Speaker
M. Kit Delgado, MD, MS
Associate Professor of Emergency Medicine and Epidemiology
Faculty Director, Penn Medicine Nudge Unit
Keywords
Distracted Driving; Auto Insurance; Smartphones
Key Points
- Distracted driving leads to over 800,000 crashes, over 400,000 injuries, and over 3,000 deaths per year. Though most people understand the dangers of texting while driving, it doesn’t always stop them from engaging with their cell phones while on the road.
- Dr. Delgado applied a heuristic model of human decision-making to explain this disparity. Using a case example from his time working in an Emergency Department, he illustrated how status quo bias, automaticity, present bias, recency bias, overconfidence bias, and social distance/norms all contributed to the failure of self-control and the resulting crash.
- The research team partnered with Progressive Auto Insurance to determine whether a usage-based insurance program, redesigned with behavioral economic insights, reduces handheld phone use while driving. They tracked active cell phone usage using telematics.
- The study had six arms: business as usual; weekly social comparison feedback (WSCF); a delayed standard financial incentive (SFI); WSCF + delayed SFI; WSCF + reframed SFI; and WSCF + doubled, reframed SFI. The delayed SFI was dispensed at the end of the intervention whereas the reframed SFI was dispensed weekly; the total amount of cash was the same.
- Drivers in the fourth arm (WSCF + delayed SFI) saw a 15% reduction in active cell phone usage; drivers in the fifth arm (WSCF + reframed SFI) saw a 21% reduction. Doubling the financial incentive did not further improve the outcome. Notably, neither WCSF nor the SFI alone led to a significant decrease in active cell phone use when compared to the control.
- For most participants, the effects of the intervention waned after the intervention period ended. However, there were a few positive outliers that maintained lower rates of active cell phone usage in the post-intervention period. The study team interviewed the outliers and identified a few key situational strategies that could help maintain long-term effects.
- The study team designed a second trial with interventions that incrementally incorporated takeaways from the interviews, including the provision of a phone mount, access to commitment + habit-building tips, and gamification. This stacking design was intended to make it easier to do the right thing and provide motivation for incremental improvements.
- They found that adding behaviorally-designed gamification, the participant’s level increasing or decreasing based on goal attainment and leaderboard competition, led to a 20% reduction in active phone use. The addition of a modest financial incentive on top of the gamification arm led to a 28% reduction. This time, the effects were sustained after the interventions ended.
Discussion Themes
The advantages of working with an industry sponsor include reach, ability to scale, and implementation opportunity. The downsides include limitations on what you can test, lengthy contracting processes, and some constraints around what data can be published. Dr. Delgado noted that, for this kind of work, the pros outweighed the cons.
The post-intervention evaluation period ranged from four to eight weeks due to limitations around enrollment and a maximum observation period.
One challenge was distinguishing between passenger trips and driver trips – a driver may let a passenger use their phone while driving, for example. They gave participants the option to retroactively reclassify trips and found that the reclassification rate was about 1%, even after incentives entered the picture.