<b>Feedback and financial incentives for reducing cellphone use while driving: a randomized trial</b>

Importance: Handheld phone use while driving is a major factor in vehicle crashes. Scalable interventions are needed to encourage drivers to put down their phones.Objective: Test whether interventions involving social comparison feedback and/or incentives can reduce drivers’ handheld phone use.Design: Randomized controlled trial.Setting: Interventions were administered nationwide in the U.S. via a mobile application in the context of a usage-based insurance program.Participants: Progressive Insurance customers were eligible if enrolled in the Snapshot Mobile program for 30-70 days. 17,663 customers were invited by email to participate, and 2,109 opted in and were randomized.Interventions: Participants were randomly assigned to one of six trial arms for a 7-week intervention period: 1) control; 2) feedback, weekly push notification about how their handheld phone use compared to that of similar others; 3) standard incentive, max $50 award at the end of the intervention based on how their handheld use compared to similar others’; 4) standard incentive + feedback, combining interventions of arms 2 and 3; 5) reframed incentive + feedback, max $7.15 award each week, framed asparticipant’s to lose; 6) doubled reframed incentive + feedback, max $14.29 weekly loss-framed award.Intervention dates: May 13-June 30, 2019.Main Outcome and Measure: 100 Proportion of drive time engaged in handheld phone use in seconds/hour (s/h) of driving.Results: Analysis completed December 22, 2023. 2,020 drivers finished the intervention period (68% female; median (IQR) age 30 (25, 39). Median (IQR) baseline handheld phone use was 216 (72, 480) s/h. Relative to control, feedback and standard incentive participants did not reduce their handheld phone use. Standard incentive + feedback participants reduced their use by −38 (95% CI: −69 to −8) s/h, P = .045; reframed incentive + feedback participants reduced their use by −56 (95% CI: −87 to −26) s/h, P &lt; .001; and doubled reframed incentive + feedback participants reduced their use by −42 s/h (95% CI: −72 to −13), P = .007. The five active treatment arms did not differ significantly from each other.Conclusions and Relevance: In this randomized trial, providing social comparison feedback plus incentives reduced handheld phone use while driving.Requests for a deidentified dataset and data dictionary can be made to the corresponding author at [e-mail]. The data will be made available with investigator support to researchers whose proposed use of the data has been approved by the authors.