ABSTRACT
OBJECTIVE: To determine how fracture clinic patients perceive the dangers of distracted driving. METHODS: Design: Analysis of patient perception subset data from the original DRIVSAFE study; a large, multi-center cross-sectional study, surveying fracture clinic patients about distracted driving. SETTING: Four level 1 Canadian trauma center fracture clinics. PATIENT SELECTION CRITERIA: English-speaking patients with a valid Canadian driver's license and a traumatic musculoskeletal injury sustained in the past six months. OUTCOME MEASURES AND COMPARISONS: Primary outcome was patients' safety ratings of driving distractions. As per the original DRIVSAFE study, patients were categorized as distraction-prone or distraction-averse using their questionnaire responses and published crash-risk odds ratios (OR). A regression analysis was performed to identify associations with unsafe driving perceptions. RESULTS: The study included 1378 patients, 749 (54.3%) male and 614 (44.6%) female. The average age was 45.8 years old ± 17.0 (range 16-87). Sending electronic messages was perceived as unsafe by 92.9% (1242/1337) of patients, while reading them was seen as unsafe by 81.2% (1086/1337). Approximately three-quarters of patients viewed making (78.9%, 1061/1344) and accepting (74.8%, 998/1335) calls on handheld mobile phones as unsafe. However, 31.0% (421/1356) of patients believed they had no differences in their driving ability when talking on the phone while 13.1% (175/1340) reported no driving differences when texting. Younger age (OR, 0.93 [95% CI 0.90-0.96], p<0.001), driving experience (OR, 1.06 [95% CI 1.02-1.09], p<0.001), and distraction-prone drivers (OR, 3.79 [95% CI 2.91-4.94], p<0.001) were associated with unsafe driving perceptions. CONCLUSIONS: There is a clear association between being prone to distractions and unsafe driving perceptions, with distraction-prone drivers being 3.8 times more likely to perceive driving distractions as safe. This information could potentially influence the appropriate delivery and content of future educational efforts to change the perception of driving distractions and thereby reduce distracted driving. LEVEL OF EVIDENCE: Level III. See Instructions for Authors for a complete description of levels of evidence.
ABSTRACT
BackgroundGovernments are attempting to control the COVID-19 pandemic with nonpharmaceutical interventions (NPIs). However, it is still largely unknown how effective different NPIs are at reducing transmission. Data-driven studies can estimate the effectiveness of NPIs while minimizing assumptions, but existing analyses lack sufficient data and validation to robustly distinguish the effects of individual NPIs. MethodsWe collect chronological data on NPIs in 41 countries between January and May 2020, using independent double entry by researchers to ensure high data quality. We estimate NPI effectiveness with a Bayesian hierarchical model, by linking NPI implementation dates to national case and death counts. To our knowledge, this is the largest and most thoroughly validated data-driven study of NPI effectiveness to date. ResultsWe model each NPIs effect as a multiplicative (percentage) reduction in the reproduction number R. We estimate the mean reduction in R across the countries in our data for eight NPIs: mandating mask-wearing in (some) public spaces (2%; 95% CI: -14%-16%), limiting gatherings to 1000 people or less (2%; -20%-22%), to 100 people or less (21%; 1%-39%), to 10 people or less (36%; 16%-53%), closing some high-risk businesses (31%; 13%-46%), closing most nonessential businesses (40%; 22%-55%), closing schools and universities (39%; 21%-55%), and issuing stay-at-home orders (18%; 4%-31%). These results are supported by extensive empirical validation, including 15 sensitivity analyses. ConclusionsOur results suggest that, by implementing effective NPIs, many countries can reduce R below 1 without issuing a stay-at-home order. We find a surprisingly large role for school and university closures in reducing COVID-19 transmission, a contribution to the ongoing debate about the relevance of asymptomatic carriers in disease spread. Banning gatherings and closing high-risk businesses can be highly effective in reducing transmission, but closing most businesses only has limited additional benefit.
