Evaluation of a population health strategy to reduce distracted driving: Examining all "Es" of injury prevention

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.

A Model of Social Media Effects in Public Health Communication Campaigns: Systematic Review

BACKGROUND

Social media platforms are frequently used in health communication campaigns. Common understandings of campaign effects posit a sequential and linear series of steps from exposure to behavior change, commonly known as the hierarchy of effects model (HOE). These concepts need to be reevaluated in the age of social media, which are interactional and communal.

OBJECTIVE

This review aims to update the traditional HOE for health communication campaigns in the context of social media, including identifying indicators of effectiveness and how these are conceptualized to lead to health-related outcomes.

METHODS

We conducted a systematic review of studies following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines reporting on the use of social media as part of health communication campaigns, extracting campaign information such as objectives, platforms used, and measures of campaign performance. We used these data, combined with our understanding of the HOE, to develop an updated conceptual model of social media campaign effects.

RESULTS

We identified 99 eligible studies reporting on 93 campaigns, published between 2012 and 2022. The campaigns were conducted in over 20 countries, but nearly half (n=42) were conducted in the United States. Campaigns targeted a variety of health issues and predominantly used Facebook, Twitter, Instagram, and YouTube. Most campaigns (n=81) set objectives targeting awareness or individual behavior change. Process measures (n=68; eg, reach and impressions) and engagement measures (n=73; eg, likes and retweets) were reported most frequently, while two-fifths (n=42) did not report any outcomes beyond engagement, such as changes in knowledge, behavior, or social norms. Most campaigns (n=55) collected measures that did not allow them to determine if the campaign objective had been met; that is, they were process evaluations only. Based on our review, our updated model suggests that campaign exposure can lead to individual behavior change and improved health outcomes, either through a direct or indirect pathway. Indirect pathways include exposure through social and policy changes. "Engagement" is positioned as critical to success, replacing awareness in the traditional HOE, and all types of engagement are treated as equal and good. No consideration is being given to potential negative engagement, such as the distribution of misinformation. Additionally, the process is no longer linear and sequential, with circular pathways evident, such as engagement not only influencing behavior change but also generating additional exposure to campaign messages.

CONCLUSIONS

Our review has highlighted a change in conventional understandings of how campaigns can influence health outcomes in the age of social media. The updated model we propose provides social media campaigners with a starting point to develop and tailor campaign messages and allows evaluators to identify critical assumptions to test, including the role and value of "engagement."

TRIAL REGISTRATION

PROSPERO CRD42021287257; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287257.

Evaluating the Impact of a Multifaceted Distracted Driving Prevention Program

OBJECTIVE

The aim of this study is to evaluate undergraduate college students' attitude changes toward distracted driving after participating in a multifaceted distracted driving prevention program.

METHODS

This study used a quasi-experimental, pre- post-test design. Participants were undergraduate college students who were aged 18 or older and had a valid driver's license. The Questionnaire Assessing Distracted Driving was used to measure participants' attitudes and behaviors. All participants completed the entire Questionnaire Assessing Distracted Driving survey and then participated in the distracted driving prevention program that consisted of a 10-minute narrated recorded PowerPoint lecture followed by a distracted driving simulation. Descriptive statistics were calculated to describe the study sample. The Questionnaire Assessing Distracted Driving data were analyzed to ascertain any statistically significant changes in responses from pre- to postintervention.

RESULTS

From pre- to post-test, there were statistically significant increases in the number of participants who reported they would tell friends to stop texting and driving if they were a passenger, refrain from texting while driving, and wait until reaching home before retrieving their cell phones from the floor of the vehicle. Participants perceived a greater threat from drivers talking on phones or texting/emailing from pre- to post-test. Moreover, attitudes toward talking on a handheld device, talking on a hands-free phone, and texting/emailing became more negative from pre- to post-test.

CONCLUSION

The intervention helped promote negative attitudes toward distracted driving in a sample of college students immediately after participating in a distracted driving prevention program.

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.