Classen Sherrilene, Winter Sandra M, Brown Charles, Morgan-Daniel Jane, Medhizadah Shabnam, Agarwal Nithin
Department of Occupational Therapy, University of Florida, Gainesville, FL, United States.
University of Florida Transportation Institute, Gainesville, FL, United States.
Front Public Health. 2019 May 3;7:111. doi: 10.3389/fpubh.2019.00111. eCollection 2019.
Distracted driving, especially driver inattention, is associated with high levels of crash-related fatalities and injury. Teen novice drivers are one of the groups most likely to drive distracted and to suffer its consequences. Teens have a higher risk of engaging in texting or secondary tasks, e.g., eating while driving. Distracted driving interventions to date aim to improve teen and societal safety, but few have achieved effectiveness. A need exists for effective evidence-based distracted driving interventions. We used an integrative review to identify rigorous evidence, and inform the development of a teen distracted driving educational intervention. This five-step review included: identifying the research problem; collecting literature; evaluating literature; synthesizing data; and presenting results. We searched 6 databases, identifying 185 articles. Following three rounds of inclusion screening (title, abstract, and full-text), captured according to a PRISMA flow chart, 17 studies met inclusion. We categorized these studies, conducted in the U.S., as five intervention types that used approaches including presentations, videos or instructional programs, education or training programs, driving simulator training, in-vehicle monitoring or feedback, and integrated programs. Study designs included randomized controlled trials pre-post, quasi-experimental, and experimental designs with prospective longitudinal cohorts. The studies were heterogeneous in design, intervention and outcome. However, three core themes emerged across studies: i.e., hazard awareness, hazard mitigation and attention maintenance are primary critically necessary skills to prevent distracted driving; engaging a parent or adult as a partner in the intervention process from classroom to car contributed to the effectiveness of the intervention; and leveraging technology in training enhanced the effectiveness of the intervention. Study limitations pertained to a focus on short-term effects; sampling distributions that did not account for gender, age, race, and/or ethnicity; types of interventions; and bias. The limitations affect the generalizability of included study findings and, potentially, the review findings, as they may not apply to populations or contexts outside those synopsized. Strengths included our team's expertise in conducting evidence-based reviews, support of a health science librarian, and use of international review guidelines. As an outcome, we are applying findings of the integrated review to develop a computer-based training addressing teen distracted driving.
分心驾驶,尤其是驾驶员注意力不集中,与大量与撞车相关的死亡和伤害事件有关。青少年新手驾驶员是最有可能分心驾驶并承受其后果的群体之一。青少年从事发短信或次要任务(如边开车边吃东西)的风险更高。迄今为止,分心驾驶干预措施旨在提高青少年和社会的安全性,但很少有措施取得成效。需要有效的循证分心驾驶干预措施。我们进行了一项综合综述,以识别严格的证据,并为青少年分心驾驶教育干预措施的开发提供信息。这一五步综述包括:确定研究问题;收集文献;评估文献;综合数据;以及呈现结果。我们搜索了6个数据库,共识别出185篇文章。根据PRISMA流程图进行三轮纳入筛选(标题、摘要和全文)后,17项研究符合纳入标准。我们将在美国进行的这些研究分为五种干预类型,这些类型采用的方法包括演示、视频或教学项目、教育或培训项目、驾驶模拟器培训、车内监测或反馈以及综合项目。研究设计包括前后对照随机对照试验、准实验以及具有前瞻性纵向队列的实验设计。这些研究在设计、干预措施和结果方面存在异质性。然而,各项研究中出现了三个核心主题:即,危险意识、危险缓解和注意力维持是预防分心驾驶的首要关键必备技能;让家长或成年人作为从课堂到车内干预过程的合作伙伴有助于提高干预效果;以及在培训中利用技术可增强干预效果。研究局限性包括侧重于短期效果;抽样分布未考虑性别、年龄、种族和/或民族;干预措施类型;以及偏差。这些局限性影响了纳入研究结果的普遍性,也可能影响综述结果,因为它们可能不适用于所概述人群或背景之外的人群或背景。优势包括我们团队在进行循证综述方面的专业知识、健康科学图书馆员的支持以及对国际综述指南的使用。作为成果,我们正在应用综合综述的结果来开发一个针对青少年分心驾驶的计算机培训课程。