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

Abstract

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.

Keywords

distracted driving high-needs teen safety school-based curriculum driver safety Train the Trainer high school–university collaboration

Introduction

The Problem of Distracted Driving

Safety is important to health. This article describes a research-to-practice project that promotes linkages between researchers and health education practitioners and addresses health promotion among ethnic and racial minority populations.

Distracted driving is a compelling problem in the United States. In 2015, driver distraction caused 10% of all fatal crashes, 15% of all injury crashes, and 14% of all motor vehicle crashes reported by the police (U.S. Department of Transportation, National Highway Traffic Safety Administration, 2017). The impact and influence of “secondary-task engagement” on driver distraction and its association with motor vehicle crashes also vary with the driver’s age-group (Guo et al., 2016). It has been reported that 25% of teens respond to a text message every time they drive, and nearly 20% of teens and 10% of parents admit that they have extended text conversations while driving (Klauer et al., 2014). A 2017 State Farm Mutual Automobile Insurance Company survey indicated that drivers perceived smartphone usage to be distracting. In fact, the increasing popularity of smartphone devices and other technological innovations that influence distraction among drivers enables motor vehicle crashes to remain one of the leading causes of death among individuals between 1 and 44 years of age (Layba, Griffin, Jupiter, Mathers, & Mileski, 2017). Distracted driving can also be caused by drivers talking with their passenger(s) (93%), having a pet ride in the vehicle (21%), and/or attending to children in the back seat (23%; StateFarm, 2017).

Teen drivers in Boston examined the ability of young drivers who were proficient at texting to drive and text safely. Using simulators, teens drove under three conditions: (1) without a cell phone, (2) texting with the phone hidden so they had to look down to see the texts, and (3) texting with the phone in a position of their choice. The simulators recorded unintentional lane shifts, speeding, crashes/near-crashes, and other driving infractions. The study found that teens’ driving abilities were impaired consistently when texting, regardless of where the phone was placed. The young drivers drifted out of lanes more often while texting and also had more near-crashes with other cars and pedestrians without being aware of these mistakes while texting (American Academy of Pediatrics, 2012). Another study concluded that teens and young drivers are inclined to be influenced by cognitive distractions more than those who are middle-aged, whereas visual and manual distractions do not discriminate among age-groups (Guo et al., 2016).

Educational programming in high schools may offer an opportunity for changing behaviors and attitudes surrounding the issue of driver distraction. High school students in high-needs districts have limited access to educational programs that teach them safe driving behaviors. In the 1970s, about 95% of students in public schools nationwide were offered driver education courses that included classroom and adult-supervised behind-the-wheel instruction (American Driver and Traffic Safety Association, 2008). Over the years, budgetary constraints forced many of these public schools to eliminate the option of offering a driver education course, particularly in high-needs districts. In New York State, schools are categorized as high-needs using the need/resource capacity index, a measure of a district’s ability to meet the needs of its students with local resources (New York State Education Department, 2012).

Theoretical Foundations

Effective public health interventions usually aim to elicit behavioral change. An understanding of both the major determinants of health and the target population can strengthen the basis for development of program initiatives (Bator & Cialdini, 2000; Glanz & Bishop, 2010; U.S. Department of Health and Human Services, 2005). Recent literature on public health programs emphasizes that interventions based on theoretical foundations and those that incorporate multiple behavioral change techniques result in greater efficacy (Glanz & Bishop, 2010; Steadman, Chao, Strong, Maxwell, & West, 2014; Webb, Joseph, Yardley, & Michie, 2010). Yet many existing programs, including distracted driving programs, use limited theory-based strategies and provide only general information about the health behavior, risks, resources for support, and perceived barriers (Doshi, Patrick, Sallis, & Calfas, 2003; Glanz & Bishop, 2010; Steadman et al., 2014).

In developing the curriculum, the authors used constructs from the health belief model (HBM; Glanz & Bishop, 2010; StateFarm, 2017; U.S. Department of Health and Human Services, 2005), the transtheoretical model (TTM; Atchley, Hadlock, & Lane, 2012; Bator & Cialdini, 2000; Glanz & Bishop, 2010; StateFarm, 2017; U.S. Department of Health and Human Services, 2005; Webb et al., 2010), the theory of planned behavior (TPB; Atchley et al., 2012; Bator & Cialdini, 2000; Glanz & Bishop, 2010; StateFarm, 2017; U.S. Department of Health and Human Services, 2005; Webb et al., 2010), and the social cognitive theory (SCT; Glanz & Bishop, 2010; StateFarm, 2017; U.S. Department of Health and Human Services, 2005), with careful consideration for the adolescent population, and their social and behavioral norms. Specifically, we sought to (1) increase knowledge about the danger and incidence of distracted driving–related crashes to increase perception of risk and susceptibility (perceived severity, perceived susceptibility—HBM), (2) discuss social norms and barriers in avoiding driving while distracted (perceived barriers—HBM, perceived behavioral control—TPB, SCT), (3) teach effective skills to maintain safe driving practices (skill-building—TTM, SCT), and (4) increase confidence in (a) avoiding distracted driving behaviors (perceived behavioral control—TPB, behavioral capability—SCT) and (b) speaking up when in situations that they perceive as dangerous (self-efficacy—HBM, SCT; U.S. Department of Health and Human Services, 2005).

Curriculum Development Initiative

Students in the federally funded Health Careers Opportunity Program identified distracted driving as their greatest concern. The Center for Community Engagement and Leadership Development at Stony Brook University formed a group of faculty representing programs in Respiratory Care, Polysomnography, Occupational Therapy, and Women in Science and Education to address this need. The School of Health Technology and Management Center for Community Engagement and Leadership Development was established in 2013 to address needs in education, health care, and social change by building relationships across Stony Brook University and the community.

While the county poverty rate is 5.7%, the rates for these school districts range from 8% to 12% and the proportion of students eligible for free/reduced lunch ranges from 22% to 69% (GreatSchools, 2016). High-needs school districts are disproportionately represented by Black and Latino students. The proportion of minority students in the participating four high-needs districts range from 18% to 72% Hispanic and 14% to 68% Black (GreatSchools, 2016). Curriculum development involved the collaboration of a motivated, collegial interdisciplinary, voluntary team interested in engaging in school–community partnerships.

The Curriculum

The target audience is students in Grades 9 to 12 in high-needs school districts in a large suburban county on the outskirts of a northeastern metropolis. The curriculum is designed to be delivered over 2 days during a normal classroom period (i.e., health class).

Day 1 involves an overview of the current statistics on distracted driving, and a video where three young women are in a serious motor vehicle crash, demonstrating the consequences of driving while distracted. Students discuss the video and its impact on their beliefs toward distracted driving.

At the start of Day 2, students reflect on Day 1 material before being separated into three interactive groups: a distracted walking exercise, a driving simulator, and a drowsy driving station. Each interactive activity highlights hands-on learning in smaller groups. Students rotate through each activity and spend approximately 10 minutes at each station, described below.

Distracted Walking Exercise

This activity was adapted from the methods used by Lamberg and Muratori (2012) to test whether, and to what extent, cognitive function is affected by cell phone use while walking. A distracted walking activity provides students the opportunity to experience the difficulty of navigating a scenario (an obstacle course) while talking on the cell phone/texting, simulating distracted driving situations without exposing students to the actual dangers of distracted driving. Students walk through an obstacle course three times: first, without a cell phone; second, with a cell phone to the ear and mentally subtracting from a given number by two (to simulate concentration involved in talking on the phone); and third, while texting a nursery rhyme into a cell phone. For each stage in the exercise, time of exercise completion and number of obstacle errors are recorded.

The walking course consists of 8 to 10 obstacles of small orange cones from approximately 4 to 14 inches in height with a yardstick placed on top. Students must step carefully over each obstacle to keep the yardstick from falling off of the cone. The overall obstacle course is approximately 30 feet long with six to eight obstacles placed at random intervals in that distance. At the end of the exercises, students reflect on their performance under the three conditions. Instructors then connect the consequences of students’ distracted walking experiences with the more severe consequences of distracted driving.

Distracted Driving Simulation Exercise

A grant from State Farm Mutual Automobile Insurance Company provided the One Simple Decision interactive U.S. Department of Transportation–approved driving simulator by Virtual Driver Interactive. This system enhances users’ ability to recognize, anticipate, and respond to driving hazards with voice-integrated technology that mimics a distracted driving experience without putting drivers at risk.

The goal of the driving simulation exercise is for students to become more acutely aware of the perils of driving while distracted. Students practice to acclimate to the simulator. Multiple distracting scenarios are presented, such as those caused by a talkative passenger, talking on a cell phone, and/or texting. Educators ask each student what effect the distraction has on their driving ability. Finally, students reflect on the various degrees of distraction while driving, the barriers they face, and how they could avoid distractions at the wheel to maintain safe driving practices.

Drowsy Driving Station

The initiative provides a unique opportunity to educate a high-risk group about the dangers associated with drowsy driving. This station includes an individual sleepiness questionnaire (Johns, 1991), a short video portraying the effects of drowsy driving, a group discussion, and an interactive game. The addition of the drowsy driving component to the distracted driving curriculum serves as a way to enhance and differentiate this program from other existing initiatives targeting distracted driving.

At the drowsy driving station, students complete an individual sleepiness assessment using a standardized tool, the Epworth Sleepiness Scale (Johns, 1991). Student scores are compared to standard values, and the educator discusses the significance of their scores, emphasizing the consequences of sleepiness. Students are randomly asked how many hours of sleep they get on an average school night, providing an opportunity to discuss the effect of sleep deprivation on physical and cognitive function, the ability to drive safely, and overall health and well-being.

The drowsy driving video illustrates the effects of sleep deprivation on driving skills and individual judgment. Postexercise discussion focuses on the dangers of driving while drowsy, and how to recognize and respond to the signs of drowsy driving as a driver or passenger. Last, students learn healthy sleep habits as a strategy to maintain safe driving practices.

An interactive Jeopardy®-type question-and-answer game included content on both drowsy driving and distracted driving. Each question/answer provides opportunities for students to explore their understanding of healthy sleep habits, and reinforces the curriculum content.

Method

An existing university school–community partnership invited high-needs school districts to participate. Schools selected the classes where the curriculum would be implemented, so students were not randomly selected for participation. Schools sent permission letters with a choice to opt out to parents. Information about the study, including the voluntary nature of participation, was conveyed to students during pre– and post–data collection. Researchers explained that consent to use the data was assumed if the questionnaire was completed. The research questions focused on student satisfaction and likeliness of speaking up in a potentially dangerous driving situation before and after the program. This protocol was approved by the Stony Brook University Institutional Review Board.

Data Collection

Students completed a survey designed specifically for this project between 1 and 3 days before the program, with 33 items regarding demographics (grade, gender, highest level of driver’s license), hours per week they currently drive on weekdays and weekends, engagement in eight listed distracted driving behaviors, five items regarding knowledge of distracted driving laws, 21 sleep habit items, and seven items inquiring about the likelihood of them falling asleep under eight conditions. Items were open-ended, multiple-choice, and Likert-type response options. They were asked what the likelihood was that they would speak up as a passenger in a car being driven by either a peer or an adult driver who was distracted (i.e., using a handheld or hands-free phone, texting, adjusting music, drinking [nonalcoholic], grooming themselves, driving while drowsy, or driving over the posted speed limit). The survey had high face validity in that the purpose of the survey was clear, items were reviewed by content experts prior to implementation, and the items are described clearly above. No statistical tests to measure reliability and validity were performed.

This same survey was repeated between 1 and 3 days after the program and also asked about their satisfaction with the Distracted Driving program and the likelihood that they would recommend the program to others.

To maintain anonymity, students sealed their completed presurveys in an envelope with their name on the outside of the envelope and gave the envelopes to the teacher with the understanding that they would receive the sealed envelope back unopened.

At the postsurvey collection day, students received their unopened envelopes containing their anonymous presurvey, a blank postsurvey, and an envelope large enough to hold both the anonymous pre- and postsurveys. Upon completion of the postsurvey, the student placed both pre- and postsurveys into the large envelope and returned the envelope to the researcher. This procedure produced paired questionnaires from the same participant.

Data Analysis

A total of 248 presurveys and 225 postsurveys were collected and entered into an SPSS (Version 23.0) data file. Surveys with more than 50% of missing data were removed, and data were cleaned and reviewed for accuracy. Data were analyzed using univariate and bivariate statistics. Descriptive statistics were used to describe the student participants and their driving and sleep behaviors. A Wilcoxon signed-rank test was conducted to compare the likelihood of students speaking up as a passenger in a vehicle being driven by a driver engaging in distracted behaviors before and after participation in the Prevention of Distracted Driving program.

Results

In all, students completed 248 presurveys and 225 postsurveys in four school districts (School A, 44; School B, 80; School C, 89; School D, 35). Student ages ranged from 14 to 20 years (mean = 16.7; median = 17; mode =17) and 51% were female. Students represented Grade 9 (9, 4%), Grade 10 (63, 26%), Grade 11 (76, 31%), and Grade 12 (99, 40%). Approximately half (49%) reported having a learner’s permit, 9% a junior driver’s license, 12% a driver’s license, and 30% not having a license to drive a vehicle.

The vast majority of students (92%) reported that the Prevention of Distracted Driving program increased their understanding of distracted driving, and 83% agreed that they were exposed to new information through the program. Eighty percent agreed that the program increased their interest in the topic. Nearly three quarters (74%) of students said that they would recommend the program to others, and 26% indicated that they might recommend the program to others.

Approximately half of students (n = 129) reported currently driving, with most driving each week between 1 and 3 hours (25%). Of those, 20 (8%) reported driving 10 or more hours per week. Half of driving students (n = 39) reported driving at night, with most (62%) driving between 1 and 3 hours per week at night. Thirty-eight percent of driving students reported talking on a cell phone using a hands-free device, and just over one quarter (28%) reported having texted while driving and driving while drowsy (25%). The most frequent distracted driving behaviors acknowledged were adjusting music (86%) and drinking a beverage (nonalcoholic) while driving (50%; see Figure 1).

Figure 1

Percentage of Students Engaging in Distracted Driving Behaviors (n = 145)

Students were significantly more likely to speak up as a passenger in a vehicle being driven by a driver engaging in distracting behaviors after participation in the Prevention of Distracted Driving program. A Wilcoxon signed-rank test indicated that the postsurvey likelihood of speaking up in each listed driving condition was statistically significantly higher (p < .001) than presurvey likelihood of speaking up for both peer and adult conditions (see Tables 1 and 2).

Table 1

Postprogram Change in Likelihood of Speaking Up When a Passenger Is With a Distracted Peer Driver (n = 173)

Distracted Driving Behavior by Peer	Peer Driver
Distracted Driving Behavior by Peer	Presurvey	Postsurvey	Significance
Handheld phone	2.86	3.27*	Z = −5.019, p < .001
Hands-free phone	2.01	2.51*	Z = −5.650, p < .001
Texting	3.22	3.56*	Z = −5.002, p < .001
Music	2.03	2.35*	Z = −5.137, p < .001
Drinking	2.11	2.51*	Z = −5.586, p < .001
Grooming	2.62	3.06*	Z = −4.550, p < .001
Drowsy	3.18	3.55*	Z = −4.421, p < .001
Overspeed	2.71	3.06*	Z = −4.946, p < .001

NOTE: 1 = very unlikely; 2 = unlikely; 3 = likely; 4 = very unlikely.

Statistically significant higher likelihood of speaking up between pre- and postsurvey at the p < .001 level.

Table 2

Postprogram Change in Likelihood of Speaking Up When a Passenger Is With a Distracted Adult Driver (n = 173)

Distracted Driving Behavior by Adult	Adult Driver
Distracted Driving Behavior by Adult	Presurvey	Postsurvey	Significance
Handheld phone	2.55	3.04*	Z = −5.259, p < .001
Hands-free phone	1.83	2.36*	Z = −5.818, p < .001
Texting	3.09	3.49*	Z = −5.198, p < .001
Music	1.75	2.24*	Z = −5.775, p < .001
Drinking	1.90	2.40*	Z = −5.588, p < .001
Grooming	2.59	3.00*	Z = −4.514, p < .001
Drowsy	3.33	3.66*	Z = −4.199, p < .001
Overspeed	2.55	2.95*	Z = −4.896, p < .001

NOTE: 1 = very unlikely; 2 = unlikely; 3 = likely; 4 = very unlikely.

Statistically significant higher likelihood of speaking up between pre- and postsurvey at the p < .001 level.

The findings in this study are subject to several limitations. Only public school students participated in the program, and therefore students in other educational settings (private, homeschooled, inpatient settings) are not represented. Since school administrators chose the specific classes where the curriculum was to be offered, participant randomization was not feasible. The analyses regarding likelihood of speaking up are based on a data collected from a single question that was not tested for reliability and validity. The findings cannot be generalized due to the lack of controls in the pretest–posttest design.

Discussion

The aim of this project was to increase knowledge about distracted driving behaviors, to address barriers to safe driving, and to teach skills to protect students from high-risk driving situations. These objectives were achieved, evidenced by the findings that (1) the vast majority of participants reported that the program exposed them to new information and increased their understanding about distracted driving and (2) the students reported a significantly higher likelihood of speaking up as a passenger in a car with a driver who is distracted, regardless of whether the driver was a peer or an adult.

Specific programmatic elements of the Prevention of Distracted Driving program were directed at increasing perception of risk and susceptibility, addressing barriers to action, and building confidence and self-efficacy in the skills necessary to avoid distraction behind the wheel and to speak up when in situations perceived as dangerous. These are key prosocial outcomes for adolescent development and support positive behavior change.

The fact that students learned new information about distracted driving speaks to the lack of preparation students receive before embarking on the roadways. The strong student interest in the topic underscores the need to educate students and make this major public health issue a priority. Nearly all students said that they would consider recommending the program to others.

Our findings reinforce the need for similar initiatives because student distracted driving behaviors are not limited to texting while driving. Twenty percent of students continue to use handheld phones while driving, and 86% report adjusting music, which involves taking their eyes off of the road and one hand off of the steering wheel.

Despite the finding that nearly half of driving students drive 3 hours or less per week, half of them drive at night, with 19% driving 4 or more hours at night. One quarter of driving students reported driving drowsy, further providing evidence to add a Drowsy Driving component to any initiative that provides driver education to high school students. We found that the combined distracted driving behaviors of driver inexperience, driving over the speed limit, drinking beverages, drowsy driving, and using hands-free phones creates exponentially elevated risk on roadways.

In order to stay safe, students have to learn about and understand the dangers of distracted driving behaviors both as a driver and as a passenger. Previous studies have demonstrated the deadly consequences of having additional teen passengers in the vehicle (Ouimet et al., 2013; Rhodes, Pivik, & Sutton, 2015; Tefft, Williams, & Grabowski, 2013; Williams & Tefft, 2014). After completing the Prevention of Distracted Driving program, students were motivated to address their future driving behaviors by signing a pledge to avoid driving while distracted. In addition, students reported a significantly higher likelihood of speaking up as a passenger in a car with a driver who is distracted.

The strengths of the Prevention of Distracted Driving program include a drowsy driving component, reliance on interactive versus didactic lessons, and a theoretical foundation incorporating multiple behavioral change techniques. As described in the curriculum section, although learning was supplemented by didactic lessons, there was a strong emphasis on active student participation and a strong focus on skill building and self-efficacy.

We observed that students lacked the skills necessary to be assertive with either with their peers or a family member in potentially dangerous driving situations. A Speak-Up station was added to further address barriers students may face in avoiding distraction and to teach students assertiveness skills through role-playing activities, like how to confront peers or adult authority figures as a passenger when they recognize dangerous driving situations. The station introduces students to the wide-ranging consequences following an auto accident, including psychological trauma, hospitalization, rehabilitation, financial burdens, and legal liability. The National Highway Traffic Safety Board warns that hands-free phones are just as dangerous as handheld phones. Reflecting on the alarming finding that over one third (38%) of students report driving while using a hands-free phone, the latest safety findings were added to the curriculum.

A Train the Trainer manual was developed to transform the curriculum into stand-alone modules for use by school districts in existing or new courses.

Footnotes

Authors’ Note:

We wish to acknowledge the participating school districts, administrators, teachers, and students for supporting this high school–university collaboration and offering the opportunity to implement our curriculum within their classrooms. We thank the Suffolk County Police Department for their collaboration and assistance in program implementation. In addition, we wish to thank Dr. Carlos Vidal, Acting Dean of Stony Brook University’s School of Health Technology and Management, for his leadership and support of the project; Jennifer Mesiano-Higham for her help in securing and managing grant funding for this project; Dr. Jie Yang of the Stony Brook University Biostatistical Consulting Core for consultation with the biostatistical analysis; and Anna Lubitz, MPH, MBA, for assistance in editing and coordinating the publication of this article. This work was supported by StateFarm (10813127, 2014 Health Careers Academic Readiness and Exploration: Healthy Lifestyles: Teenage Distracted Driving; 16609331, 2015 Prevention of Distracted Driving High School Students; 24064771, 2016 Prevention of Distracted Driving: Train the Trainer; 30854131, 2017 Expansion of Prevention of Distracted Driving Program).

References

American Academy of Pediatrics. (2012, April). Teen-led study highlights dangers of texting and driving. Retrieved from https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Teen-led-study-highlights-dangers-of-texting-and-driving.aspx

American Driver and Traffic Safety Association. (2008). National overview of driver education. Washington, DC: U.S. Department of Transportation, National Highway Traffic Safety Administration. Retrieved from http://www.adtsea.org/ADTSEA%20PDF’s/NationalOverviewofDriverEdSect1.pdf

Atchley

Hadlock

Lane

(2012). Stuck in the 70s: The role of social norms in distracted driving. Accident Analysis & Prevention, 48, 279-284.

Bator

R. J.

Cialdini

R. B.

(2000). The application of persuasion theory to the development of effective proenvironmental public service announcements. Journal of Social Issues, 56, 527-541.

Doshi

Patrick

Sallis

J. F.

Calfas

(2003). Evaluation of physical activity web sites for use of behavior change theories. Annals of Behavioral Medicine, 25, 105-111.

Glanz

Bishop

D. B.

(2010). The role of behavioral science theory in development and implementation of public health interventions. Annual Review of Public Health, 31, 399-418.

GreatSchools. (2016). Public and private school ratings, reviews and parent community. Retrieved from http://www.greatschools.org

Guo

Klauer

S. G.

Fang

Hankey

J. M.

Antin

J. F.

Perez

M. A.

. . . Dingus

T. A.

(2016). The effects of age on crash risk associated with driver distraction. International Journal of Epidemiology, 46, 258-265. doi:10.1093/ije/dyw234

Johns

M. W.

(1991). A new method for measuring daytime sleepiness: The Epworth sleepiness scale. Sleep, 14, 540-545.

10.

Klauer

S. G.

Guo

Simons-Morton

B. G.

Ouimet

M. C.

Lee

S. E.

Dingus

T. A.

(2014). Distracted driving and risk of road crashes among novice and experienced drivers. New England Journal of Medicine, 370, 54-59.

11.

Lamberg

E. M.

Muratori

L. M.

(2012). Cell phones change the way we walk. Gait & Posture, 35, 688-690.

12.

Layba

Griffin

L. W.

Jupiter

Mathers

Mileski

(2017). Adolescent motor vehicle crash prevention through a trauma center–based intervention program. Journal of Trauma and Acute Care Surgery, 83, 850-853. doi:10.1097/TA.0000000000001605

13.

New York State Education Department. (2012). Need/resource capacity categories. Retrieved from http://www.p12.nysed.gov/irs/accountability/2011-12/NeedResourceCapacityIndex.pdf

14.

Ouimet

M. C.

Pradhan

A. K.

Simons-Morton

B. G.

Divekar

Mehranian

Fisher

D. L.

(2013). The effect of male teenage passengers on male teenage drivers: Findings from a driving simulator study. Accident Analysis & Prevention, 58, 132-139.

15.

Rhodes

Pivik

Sutton

(2015). Risky driving among young male drivers: The effects of mood and passengers. Transportation Research Part F: Traffic Psychology and Behaviour, 28, 65-76.

16.

StateFarm. (2017, March). Smartphones while driving: We know it’s risky. So why do we do it? Retrieved from https://newsroom.statefarm.com/8th-state-farm-distracted-driving-survey/

17.

Steadman

Chao

M. S.

Strong

J. T.

Maxwell

West

J. H.

(2014). C U L8ter: YouTube distracted driving PSAs use of behavior change theory. American Journal of Health Behavior, 38, 3-12.

18.

Tefft

B. C.

Williams

A. F.

Grabowski

J. G.

(2013). Teen driver risk in relation to age and number of passengers, United States, 2007-2010. Traffic Injury Prevention, 14, 283-292.

19.

U.S. Department of Health and Human Services, National Institutes of Health. (2005). Theory at a glance: A guide for health promotion practice. Retrieved from https://www.sbccimplementationkits.org/demandrmnch/wp-content/uploads/2014/02/Theory-at-a-Glance-A-Guide-For-Health-Promotion-Practice.pdf

20.

U.S. Department of Transportation, National Highway Traffic Safety Administration. (2017). Traffic safety facts: Research note—Distracted driving 2015. Retrieved from https://crashstats.nhtsa.dot.gov/Api/Public/ViewPublication/812381

21.

Webb

Joseph

Yardley

Michie

(2010). Using the Internet to promote health behavior change: A systematic review and meta-analysis of the impact of theoretical basis, use of behavior change techniques, and mode of delivery on efficacy. Journal of Medical Internet Research, 12, e4. doi:10.2196/jmir.1376

22.

Williams

A. F.

Tefft

B. C.

(2014). Characteristics of teens-with-teens fatal crashes in the United States, 2005-2010. Journal of Safety Research, 48, 37-42.