Injury prevention programs against distracted driving among students

The effect of intervention programs on road traffic injury prevention among adolescents and young people: a systematic review

Road traffic injuries (RTIs) are a significant cause of death and disability among young people worldwide. Programs that use injury prevention strategies have been shown to effectively reduce the number of injuries. This systematic review aims to present the available evidence on the effectiveness of intervention programs in preventing RTIs among adolescents and young adults. Articles were identified and retrieved from databases including PubMed, Embase, Web of Science, Scopus, Science Direct, Magiran, SID, and Iran Medex. Two reviewers independently screened the articles. Articles published from the first year of publication until January 2018 that met the eligibility criteria were included in the review. These articles covered randomized controlled trials, pretest/post-test interventions, and controlled pretest/post-test interventions aimed at reducing RTIs among adolescents and young people aged 12-26 years. The framework, provided by Murphy and Haddon, were used to categorize the interventions. According to this framework, the interventions were categorized into five groups including education/behavior change, incentive, engineering/technology, legislation/enforcement, and multifaceted programs. The methodological quality of the studies was assessed using the Effective Public Health Practice Project. Of the initial 3165 findings, 13 studies met the inclusion criteria. Eleven of these studies used educational/behavioral approaches, while two employed multifaceted programs. In the educational/behavioral approach, participants' behaviors were considered as outcome variables. Only one of these studies was not successful. Multifaceted interventions were successful in changing behaviors. No studies were found on the effectiveness of other interventions. Eight studies were assessed as having moderate quality. The systematic review shows that educational/behavioral strategies and multifaceted programs are effective in reducing RTIs among young adults and adolescents. However, there is a lack of studies on other potential interventions. The quality of the included studies was moderate, suggesting a need for more rigorous research.

Factors affecting road safety compliance in a low- and middle-income country: An observational study from Lebanon

Road traffic injury is a major public health problem in Lebanon. This study aims to assess compliance with safety measures including seatbelt and helmet use in adults and children, and the prevalence of distracted driving among road users across Lebanon different governorates. It further aims to investigate predictors of compliance with seatbelt and helmet use. A cross-sectional observational field study was conducted at multiple governorates in Lebanon. Data collected included information on vehicles, road users and passengers. Univariate and multivariable logistic regression analyses were performed to identify trends in compliance with safety measures and distracted driving, and predictors of compliance. A total of 13,790 road users were observed. The rate of seatbelt and helmet use were 37.4% and 38.9%, respectively, among adults. Distracted behavior was present in 23.7% of car drivers and 22.8% of motorcyles adult riders. Compliance with seatbelt use was lower outside the capital city Beirut [OR = 5.236 (4.566-6.004), P <0.001], in males [OR = 1.688 (1.52-1.874), P <0.001], in drivers of taxi/vans [OR = 1.929 (1.71-2.175), P <0.001] or trucks [OR = 3.014 (2.434-3.732), P <0.001], and vehicles of lower price [OR = 3.291 (2.836-3.819), P <0.001]. Children vehicle passengers were 87.9% while motorcycles pillion riders were 12.1%. The rates for child car restraint and helmet use were 25.8% and 20.1%, respectively. Predictors of failure to use a child restraint system in vehicles were the youngest age group (0-5 years) [OR = 2.06, CI (1.40-3.02), P<0.001], sitting in the back seat [OR = 1.56, CI (1.09-2.23), P<0.001], ridding in the afternoon [OR = 1.43, CI (1.05-1.94), P = 0.02], and being outside Beirut [OR = 2.12, CI (1.41-3.17), P<0.00]. Public awareness efforts and better enforcement of road safety legislations are needed to increase the alarmingly low rates of compliance with safety measures and safeguard lives on the road.

'Just Drive': An Employee-Based Intervention to Reduce Distracted Driving

Distracted driving is a major danger on today's roadways. Employers play a critical role in developing distracted driving policies and promoting a culture of workplace driving safety. The purpose of this study was to evaluate the effectiveness of an in-person work-based class to reduce distracted driving in participating employees. The "Just Drive-Take Action Against Distraction" class was designed by the UC San Diego Training, Research and Education for Driving Safety (TREDS) program to increase awareness of the dangers of distracted driving and to encourage employees to be safe and responsible drivers, both on and off the job. Participants completed pre- and post-anonymous surveys and, in a subset of attendees, volunteers were contacted via email 3 months post-intervention to complete a driving-behavior survey on Surveymonkey.com. 115 classes for 6896 employees were delivered at 54 agencies in Southern California. A total of 4928 participants completed the pre- and post-survey; 2014 n = 2263 and 2015 n = 2665. The course was found useful (85%) and engaging (85.6%). For non-commercial drivers, 55.6% of participants reported an increase of 80-100% in awareness of the dangers of distracted driving, and 67.2% reported an increase of 80-100% in their motivation to change. For commercial drivers, 71.3% reported a motivation increase of 80-100%. There were significant increases in knowledge for both groups. In the three-month follow-up survey, participants identified multiple positive changes in distracted driving behavior. This 1-h employer-supported intervention demonstrated positive changes in short-term intention and medium-term behaviors.

Implementation is not enough: Graduated drivers licensing benefits from a comprehensive enforcement, education, and awareness campaigns

BACKGROUND

Graduated drivers license (GDLs) are required in most states. Graduated drivers licenses are intermediate licenses requiring a supervisory period prior to full licensure. Surveys suggests poor acceptance of GDL restrictions high variability in GDL compliance. New Jersey initiated GDLs in 2002 and introduced a comprehensive public health campaign in 2010. This study analyzed the effect of GDL and the campaign on teen driver-related fatalities and hypothesized that implementation alone was insufficient to decrease deaths.

METHODS

Data were analyzed from 1998 to 2016 from New Jersey's Fatal Accident Investigation Unit. In 2005, collaboration with state police added total crash fatalities and teen passenger deaths to the data set. Patterns in data before and after GDL implementation in 2002 and a comprehensive campaign in 2010 were evaluated to determine effects in New Jersey. Paired t tests, analysis of variance, and regression analyses were performed, with p value less than 0.05 considered significant.

RESULTS

Little effect was seen after initiation of GDL, with no change in number of dead teen drivers (44 vs. 49, p > 0.05) or fatal accidents (117 vs.115, p > 0.05) in the 4 years before and after implementation. However, after the comprehensive campaign, decreases are seen in dead teenaged drivers (42 vs. 22, p < 0.005) and total fatal accidents involving teens (107 vs. 61, p < 0.005). Comparing 4 years before and 6 years after the campaign demonstrates decreases in total crash fatalities involving teen drivers (112 vs. 66, p < 0.05) and in the number of dead teenaged passengers in a vehicle operated by another teen (19 vs. 11 p < 0.05).

CONCLUSIONS

Implementation of GDLs alone may not be an effective strategy in decreasing the number of teen fatalities. A multipronged approach combining comprehensive, public-health based campaign with targeted enforcement is necessary to decrease the number of teen driver-related deaths. Additional studies are needed to assess the relationship between decreased death and compliance with GDLs.

LEVEL OF EVIDENCE

Retrospective comparative study, level III.

Potential perils of peri-Pokémon perambulation: the dark reality of augmented reality?

Recently, the layering of augmented reality information on top of smartphone applications has created unprecedented user engagement and popularity. One augmented reality-based entertainment application, Pokémon Go (Pokémon Company, Tokyo, Japan) has become the most rapidly downloaded in history. This technology holds tremendous promise to promote ambulatory activity. However, there exists the obvious potential for distraction-related morbidity. We report two cases, presenting simultaneously to our trauma center, with injuries sustained secondary to gameplay with this augmented reality-based application.