Is distraction on the road associated with maladaptive mobile phone use? A systematic review

Maladaptive Mobile Phone Use (MMPU) (also known as Smartphone Addiction, Nomophobia, Fear of Missing Out, or Problematic Mobile Phone Use) is a growing mental health problem. However, the health and safety consequences of MMPU remain unexplored in many real-life contexts. A potential setting where MMPU may have some negative repercussions is on the road. It is well established that road users (e.g., drivers, motorcyclists, pedestrians, and cyclists) increasingly injure themselves or others due to distractions such as phone use while on the road. Emerging research suggests that MMPU is a possible determinant of this risky behaviour. Therefore, it is essential to investigate the relationship between MMPU and mobile phone use behaviour on the road, as it could help guide and improve interventions aimed at increasing road safety. This systematic review investigated the relationship between maladaptive mobile phone use and mobile phone use behaviour on the road in terms of attitudes and risk perception, intention, phone use engagement, performance changes, and safety outcomes. A total of 44 studies were identified with 47 unique samples of road users, of which 68.1% (32/47) were comprised of drivers, 19.1% (9/47) were pedestrians, 8.5% (4/47) were unspecified road users, and there was one group of motorcyclists and cyclists. Our findings confirmed that MMPU is related to risky behaviour on the roads. In the 29 studies considering observed or self-reported behaviour, 90.9% (30/33) found that road users who scored higher in MMPU are more likely to use their phones on the road as cyclists, drivers, motorcyclists, and pedestrians. Of the nine studies that analysed performance changes, 55.6% (5/9) showed evidence that MMPU changes the performance of road users engaging in mobile phone use, meaning that there is evidence suggesting that MMPU determines the level of impairment. Of the nine studies that analysed the safety-related-outcomes, 66.7% (6/9) found that the higher the MMPU score, the more likely road users are to experience safety-critical traffic events. This review contributes to the literature by showing a pathway between the negative health consequences of MMPU and road trauma. We also identified that the quality of the studies was generally low due to study design and blinding aspects. This field of research also lacks standard practices as researchers avoid using established and well-validated questionnaires, often creating new ones to measure MMPU. This hinders the generalisability of the findings and raises questions about the construct validity and external validity of MMPU. The usefulness of future research would be enhanced by a consistent methodological approach using the same scales based on standard behavioural definitions. The cross-disciplinary nature of MMPU effects means that transport and road safety professionals need to work with healthcare professionals and technology organisations to understand and address MMPU as a contributing factor to road crashes.