Factors Influencing the Smartphone Usage Behavior of Pedestrians: Observational Study on "Spanish Smombies"

Usability and Acceptability of a Conversational Agent Health Education App (Nthabi) for Young Women in Lesotho: Quantitative Study

BACKGROUND

Young women in Lesotho face myriad sexual and reproductive health problems. There is little time to provide health education to women in low-resource settings with critical shortages of human resources for health.

OBJECTIVE

This study aims to determine the acceptability and usability of a conversational agent system, the Nthabi health promotion app, which was culturally adapted for use in Lesotho.

METHODS

We conducted a descriptive quantitative study, using a 22-item Likert scale survey to assess the perceptions of the usability and acceptability of 172 young women aged 18-28 years in rural districts of Lesotho, who used the system on either smartphones or tablets for up to 6 weeks. Descriptive statistics were used to calculate the averages and frequencies of the variables. χ2 tests were used to determine any associations among variables.

RESULTS

A total of 138 participants were enrolled and completed the survey. The mean age was 22 years, most were unmarried, 56 (40.6%) participants had completed high school, 39 (28.3%) participants were unemployed, and 88 (63.8%) participants were students. Respondents believed the app was helpful, with 134 (97.1%) participants strongly agreeing or agreeing that the app was "effective in helping them make decisions" and "could quickly improve health education and counselling." In addition, 136 (98.5%) participants strongly agreed or agreed that the app was "simple to use," 130 (94.2 %) participants reported that Nthabi could "easily repeat words that were not well understood," and 128 (92.7%) participants reported that the app "could quickly load the information on the screen." Respondents were generally satisfied with the app, with 132 (95.6%) participants strongly agreeing or agreeing that the health education content delivered by the app was "well organised and delivered in a timely way," while 133 (96.4%) participants "enjoyed using the interface." They were satisfied with the cultural adaptation, with 133 (96.4%) participants strongly agreeing or agreeing that the app was "culturally appropriate and that it could be easily shared with a family or community members." They also reported that Nthabi was worthwhile, with 127 (92%) participants reporting that they strongly agreed or agreed that they were "satisfied with the application and intended to continue using it," while 135 (97.8%) participants would "encourage others to use it." Participants aged 18-24 years (vs those aged 25-28 years) agreed that the "Nthabi app was simple to use" (106/106, 100% vs 30/32, 98.8%; P=.01), and agreed that "the educational content was well organised and delivered in a timely way" (104/106, 98.1% vs 28/32, 87.5%; P=.01).

CONCLUSIONS

These results support further study of conversational agent systems as alternatives to traditional face-to-face provision of health education services in Lesotho, where there are critical shortages of human resources for health.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04354168; https://www.clinicaltrials.gov/study/NCT04354168.

Development and psychometric analysis of the smombie scale for adolescents

PURPOSE

Adolescent pedestrian accidents are increasing because of the "smombie" phenomenon, referring to pedestrians who are distracted by their smartphones and become unaware of their surroundings. In the field of nursing, this phenomenon can negatively affect adolescents' health and well-being. We developed the "smombie scale for adolescents" and examined its psychometric properties.

DESIGN AND METHODS

We revised five items and the response scale of an existing smombie scale for adults based on cognitive interviews and content validity test, and included guiding descriptions for adolescents. Using the revised scale, we surveyed 430 adolescents from South Korea to assess construct validity through confirmatory factor analysis. To review group validity, a logistic regression was conducted using responses to the item on whether participants experienced accidents related to smartphone usage on the street or sidewalk.

RESULTS

The 15 items in the four-factor structure, which was validated using confirmatory factor analysis, demonstrated: a chi-square value (p) of 232.63 (< 0.001), root mean square error of approximation of 0.06, goodness of fit index of 0.93, and Tucker-Lewis index of 0.94. The scale's Cronbach's α was 0.85, indicating good internal consistency. Logistic regression results considering actual accident occurrence showed that Factor 1 (perceived risk) and Factor 3 (pending instant message) were significantly correlated with smombie-related accidents.

CONCLUSIONS

The smombie scale for adolescents demonstrated adequate construct and group validity, and good reliability.

PRACTICE IMPLICATIONS

Its application can yield valuable insights into the effectiveness of pediatric nurses' educational and preventative efforts related to the smombie phenomenon in adolescents.

Crashes involving distracted pedestrians: Identifying risk factors and their relationships to pedestrian severity levels and distraction modes

The concept of distracted pedestrians and its impact on highway safety has gained increasing attention in recent years. However, studies focusing exclusively on distracted pedestrian crashes are less pervasive than distracted driving. In addition, most prior studies investigate the harmful effect of cellphone usage while walking, without considering other forms of pedestrian distraction. Also, the existing literature provides limited knowledge on comprehending the affinities between pedestrian distraction and safety consequences. This study aims to reveal the chain of contributing factors involved in distracted pedestrian crashes, considering both pedestrian severity levels and specific distraction-related tasks. Ten years (2010-2019) of related crashes were extracted from the Louisiana Department of Transportation and Development (LADOTD) database, and association rule mining (ARM) was applied to identify the meaningful crash patterns. Different distracting activities of pedestrians were introduced from the narratives of police-investigated crash reports. The study findings exhibit the complex nature of distracted pedestrian crashes by highlighting the intricate relationships between risk factors. On road segments, distracted male pedestrians aged 41-64 were more likely to be fatal/severely injured in dark-not-lighted conditions. Crashes involving pedestrians using electronic devices were often found at intersections. Distractions caused by pets, persons, or objects were strongly associated with crossing segments in rural settings. In-person conversation while standing on roadways in urban residential locations without traffic controls was found to increase vulnerability. Working on vehicles while wearing dark clothes and in dark-not-lighted conditions was identified as an influential factor in crash occurrence. Moreover, careless or inattentive actions of pedestrians while playing on the road segments were associated with a high likelihood of crashes. These study outcomes are crucial in uncovering the coexisting crash characteristics related to distracted pedestrians, which can be helpful in targeting and developing effective educational, design, and enforcement strategies to improve pedestrian safety.

Smartphones and rightward collisions

People tend to deviate to the right when walking through a narrow aperture (e.g., a doorway), resulting in a rightward bias in collisions. This study examines the effects of smartphone use on rightward collisions while walking. When pedestrians walk through a narrow aperture, they usually head straight to the perceived centre of the aperture, which is shifted slightly to the right, without updating the estimates. The rightward shift of the perceived centre is attributable to the rightward attentional shift in the extrapersonal space. Pedestrians using smartphones tend to fixate on the phone most of the time and thus tend not to look at their surroundings (i.e., extrapersonal space). Therefore, we predict that smartphone use will reduce rightward collisions. To test this prediction, we used a narrow-doorway task in which participants walked through a narrow doorway either with or without a smartphone. The participants with smartphones used them to perform either verbal or spatial tasks. The number of rightward collisions decreased when the participants used smartphones. The type of task had no effect on the lateral collision biases. These results were interpreted in terms of lateral attentional bias in peripersonal and extrapersonal spaces.

Correlations between Problematic Mobile Phone Use and Depressiveness and Daytime Sleepiness, as Well as Perceived Social Support in Adolescents

(1) The aim of this study was to estimate the scale of mobile phone addiction among young adults as well as to establish whether the low level of perceived social support is related to problematic smartphone use, and whether an addictive pattern of mobile phone use is related to the prevalence of depressiveness and excessive daytime sleepiness. (2) The study was carried out using the diagnostic poll method via the questionnaire technique. Both the author's own questionnaire and the following standardized research tools were used: the Mobile Phone Problem Use Scale for Adolescents (MPPUSA), the Beck Depression Inventory (BDI), the Epworth Sleepiness Scale (ESS), and the Multidimensional Scale of Perceived Social Support (MSPSS). (3) Perceived social support was significantly lower in the group of respondents who problematically used their mobile phones in comparison with the ones who used them in a proper way. Severity of depressive symptoms and daytime sleepiness was significantly higher in respondents addicted to their mobiles compared to nonaddicted ones. (4) Conclusions: An important correlation between phone addiction and the prevalence of depressive symptoms and excessive daytime sleepiness exists. Problematic mobile phone use concerns individuals with low levels of perceived social support.

The range of visual detection of ground-level cues during distracted walking: Effect of cue contrast and walking speed

Walking while distracted by a smartphone has been a major safety concern for pedestrians. Visual and cognitive attention paid to the smartphone while walking with the head tilted downward would affect the ability to perceive walkway hazards and elevate risks for pedestrian accidents associated with physical contact with obstacles. A laboratory experiment was conducted to evaluate the performance of detecting ground-level visual cues during texting while walking. Forty young smartphone users performed walking trials at faster, preferred, and slower speeds for the dual-task walking on a treadmill and detected approaching cues of three contrast levels. Detection distance was quantified from the location of cue detection to the participants to assess the effects of walking speed and cue contrast on detection performance. Results show that detection distance varied from 1.7 m to 2.9 m for Low to High contrast cues and from 2.3 m to 2.5 m for Slower to Faster walking speeds, and the effects of contrast and speed were statistically significant (p < 0.05). Study findings suggest that higher contrast fixtures or in-ground signals and slower walking would help smartphone users perceive walkway hazards and in-ground safety signals earlier during their distracted walking.

Factors Influencing Pedestrian Smartphone Use and Effect of Combined Visual and Auditory Intervention on “Smombies”: A Chinese Observational Study

Objective: This was a large-scale multicenter study with two objectives. One was to study the factors influencing pedestrian smartphone use while crossing roads, and the other was to study the effect of combined visual and auditory intervention on smartphone zombies (smombies) at crossroads.

Methods: This study was conducted in four different Chinese cities. By observing pedestrians crossing intersections, the weather, time, and characteristics of the pedestrians were recorded by four researchers. Then, its influencing factors and the effects of the intervention were studied in two consecutive periods.

Results: A total of 25,860 pedestrians (13,086 without intervention and 12,774 with visual and auditory intervention) were observed in this study. Logistic regressions showed that gender, age of the pedestrians, weather, and time were the factors influencing smombies crossing roads. The number of smartphone users decreased from 4,289 to 3,579 (28.1%) (χ² = 69.120, p < 0.001) when the intervention was conducted.

Conclusion: Based on large-sample, multicenter research, this study revealed the factors influencing pedestrian smartphone use while crossing roads, contributing to our understanding of the current situation of smombies in China. Furthermore, the effect of visual and auditory intervention was demonstrated, providing a new paradigm for global prevention of smombie behavior.

Phubbing among Lebanese young adults: Scale validation and association with mental health (depression, anxiety, and stress)

Mobile phones use has not been without several social and psychological problems, specifically during the fast spread of the COVID-19 infection, which imposed strict restrictions and isolation. This research principal aims were to (1) confirm the validity of the Generic Scale of Phubbing in Arabic (GSP), and (2) evaluate the association between phubbing and mental health (depression, anxiety and stress). A first cross-sectional study enrolled 203 participants to confirm the factor structure of the phubbing scale among Lebanese young adults. A confirmatory factor analysis (CFA) was carried out on the whole sample using SPSS AMOS v.24 to confirm the four-factor structure of the GSP. The root mean square error of approximation (RMSEA) statistic, the comparative fit index (CFI) and the Tucker Lewis Index (TLI) were used to evaluate the goodness-of-fit of the model. RMSEA values ≤0.08 and ≤ 0.10 indicate a good and acceptable fit respectively. CFI and TLI values ≥0.90 indicate good model fit. A second cross-sectional study enrolled 461 respondents (18-29 years old) to conduct the multivariable analysis. The fit indices values were as follows: χ2/df = 181.74/84 = 2.16, TLI = .92, CFI = .94 and RMSEA = .076 [95% CI .061-.091] respectively, indicating an excellent fit of the model. The results of the multiple linear regression using the ENTER model, when taking the phubbing score as the dependent variable, showed that female gender (β = 0.11; t(454) = 2.50; p = .013), more stress (β = 0.27; t(454) = 3.94; p < .001), more anxiety (β = 0.30; t(454) = 4.24; p < .001), and older age (β = 0.28; t(454) = 6.12; p < .001) were positively correlated with higher phubbing, or higher household crowding index (β = -0.15; t(454) = -3.62; p < .001) was significantly correlated with less phubbing. The results of this study were able to confirm the validity of the Arabic version of the GSP scale. This will allow Lebanese clinicians to use this validated tool to screen for the presence of the phubbing phenomenon within this age group. We propose finding possible correlation between phubbing and others factors (such as obsession and loneliness) and validating this scale in other Arabic-speaking countries.

Phubber’s Emotional Activations: The Association between PANAS and Phubbing Behavior

Currently, mobile phones are widely used worldwide. Thus, phubbing rapidly became a common phenomenon in our social life. Phubbing is considered by the literature as a new form of technology-related addiction that may undermine interpersonal relationships and mental health. Our study contributed to exploring phubbers’ emotional activation as no other work has investigated it so far. Indeed, researchers have only explored phubbees’ but not phubbers’ emotional correlates. A sample of 419 Italian individuals (143 males) participated in our data collection on a voluntary basis. The results showed that phubbing is related to negative affects, but not to positive affects. Moreover, phubbing in both its components (i.e., communication disturbance, phone obsession) appeared to elicit an emotional activation similar to that of social media addiction. These findings may help in strengthening the discussion around the emotional consequences of virtual environment design, as well as the awareness about what happens at a relational level during phubbing.

Intelligent Mobility in the City: The Influence of System and Context Factors on Drivers’ Takeover Willingness and Trust in Automated Vehicles

Automated driving in urban environments not only has the potential to improve traffic flow and heighten driver comfort but also to increase traffic safety, particularly for vulnerable road users such as pedestrians. For these benefits to take effect, drivers need to trust and use automated vehicles. This decision is influenced by both system and context factors. However, it is not yet clear how these factors interact with each other, especially for automated driving in city scenarios with crossing pedestrians. Therefore, we conducted an online experiment in which participants (N = 68) experienced short automated rides from the driver’s perspective through an urban environment. In each of the presented videos, a pedestrian crossed the street in front of the automated vehicle while system and context factors were varied: 1) the crossing pedestrian’s intention was either visualized correctly (as crossing) or incorrectly (visualization missing) by the automated vehicle (system factor), 2) the pedestrian was either distracted by using a smartphone while crossing or not (context factor), and 3) the scenario was either more or less complex depending on the number of other vehicles and pedestrians being present (context factor). In situations with a system malfunction where the crossing pedestrian’s intention was not visualized, participants perceived the situation as more critical, had less trust in the automated system, and a higher willingness to take over control regardless of any context factors. However, when the system worked correctly, the crossing pedestrian’s smartphone usage came into play, especially in the less complex scenario. Participants perceived situations with a distracted pedestrian as more critical, trusted the system less, indicated a higher willingness to take over control, and were more uncertain about their decision. As this study demonstrates the influence of distracted pedestrians, more research is needed on context factors and their inclusion in the design of interfaces to keep drivers informed during automated driving in urban environments.

Problematic Smartphone Use in Spanish and Italian University Students

Sustainable education requires the proper usage of technological devices. Among these is the smartphone, which is used by millions of young people around the world in today’s society. The objective of this study was to understand the smartphone usage profile of Spanish and Italian university students. It also aimed to identify possible problematic uses, and the differences in smartphone use (or abuse) between the participating subjects. The study was descriptive and comparative, with the intentional sampling of N = 1412 subjects studying at the education faculties of the University of Alicante (UA) and the Suor Orsola Benincasa University (UNISOB). A previously-validated questionnaire with 27 items was employed during the 2019–20 academic year. The data was analysed using the SPSS 25 programme. Descriptive and inferential analyses were carried out. The results obtained after the analysis of the data indicated that, of the four possible user types—occasional, habitual, at risk, and problematic—more than half of the sample identified themselves as habitual users. It can be concluded that there are significant differences between the universities: the UA students exhibited more problematic use than the UNISOB students. It is therefore necessary to prepare training programmes that are designed to avert problematic behaviours related to smartphone use.

Between Post-Flâneur and Smartphone Zombie: Smartphone Users’ Altering Visual Attention and Walking Behavior in Public Space

The extensive use of smartphones in our everyday lives has created new modes of appropriation and behavior in public spaces. Recognition of these are essential for urban design and planning practices which help us to improve the relationship between humans, technologies, and urban environment. This study aims to research smartphone users in public space by observing their altering visual attention and walking behavior, and, in this way, to reveal the emergent “new figures”. For this purpose, Korenmarkt square in Ghent, Belgium, was observed for seven days in 10-min time intervals. The gaze and walking behavior of smartphone users were encoded as geo-located and temporal data, analyzed and mapped using statistical and spatial analysis methods. Developing and implementing new methods for identifying the characteristics of smartphone users, this study resulted in a nuanced characterization of novel spatial appropriations. The findings led to a better understanding and knowledge of the different behavior patterns of emergent figures such as “post-flâneurs” and “smartphone zombies” while uncovering their altering visual interactions with and movements in the public space. The results evoked questions on how researchers and designers can make use of spatial analysis methods and rethink the public space of the future as a hybrid construct integrating the virtual and the physical.