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Background: Cell phone use while driving (CPWD) increases the risk of crashing and is a major contributor to injuries and deaths. The objective of this study was to describe the evaluation of a multifaceted, evidence-based population health strategy for the reduction of distracted driving., Methods: A multipronged campaign was undertaken from 2014 to 2016 for 16- to 44-year-olds, based on epidemiology, focused on personal stories and consequences, using the "Es" of injury prevention (epidemiology, education, environment, enforcement, and evaluation). Education consisted of distracted driving videos, informational cards, a social media AdTube campaign, and a movie theater trailer, which were evaluated with a questionnaire regarding CPWD attitudes, opinions, and behaviors. Spatial analysis of data within a geographic information system was used to target advertisements. A random sample telephone survey evaluated public awareness of the campaign. Increased CPWD enforcement was undertaken by police services and evaluated by ARIMA time series modeling., Results: The AdTube campaign had a view rate of >10% (41,101 views), slightly higher for females. The top performing age group was 18- to 24-year-olds (49%). Our survey found 61% of respondents used handheld CPWD (14% all of the time) with 80% reporting our movie trailer made them think twice about future CPWD. A stakeholder survey and spatial analysis targeted our advertisements in areas of close proximity to high schools, universities, near intersections with previous motor vehicle collisions, high traffic volumes, and population density. A telephone survey revealed that 41% of the respondents were aware of our campaign, 17% from our print and movie theater ads and 3% from social media. Police enforcement campaign blitzes resulted in 160 tickets for CPWD. Following campaign implementation, there was a statistically significant mean decrease of 462 distracted driving citations annually (p = 0.001)., Conclusion: A multifaceted, evidence-based population health strategy using the Es of injury prevention with interdisciplinary collaboration is a comprehensive method to be used for the reduction of distracted driving., Level of Evidence: Therapeutic, level IV., (Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The National Center for Statistics and Analysis reports at least eight deaths and 1,160 daily injuries due to distracted driving (DD) in the United States. Drivers younger than 20 years are most likely to incur a distraction-related fatal crash. We aimed to determine short- and long-term impact of a multimodal educational program including student-developed interventions, simulated driving experiences, and presentations by law enforcement and medical personnel., Methods: A single-day program aimed at teen DD prevention was conducted at a high school targeting students aged 15 years to 19 years old. Students were surveyed before, after, and at 6 weeks. We surveyed age, gender, knowledge, and experience regarding DD. Summary statistics were obtained at each survey time point. Bivariate and multivariable analysis were conducted to assess whether change in responses varied over time points. Multivariable models were adjusted for sex and urban and rural driving., Results: Preintervention, postintervention, and 6-week follow-up surveys were completed by 359, 272 (76%), and 331 (92%) students, respectively. At baseline and 6-week follow-up, the most frequent passenger-reported DD behaviors were cell phone (63% [63% at follow-up) and radio use (61% [63%]). Similarly, the most frequent driver-reported DD behaviors were cell phone (68% [72%]) and radio use (79% [80%]). When students were asked, "How likely are you to use your cell phone while driving?" they answered "never" 35%, 70%, and 46% on the preintervention, postintervention, and 6-week surveys. They were less likely to report consequences to be worse or change in attitude to a great extent at 6 weeks (p < 0.01). Gender and urban or rural driving were not significantly associated with responses., Conclusions: While DD education may facilitate short-term knowledge and attitude changes, there appears to be no lasting effect. Research should be focused toward strategies for longer-term impact., Level of Evidence: Therapeutic study, level II.

Traumatic injuries account for millions of emergency room visits and hospital admissions annually. Motor vehicle crashes (MVCs) remain a leading cause of mortality between the ages of 1 and 44 years. With the popularity of smart devices, drivers are ever more distracted on the road. Programs that educate drivers on safe actions and to raise awareness of the perils of drunk and distracted driving exist, but there are few data that demonstrate a reduction in motor vehicle injury rates. We sought to determine if the implementation of such a program in our community would impact the rates of MVCs. Assessing the effectiveness of the Save A Life Tour, a risk reduction program, this intervention was instituted at a single area high school. The numbers of adolescent drivers aged 16 to 21 years involved in MVCs treated at the regional Level I trauma center were compared over two time intervals and between two adjoining counties. The time intervals consisted of preintervention and postintervention surveillance, each over a period of 3 years. Using our trauma registry, we compared the incidence of MVC between the two counties and between the two age groups. The data were also compared with the incidence among these populations nationally. In the preintervention period, the number of adolescent MVCs treated from the catchment area was 166, and the number in the postintervention period was 105. This represented a risk reduction of 37% (p < 0.05). During the same intervals, the incidence in the nonintervention control catchment area increased by 12%. There was no significant change in the population aged 16 to 21 years over the time intervals in either area. These results suggest that ongoing educational intervention programs aimed at adolescent drunk and distracted driving can have an impact on these life-threatening behaviors and on the incidence of MVCs., Level of Evidence: Therapy, level IV.

Background: Distracting driving is considered a dangerous epidemic in teenage drivers and adult drivers nationwide. Cell phone use, such as talking and texting is one of the most common driving distractions among adult and teenage drivers. Using the model of a previously published study from New Haven, Connecticut, we sought to investigate the driving behaviors of parents while transporting their children in Alabama., Methods: A comparison study was conducted of 150 participants from suburban (n = 86) and rural (n = 64) clinics in Alabama. Participants were recruited to complete a survey regarding their cell phone usage while driving with children. The inclusion criteria were having children younger than 18 years, a valid driver's license, and cell phone and English speaking. The survey consisted of 10 questions focusing on parental driving behaviors. Following the survey, an educational intervention was provided. A Z test proportions was used to compare the responses., Results: Ninety percent of the suburban parents reported cell phone use while driving their children as compared with 86% of the rural parents. A significant difference was found between suburban parents and rural parents for cell phone use in speaker mode (Z = 3.35; p < 0.001; 95% confidence interval, 13-45), reading and sending texts while driving (Z = 4.1; p < 0.001; 95% CI, 19-51), and surfing the Internet (Z = 4.9; p < 0.001; 95% CI, 25-57). There was no statistical significance noted for the following: use of Bluetooth device, talking on the cell phone when parked/at red light, and texting while parked/at red light., Conclusions: Cell phone use among parents while transporting children is common in the state of Alabama. Parents living in suburban areas use cell phones in the speaker mode, read and send text messages, and surf the Web more often when compared with parents in rural areas. Further research on how to best implement injury prevention interventions should be done to target high-risk areas with distracted driving behaviors., Level of Evidence: Epidemiologic study, level III.

Background: Motor vehicle crashes are the leading cause of death and nonfatal injury among young adults. The aims of this study were to assess the magnitude of distracted driving (DD) among students and to examine the effectiveness of awareness campaign against DD. We hypothesized that DD is prevalent among students and educational efforts such as DD awareness campaign can effectively reduce it., Methods: This study was conducted within the University of Arizona that has a student enrollment of 42,000 students. We conducted our prospective interventional study in four phases at the university campus. Phase 1 involved 1-week preintervention observation, Phase 2 involved 1-week intervention, Phase 3 involved 1-week postintervention observation, and Phase 4 involved 1-week 6-month postintervention observation. We used a combination of e-mails, pamphlets, interactive sessions, and banners as intervention tools in student union. Our primary outcome was the prevalence of DD before, after, and 6 months after intervention., Results: A total of 47,764 observations (before, 14,844; after, 17,939; 6 months after, 14,981) were performed. During the study period, overall rate of DD rate among the students was 8.8 (5.4) per 100 drivers (texting, 4.8 [3.7] per 100 drivers; talking, 3.9 [2.0] per 100 drivers).The baseline rate of DD among students during the phase one was 9.0 (1.2) per 100 drivers (texting, 4.8 [1.7] per 100 drivers; talking, 4.1 [1.1] per 100 drivers). Following intervention, there was a 32% significant reduction in overall DD (9.0 [1.2] vs. 6.1 [1.7], p < 0.001) in the immediate postintervention phase; however, the rate of DD returned to baseline at 6 months after intervention and trended toward increase (9.0 [1.2] vs. 11.1 [8.4], p = 0.34)., Conclusion: DD is prevalent among university students. Following a comprehensive preventive campaign against DD, there was a 32% reduction in the rate of DD in the immediate postintervention period. However, a single episode of intervention did not have a sustainable preventive effect on the DD, and the rate increased to the baseline at 6-month follow-up. Targeting DD with a successful injury prevention campaign with repeated boosters may decrease its prevalence among the students.