Running head: Physician’s Ability to Address Driving Safety with Their Patients 1 8 Physician’s Ability to Address Driving Safety with Their Patients The University of Toledo Juliane Johnson 11/30/2011 Scope of the Problem Injury and death due to motor vehicle accidents are serious, but often neglected issues globally. According to the U.S. Census, there are about 312,689,471 people in the United States and about 196,165,666 of them have driver’s licenses(Bureau, 2011). With so many drivers on the road education and awareness of driving safety are key factors in decreasing the risk of accidents and deaths among those driving. The amount of accidents due to distracted driving, driving under the influence and other driving errors is overwhelming and there many things that can be done to decrease the amount of accidents, injuries, and fatalities. There have been advances in the prevention of motor vehicle crash rates and over the past few decades the volume of motor vehicle accident fatalities has decreased for every age group. In 1985, there were about 17.8 deaths per 100,000 people between the ages of 35-69 and in 2009 that number dropped to about 12.5(Safety, 2008). Over time, new education programs, safer vehicles, safer roads and many other factors have contributed to these decreases in deaths, but the problem has not vanished completely. Motor vehicle accidents still account for more deaths between the ages 5-34 than any other cause. As of 2008, unintentional motor vehicle traffic deaths were the leading cause of death for all people between the ages 5-34 and accounted for 37,985 deaths in all people("Injury Prevention & Control: Data & Statistics," 2010). One of the most crucial aspects of intervention programs is beginning to reach the individuals who are at the highest risk of accidents along with finding new venues to reach all populations(McEvoy, Stevenson, & Woodward, 2007). Specifically, distractions while driving are a leading cause of motor vehicle accidents that can be addressed with a change of behavior. According to the Fatality Analysis Reporting System (FARS), there were a total of 51,857 fatalities caused by crashes involving distractions in 2008 (Wilson & Stimpson, 2010). Drivers are more frequently using distracting devices like cell phones, GPS units and complex stereos while in cars than ever before. These devices may even be built directly into new models as a standard package, which can sometimes give the misconception that the devices can be used safely while driving and this is not a healthy message to send drivers.(Jacobson & Gostin, 2010). The most recent statistics even suggest that up to 21% of all traffic accidents are due to distractions while driving. Finding out how to stop this critical trend is very important to decreasing the amount of fatalities reported. One clear answer is passing legislation that can prohibit or reduce these distracted behaviors. “Since 2007, 34 states have ena.

1. Running head: Physician’s Ability to Address Driving Safety
with Their Patients 1
8
Physician’s Ability to Address Driving Safety with Their
Patients
The University of Toledo
Juliane Johnson
11/30/2011
Scope of the Problem
Injury and death due to motor vehicle accidents are
serious, but often neglected issues globally. According to the
U.S. Census, there are about 312,689,471 people in the United
States and about 196,165,666 of them have driver’s
licenses(Bureau, 2011). With so many drivers on the road
education and awareness of driving safety are key factors in
decreasing the risk of accidents and deaths among those driving.
The amount of accidents due to distracted driving, driving under
the influence and other driving errors is overwhelming and there
many things that can be done to decrease the amount of
accidents, injuries, and fatalities. There have been advances in
the prevention of motor vehicle crash rates and over the past
few decades the volume of motor vehicle accident fatalities has
decreased for every age group. In 1985, there were about 17.8
deaths per 100,000 people between the ages of 35-69 and in
2009 that number dropped to about 12.5(Safety, 2008). Over
time, new education programs, safer vehicles, safer roads and

2. many other factors have contributed to these decreases in
deaths, but the problem has not vanished completely. Motor
vehicle accidents still account for more deaths between the ages
5-34 than any other cause. As of 2008, unintentional motor
vehicle traffic deaths were the leading cause of death for all
people between the ages 5-34 and accounted for 37,985 deaths
in all people("Injury Prevention & Control: Data & Statistics,"
2010). One of the most crucial aspects of intervention programs
is beginning to reach the individuals who are at the highest risk
of accidents along with finding new venues to reach all
populations(McEvoy, Stevenson, & Woodward, 2007).
Specifically, distractions while driving are a leading cause
of motor vehicle accidents that can be addressed with a change
of behavior. According to the Fatality Analysis Reporting
System (FARS), there were a total of 51,857 fatalities caused by
crashes involving distractions in 2008 (Wilson & Stimpson,
2010). Drivers are more frequently using distracting devices
like cell phones, GPS units and complex stereos while in cars
than ever before. These devices may even be built directly into
new models as a standard package, which can sometimes give
the misconception that the devices can be used safely while
driving and this is not a healthy message to send
drivers.(Jacobson & Gostin, 2010). The most recent statistics
even suggest that up to 21% of all traffic accidents are due to
distractions while driving. Finding out how to stop this critical
trend is very important to decreasing the amount of fatalities
reported. One clear answer is passing legislation that can
prohibit or reduce these distracted behaviors. “Since 2007, 34
states have enacted distracted driving legislation, with
additional states considering adoption”(Jacobson & Gostin,
2010, p. 1419). Outside of legislation, because citizens are
often not educated on current laws and these laws also tend to
be hard to enforce, other venues need to be recognized.
Changing individual’s behaviors in order to prevent these
crashes is a good way to decrease the amount of fatalities. In
order to change these behaviors, new interventions need to be

3. explored, for example, including cautions and education in a
new and innovative place like a doctor’s office.
Physicians historically are people who can be trusted and
their advice is often found more important than any other source
for people. Some rely solely on the direction of their
physicians when it comes to dealing with sickness, injury,
recovery, and health in general(Omer, Salmon, Orenstein,
DeHart, & Halsey, 2009). This indicates the inclusion of motor
vehicle accident injury and death in this category because it so
heavily affects the health of the U.S. population. Along with
supplemental education provided by physicians, educational
media can be beneficial to those who are spending valuable time
in physician’s waiting rooms. If physicians are able to take on
a new responsibility with patients that place them in the role of
educator and prevention advocate there may be more
opportunities to decrease these fatalities.
Research Questions
Do physicians educate, converse, or direct patients on motor
vehicle safety or educational tools for safe driving?
What stage of change are most physicians in regarding
incorporating education about driving safety into everyday
practice with all patients?
What are the barriers physicians identify preventing safe
driving counseling?
Program Objectives
The goal of this intervention is to target physicians and
their clientele in a distracted driving campaign that will raise
awareness of the issue. Driving distractions is one of the most
critical areas of motor vehicle accidents because of the amount
of distractions available. Cell phone use, stereos, GPS systems,
televisions, excessive amounts of passengers, and alcohol or
drug use are all highly risky behaviors when driving.
Goal: Increase physician’s conversations with patients
regarding driving safety.
Objective: 20% of physicians who receive the intervention will
include driver safety in their daily patient conversation by the

4. end of 2012.
Objective: 50% of physicians who receive the intervention will
display the distracted driving media in their office in some way
by the end of March 2012.
Goal: Decrease distracted driving for clientele that receive
educational techniques from their physician.
Objective: 50% of individuals who receive educational
supplements by physician will be accident free for at least one
year post.
Objective: All individuals who receive educational supplements
will have a follow-up session within six months.
Goal: Decrease motor vehicle accidents due to distracted
driving in all clientele who receive educational supplements.
Objective: Clientele who receive educational supplements from
physicians will experience 25% less motor vehicle crashes due
to distracting activity.
Explanation of the Intervention
The primary goal of the intervention is to realize the stage
of change the physician is in with alliance to the
Transtheoretical model. In addition, the intervention is based
on aspects of the Health Belief model in areas of benefits and
barriers. If the intervention is successful, the physicians should
recognize the benefits of speaking with their patients along with
overcoming barriers regarding safe driving counseling.
Additionally, as the physicians receive different aspects of the
intervention, they may move through stages of change and be
more likely to change their behaviors. The intervention is a
social marketing campaign based on distracted driving
behaviors that will be shown in physician’s offices in various
places along with a web based seminar or webinar that the
physicians will participate in for continuing education credits
(CEU’s). The marketing pieces will show statistics’ about
DUI’s, cell phone use, and distractions involving car stereos to
show the severity of the problem along with the consequences to
the viewers. These marketing tools will also be used to show
the benefits of counseling in this area to the physicians. Using

5. depictions of cell phone use and using the radio while driving
will show how susceptible most individuals are to these
behaviors.
The primary focus of the intervention is physicians and
their ability or choice to counsel their patients about driving
safety along with trying to increase the conversations that
physicians are having with their patients. If physicians realize
the benefits and overcome barriers of these interactions they
may increase their efficacy in changing their patient’s
behaviors. The webinar aspect of the intervention acts as a
process of change because it may be the first time a physician
has seen any information on this health behavior change. If a
physician uses the webinar and understands some of the benefits
it is possible to say they may have moved from pre-
contemplation to contemplation or even preparation in the
Transtheoretical model (Glanz, Rimer, & Viswanath, 2008). As
a secondary audience, the intervention will target the patients in
their physician’s office to increase awareness, education, and
safe behavior. Self-efficacy is another aspect of the
intervention but will only be measured in the survey for the
physicians. The hope is that the intervention will reach as many
individuals as possible by making them public and available.
The images will be available at all times when the office is open
and will be targeting specific behaviors opposed to specific
populations. Distracted driving affects all populations with an
emphasis on those who use electronic devices and all
populations need to be addressed (McEvoy, et al., 2007).
A unique twist this intervention has is the population that
will be targeted. In the past researchers have tried to focus on a
specific population with interventions in order to create a better
result. This intervention is not focused on a specific population
other than the physician’s clientele, which can vary. An
important aspect of this intervention is the patient-health
provider relationship and how an open-communication
relationship can help to decrease health risks outside of disease
and sickness. The population may vary, but being able to focus

6. in on the ability of the physician to instill new ideas and
behaviors in their patients is something that may begin to have a
serious effect on the driving behaviors. In the past, physicians
have played a vital role in individual’s ability to quit smoking,
lose weight, and even vaccinate themselves and their
children(Omer, et al., 2009).
Additionally, the intervention will include a system for
participating physicians to recognize high-risk patients to focus
on or include in educational time for driving safety. As a cue to
action, the highest risk patients like teens, young adults, and
possibly older adults will have some sort of notification in
his/her chart to mark the level of risk they present and prompt
the physician to act. The notification will signify a higher risk
and, in turn, remind the physician to have a conversation about
driving safety. These cues to action will serve as a strong
reminder that these patients are more likely to experience a
crash and hence, need to be educated. This section of the
intervention is based on the Health belief model also.
Media-based campaigns have been used numerous times in
the past in other areas to change behaviors of particular
populations. Using media campaigns like billboards, posters,
commercials, and slogans has worked to change behaviors like
drunk driving and binge drinking in the past. In 2005, a social
marketing campaign was introduced to college students in order
to decrease drinking and driving that included advertisements
that were printed on postcards and other various media forms
that would be distributed. Along with increased law
enforcement, the campaign got relatively positive effects.
College students had a significant decrease in self-reported DUI
in the campuses that the intervention was applied at (Clapp et
al., 2005) Furthermore, additional studies are have been
completed that suggests that these types of interventions wield
positive benefits and are able to change behavior (Glassman,
Dodd, Miller, & Braun, 2010).
These media pieces could be utilized in physician’s offices
first, but transferring them into other settings is also possible.

7. For example, because the target population is vague and the
intervention can be transformed to fit high-risk populations, this
campaign could be used as screen savers on university campus
computers, hospital emergency rooms, and even dorms on
campus. Having the ability to manipulate the intervention
makes it more feasible to research in multiple venues.
Evaluation
The evaluation tool will be a survey questionnaire given to
physician’s who see patients on a regular basis. The
physician’s will be selected from a convenience sample of
Toledo area physicians who have offices in Lucas, Fulton,
Sandusky, Wood, or Ottawa County. The survey questions will
be measuring the physician’s ability, likelihood and thoughts or
feelings about speaking with their patients about safe driving,
distracted driving, and good driving habits. In addition, the
survey will be looking to measure the stage of change each
physician is in regarding implementing a supplementary
educational program. The data will be collected both before
and after the media campaign is implemented in a pre/post-test
format. Each physician chosen will receive the pre-test survey
electronically on February 1, 2012 and a second round two
weeks later. Additionally, as control, physician’s offices who
are not receiving the interventions will also receive the
pre/post-test. The pre-test survey will be prior to the media
campaign in their facility. The post-test survey will be sent out
electronically on November 1, 2012 along with a second round
two weeks following.
The goal of the survey is to see what changes are made to
the interactions with physicians and their patients with the
introduction of the social marketing campaign and the
educational supplements. The data will be looked at pre
implementation along with post to determine if the physicians
have changed their habits regarding motor vehicle safety
discussions with patients.
Limitations

8. Some of the major limitations of this evaluation include
the inability to control for self-reported data. All data is via
survey and will be self-reported. Second, the intervention will
likely not be as effective with individuals who are blind,
illiterate, or unable to read English because they will not
experience the entire effect of the social marketing campaign.
Another limitation may be a bias by the physician because of
personal experiences like not having any children who are of
driving age or not ever experiencing the effects of serious motor
vehicle accidents.
Conclusion
Overall, the intervention and evaluation tool have the
possibility of increasing awareness of the global issue of motor
vehicle accident resulting in injury or death. Driving with
distractions is an important health behavior that needs to be
addressed with several interventions in order to make a real
difference. This intervention proposes a new venue to get a
valid and important point to driving population.
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