'Just Drive': An Employee-Based Intervention to Reduce Distracted Driving.

Distracted driving is a major danger on today's roadways. Employers play a critical role in developing distracted driving policies and promoting a culture of workplace driving safety. The purpose of this study was to evaluate the effectiveness of an in-person work-based class to reduce distracted driving in participating employees. The "Just Drive-Take Action Against Distraction" class was designed by the UC San Diego Training, Research and Education for Driving Safety (TREDS) program to increase awareness of the dangers of distracted driving and to encourage employees to be safe and responsible drivers, both on and off the job. Participants completed pre- and post-anonymous surveys and, in a subset of attendees, volunteers were contacted via email 3 months post-intervention to complete a driving-behavior survey on Surveymonkey.com. 115 classes for 6896 employees were delivered at 54 agencies in Southern California. A total of 4928 participants completed the pre- and post-survey; 2014 n = 2263 and 2015 n = 2665. The course was found useful (85%) and engaging (85.6%). For non-commercial drivers, 55.6% of participants reported an increase of 80-100% in awareness of the dangers of distracted driving, and 67.2% reported an increase of 80-100% in their motivation to change. For commercial drivers, 71.3% reported a motivation increase of 80-100%. There were significant increases in knowledge for both groups. In the three-month follow-up survey, participants identified multiple positive changes in distracted driving behavior. This 1-h employer-supported intervention demonstrated positive changes in short-term intention and medium-term behaviors.

Development of a curriculum and roadside screening tool for Law enforcement identification of medical impairment in aging drivers.

BACKGROUND: An estimated one in five drivers will be over 65 by 2030. Compared with their younger counterparts, older adults are more likely to experience health and functional impairments, including cognitive dysfunction, which may interfere with their ability to drive safely. Law enforcement officers, as part of the public safety community, need help in developing the necessary skills to identify and manage these medically affected drivers. METHODS: To address this need, in partnership with the California Highway Patrol (CHP), Training, Research and Education for Driving Safety (TREDS) at the University of California, San Diego, developed a certified two-hour training curriculum. To complement the training, the TREDS team also developed a roadside screening tool to assess for disorientation related to person, place, and time. The tool was developed, validated with a sample of persons with dementia compared to cognitively normal controls, and deployed in the training. A total of 2,018 police officers received instruction at 103 training sessions. RESULTS: At baseline, prior to training, only 26 % of officers had reported drivers to the Department of Motor Vehicles in the previous 6 months. After training, 96 % stated they were likely to use their standard reporting forms, and 90 % reported they were likely to use the roadside screening tool. CONCLUSIONS: The certified training and tool were well received and resulted in changes to knowledge, attitudes, and intention to incorporate their new knowledge and tools into roadside screening.

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 (ß = 0.37), perception of safety of multitasking while driving (ß = 0.19), social norms (i.e., observing others multitasking while driving; ß = 0.29), and having a history of crashing due to multitasking while driving (ß = 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.

Evaluation of curriculum to improve health professionals' ability to manage age-related driving impairments.

As our elderly population increases in proportion with respect to the rest of society, age-related driving impairments are increasing in importance as a public health concern. In this context, health professionals play an important role in identifying impaired drivers. This situation is complicated for two reasons: discussion of driving cessation is a sensitive topic for both health professionals and the elderly, and physicians have limited familiarity with the current American Medical Association (AMA) screening guidelines or mandated reporting laws. To assess curriculum that trains health professionals to increase their awareness, screening, management, and reporting of age-related driving impairments. Between 2009 and September 2011, 47 trainings were delivered to 1202 health professionals. The majority of trainings were seminars or lectures lasting 1h; all were conducted in southern California. The training curriculum was divided into four sections: introduction and background; screening and interpretation; managing outcomes and reporting; and referrals and resources. Videos addressed broaching the topic with patients and counseling on driving cessation. The curriculum was delivered by physicians with the support of public health-trained program staff. Pre- and post-testing was done with 641 of the participants; the majority were physicians. Post-training, participants' confidence in ability to screen increased to 72% and intent to screen increased to 55%. Fully 92% stated they had developed a better understanding of California's mandated reporting laws. Similarly, 92% said they had developed a better understanding of the medical conditions and medications that may impair older adults' ability to drive safely. Furthermore, 91% said mandated-reporting laws helped protect the safety of patients and others, and 59% said it was easier to discuss and justify driving cessation with patients. In-person training of health professionals on age-related driving impairments was well received and resulted in increased self-reported knowledge, confidence to screen, and intent to screen. Physicians were supportive of mandatory reporting laws.

Road safe seniors: Screening for age-related driving disorders in inpatient and outpatient settings.

INTRODUCTION: Older drivers are increasing in number and they often have health conditions that place them at high risk for motor-vehicle crashes (MVC). Screening is underutilized, and is rarely done in hospital settings. METHODS: A convenience sample of 755 older adults completed age related driving disorders screening at University of California, San Diego inpatient and outpatient health centers. Screening included three strength/frailty tests, two vision tests (acuity and fields), and two cognitive tests, based on AMA recommendations. The average age of participants was 72.5; 55.5% were male and 94% English-speaking; 17.8% of older adults failed at least one aspect of screening. RESULTS: In multivariate analysis, significant associations of failed status were age, male sex, selfrestrictions of driving, and inpatient screening locations. The screening identified one in six adults to be 'high-risk' for age related driving disorders. Screening was effective and feasible in both inpatient and outpatient settings. IMPACT ON INDUSTRY: As the driving population ages, industry, government and health car providers need to plan for the management of driving impairments in older adults.

Age-related driving disorders: screening in hospitals and outpatients settings.

AIM: Older drivers are increasing in number and they often have health conditions that place them at high risk for motor vehicle crashes. The aims of this study were to: (i) evaluate the feasibility and acceptability of screening inpatients and outpatients over the age of 60 years for age-related driving disorders; and (ii) determine the patient characteristics associated with screening outcomes. METHODS: A convenience sample of 397 participants completed age-related driving disorders screening at University of California, San Diego, inpatient and outpatient settings. Eligibility criteria included California-licensed drivers over the age of 60 years who were English or Spanish speaking. Baseline screening included driving habits, restrictions, history of crashes, and medical history, including medications. Screening included visual acuity, visual fields, three strength frailty tests and two cognitive tests. RESULTS: The average age of participants was 72 years; 59% were male and 12% Hispanic. Almost 20% of older adults failed at least one test, and were labeled 'high risk' for age-related driving disorders. In multivariate analysis, significant predictors of high-risk status were age, male sex, self-restrictions of driving and use of larger amounts of prescription drugs. Screening took approximately 15 min and participant satisfaction was high. CONCLUSION: A brief screening evaluation identified one in five adults to be 'high risk' for age-related driving disorders. Screening was effective in both outpatient and inpatient settings, was well received and simple to administer.