Public opinion on motor vehicle-related injury prevention policies: a systematic review of a decade of research

Challenges of enforcing cellphone use while driving laws among police in the USA: a cross-sectional analysis

OBJECTIVES

Research suggests that cellphone use while driving laws may be difficult for police to enforce in the USA, but this is unknown. A national survey of police officers was conducted to determine whether barriers to enforcing these laws exist, what aspects of laws make them easier to enforce and ways to discourage the behaviour among drivers.

DESIGN

Cross-sectional survey.

SETTING

USA.

PARTICIPANTS

Individuals >18 years of age employed as a law enforcement officer from all 50 states were recruited via convenience sampling through multiple modalities from November 2019 to April 2020. Officers (N=353) from 31 states participated.

PRIMARY AND SECONDARY OUTCOME MEASURES

Descriptive statistics and multi-level logistic regression analyses were run to assess the responses.

RESULTS

The most common barriers to enforcing texting bans (ie, the most prevalent law) were drivers concealing their phone use (78%) and the officer not being able to determine what the driver was doing on their phone (65%). If a universal hand-held cellphone ban was in effect in their state, officers were 77% less likely (adjusted OR=0.23; 95% CI 0.08 to 0.70) to report that a texting ban was difficult to adjudicate. The majority of officers (86%) agreed that having one general law that prohibits any type of hand-held cellphone use would aid with enforcement, and that laws must be a primary offence (87%), and be applicable to all licensed drivers (91%). Most officers felt that driver education is needed.

CONCLUSIONS

While numerous barriers to enforcement were identified, opportunities exist to improve current legislation to aid enforcement efforts and to prevent the behaviour among drivers.

Attitudes toward mandatory ignition interlocks for all offenders convicted of driving while intoxicated

INTRODUCTION

Ignition interlocks are effective in reducing alcohol-impaired driving recidivism for all offenders, including first-time offenders. Despite their effectiveness, interlock use among persons convicted of driving while intoxicated from alcohol (DWI) remains low. This cross-sectional survey of U.S. adults assessed public support for requiring ignition interlocks for all convicted DWI offenders including first-time offenders. The goal was to update results from a similar 2010 survey in light of new state requirements and increased interlock installations.

METHODS

Questions were included in the Porter Novelli FallStyles survey, which was fielded from September 28 to October 16, 2015. Participants were the 3,536 individuals who provided an opinion toward requiring ignition interlocks for all offenders. For analyses, opinion toward requiring interlocks for all offenders was dichotomized into 'agree' and 'neutral/disagree.' To handle missing data, 10 imputed datasets were created and pooled using fully conditional specification (FCS).

RESULTS

Fifty-nine percent of adults supported requiring interlocks for all DWI offenders. Multivariate analysis revealed that persons who did not report alcohol-impaired driving (AID) were 60% more likely to support requiring interlocks than those who reported AID. Having heard of interlocks also increased support. Support was generally consistent across demographic subgroups.

CONCLUSIONS

Interlocks for all offenders have majority support nationwide in the current survey, consistent with previous reports. Support is lowest among those who have reported alcohol-impaired driving in the past 30days. These results suggest that communities with higher levels of alcohol-impaired driving may be more resistant to requiring ignition interlocks for all convicted DWI offenders. Future studies should examine this association further. Practical applications: These results indicate that the majority of adults recognize DWI as a problem and support requiring interlocks for all offenders.

Associations between alcohol consumption patterns and attitudes towards alcohol interlocks

BACKGROUND

Drink-driving and alcohol-related crashes are a significant problem globally. Alcohol interlocks are used to prevent drivers with a blood alcohol concentration above a pre-determined level from starting their vehicle, making the technology highly effective in preventing drink-drive episodes. While alcohol interlocks are commonly used in drink-drive offender groups, their broader use as a preventative road safety strategy is considered increasingly feasible. In this context it is important to understand attitudes towards the technology, and to investigate whether these attitudes vary according to alcohol consumption patterns as this influences the acceptability of a broad-based preventative alcohol interlock program.

METHODS

A representative sample of 2994 Australian drivers participated in an online cross-sectional survey. Participants reported their alcohol consumption, drink-drive behaviour and attitudes towards the use of alcohol interlocks for personal use and for drink-drive offenders.

RESULTS

Half of the sample stated that alcohol interlocks would be of use personally. Seventy-four percent of high-risk drinkers (defined by an AUDIT score ≥20) stated they would find the technology personally useful when compared to 49% of low-risk drinkers (AUDIT ≤7). Overwhelmingly, more than 80% of participants agreed with the mandatory instalment of alcohol interlocks and compulsory clinical interventions for drink-drive offenders, with more low-risk drinkers supporting this than the high-risk drinkers.

CONCLUSIONS

While there were mixed opinions regarding the perceived personal usefulness of alcohol interlocks, higher-risk drinkers were most likely to perceive interlocks as being of use for themselves. This high-risk group however, was less likely to provide support for clinical interventions and additional re-licensing requirements aimed at eliciting changes in drinking behaviour. These findings have important implications for drink-drive offender relicensing and the likely success of drink-driver education, and interventions aimed at curbing risky alcohol consumption.

Road traffic mortality in the Slovak Republic in 1996-2014

OBJECTIVE

Road traffic mortality takes an enormous toll in every society. Transport safety interventions play a crucial role in improving the situation. In the period 1996-2014 several road safety measures, including a complex new road traffic law in 2009, were implemented in the Slovak Republic, introducing stricter conditions for road users. The aim of this study is to describe and analyze the trends in road user mortality in the Slovak Republic in individual age groups by sex during the study period 1996-2014.

METHODS

Data on overall mortality in the Slovak Republic for the period 1996-2014 were obtained from the Statistical Office of the Slovak Republic. Mortality rates were age-adjusted to the European standard population. Joinpoint regression was used to assess the statistical significance of change in time trends of calculated standardized mortality rates.

RESULTS

Mortality rates of all types of road users as well as all age groups and both sexes in the Slovak Republic in the period 1996-2014 are decreasing. The male : female ratio decreased from 4:1 in 1996 to 2:1 in 2014. Motor vehicle users (other than motorcyclists) and pedestrians have the highest mortality rates among road user groups. Both of these groups show a significant decline in mortality rates over the study period. Within the age groups, people age 65 years and over have the highest mortality rates, followed by the age groups 25-64 and 15-24 years old. Joinpoint regression confirmed a steady, significant decline in all mortality rates over the study period. A statistically significant decrease in mortality rates in the last years of the study period was observed in the age group 25-64 and in male motorcycle users. Assessing the impact of the 2009 road traffic law, a drop was observed in the average standardized mortality rate of all road traffic users from 14.56 per 100,000 person years in the period 1996-2008 to 7.69 per 100,000 person years in the period 2009-2014. A similar drop in the average standardized mortality rate was observed in all individual road user groups.

CONCLUSIONS

The implementation of the new traffic regulations may have contributed significantly to the observed decrease in mortality rates of road users in the Slovak Republic. A significant decrease in mortality was observed in all population groups and in all groups of road users. The introduction of a new comprehensive road traffic law may have expedited the decrease of road fatalities, especially in the age group 25-64 years old. This type of evidence-based epidemiology data can be used for improved targeting of future public health measures for road traffic injury prevention.

Road Traffic and Other Unintentional Injuries Among Travelers to Developing Countries

Injuries result in nearly 6 million deaths and incur 52 million disability-adjusted life-years annually, making up 15% of the global disease burden. More than 90% of this burden occurs in low- and middle-income countries. Given this burden, it is not unexpected that injuries are the leading cause of death among travelers to low- and middle-income countries, namely, from road traffic crashes and drowning. Therefore, pretravel advice regarding foreseeable dangers and how to avoid them may significantly mitigate injury risk, such as wearing seatbelts, helmets, and personal flotation devices when appropriate; responsibly consuming alcohol; and closely supervising children.

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.

Public awareness of and support for infrastructure changes designed to increase walking and biking in Los Angeles County

OBJECTIVE

Policies to promote active transportation are emerging as a best practice to increase physical activity, yet relatively little is known about public opinion on utilizing transportation funds for such investments. This study sought to assess public awareness of and support for investments in walking and biking infrastructure in Los Angeles County.

METHOD

In the fall of 2013, the Los Angeles County Department of Public Health conducted a telephone survey with a random sample of registered voters in the region. The survey asked respondents to report on the presence and importance of walking and biking infrastructure in their community, travel behaviors and preferences, and demographics.

RESULTS

One thousand and five interviews were completed (response rate 20%, cooperation rate 54%). The majority of participants reported walking, biking, and bus/rail transportation investments as being important. In addition, participants reported a high level of support for redirecting transportation funds to active transportation investment - the population average was 3.28 (between 'strongly' and 'somewhat' support) on a 4 point Likert scale.

CONCLUSION

Voters see active transportation infrastructure as being very important and support redirecting funding to improve the infrastructure. These findings can inform policy-decisions and planning efforts in the jurisdiction.

Using Enforcement and Adjudication Data to Assess the Impact of a Primary Safety Belt Law

BACKGROUND

Identification of effective implementation strategies for motor vehicle injury prevention law is an important priority for research in public health law and policy. Extensive literature in related fields demonstrates the relationship between enforcement activities and achievement of safety objectives.

PURPOSE

We conducted this study to determine the role of enforcement and adjudication in the implementation of a primary safety belt law, including the level and sustainability of safety belt-related conviction rates, using newly available data from the state judicial administrative authority. A secondary goal was to assess the contribution of the administrative data set to the analysis of the primary safety belt law.

METHODS

The analysis used an interrupted time series design to evaluate the longitudinal effect of the primary safety belt law implementation in 2007 on safety belt infractions and convictions in Kentucky, 2003-2012. Segmented regression analysis was used to estimate changes in the level and trend of safety belt nonuse conviction rate after the full implementation of the law, while controlling for the baseline level and trend. The association between the safety belt-related conviction rates and other expected outcomes of the law's implementation was studied.

RESULTS

Safety belt citations doubled and convictions nearly tripled during the decade studied, most dramatically in the first year. Increases were sustained throughout the study period. There was a strong positive linear association between the safety belt nonuse conviction rate and the observed safety belt use in the state, as well as a strong negative association between the safety belt nonuse conviction rate and the number of nonrestrained motor vehicle crash fatalities.

DISCUSSION

Our analysis demonstrates that Kentucky's public safety and judicial systems took the new law seriously and enforced it effectively and that the increased level of enforcement persisted for at least 5 years after implementation. We also find that data from judicial system administrative agency reports make an important contribution to public policy analysis. In the face of persistent antiregulatory forces and public-sector budget cuts, it is critically important to document the relationship between enforcement activities and the achievement of legislative goals.

Research-informed evidence and support for road safety legislation: findings from a national survey

Public opinion is influential in the policymaking process, making it important to understand the factors that influence popular support or opposition to public health policies. Researchers and policymakers tend to agree that scientific evidence can inform decision-making, but this influence has not been explored sufficiently, especially in the area of injury prevention. This paper considers the potential for the communication of evidence-based research and public health data to influence opinion about legislation that could reduce road-related injury. We conducted a nationally-representative online survey to assess public attitudes toward four road-safety laws; ignition interlock, school zone red-light cameras, restrictions on infotainment systems, and children's bicycle helmets. For each law, we assessed initial support and then provided a research-informed statistic on either the injury risk posed or the law's efficacy reducing risk and re-examined the law's support or opposition. The survey was completed by 2397 U.S. adults. Each law was initially supported by a majority of respondents, with greatest support for ignition interlock (74.4%) and children's bicycle helmets (74.8%). Exposure to research-informed statements increased legislative support for 20-30% of respondents. Paired analyses demonstrate significant increases toward supportive opinions when comparing responses to the initial and research-informed statements. The study demonstrates considerable public support for evidence-based road-related laws. Overall support was augmented by exposure to research data. Injury prevention practitioners can capitalize on this support in efforts to build support for legislation that would prevent injury. Researchers should be encouraged to expand their efforts to share research results with both the public and policymakers.