Behavioral Interventions for Increasing Seat Belt Use and Decreasing Distracted Driving Using Telematics: A National Randomized Trial.

Abstract

<b>Objectives.</b> To test low-cost, scalable interventions designed to encourage seat belt use (primary outcome) and discourage handheld phone use while driving. <b>Methods.</b> A randomized controlled trial assigned 1139 consenting General Motors‒connected vehicle customers in the United States to 1 of 4 groups for a 10-week intervention: (1) control, (2) behavioral engagement, (3) behavioral engagement plus raffle, and (4) behavioral engagement plus shared pot. Behavioral engagement involved education, personalized tips, a "wish outcome obstacle plan" exercise, and weekly feedback about buckling and handheld-free streaks. Participants in the behavioral engagement plus raffle group also earned a chance at a $125 prize each week they had a buckling or handheld-free streak. Those in the behavioral engagement plus shared pot group earned an equal share of this prize for each streak. The intervention was delivered virtually in spring 2023. <b>Results.</b> Participants in the behavioral engagement plus shared pot group had a higher buckling rate (91.3%) than those in the behavioral engagement plus raffle (89.5%), behavioral engagement (89.4%), or control (88.3%) groups-differences that remained significant at follow-up. Handheld phone use did not differ significantly. <b>Conclusions.</b> A behavioral intervention with a shared pot incentive could be delivered at scale to reduce injuries and deaths associated with vehicular crashes. <b>Trial Registration.</b> ClinicalTrials.gov identifier: NCT05469477. (<i>Am J Public Health</i>. 2025;115(5):758-768. https://doi.org/10.2105/AJPH.2024.307980).