1. Running Head: POD PAPER 1
POD Paper: Texting While Driving
Brittany Hamaker, Tram Le, Le’Ann Livingston
Roxanne Medina, Yecenia Miranda, Mariah Overstreet
Patty Hanks Shelton School of Nursing
Tammie Coffman, RN, MSN, OCN-C
December 2, 2014

2. POD PAPER 2
Introduction
Texting and driving is a epidemic that is spread out vastly among the United States.
Many teenagers and young adults are falling prey to the tempting habit of texting and driving
because of lack of developmental cognition and peer pressure. The community as a whole is
suffering from this habit because of the vicious consequences that come from an accident caused
by distracted driving. The POD group ECHO has come up with a plan to help reduce this
epidemic and hopefully cease and desist this terrible phenomenon.
Community Defined
The World Health Organization (WHO) defines community as “a group of people, often
living in a defined geographical area, who may share a common culture, values and norms, and
are arranged in a social structure according to relationships which the community has developed
over a period of time” (Stanhope and Lancaster, 2014, pg. 397). A community includes three
factors: the people, which include the members or residents of the community; the place, which
encompasses the geographic location and time dimensions; and the function, which is the aims
and activities of the community (Stanhope and Lancaster, 2014, pg. 397-398). The communities
that will be focused on in this paper are youths between sixteen and twenty-five years of age in
Taylor County, Texas who participate in texting while driving. Reducing the amount of young
adults who are texting while driving is of increasing importance among this community due to
the growing number of car crashes resulting in injury and fatality.
People up to twenty-four years of age are still considered to be adolescents. “The US
Department of Health and Human Resources now divides adolescence into three stages: early
adolescence (ages eleven–thirteen), middle adolescence (ages fourteen–eighteen), and late

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adolescence (ages nineteen- twenty-four).” (Blimling, 2013, pg. 11) The majority of this
community attends either a high school or college in the Taylor County area. According to
Erikson’s Theory of Psychosocial Development, this community will either be in the Identity
versus Role Confusion stage or the Intimacy versus Isolation stage (Wilkinson and Treas, 2011,
pg. 162). In both of these stages the views and opinions of others plays a role in shaping a
person’s identity. Staying in touch with family and especially friends is of utmost importance to
those in this population. Many people in this community find their sense of belonging through
friends and social connections, so getting a text message reassures them that they are important.
The excitement of getting a text message and wanting to know who it is from and what they have
to say is so important to some people that they will check that text message no matter where they
are or what they are doing, even while driving.
Blimling (2013) asked himself, “Why do so many traditionally aged college students
engage in inappropriate behaviors, even when they are smart enough to know better?” Blimling
(2013) tells us that the prefrontal cortex of the brain does not actually fully develop until around
age twenty-five and the prefrontal cortex is the part of the brain that “controls executive
functions such as learning to consider in advance the consequences of actions, risk taking,
perseverance, time management, decision making, planning, sensation seeking, and
understanding other people’s perspectives.” Adolescents believe they are invincible and nothing
will happen to them if they text while they drive. The inability of the adolescent brain to make
decisions while fully understanding the consequences of those decisions could contribute to the
number of adolescents that choose to text while they drive.
The Centers for Disease Control and Prevention’s (CDC) web page, Distracted Driving,
defines distracted driving as “driving while doing another activity that takes your attention away

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from driving.” Each year, many people, especially teenagers and young adults, are injured and/or
killed in car accidents that were caused by distracted driving, which includes texting while
driving. The Distracted Driving web page reports that “in 2011, nearly one in five crashes
(17%) in which someone was injured involved distracted driving” and that “each day in the
United States, more than 9 people are killed and more than 1,153 people are injured in crashes
that are reported to involve a distracted driver.” The CDC also did a survey on distracted driving
where 31% of the people surveyed said that they read or sent a text message or email while
driving.
Although this paper focuses only on one geographic location, there is evidence to support
that texting while driving truly is a national problem. Distraction.gov’s web page, What is
Distracted Driving? Key Facts and Statistics, gives some interesting facts about distracted
driving across the United States. Some of these facts include:
 10% of all drivers under the age of twenty involved in fatal crashes were reported as
distracted at the time of the crash. This age group has the largest proportion of drivers
who were distracted.
 Drivers in their twenties make up 27% of the distracted drivers in fatal crashes.
 At any given daylight moment across America, approximately 660,000 drivers are using
cell phones or manipulating electronic devices while driving, a number that has held
steady since 2010.
 Engaging in visual-manual subtasks (such as reaching for a phone, dialing and texting)
associated with the use of hand-held phones and other portable devices increased the risk
of getting into a crash by three times

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 Five seconds is the average time your eyes are off the road while texting. When traveling
at 55 mph, that's enough time to cover the length of a football field blindfolded.
 A quarter of teens respond to a text message once or more every time they drive. 20% of
teens and 10% of parents admit that they have extended, multi-message text
conversations while driving.
Community as Client
Stanhope and Lancaster (2014) reveal that “the community is the client only when the
nursing focus is on the collective or common good of the population instead of on individual
health” (pg. 398-399). Texting while driving is a community issue for this very reason; if one
person on the road is texting, everyone on the road is at risk. Texting while driving not only
poses a risk of injury to those partaking in the texting, but also to everyone else on the road. It is
important to bring awareness to the issue of texting while driving because it is a very dangerous
activity that could cause very serious injuries to those who choose to text and those around them.
A texting driver is not only putting themselves at risk, but they are putting everyone around them
at risk. Drivers ages 16-25 make up the largest population of distracted drivers, and thus need
interventions to make them realize how dangerous texting while driving is. By raising awareness
of this issue, the number of people who are injured or killed each year in car accidents caused by
texting and driving could be greatly reduced. If people began to realize the dangerous outcomes
that can result from texting while driving, they might choose to become more attentive drivers,
which would make the roads safer for everyone and decrease the number of accidents and
injuries caused by any kind of distracted driving.

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Community Health
The goal of community-oriented practice within the given population can be developed
through identification of three important terms of community health. According to Stanhope &
Lancaster (2014), “community health is made up of three common characteristics, or
dimensions: status, structure, and process” and “each dimension reflects a unique aspect of
community health” (p 400). Collectively these dimensions are vital in the process of identifying
and managing needs and behaviors within the community.
Status
“Community health in terms of status, or outcome, involves biological or physical parts,
as well as emotional and social parts” (Stanhope & Lancaster, 2014, p. 400). The biological part
of community health is often measured by “morbidity and mortality rates, life expectancy
indexes, and risk factor profiles” (Stanhope and Lancaster, 2014, p. 400). The Center for
Disease Control reported the following risk factors attributing to young adult texting and driving:
Younger, inexperienced drivers under the age of 20 may be at increased risk;
they have the highest proportion of distraction-related fatal crashes. Texting while
driving is linked with drinking and driving or riding with someone who has been drinking
among high school students in the United States, according to a CDC study that analyzed
self-report data from the 2011 national Youth Risk Behavior Survey. Students who
reported engaging in risky driving behaviors said that they did so at least once in the 30
days prior to the survey. 5 key findings from the study revealed that nearly half of all
U.S. high school students’ aged 16 years or older text or email while driving. (Center for
Disease Control, What are the Risks? 2014)

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The Texas Department of Transportation (TXDOT, 2014) has issued that “distracted
driving-related crashes in Texas are highest among young adults ages 16 to 24, followed by
adults over the age of 44. Last year in Texas, 505 people were killed and 19,981 people were
seriously injured in distracted driving crashes”. KRBC’s news reporter Ariana Lubelli (2014)
reported, “So far this year there have been just under 100 vehicle related fatalities in the Abilene
TXDoT region alone. That is up more than 20 fatalities when compared to this time last year.”
Lubelli’s report addressed the emotional aspect by interviewing a driving instructor and student
of Abilene Texas AOK driving school. The instructor stated that teaching their students the
dangers of distracted driving is one of their top priorities on the lesson plan. One student, a
victim of a distracted driving incident shared; “It really scared me, and I do not want to be
distracted when I’m driving”.
Structure
“Structure is defined in terms of services and resources. Measures of community health services
and resources include service use patterns, treatment data from various health agencies, and
provider-to-client ratios” (Stanhope & Lancaster, 2014). According to the Texas Department of
Public Safety, there are three types of accessible driver’s education for teens: a traditional driver
education course offered by a driver training school, e.g. Abilene’s AOK driving school, parent-
taught driver education (PTDE) and driver education offered in public schools. Given these
resources, problems related to safe driving such as texting while driving arise due to a variety of
factors that are defining characteristics of the community structure itself. Measures of
community structure include demographics, age and educational level (Stanhope & Lancaster, p.
400). Age is the biggest factor in the texting while driving community, as evidenced by
Erickson’s developmental stage of “Identity vs. Role Confusion”. Moreover, the fact that first

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time drivers have the option of three completely different learning avenues leads to educational
holes across the target population.
Process
“The view of community health as the process of effective community functioning or
problem solving is well established” (Stanhope & Lancaster, 2014). According to Stanhope &
Lancaster, (2014), “process is especially appropriate to nursing because it directs the study of
community health for community action” (p. 400). Practicing community competence is
essential to establishing and implementing goals. Conditions of community competence include:
commitment to community health, awareness of self and others, clarity of situational definitions,
effective communication, conflict containment, accommodation, management of relations with
larger society and participation. (Stanhope & Lancaster, 2014)
Influencing parts of the community such as TXDOT, AOK driving school, teachers,
coaches and nurses should work together for the ultimate goal of risk reduction. The “High Risk
Adolescent Trauma Prevention Program” at the Shock Trauma Center of the University of
Maryland Medical Center displays a perfect exhibition of how nurses can make a great impact on
the texting while driving community. The nurses formed a committee and partnerships with the
departments of juvenile justice which could be substituted by local schools, the county, and parts
of community mentioned previously. The program was educational and consisted of a tour
portion of the trauma center, a showing of a video of a patient in the critical care unit,
demonstration of equipment, and description of critical care sights and sounds. (Dearning &
Yohn, 2009) With this type of prevention program, “adeptness at recognizing, obtaining, and
using external resources and support is achieved” (Stanhope & Lancaster, 2014).

9. POD PAPER 9
Partnerships
According to Stanhope and Lancaster (2014), community partnerships is defined as a
“relationship between individuals, groups, or organizations in which the parties are working
together to achieve a joint goal. Partnerships involve informed, flexible, and negotiated
distribution of power among all participants in the process of change for community health.” (pg.
########) Our community-based undergraduate nursing pod ECHO sought out to establish
partnerships in Taylor County to enhance the awareness and dangers of texting while driving.
KTXS news, KTAB news, police department, AOK driving school, AT&T and local high school
teachers and coaches partner together during pep rallies and sporting events to target and educate
the young adult drivers about distractions while driving, especially texting. Presenting during
sports events will not only target the young population at most risk in the community but parents
of these children, other family members and other people in the stands.
An example of a presentation could be a car being displayed in front of the entrance of
the sporting event to represent a “scared-straight” tactic, along with a billboard with the victims
who lost their lives in the accident. After the crowd has had a moment to take it all in, a video
of a young girl and her mother will be played. This video, a YouTube clip that POD echo
found, is a story about a mother and her teen that was in a terrible accident because she was
looking at a text message while driving. Towards the end of this video, the video revealed that
the text she was reading that caused the accident was from her mother. The video will show the
young adults that they are not as invincible as they believe. The priority among the population
is for them to know that it can wait and one message is not worth your life or the lives of others.
The goal of educating young adults will be to reduce the amount of texting and driving and

10. POD PAPER 10
therefore reducing the amount of wrecks and deaths due to distracted driving within the next
year.
An OK driving school will display the video and news clips to future drivers. AT&T has
implemented an app on all phones that will allow drivers to receive no calls or messages while
operating a motor vehicle. The police department will issue tickets to those caught texting while
driving. Teachers and coaches will continue to use the scared straight tactic year after year,
except with new images of young adults who have texted while driving.
Data
Statistics have shown that drivers eighteen years and younger are at a greater risk for
more car accidents. “A 2006 research study published by the National Highway Traffic Safety
Administration and the Virginia Tech Transportation Institute… found that driver distraction
accounted for 78% of crashes and 65% of near-crashes.”(Adeola & Gibbons, 2013). Although
most drivers agree that driving while texting is dangerous, there are still a large amount of
drivers who report that they still text and drive. Fifty-two percent who report that they use their
phones while driving are under the age of eighteen. The table is a list of percentages of drivers
eighteen years and under reporting the following:
The percentage of teenagers that reported that they never text and
drive is alarming because these drivers are already inexperienced.
Adding a distraction with the already inexperienced driver will not
only be dangerous to the driver but to any other drivers on the road.
Distractions such as electronic devices increase the risk for motor
vehicle crashes. Texting and driving involves using the driver’s
Initiating texts 70%
Replying to texts 81%
Reading texts 92%
Never text & drive 2%

11. POD PAPER 11
cognitive, visual, and manual sensory simultaneously. According to the Journal of Trauma
Nursing, when drivers are looking at their phones for approximately 4-6 seconds, it is the
equivalent of blindly driving the length of a football field at 55 mph (Adeola & Gibbons, 2013).
Pew Research Center (2011), a secondary resource from Applied Cognitive Psychology, states
that when they surveyed Americans in 2007, 58% reported that they send and receive text
messages while driving; the numbers grew to almost 75% when the same research was surveyed
in 2011.
Experiment
To prove that texting is a distraction when performing other tasks, Thirty Marymount
University gathered twenty-five volunteers to perform in this experiment. Their experiment was
walking through an adjusted doorway or a cluttered classroom to prove that texting will impact
the participant’s ability to determine their limitations. These participants were randomly
assigned to be a texter and a non-texter. Without any knowledge of what the experimenter is
doing, the width of the doorway is re-adjusted. The texters are to text a sentence that is 15-21
characters while walking through the door. The following chart is the findings after conducting
the experiment:
The study shows that there was
a difference between the texters
and non-texters and a difference
between the texters before and
during the experiment. The
finding also showed that the

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walking speed of the texters is significantly lower than the walking speed of the non-texters. “It
appears that the distraction produced by texting in our experiment is a combination of both a
cognitive and visual perceptual distraction, and it is these distracters together that texters are
compensating for by being more cautious” (Lopresti-Goodman, Rivera, & Dressel).
Education
To educate young driver about the risks of texting and driving, the people can use games
as tools to facilitate learning. George Mason University conducted a demonstration using a
video game experiment. Using the Gran Turisomo 4 game, the participants were to drive around
the course while sending and receiving text messages from their cellphone. The graduate
students stated, “To successfully complete the test course, drivers were required to follow a lead
police car through the many twists and turns of the track without significant lane deviations”
(Saqer, De Visser, & Strohl, 2014). When the game ends, the drivers are given a pass or fail
grade. The Distraction N’ Driving team from GMU have been to many high schools to present
their program. They have also been receiving a lot of recognition from the Human Factors and
Ergonomics Society and local radio stations. Another way to educate students who are visual
learners is to show them a video about the consequence of texting and driving. This video
described above in the Partnerships section educates the watcher that texting and driving could
happen to anyone, and if you know someone that is driving, do not text them and wait.
Community Nursing Diagnosis
After analyzing the data, the nursing diagnosis pertaining to this situation is risk for
injury among adolescents and young adults 16-25 years of age related to texting and driving in
Taylor County, Texas. The goal we want to achieve is within one year, the percentage of wrecks

13. POD PAPER 13
and fatalities from texting while driving will decrease by 25%. By year 2017, the percentage of
wrecks and fatalities from texting will decrease by 45%.
Planning
The purpose of the study was to increase awareness to this age group of the damaging
consequences of texting and driving resulting in motor vehicle accidents, or MVA. The
community was chosen and defined within the nursing diagnosis; risk for injury among
adolescents and young adults 16-25 years of age related to texting while driving in Taylor
County, Texas. Data was collected from primary and secondary resources. After the nursing
diagnosis was issued, then the goal was established; within one year the percentage of wrecks
and fatalities from texting while driving will decrease by 25%. By year 2017, the percentage of
wrecks and fatalities from texting will decrease by 45%.
To test the statistics, we did a windshield survey around town for 15 minutes, mid-
morning. We looked for a driver who could be a distracted driver, either texting or doing
something other than driving. The driver had to be actively looking at their screen or looking
into their lap in order to meet the criteria. The results were astounding. In the entirety, 10
people during the 15 minutes were driving and looking at their phone. The majority of the
drivers were young adults.
Once the data and evidence was gathered, multiple interventions were planned.
Collaborations were made with phone companies, AT&T, Sprint, Verizon, etc., about increased
awareness of free driving apps available for the parents or individual to use. The purpose of the
app is if the vehicle speed reaches a certain limit, then the phone will automatically go into
silence and/or send a message to the sender that the driver is on the road. We also worked with

14. POD PAPER 14
schools, to show videos the effects of texting and driving, like the video with the adolescent girl
who was in an accident from texting and driving, during pep rally and major school events.
Driving schools, such as A-OK, and church youth groups can increase exposure and further drive
the point into the adolescents and young adults by showing the video as well. The faculty or
church staff can provide pledges to not text and drive because some adolescents have better
sense of commitment when they have a written
contract. A mangled vehicle can be shown on campus
to have a visual of what the accident most likely
would appear as and have a thought of what the
passenger would look like in the vehicle.
Implementation
Implementation involves the work and
activities aimed to achieve the goals and
objectives. Today many parents are asking their
children to sign a pledge stating they will not text and
drive, but Taylor County needs more than just a
pledge to sway the adolescents and young adults from
texting and driving. They need to gain awareness of
what can happen in a matter of seconds or minutes and
how fast their lives can change in a blink of an
eye. The images above are of when the driver of the Volkswagen was texting while driving
when she pulled out of a side street, not seeing a motorcycle. The motorcyclist and both of the
car’s occupants were killed instantly.

15. POD PAPER 15
Some high schools use prom/graduation season to display a mangled car outside to demonstrate
what can happen while drinking and driving, but statistically, texting while driving has caused
more accidents in the last five years than driving under the influence of alcohol. MVAs are the
leading cause of accidental death among adolescents.
In order to bring this to light, as a form of implementation, carnage of a car wreck will be
placed outside the entrance of every local high school and college homecoming game. At half
time a screen will drop down and display a video of an adolescent girl who thought she was
invincible and nothing could ever happen to her. The video states:
“She was left blind in one eye and severely disabled after crashing her car while texting
at the wheel. Now, Liz Marks has revealed the loneliness she feels in the wake of the
incident in April 2012. The 20-year-old was driving her Mazda 3 along a road in St
Michaels, Maryland, when she received a text from her mother, Betty. Without thinking,
she looked down at her phone to read the message. Seconds later, she crashed into a tow
truck driven by 25-year-old Roy Dixon that was stopped on St Michaels Road waiting to
turn left on to Wales Lane. The truck had its left signal turned on. Miss Marks, then
aged 17, was airlifted to the University of Baltimore Shock Trauma Center with serious
brain and facial injuries, where she remained in intensive care for nearly a month. In
subsequent weeks, she was forced to undergo a number of surgeries, including an 11-
hour procedure on her brain, according to The Star Democrat in Maryland. Two-and-a-
half years on, she remains blind in one eye, has lost her sense of smell, cannot hear
properly, is unable to create tears due to damaged tear ducts and cannot fall asleep
naturally. But despite her shocking injuries, Miss Marks revealed one of the most
devastating consequences of the crash was the loss of her friends, many of whom couldn't
deal with her situation. 'The hardest part about my life after the car accident was the fact

16. POD PAPER 16
that I was alone,' Miss Marks said in a video pleading with drivers not to text and drive.
'Everyone was away at college, I wasn't. My friends were there for me at first, but after a
while they weren't. I just remember sitting at home, thinking to myself, "I have no-one".'
Before the crash, the former student at St. Michaels High School was a 'popular' teenager
who went to high school parties, sports games, bowling with friends and even did some
modeling. But after the incident, she felt so lonely that she was driven to begging for
friends on Facebook. Wiping away tears, her mother, Betty, said: 'I looked up on her
Facebook page and she said, "Can anybody please hang out with me today? I don't have
any friends".' She added: 'My main worry for Liz as a parent before she started driving
was the typical teenage things: the drugs, the alcohol, being safe and hanging around the
right sort of kids. 'I didn't think Liz was connected to her mobile phone. I would ask her
all the time, "Liz, do you text and drive?", and she said, "No Mom, I swear I don't".' She
said she was horrified to discover the 'overwhelming devastation' her daughter faced 'over
a stupid text' following the crash, which happened at around 10.50 A.M. on Saturday,
April 7, 2012. Miss Marks, who was later transferred to a rehab center, where she
celebrated her 18th birthday and received round-the-clock care, admitted she used her
phone constantly while at high school. 'I used my cell phone every second, every
minute, every hour. If I didn't have it, I would freak out because I couldn't connect with
my friends,' she said. 'If I didn't have my cell phone I felt lonely.' She added: 'I ignored
those warnings about texting and driving because everyone else was doing it, I thought it
was okay, I thought I was invincible. But clearly, I was completely wrong.' Following
the crash, police discovered a phone on the floorboards of Miss Marks's car. The victim
later admitted she had looked at her phone after receiving a message from her mother.
Miss Marks and her mother created the video with the U.S. Department of
Transportation’s National Highway Traffic Safety Administration. It was later posted to
the department's YouTube page. In the footage, Mrs. Marks warned others of the

17. POD PAPER 17
dangers of texting drivers, saying: 'Don't text your loved ones when you know they're
driving. It can change their lives forever.' Her daughter added: 'If you get a text, don't
look at it,' Marks said. 'It's not worth it.' The pair has also set up a Facebook page,
named 'Don't Text N Drive 4 Liz Marks', which has been 'liked' nearly 700 times in the
past 12 hours.” (MailOnline, https://www.youtube.com/watch?v=Y_P4dtx-JVs).
Within 6 months of local high schools and colleges seeing the message of “It Can Wait,”
a survey of five questions will be sent out asking about texting and driving. Within one year, we
predict the percentage of wrecks and fatalities from texting while driving will decrease by 25%.
By year 2017, we predict the percentage of wrecks and fatalities from texting will decrease by
45%.
Evaluation
Raising awareness among the community will take commitment and many efforts. The
psychology department at George Mason University states;
“Increasing consumer awareness of public safety concerns can take many years of
concerted efforts before behavioral changes are observed. Often times, the behavioral
changes are most evident in generations that were exposed to the awareness campaigns as
small children. For example, twenty years ago, many organizations worked to educate
drivers on the dangers of driving while intoxicated or without proper seat restraint.
Today, these dangers are ingrained in our society and evident in laws and cultural norms.
It may take many years for programs demonstrating the dangers of distracted driving to
have the same impact, but it is critical to continue these efforts on our young and future
drivers. The Distractions N’ Driving program illustrates a powerful, practical, and cost-
ineffective option that many graduate programs and companies can implement in their

18. POD PAPER 18
local communities to increase awareness on the dangers of texting while driving”(Saqer,
de Visser, & Strohl).
After reviewing the surveys and six months after witnessing or participating in the “It Can Wait”
message, the video game experiment, or the doorway challenge, the experimenters would go
back to the high schools/colleges, and the students would be administered a survey about the use
of their phones while driving. The goal is to have the percentage of wrecks and fatalities to be
decreased. Within one year the percentage of wrecks and fatalities from texting while driving
will decrease by 25%. By year 2017, the percentage of wrecks and fatalities from texting will
decrease by 45%. Administering pledges to commit to not text and drive, conducting safe
driving habits, and teaching the drivers to speak up when other are texting and driving will lower
the percentage of fatalities. The pledges that are provided to the students at the end of
demonstrations are a great way to evaluate if the students listened and learned from these
demonstrations. Taking this pledge to not text and drive and be accountable for others to do the
same will provide these students a tangible contract for themselves and for their families, school,
and peers.
Conclusion
Teenagers and young adults don’t fully understand the dangers and consequences that
come from texting and driving. Implementing scare tactics, informational videos, and surveys in
the schools and community can bring down the rate of drivers who text while driving. With more
information and more access to this knowledge, texting and driving will no longer be of growing
concern, but as a thing of the past. The community as a whole can feel safe on the streets and
mothers will no longer feel the pain and loss from losing a child. Texting and driving will reduce
greatly and will no longer be a problem if these plans are executed.

19. POD PAPER 19
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