Original Investigation
Public Health
July 10, 2024
Feedback and Financial Incentives for Reducing Cell Phone Use While Driving: A Randomized Clinical Trial
M. Kit Delgado, Jeffrey P. Ebert, Ruiying A. Xiong, et al
JAMA Netw Open. 2024;7(7):e2420218. doi:10.1001/jamanetworkopen.2024.20218
Question Can behavioral interventions decrease handheld cell phone–based driver distraction?
Findings In this randomized clinical trial with 2020 participating auto insurance customers, the median baseline level of handheld phone while driving was 216 seconds per hour. Those randomized to interventions combining social comparison feedback and financial incentives reduced their handheld phone use while driving by 15% to 21% relative to the control group.
Meaning The findings of this study suggest that auto insurers could incorporate these interventions into behavior-based insurance plans and potentially reduce distracted driving at scale and therefore crash risk in the population.
Abstract
Importance Handheld phone use while driving is a major factor in vehicle crashes. Scalable interventions are needed to encourage drivers not to use their phones.
Objective To test whether interventions involving social comparison feedback and/or financial incentives can reduce drivers’ handheld phone use.
Design, Setting, and Participants In a randomized clinical trial, interventions were administered nationwide in the US via a mobile application in the context of a usage-based insurance program (Snapshot Mobile application). Customers were eligible to be invited to participate in the study if enrolled in the usage-based insurance program for 30 to 70 days. The study was conducted from May 13 to June 30, 2019. Analysis was completed December 22, 2023.
Interventions Participants were randomly assigned to 1 of 6 trial arms for a 7-week intervention period: (1) control; (2) feedback, with weekly push notification about their handheld phone use compared with that of similar others; (3) standard incentive, with a maximum $50 award at the end of the intervention based on how their handheld phone use compared with similar others; (4) standard incentive plus feedback, combining interventions of arms 2 and 3; (5) reframed incentive plus feedback, with a maximum $7.15 award each week, framed as participant’s to lose; and (6) doubled reframed incentive plus feedback, a maximum $14.29 weekly loss-framed award.
Main Outcome and Measure Proportion of drive time engaged in handheld phone use in seconds per hour (s/h) of driving. Analyses were conducted with the intention-to-treat approach.
Results Of 17 663 customers invited by email to participate, 2109 opted in and were randomized. A total of 2020 drivers finished the intervention period (68.0% female; median age, 30 [IQR, 25-39] years). Median baseline handheld phone use was 216 (IQR, 72-480) s/h. Relative to control, feedback and standard incentive participants did not reduce their handheld phone use. Standard incentive plus feedback participants reduced their use by −38 (95% CI, −69 to −8) s/h (P = .045); reframed incentive plus feedback participants reduced their use by −56 (95% CI, −87 to −26) s/h (P < .001); and doubled reframed incentive plus feedback participants reduced their use by −42 s/h (95% CI, −72 to −13 s/h; P = .007). The 5 active treatment arms did not differ significantly from each other.
Conclusions and Relevance In this randomized clinical trial, providing social comparison feedback plus incentives reduced handheld phone use while individuals were driving.
Trial Registration ClinicalTrials.gov Identifier: NCT03833219
