Impact of distraction on the driving performance of adolescents with and without attention-deficit/hyperactivity disorder

IMPORTANCE

This study extends the literature regarding attention-deficit/hyperactivity disorder (ADHD)-related driving impairments to a newly licensed, adolescent population.

OBJECTIVE

To investigate the combined risks of adolescence, ADHD, and distracted driving (cell phone conversation and text messaging) on driving performance.

DESIGN, SETTING, AND PARTICIPANTS

Adolescents aged 16 to 17 years with (n = 28) and without (n = 33) ADHD engaged in a simulated drive under 3 conditions (no distraction, cell phone conversation, and texting). During each condition, one unexpected event (eg, another car suddenly merging into driver's lane) was introduced.

INTERVENTIONS

Cell phone conversation, texting, and no distraction while driving.

MAIN OUTCOMES AND MEASURES

Self-report of driving history, average speed, standard deviation of speed, standard deviation of lateral position, and braking reaction time during driving simulation.

RESULTS

Adolescents with ADHD reported fewer months of driving experience and a higher proportion of driving violations than control subjects. After controlling for months of driving history, adolescents with ADHD demonstrated more variability in speed and lane position than control subjects. There were no group differences for braking reaction time. Furthermore, texting negatively impacted the driving performance of all participants as evidenced by increased variability in speed and lane position.

CONCLUSIONS

To our knowledge, this study is one of the first to investigate distracted driving in adolescents with ADHD and adds to a growing body of literature documenting that individuals with ADHD are at increased risk for negative driving outcomes. Furthermore, texting significantly impairs the driving performance of all adolescents and increases existing driving-related impairment in adolescents with ADHD, highlighting the need for education and enforcement of regulations against texting for this age group.

Prevalence of and attitudes about distracted driving in college students

OBJECTIVE

To identify current distracted driving (DD) behaviors among college students, primarily those involving cell phone use, and elucidate the opinions of the students on the most effective deterrent or intervention for reducing cell phone use.

METHODS

Students enrolled at 12 colleges and universities were recruited to participate in an online, anonymous survey. Recruitment was done via school-based list-serves and posters. School sizes ranged from 476 to over 30,000. The validated survey included 38 questions; 17 were specifically related to distracted driving.

RESULTS

Four thousand nine hundred sixty-four participants completed the surveys; the average age was 21.8, 66% were female, 82.7% were undergraduates, and 47% were white/non-Hispanic. Additionally, 4,517 (91%) reported phoning and/or texting while driving; 4,467 (90%) of drivers said they talk on the phone while driving; 1,241 (25%) reported using a hands-free device "most of the time"; 4,467 (90%) of drivers reported texting while driving; 2,488 (50%) reported sending texts while driving on the freeway; 2,978 (60%) while in stop-and-go traffic or on city streets; and 4,319 (87%) at traffic lights. Those who drove more often were more likely to drive distracted. When asked about their capability to drive distracted, 46% said they were capable or very capable of talking on a cell phone and driving, but they felt that only 8.5% of other drivers were capable. In a multivariate model, 9 predictors explained 44% of the variance in DD, which was statistically significant, F (17, 4945) = 224.31; P <.0001; R(2) = 0.44. The four strongest predictors (excluding driving frequency) were self-efficacy (i.e., confidence) in driving while multitasking (β = 0.37), perception of safety of multitasking while driving (β = 0.19), social norms (i.e., observing others multitasking while driving; β = 0.29), and having a history of crashing due to multitasking while driving (β = 0.11).

CONCLUSIONS

Distracted driving is a highly prevalent behavior among college students who have higher confidence in their own driving skills and ability to multitask than they have in other drivers' abilities. Drivers' self-efficacy for driving and multitasking in the car, coupled with a greater likelihood of having witnessed DD behaviors in others, greatly increased the probability that a student would engage in DD. Most students felt that policies, such as laws impacting driving privilege and insurance rate increases, would influence their behavior.

Distracted driving in elderly and middle-aged drivers

Automobile driving is a safety-critical real-world example of multitasking. A variety of roadway and in-vehicle distracter tasks create information processing loads that compete for the neural resources needed to drive safely. Drivers with mind and brain aging may be particularly susceptible to distraction due to waning cognitive resources and control over attention. This study examined distracted driving performance in an instrumented vehicle (IV) in 86 elderly (mean=72.5 years, SD=5.0 years) and 51 middle-aged drivers (mean=53.7 years, SD=9.3 year) under a concurrent auditory-verbal processing load created by the Paced Auditory Serial Addition Task (PASAT). Compared to baseline (no-task) driving performance, distraction was associated with reduced steering control in both groups, with middle-aged drivers showing a greater increase in steering variability. The elderly drove slower and showed decreased speed variability during distraction compared to middle-aged drivers. They also tended to "freeze up", spending significantly more time holding the gas pedal steady, another tactic that may mitigate time pressured integration and control of information, thereby freeing mental resources to maintain situation awareness. While 39% of elderly and 43% of middle-aged drivers committed significantly more driving safety errors during distraction, 28% and 18%, respectively, actually improved, compatible with allocation of attention resources to safety critical tasks under a cognitive load.

Distracted driving: prevalence, problems, and prevention

While the number of motor vehicle crashes has declined over the years, crashes resulting from distracted driving are increasing in the United States resulting in significant morbidity and mortality. The national public seems to be aware of the dangers associated with using technology while driving, but continues to engage in this dangerous behaviour, and may be unaware of or underestimate the impact of cell phone use on their own driving performance. Problems associated with distracted driving are not limited to novice or teenage drivers; multifaceted universal prevention efforts aimed at impacting large segments of the population may have the greatest impact. Legislation limiting drivers' cell phone use has had little impact, possibly due to low regulation and enforcement. Behaviour change programmes, improved vehicle safety, and public awareness campaigns have been developed as potential preventive efforts to reduce accidents caused by distracted drivers.

Adolescent Cellphone Use While Driving: An Overview of the Literature and Promising Future Directions for Prevention

Motor vehicle crashes are the leading cause of death in adolescents, and drivers aged 16-19 are the most likely to die in distracted driving crashes. This paper provides an overview of the literature on adolescent cellphone use while driving, focusing on the crash risk, incidence, risk factors for engagement, and the effectiveness of current mitigation strategies. We conclude by discussing promising future approaches to prevent crashes related to cellphone use in adolescents. Handheld manipulation of the phone while driving has been shown to have a 3 to 4-fold increased risk of a near crash or crash, and eye glance duration greater than 2 seconds increases crash risk exponentially. Nearly half of U.S. high school students admit to texting while driving in the last month, but the frequency of use according to vehicle speed and high-risk situations remains unknown. Several risk factors are associated with cell phone use while driving including: parental cellphone use while driving, social norms for quick responses to text messages, and higher levels of temporal discounting. Given the limited effectiveness of current mitigation strategies such as educational campaigns and legal bans, a multi-pronged behavioral and technological approach addressing the above risk factors will be necessary to reduce this dangerous behavior in adolescents.

Attitudes on technological, social, and behavioral economic strategies to reduce cellphone use among teens while driving

OBJECTIVE

The majority of U.S. teens admit to handheld cellphone use while driving, an increasingly common cause of crashes. Attitudes toward novel cellphone applications and settings that block use while driving are poorly understood, potentially limiting uptake. We examined teens' willingness to reduce cellphone use while driving and perceptions of potential strategies to limit this behavior.

METHODS

Teen drivers (n = 153) aged 16-17 who owned smartphones and admitted to texting while driving completed an online survey. Survey instruments measured willingness to give up cellphone use and perceptions of technological and behavioral economic strategies to reduce cellphone use while driving. We used chi-square tests to test the hypothesis that willingness to give up certain types of cellphone use while driving and the perceptions of strategies to reduce cellphone use while driving would differ by self-reported frequency of texting while driving in the past 30 days (low [1-5 days] vs. high [6 or more days]).

RESULTS

Most teens were willing or somewhat willing to give up reading texts (90%), sending texts (95%), and social media (99%) while driving. However, they were not willing to give up navigation (59%) and music applications (43%). Those who engaged in high-frequency texting while driving were more likely to say that they were not willing to give up navigation applications (73 vs. 44%, P <.001), music applications (54 vs. 32%, P <.001), and reading texts (15 vs. 4%, P =.029). Overall, the following strategies where rated as likely to be very effective for reducing texting while driving: gain-framed financial incentives (75%), loss-framed financial incentives (63%), group-based financial incentives (58%), insurance discounts (53%), automatic phone locking while driving (54%), e-mail notifications to parents (47%), automated responses to incoming texts (42%), peer concern (18%), and parental concern (15%). Those who engaged in high-frequency texting while driving were less likely to say that following strategies would be very effective: automated responses to incoming texts (33 vs. 53%, P =.016), peer concern (9 vs. 29%, P =.002), and parental concern (9 vs. 22%, P =.025). The strongest perceived benefit of cellphone blocking apps was decreasing distraction (86%). The predominant reason for not wanting to use this technology was not wanting parents to monitor their behavior (60%).

CONCLUSIONS

Promising strategies for increasing acceptance of cellphone blocking technology among teen drivers include automated screen locking and permitting hands-free navigation and music combined with behavioral economic incentives to sustain engagement.

Teen Drivers' Perceptions of Inattention and Cell Phone Use While Driving

OBJECTIVE

Inattention to the roadway, including cell phone use while driving (cell phone calls, sending and reading texts, mobile app use, and Internet use), is a critical problem for teen drivers and increases risk for crashes. Effective behavioral interventions for teens are needed in order to decrease teen driver inattention related to cell phone use while driving. However, teens' perceptions of mobile device use while driving is a necessary component for theoretically driven behavior change interventions. The purpose of this study was to describe teen drivers' perceptions of cell phone use while driving in order to inform future interventions to reduce risky driving.

METHODS

We conducted 7 focus groups with a total of 30 teen drivers, ages 16-18, licensed for ≤ 1 year in Pennsylvania. The focus group interview guide and analysis were based on the Theory of Planned Behavior, identifying the attitudes, perceived behavioral control, and norms about inattention to the roadway. Directed descriptive content analysis was used to analyze the focus group interviews. All focus groups were coded by 2 research team members and discrepancies were reconciled. Themes were developed based on the data.

RESULTS

Teens had a mean age of 17.39 (SD = 0.52), mean length of licensure of 173.7 days (SD = 109.2; range 4-364), were 50% male and predominately white (90%) and non-Hispanic (97%). From the focus group data, 3 major themes emerged: (1) Recognizing the danger but still engaging; (2) Considering context; and (3) Formulating safer behaviors that might reduce risk. Despite recognizing that handheld cell phone use, texting, and social media app use are dangerous and distracting while driving, teens and their peers often engaged in these behaviors. Teens described how the context of the situation contributed to whether a teen would place or answer a call, write or respond to a text, or use a social media app. Teens identified ways in which they controlled their behaviors, although some still drew attention away from the roadway.

CONCLUSIONS

Cell phone use while driving is a contributor to motor vehicle crashes in teens, and effective interventions to decrease risks are needed. Teens viewed some types of cell phone use as unsafe and describe methods in which they control their behaviors. However, some of their methods still take attention off the primary task of driving. Teens could benefit from behavior change interventions that propose strategies to promote focused attention on the roadway at all times during the driving trip.

Risk Perceptions of Cellphone Use While Driving: Results from a Delphi Survey

Cellphone use while driving has been recognized as a growing and important public health issue by the World Health Organization and U.S. Center for Disease Control and Prevention. Surveys typically collect data on overall texting while driving, but do not differentiate between various forms of cellphone use. This study sought to improve the survey indicators when monitoring cellphone use among young drivers. Experts and young drivers were recruited to propose behavioral indicators (cellphone use while driving behaviors) and consequential indicators (safety consequences of cellphone use while driving) in 2016. Subsequently, experts and young drivers selected the top indicators using the Delphi survey method. We enrolled 22 experts with published articles on cellphone use while driving nationally, and seven young drivers who were freshmen at a state university. Sending a text or e-mail on a handheld phone was picked as the top behavioral indicator by both groups. However, young drivers chose playing music on a handheld phone as the second most important behavioral indicator, which was overlooked by experts. Injury/death and collision were the top two consequential indicators. Experts and young drivers identified the important survey indicators to monitor cellphone use while driving.

Neural Correlates of Simulated Driving While Performing a Secondary Task: A Review

Distracted driving consists in performing a secondary task while driving, such as cell-phone conversation. Given the limited resources of the attentional system, engaging in a secondary task while driving increases the risk to have car accidents. The secondary task engagement while driving can depend on or be affected by different factors, including driver's individual characteristics, necessities, environmental conditions, and so forth. In the present work, the neuroimaging studies that investigated the brain areas involved in simulated driving during the execution of a secondary task (visual and overall auditory tasks) were reviewed in light of driving settings. In general, although there are also differences in decrease and increase brain activations across studies, due to the varieties of paradigms used (simulators, secondary tasks and neuroimaging techniques), the dual-task condition (simulated driving plus secondary task), as compared to the simulated driving-alone condition, was generally found to yield a significant shift in activations from occipital to fronto-parietal brain regions. These findings show that when a secondary task is added during driving the neural system redirects attentional resources away from visual processing, increasing the possibility of incorrect, dangerous or risky behavioral responses. The shift of the attentional resources can occur even if driving behavior is not explicitly affected. Limits of the neuroimaging studies reviewed and future research directions, including the need to explore the role of personality factors in the modulation of the neural programs while engaging distracted driving, are briefly discussed.

Effect of Using Mobile Phones on Driver's Control Behavior Based on Naturalistic Driving Data

Distracted driving behaviors are closely related to crash risk, with the use of mobile phones during driving being one of the leading causes of accidents. This paper attempts to investigate the impact of cell phone use while driving on drivers' control behaviors. Given the limitation of driving simulators in an unnatural setting, a sample of 134 cases related to cell phone use during driving were extracted from Shanghai naturalistic driving study data, which provided massive unobtrusive data to observe actual driving process. The process of using mobile phones was categorized into five operations, including dialing, answering, talking and listening, hanging up, and viewing information. Based on the concept of moving time window, the variation of the intensity of control activity, the sensitivity of control operation, and the stability of control state in each operation were analyzed. The empirical results show strong correlation between distracted operations and driving control behavior. The findings contribute to a better understanding of drivers' natural behavior changes with using mobiles, and can provide useful information for transport safety management.

Post and during event effect of cell phone talking and texting on driving performance--a driving simulator study

OBJECTIVE

A number of studies have been done in the field of driver distraction, specifically on the use of cell phone for either conversation or texting while driving. Researchers have focused on the driving performance of drivers when they were actually engaged in the task; that is, during the texting or phone conversation event. However, it is still unknown whether the impact of cell phone usages ceases immediately after the end of task. The primary objective of this article is to analyze the post-event effect of cell phone usage (texting and conversation) in order to verify whether the distracting effect lingers after the actual event has ceased.

METHODS

This study utilizes a driving simulator study of 36 participants to test whether a significant decrease in driver performance occurs during cell phone usage and after usage. Surrogate measures used to represent lateral and longitudinal control of the vehicle were standard deviation (SD) of lane position and mean velocity, respectively.

RESULTS

RESULTS suggest that there was no significant decrease in driver performance (both lateral and longitudinal control) during and after the cell phone conversation. For the texting event, there were significant decreases in driver performance in both the longitudinal and lateral control of the vehicle during the actual texting task. The diminished longitudinal control ceased immediately after the texting event but the diminished lateral control lingered for an average of 3.38 s. The number of text messages exchanged did not affect the magnitude or duration of the diminished lateral control.

CONCLUSION

The result indicates that the distraction and subsequent elevated crash risk of texting while driving linger even after the texting event has ceased. This finding has safety and policy implications in reducing distracted driving.

A Behavioral Economic Analysis of Demand for Texting while Driving

The overarching goal of the present study was to determine whether a behavioral economic framework of demand analysis is applicable to texting while driving. To this end, we developed a novel hypothetical task designed to quantify the intensity and elasticity of the demand for social interaction from texting while driving. This task involved a scenario in which participants receive a text message while driving, and they rated the likelihood of replying to a text message immediately versus waiting to reply until arriving at a destination when the amounts of a fine for texting while driving ranged from $1 to $300. To assess the construct validity of the task, the scenario presented two delays to a destination (15 min and 60 min). The demand for social interaction from texting was more intense (greater at the lowest amount of the fine) and less elastic (less sensitive to the increase in the amounts of the fine) for drivers who self-reported a higher frequency of texting while driving than for those who self-reported a lower frequency of texting while driving. Demand was also more intense and less elastic under the 60-min delay condition than under the 15-min condition. The results of this proof-of-concept study suggest that behavioral economic demand analyses are potentially useful for understanding and predicting texting while driving.

Development of a Theoretically Grounded, Web-Based Intervention to Reduce Adolescent Driver Inattention

Motor vehicle crashes are the leading cause of adolescent death. Inattention to the roadway contributes to crash risk and often results from distractions, such as cell phone calls, texting, and peer passengers. We report on the development of a web-based intervention based on the Theory of Planned Behavior that aims to reduce adolescent driver inattention ( Let's Choose Ourselves). In Phase I, we collected qualitative and quantitative data on adolescents' attitudes, perceived behavioral control, and subjective norms about driver inattention through focus groups with newly licensed adolescent drivers. In Phase II, we developed the content in an e-learning delivery system, performed beta- and pilot testing, and made refinements. In Phase III, we conducted a randomized controlled trial to evaluate feasibility. The development of Let's Choose Ourselves provides information for school nurses regarding intervention development strategies as well as promotion of safe adolescent driving by reducing driver inattention.

Seat-belt use still low in Kuwait: self-reported driving behaviours among adult drivers

Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study objectives were to identify and estimate current factors associated with seat-belt use and levels of potentially unsafe driving behaviours in Kuwait. In 2010, 741 adults were surveyed regarding driving habits and history. Only 41.6% of drivers reported always using a seat belt. Front seat passenger belt use was more common (30.5%) than rear seat belt use (6.5%). Distracted driving behaviours were common, including mobile phone use ('always' or 'almost always': 51.1%) and texting/SMS (32.4%). Logistic regression indicated that drivers who were young (18-19 years), male, Kuwaiti nationals or non-Kuwaiti Arabs, drove over the speed limit, had traffic violation tickets or >1 car crashes in the last year, were less likely to use seat belts. Targeted initiatives to increase public awareness and to enforce car-safety legislation, including use of seat belts, are necessary to decrease the health burden of car crashes in Kuwait.

Preventable Injuries/Fatalities Due to Distracted Driving: A Call for a Coordinated Action

In the past decade, distracted driving has emerged as one of the most prominent global road safety concerns. The singular and combined efforts of many organizations, such as Drop It And Drive (DIAD) and the Traffic Injury Research Foundation (TIRF), have identified the need for partnerships, shared information, and access to interpretable research findings to guide decision making and to identify effective strategies to reduce, if not eliminate, preventable injuries/fatalities from distracted driving, including whiplash-associated disorders. This editorial describes activities in 5 target areas identified in our environmental scan in Canada: (1) provincial/territorial government strategies, (2) enforcement, (3) data collection and measurement, (4) awareness campaigns, and (5) legislation. We will also reinforce the potential benefits of seeking and establishing meaningful interdisciplinary partnerships to reduce distracted driving across the globe. Finally, this editorial provides an example of how these interdisciplinary partnerships can help reduce preventable, life-altering injuries/deaths caused by distracted driving. J Orthop Sports Phys Ther 2016;46(10):818-821. doi:10.2519/jospt.2016.0113.

Factors Associated with Cell Phone Use While Driving: A Survey of Parents and Caregivers of Children Ages 4-10 Years

OBJECTIVES

To examine characteristics associated with cell phone use while driving by parents and caregivers of children ages 4-10 years.

STUDY DESIGN

National cross-sectional online survey with a convenience sample (March 2017-April 2017).

INCLUSION CRITERIA

Parent/caregiver of a child age 4-10 years in their home, age ≥18 years, read and spoke English, and drove child ≥6 times in previous 3 months. Adjusted logistic regression analyses were modeled for outcome measures of previous 3-month self-report cell phone use while driving with the child.

RESULTS

The analytic sample was n = 760. In the previous 3 months, 47% of parent/caregivers talked on a hand-held phone, 52.2% talked on a hands-free phone, 33.7% read texts, 26.7% sent texts, and 13.7% used social media while driving with their child in the vehicle. Compared with those who always used their typical child restraint system, participants who did not always use were more likely to talk on a hands-free phone (aOR 1.97, 95% CI 1.26-3.09), read a text (aOR 1.74, 95% CI 1.11-2.73), send a text (aOR 1.65, 95% CI 1.04-2.62), and use social media (aOR 2.92, 95% CI 1.73-4.94) while driving. Higher income, not wearing a seat belt (driver) on every trip, and driving under influence of alcohol also were associated with various types of cell phone use while driving.

CONCLUSIONS

Inconsistent child restraint system use, lack of seat belt use, and driving under the influence of alcohol are associated with parent/caregiver cell phone use while driving. Screening and education related to parental driving behaviors should include addressing multiple risk behaviors.

Improving EEG-Based Driver Distraction Classification Using Brain Connectivity Estimators

This paper discusses a novel approach to an EEG (electroencephalogram)-based driver distraction classification by using brain connectivity estimators as features. Ten healthy volunteers with more than one year of driving experience and an average age of 24.3 participated in a virtual reality environment with two conditions, a simple math problem-solving task and a lane-keeping task to mimic the distracted driving task and a non-distracted driving task, respectively. Independent component analysis (ICA) was conducted on the selected epochs of six selected components relevant to the frontal, central, parietal, occipital, left motor, and right motor areas. Granger-Geweke causality (GGC), directed transfer function (DTF), partial directed coherence (PDC), and generalized partial directed coherence (GPDC) brain connectivity estimators were used to calculate the connectivity matrixes. These connectivity matrixes were used as features to train the support vector machine (SVM) with the radial basis function (RBF) and classify the distracted and non-distracted driving tasks. GGC, DTF, PDC, and GPDC connectivity estimators yielded the classification accuracies of 82.27%, 70.02%, 86.19%, and 80.95%, respectively. Further analysis of the PDC connectivity estimator was conducted to determine the best window to differentiate between the distracted and non-distracted driving tasks. This study suggests that the PDC connectivity estimator can yield better classification accuracy for driver distractions.

Distracted driving on YouTube: implications for adolescents

For the first time in 50 years, traffic fatalities have increased in the United States (US). With the emergence of technology, comes the possibility, that distracted driving has contributed to a decrease in safe driving practices. The purpose of this study was to describe the content on the popular video sharing site, YouTube to ascertain the type of content conveyed in videos that are widely viewed. The 100 most widely viewed English language videos were included in this sample, with a collective number of views of over 35 million. The majority of videos were television-based and Internet-based. Pairwise comparisons indicated that there were statistically significant differences between the number of views of consumer generated videos and television-based videos (p = 0.001) and between television-based videos and Internet-based videos (p < 0.001). Compared with consumer generated videos, television-based videos were 13 times more likely to discuss cell phone use as a distractor while driving, while Internet-based videos were 6.6 times more likely to discuss cell phone use as a distractor while driving. In addition, compared with consumer generated videos, television-based videos were 3.67 times more likely to discuss texting as a distractor while driving, whereas Internet-based videos were 8.5 times more likely to discuss texting as a distractor while driving. The findings of this study indicate that the videos on YouTube related to distracted driving are popular and that this medium could prove to be a successful venue to communicate information about this emergent public health issue.

It can W8: A community intervention to decrease distracted driving

Researchers tested an intervention to decrease cell-phone use while driving on a university campus. A total of 3,827 driving observations were recorded on a campus roadway over a three-week period. The campus intervention, consisting of fear appeals, pledges, and behavioral prompts, was tested using an ABA reversal design (Baseline-Intervention-Baseline) with observed cell-phone use as the dependent measure. A Chi-Square test of independence indicated the percentage of drivers talking on a cell phone decreased significantly from 8.5% of 945 drivers at Baseline to 5.5% of 1,428 drivers following the Intervention. In contrast, the percentage of drivers observed texting increased significantly from 4% of 945 drivers at Baseline to 6.2% of 1,428 drivers following the Intervention. Additionally, safety-belt use was associated with the type of phone use observed. Findings were significantly different for women versus men. Results are discussed in the context of behavioral community intervention and gender differences in traffic-safety behavior.

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.

Cellphone-distracted crashes of novice teen drivers: Understanding associations of contributing factors for crash severity levels and cellphone usage types

OBJECTIVE

As novice teen drivers are uniquely susceptible to the harmful effects of secondary activities on cellphones, 38 states and Washington D.C. have banned all types of cellphone usage for drivers younger than 18 years or in the learner/intermediate phase of driving. Despite the prevalence of such cellphone prohibitions, several surveillance studies have highlighted the persistent engagement of teenagers in cellphone-distracted driving, which increases the related crash risk. Most of the prior studies broadly consider cellphone usage as a general distraction instead of investigating different distraction-related tasks associated with cellphone use. This study analyzed the cellphone crashes of novice teenagers (aged 15-17 years) to discover the grouping of contributing factors by crash severity levels and cellphone usage types.

METHODS

The current study collected five years (2015-2019) of related crash data from the Louisiana Department of Transportation and Development. A manual effort was carried out to recognize the type of cellphone tasks before collision by reading the narratives of police-investigated crash reports. Association rule mining was applied to explore the associations between numerous crash attributes in multiple circumstances without relying on any predetermined hypotheses.

RESULTS

The cumulative effect of cellphone distraction and no seatbelt usage is frequently visible in confirmed injury crash scenarios. Cellphone crashes of novice teenagers at intersections are strongly associated with talking/listening rather than texting/browsing/dialing and reaching for/answering/locating. The associations among environmental factors and modes of cellphone usage significantly influence the manner of collisions. Single-vehicle crashes are associated with cellphone manipulation while driving on weekends in cloudy weather, whereas sideswipe collisions are frequent in evening hours during reaching for/answering/locating the cellphones. In relation to texting/browsing/dialing, novice teenagers operating vans/SUVs are strongly associated with traffic control violations.

CONCLUSIONS

The findings are expected to be beneficial for policymakers and other safety officials to develop strategic planning and implementable countermeasures when dealing with cellphone-distracted novice teenagers. The association of factors identified from the analysis exhibits real-world crash scenarios critical to strengthening driver education programs to mitigate teen driver crashes. Moreover, cellphone crashes and related casualties can be reduced by eliminating or improving one of the attributes involved in the crash patterns.

Evaluating the Effectiveness of a Front Windshield Sticker Reminder in Reducing Texting while Driving in Young Adults

Texting while driving is a dangerous activity that is on the rise in the United States (U.S.). Since 2011 there has been a 17% increase in the number of people injured in a motor vehicle crash involving a distracted driver. Bans on the act of texting and driving have already taken place in 46 states in the U.S., but studies have shown that they are ineffective. An unstudied method of reducing texting while driving is sticker reminders. Sticker reminders have already been proven to be an effective intervention in the realm of driver safety; one study found that a "Buckle-Up" dashboard sticker doubled the use of safety belts by front seat passengers. In this study, 104 medical students aged 21 - 29, from the University of Central Florida (UCF) College of Medicine were randomly divided into two groups, an interventional group receiving a "Drive in the Moment" windshield sticker, and a control group not receiving the sticker. Both groups took a pre- and post-survey that recorded self-reported texting and driving frequency. The results showed that the sticker intervention significantly reduced reported rates of sending texts while driving, reading texts while driving, and using social media while driving (p < 0.05). The results of this study suggest that a novel sticker-intervention could potentially serve as a point of attack when addressing the growing and dangerous texting while driving the epidemic.

Machine-learning approach to predict on-road driving ability in healthy older people

AIM

In Japan, fatal traffic accidents due to older drivers are on the rise. Considering that approximately half the older drivers who have caused fatal accidents are cognitively normal healthy people, it has been required to detect older drivers who are cognitively normal but at high risk of having fatal traffic accidents. However, a standardized method for assessing the driving ability of older drivers has not yet been established. We thus aimed to identify a new sensing method for the evaluation of the on-road driving ability of healthy older people on the basis of vehicle behaviors.

METHODS

We enrolled 33 healthy older individuals aged over 65 years and utilized a machine-learning approach to dissociate unsafe drivers from safe drivers based on cognitive assessments and a functional visual acuity test.

RESULTS

The linear support vector machine classifier successfully dissociated unsafe drivers from safe drivers with accuracy of 84.8% (sensitivity of 66.7% and specificity of 95.2%). Five clinical parameters, namely age, the first trial of the Rey Auditory Verbal Learning Test immediate recall, the delayed recall of the Rey-Osterrieth Complex Figure Test, the result of the free-drawn Clock Drawing Test, and maximal visual acuity, were consistently selected as essential features for the best classification model.

CONCLUSION

Our findings improve our understanding of clinical risk factors leading to unsafe driving and may provide insight into a new intervention that prevents fatal traffic accidents caused by healthy older people.

An Integrative Review on Teen Distracted Driving for Model Program Development

Distracted driving, especially driver inattention, is associated with high levels of crash-related fatalities and injury. Teen novice drivers are one of the groups most likely to drive distracted and to suffer its consequences. Teens have a higher risk of engaging in texting or secondary tasks, e.g., eating while driving. Distracted driving interventions to date aim to improve teen and societal safety, but few have achieved effectiveness. A need exists for effective evidence-based distracted driving interventions. We used an integrative review to identify rigorous evidence, and inform the development of a teen distracted driving educational intervention. This five-step review included: identifying the research problem; collecting literature; evaluating literature; synthesizing data; and presenting results. We searched 6 databases, identifying 185 articles. Following three rounds of inclusion screening (title, abstract, and full-text), captured according to a PRISMA flow chart, 17 studies met inclusion. We categorized these studies, conducted in the U.S., as five intervention types that used approaches including presentations, videos or instructional programs, education or training programs, driving simulator training, in-vehicle monitoring or feedback, and integrated programs. Study designs included randomized controlled trials pre-post, quasi-experimental, and experimental designs with prospective longitudinal cohorts. The studies were heterogeneous in design, intervention and outcome. However, three core themes emerged across studies: i.e., hazard awareness, hazard mitigation and attention maintenance are primary critically necessary skills to prevent distracted driving; engaging a parent or adult as a partner in the intervention process from classroom to car contributed to the effectiveness of the intervention; and leveraging technology in training enhanced the effectiveness of the intervention. Study limitations pertained to a focus on short-term effects; sampling distributions that did not account for gender, age, race, and/or ethnicity; types of interventions; and bias. The limitations affect the generalizability of included study findings and, potentially, the review findings, as they may not apply to populations or contexts outside those synopsized. Strengths included our team's expertise in conducting evidence-based reviews, support of a health science librarian, and use of international review guidelines. As an outcome, we are applying findings of the integrated review to develop a computer-based training addressing teen distracted driving.

High School Student Driving Perceptions Following Participation in a Distracted Driving Curriculum

Objectives. Distracted driving is a major public health issue in the United States. In response to requests from high school students participating in a university-based initiative, the authors describe the collaborative development and implementation of a curriculum designed to address distracted driving behaviors among students in four high-needs school districts in the northeastern United States. Method. The curriculum integrates current statistics on distracted and drowsy driving and three interactive learning stations: driving while distracted, walking while distracted, and driving while drowsy. Pre- and postsurveys were conducted to collect student driving data, assess student satisfaction with the program, and assess their likelihood of speaking up as a passenger in a high-risk situation. Results. The majority of students reported that they learned new information and would recommend the program to others. A Wilcoxon signed-rank test showed that students were more likely to speak up as a passenger with a distracted or drowsy driver (p < .001) after the program. Conclusion. This experience demonstrates a voluntary, multidisciplinary, university-based collaboration in the development of a novel public health education initiative. Based on the success of this phase, school districts elected to participate in Train the Trainer sessions to continue the program within their local high-needs school district.