almost all interventions addressed deliberate engagement in mobile phone distractions, while the automatic and fast processes involved in such behaviours were often overlooked. Mobile phone distractions are in part habitual behaviours, yet the existing mitigation efforts mostly assumed intentional engagement. More focus on the habitual nature of mobile phone distractions is needed.

Texting While Driving: A Literature Review on Driving Simulator Studies

Road safety is increasingly threatened by distracted driving. Studies have shown that there is a significantly increased risk for a driver of being involved in a car crash due to visual distractions (not watching the road), manual distractions (hands are off the wheel for other non-driving activities), and cognitive and acoustic distractions (the driver is not focused on the driving task). Driving simulators (DSs) are powerful tools for identifying drivers' responses to different distracting factors in a safe manner. This paper aims to systematically review simulator-based studies to investigate what types of distractions are introduced when using the phone for texting while driving (TWD), what hardware and measures are used to analyze distraction, and what the impact of using mobile devices to read and write messages while driving is on driving performance. The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guidelines. A total of 7151 studies were identified in the database search, of which 67 were included in the review, and they were analyzed in order to respond to four research questions. The main findings revealed that TWD distraction has negative effects on driving performance, affecting drivers' divided attention and concentration, which can lead to potentially life-threatening traffic events. We also provide several recommendations for driving simulators that can ensure high reliability and validity for experiments. This review can serve as a basis for regulators and interested parties to propose restrictions related to using mobile phones in a vehicle and improve road safety.

Effectiveness of a Text Message Intervention Promoting Seat Belt Use Among Young Adults: A Randomized Clinical Trial

IMPORTANCE

Approximately 1 in 10 adults do not always wear a seat belt, with the lowest use rates reported among young adults.

OBJECTIVE

To determine the efficacy of a 6-week automated behavioral text message program promoting seat belt use compared with an attention control.

DESIGN, SETTING, AND PARTICIPANTS

This parallel, 2-group, single-blind, individually randomized clinical trial included a convenience sample of patients recruited from 4 emergency departments in 2 cities in Pennsylvania from December 2019 to September 2021, with follow-ups at 6 and 12 weeks after randomization. Patients in stable condition aged 18 to 25 years who, in standardized screening, reported driving or being a passenger in a car without always using a seat belt in the past 2 weeks were eligible for recruitment. Participants who completed a 2-week trial run-in phase were randomly assigned 1:1 to the intervention or the assessment control. Data were analyzed from October 2019 to January 2020.

INTERVENTIONS

The intervention group received Safe Vehicle Engagement (SAVE), a 6-week automated interactive text message program, including weekly seat belt use queries with feedback and goal support to promote consistent use of a seat belt. The control group received identical weekly seat belt use queries but no additional feedback.

MAIN OUTCOMES AND MEASURES

The primary outcome was the proportion of young adults reporting always wearing a seat belt over the past 2 weeks, collected at 6 weeks (after a 2-week run-in) via web-based self-assessments and analyzed under intent-to-treat models using multiple imputation procedures. Sensitivity analyses included complete-case analyses of ordered categorical outcomes by vehicle seat position. Secondary outcomes included seatbelt use at 12 weeks and select cognitive constructs related to seat belt use.

RESULTS

A total of 218 participants (mean [SD] age, 21.5 [2.1] years; 139 [63.8%] women) were randomized, with 110 randomized to SAVE and 108 randomized to the control group. A total of 158 individuals (72.4%) were included in the 6-week follow-up. The rate of always using a seat belt over the past 2 weeks at the 6-week follow-up was 41.3% (95% CI, 30.6%-52.0%) among SAVE participants and 20.0% (95% CI, 10.6%-29.3%) among control participants (odds ratio [OR], 2.8; 95% CI, 1.4-5.8; P = .005). A total of 140 individuals (64.2%) participated in the 12-week follow-up. At 12 weeks, the rate of always using a seat belt over the past 2-weeks was 42.8% (95% CI, 31.2%-54.2%) among SAVE participants and 30.7% (95% CI, 19.6%-41.6%) among control participants (OR, 1.7; 95% CI, 0.9-3.4; P = .13). When examining ordered categories of seat belt use by seat position, there were significantly greater odds of wearing a seat belt at 6 and 12 weeks among SAVE participants vs control participants (eg, 6 weeks for driver: OR, 5.2; 95% CI, 2.6-10.5; 6 weeks for front passenger: OR, 4.3; 95% CI, 2.2-8.2; 6 weeks for back passenger: OR, 4.3; 95% CI, 2.2-8.2).

CONCLUSIONS AND RELEVANCE

In this randomized clinical trial, an interactive text message intervention was more effective at promoting seat belt use among targeted young adults than an attention control at 6 weeks. There was no significant difference between groups in always wearing a seat belt at 12 weeks. These findings, if replicated in a larger sample, suggest a scalable approach to improve seat belt use.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03833713.