As you’re driving down the expressway, your cell phone pings, and you glance down at an incoming text message from your best friend. Next thing you know, your car slams the guardrail. The crash leaves you with a severe concussion and a serious lesson learned about distracted driving.
Even though most of us know that using a handheld cell phone while driving is dangerous, we still keep doing it. The availability of more and more of our favorite cell phone functions — texting, checking email, playing music, looking up directions, and posting on social media — poses an ever-present temptation. This is especially true for young drivers, whose adolescent minds are cognitively wired towards instant gratification. A 2015 national survey of 1,243 high school students funded by the National Institutes of Health found that 83 percent reported engaging in electronic device use while driving at least once in the last 30 days. R
esearchers at the University of Pennsylvania and the Center for Injury Research and Prevention (CIRP) at the Children’s Hospital of Philadelphia have teamed up to study this pervasive problem from multiple vantage points. By advancing distracted driving research, they aim to lower the number of crashes resulting from cell phone use and to encourage teen drivers to focus their attention on the roadway. Their efforts align with the U.S. federal government’s “Healthy People 2020” objectives, which highlight motor vehicle crashes due to distracted driving as the top emerging issue in injury prevention that needs further research, analysis, and monitoring.
Kit Delgado, MD, MS, an emergency physician at the Perelman School of Medicine at Penn, too often has the unfortunate job of telling parents when their teen has been seriously injured or has died from a car crash.
“It’s frustrating when there is not a whole lot you can do as a physician, but it also motivates me to think of ways to prevent these injuries in the first place,” said Dr. Delgado, who also is an investigator with the Center for Health Incentives and Behavioral Economics at the Leonard Davis Institute at Penn. “Teens are inexperienced when they get behind the wheel, and they have this ubiquitous distraction of cell phones, which are the reason why teens are more likely than any other cohort to be killed in distracted driver crashes.”
Dr. Delgado became interested in new smartphone apps that interact with windshield-mounted devices to directly measure cell phone use when vehicles are in motion. These tools can be configured to restrict certain types of cell phone functions, such as texting, while driving. He saw a research opportunity to better understand how implementation of this technology could be used to reduce distracted driving crashes and engage teens and their families in ways that promote better driving behavior. Dr. Delgado has two studies underway called Way to Safety 2.0 and 3.0.
The first feasibility study, which CIRP helped to coordinate, is nearly complete. About 34 novice teen drivers enrolled, and they were assigned to a control group or one of three different cell-phone blocking strategies. An “opt-in” approach required teens to turn on the app when they got in the car, comparable to turning on airplane mode when flying. The app locked the phone screen once the car’s speed reached more than 10 miles per hour. Study participants had the option of overriding the blocking with the touch of a button.
The second approach, called “opt out,” also allowed participants to override the blocking, but the difference is that the app activated automatically. A third approach was “opt-out” blocking combined with a disincentive: The parents received an email alert telling them whenever the driver overrode the blocking function. The second study which has just launched is similar in design but with a slight twist. It involves teen-parent dyads who will enroll in the study together. Based on a previous teen survey, the researchers found that about 75 percent of teens who admitted to texting while driving reported that they have observed their parents doing the same thing.
“We wanted to get around the ‘do as I say not as I do’ phenomenon,” Dr. Delgado said. “We will see if teens’ ability to hold their parents accountable both reduces their cell phone use and the parents’ cell phone use while driving.”
The Way to Safety 3.0 study team will install the tracking and blocking app on both the parent’s cell phone and the teen’s cell phone. They will use the “opt-out” configuration so that the blocking automatically activates at 10 miles per hour. In the first study arm, the parents will receive an email alert when teens override the blocking function. In the second study arm, the teens also will receive an email alert when their parents override the cell-phone block feature.
In future research, Dr. Delgado is interested in seeing if frequently delivered behavioral incentives, or perhaps through the repurposing of discounts on insurance premiums, could facilitate adoption of these technological interventions and motivate drivers to stay engaged in using them as a way for the entire family to reduce cell phone distractions while driving.
Catherine McDonald, PhD, RN, an assistant professor of Nursing in the Family and Community Health Department at Penn’s School of Nursing and a senior fellow with CIRP, also is building a program of research aimed at understanding how and why teen drivers crash. Currently, Dr. McDonald is analyzing data from a randomized control trial in which she tested the feasibility of a web-based intervention that she developed addressing teens’ attitudes, subjective norm beliefs, and perceived behavior control related to driver inattention.
The study involved teens who completed self-report surveys and went through CIRP’s simulated driving assessment. Half of the study participants received the online distracted driving intervention, and both groups returned after three months for a second simulated driving assessment to see if their distracted driving behaviors had changed over time.
During the course of her research in the development of the intervention, Dr. McDonald has realized that it is important for researchers to consider the language that teens use about their cell phone habits. It might seem straightforward to ask, “Do you text and drive?” Yet, a teen who answers, “No,” could assume that the question refers to highway driving and may not consider his frequent texting while waiting at stoplights as dangerous. Dr. McDonald also pointed out that context plays a large role in whether or not teens engage in cell phone use while driving. For example, if an incoming message is from a close social contact, such as a boyfriend or girlfriend, they often feel a greater need to respond. Previous CIRP research has shown that parents are among the biggest offenders in terms of calling teens while they are driving.
By combining what they learn from research on both the technological and educational sides of the problem, the researchers will continue to collaborate on figuring out the best ways to reduce the risky behavior of cell phone use while driving. They hope their findings will gain momentum and lead the way to more funding that will allow them to scale up their distracted driving research on a national level and make bigger inroads to prevent deadly teen crashes.