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Archive for category: Automobile Safety and Insurance

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When Self-Service is Not an Option – Refueling with a Disability

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

When I was a kid I loved the movie “Back to the Future” with Michael J Fox.  I remember clearly the scene where it shows his parents in the 50’s at a gas station – back then, “full serve” meant windows were cleaned, the car shined, tires pumped, and of course your gas tank refilled.  It was like the pit-stop at a NASCAR race where you would have multiple people at your vehicle getting you on your way quickly.  Fast forward to today where “full-serve” is uncommon, and finding a station where someone can fill your tank while you wait in the car might require you to venture out of your way. 

So, how does this translate for people with disabilities?  Well, firstly, there are many people that can and do drive a car regardless of a mobility impairment.  Cars can be modified to accommodate the specific needs of many people with physical challenges.  Hand controls, left-footed gas pedals, spinner knobs, automatic wipers, voice controls…to name a few.  That is all fine while the vehicle is being operated, but what about when it is time to refuel?  It is possible, but not always efficient or safe, for people with a physical impairment to get out of the vehicle, grab their mobility device, and wait outside the car in the elements to refuel.  Not to mention the safety risks of these tight spaces, other vehicles, and fall / slipping hazards of wet and uneven ground.

Considering the move away from “full-serve”, I wanted to look in detail at the services offered by gas stations to help people to refuel when mobility is a challenge.  I was surprised at what I found – some stations have well listed policies that are clear and supportive, while others have no policy or tell people to “call ahead” before coming to refuel.

Here is what I found about ways to refuel if getting out and around your car at a gas station is not the best choice for you…

I give the following companies a THUMBS UP:

ESSO

(https://www.esso.ca/en/gas-stations)

Drivers with disabilities can use the Esso Fuel Finder to find stations that offer the fueling option that best meets your needs: 

Split serve stations: Both full- and self-service options are available to customers
Full serve only stations: Full service is available to customers
Self-serve only stations: While some of our stations have designated Disability Fueling Assistant hours where more than one attendant is available, often there is only one attendant on duty at self-serve stations.

We recommend you call ahead to see if appropriate staffing arrangements can be made. Contact information is available on the Esso Fuel Finder.

SHELL

(http://www.shell.ca/en_ca/motorists/inside-our-stations/refueling-for-drivers-with-disabilities.html)

Drivers with a disabled parking permit will receive full service at self-serve prices at stations with both full and self-serve pumps. The gas station attendant will fuel your vehicle at the self-service island so that you pay only the self-serve price for fuel. Customers should identify themselves to one of our gas station attendants. Please note this service is available only during full service hours.

At self-serve only stations, staff will make every effort to help customers displaying disabled parking permits with refueling. Please identify yourself to one of our gas station attendants. We also encourage you to contact your local station to discuss your individual needs as some stations have limited staff and payment access.

PETRO CANADA

(http://retail.petro-canada.ca/en/stationsstores/customers-with-accessibility-needs.aspx)

At participating split-service stations, a site which provides self-service and full-service at the islands, drivers with an accessible parking permit will receive full-service at self-serve prices. The full-service attendant will fuel your vehicle at the self-service island so that you pay only the self-serve price for fuel.

Find a Petro-Canada station with full service

At participating self-serve stations, customers with an accessible parking permit can drive up to a two-way call station located at the fuel island and press the button to speak to the attendant inside the store to request assistance with fueling their vehicle.

The following get a THUMBS DOWN:

PIONEER

(http://www.pioneer.ca/Portals/1/Images/About%20Pioneer/Pioneer%20Accessiibility%20Policy.pdf)

Pioneer’s site only speaks to assistive devices, communication, support persons and service animals, but does not address the challenge of people with physical impairments being able to refuel.

CANADIAN TIRE GAS

For non-full serve stations, people are required to schedule an appointment with the retailer for refueling.  ONRoute locations offer full serve to all customers between the hours of 7am and 10pm, 7 days a week.  For service outside of these hours, an appointment is required.  Those using the full serve through the Disability Assistance Program will be charged self-serve prices.

COSTCO and ULTRAMAR:

No information is provided. 

In summary, I was impressed by what I found and applaud Shell, Esso and Petro-Canada for being so progressive and supportive on this issue. For the rest, I presume that the Accessibility for Ontarians with Disability Act (AODA) will require those that are behind in offering disability-friendly refueling options to develop policies and procedures and to post these to be easily found on their websites.   In the meantime, I trust those drivers with mobility issues will use and benefit from what Shell, Esso and Petro-Canada have to offer people in their situation.

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A MUST READ New Guideline for Insurance OTs in Ontario

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

With all the legislative changes in the very contentious auto insurance industry, it can be hard to stay current.  Case law, reports, position papers, and of course the high-profile circulations of the Toronto Star.  But sometimes what goes unnoticed is the work of the Colleges or Professional Associations that spend time and resources trying to provide guidance and support to those of us working in this everchanging area of practice.

In the world of Occupational Therapy, one recent document has been posted by the College of Occupational Therapists of Ontario that thoroughly speaks to the challenges, college expectations and tug-of-war that OT’s experience in this difficult sector.  This circulation, entitled “Guideline for Working with Third Party Payers” is a must-read for OT’s in the insurance industry, and serves as a useful tool for anyone (clients, lawyers, insurers, other professionals) who retain, work with, or otherwise engage with an OT for assessment or treatment services.  The guideline (https://www.coto.org/news/new-guidelines-for-working-with-third-party-payers) covers all important aspects of practice in the world of third party work, and includes the following summarized sections:

Providing Ethical and Competent Client Care reviews the Ethical responsibilities of the OT to be transparent, fair and impartial.

Defining Your Role and Setting Expectations with Stakeholders addresses how important it is for OT’s to follow the Standards for OT Assessment and to understand the limits to their own competencies when accepting referrals.

Consent and Personal Health Information discusses how to manage difficult consent situations, for example if another person indicates they got “consent” for the OT, or if a client later withdraws consent during an assessment or treatment. Importantly, it also talks to an OT’s requirement to get new consent when presented with a request to review or comment on new information that was not received when initial consent was obtained.  The submission of reports in draft form to third parties is also covered.

Managing Records and Reports reminds OT’s of their responsibility with record keeping, privacy legislation, and of course the client’s right to access their records.

Managing Conflicts of Interest considers the challenges in this high-stakes industry that is fraught with important funding decisions, conflicting agendas, and relationships that can be formed with clients, insurers, lawyers and the like.  This section deals with these competing interests, conflicting standards and opinions, personal conflicts between oneself and third parties, companies or even other professionals.  Also covered in this section is referrals received from friends or family members, being requested to observe an independent medical exam, and treating clients that are related.  OT’s are reminded that practicing within a conflict of interest (perceived, real or implied) is considered professional misconduct.

Managing Professional Boundaries are addressed and this section highlights different types of potential boundary crossings with clients and referral sources / payers.  It speaks to monetary relationships and financial / gift incentives as a boundary crossing and one that can jeopardize client outcomes and breach professional boundaries.

Use of Title is discussed as a reminder to the different titles an OT may have in providing service, and how to be clear about their role at all times.

Independent Practice reviews the nature of being an “independent contractor or provider” and the resources available to set up, and run, an independent operation.

Lastly, the guideline covers the expectations for providing services to clients who Live Outside of Ontario and reminds OT’s that the client’s location, not theirs, is the jurisdictional boundary and practicing outside of Ontario is not permitted unless the OT has a license in that location as well.

Overall, this document is a useful tool and hard reminder to OT’s of their obligations and expectations as licensed professionals in Ontario.  It may also prove helpful for other stakeholders to review, such that they too understand the rules and boundaries on OT’s so that they can be mindful of these in their working relationships with us.

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The GOS-E and Catastrophic Determination – Gathering EVIDENCE of Pre-Accident Function

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Over the last few months we have had the privilege of presenting to a multitude of Personal Injury Lawyers on the June 1, 2016 changes to catastrophic determination, most specifically on the Glascow Outcome Scale Extended (GOS-E).  If you are working in motor vehicle accident (MVA) rehabilitation or personal injury law, this scale is one you need to be familiar with.

To qualify for catastrophic under the GOS-E, it speaks openly about changes to QUALITY and FREQUENCY of participation in pre-accident tasks under the facets of independence in and outside the home, travelling locally and abroad, productivity, social / leisure participation and relationships.  Within this, it considers HOW OFTEN someone did something, but even bigger than that is FOR HOW LONG and at WHAT INTENSITY.

As OT’s working in this sector, it is important that we gather this information in great detail during our initial assessment to not only get a better picture of pre-accident lifestyle and function, but to create early records that could relate to catastrophic determination at 6 months, 1 or 2 years’ post-accident.

During a presentation, one lawyer questioned the “qualitative way” by which pre-accident information is usually gathered (by asking family or through client self-report).  He asked if there was better evidence, “proof” if you will, that could speak objectively to “pre-accident function”.  This was a great question because right now the only pre-accident “evidence” the industry tends to gather are medical records and these speak to health, not function (and the two can be very different).  Function is best outlined by finding out how people spent their time – something that one would think would be difficult to objectively measure for the purpose of “evidence”, but let’s think again.

The evidence of how people spend their time is actually everywhere.  My morning dog walk and sleep habits are tracked on my fit bit and transferred to my computer and phone.  My car logs the kilometers I drive, and the repair shop inputs these with every oil change.  The gym tracks my attendance.  My phone apparently stalks me by recording everywhere I take it, the websites I visit, the apps I use and the people I speak to, text and email.  The photos in my phone also tell the story of my life and where my time is spent.  My computer records the number of emails I send and receive and the places I visit online.   My emails are sorted and can detail the time I spend organizing and taking trips (local and abroad), socializing, and even my relationship communication habits.  If I had a personal Facebook account this would detail for you the people I chat with, how often, and the places I visit, take photos and upload.  Twitter, Instagram and Snapchat would do the same.  But honestly most of the information about my time spent would be easily revealed through my financial records.  Most of the things I do cost money.  My credit card and bank statements will show you the frequency by which I get a latte, the costs for my gym program, the amount of shopping I do, the people I pay to help manage aspects of my house, the places I eat or indulge, the number of times I visit the movies or do something fun, the things I enroll my children in, etc.  These will even tell you the therapies or treatments I might get privately that my doctor doesn’t even know about.

We know that being involved in the insurance system exposes aspects of people’s lives that they may not want to share.  All privacy is forgone when you want and need help from an insurer, or when you want and need to sue someone who was at-fault for causing you injury and harm.  Unfortunately, with the changes to Catastrophic Determination, the gap just widened in terms of the information that needs to be gathered and the “proof” that needs to be provided to access the benefits an injured person may need.  However, the information is out there – little is sacred or private anymore. 

If this is helpful, here is a list of information that could be gathered to support changes to FREQUENCY and QUALITY of participation in most activities before and after an accident.   Getting someone’s personal records for the year prior to an accident, and then for the first-year post, will be highly informative, helpful and revealing…if they are agreeable to share:

Bank Statements / Financial Records will show MOST purchases related to social / leisure activities:

Memberships / clubs / subscriptions
Dinners / coffees / movies
Vacations
Shopping habits
Sports / fitness
Gas / driving / parking habits

Other places will also have records:

Gym / rec center attendance
Schools / school records
Employment records
Evidence of trips / vacations / social events on SM – FB, Twitter etc (before the accident)
Car / vehicle records – how often the car was driven based on KM’s
Points cards for anything like movies, Starbucks, Airlines, etc
Call / cell records and communication habits
Medical records

I hope this helps the lawyers and injured people of the insurance system to find the “evidence” they might need to really demonstrate to an insurer how their life has been impacted following an accident.  And for the OT’s gathering similar data subjectively, be specific and thorough in your questioning under the GOS-E spheres.  Your reports are highly important and may become the difference between someone being deemed catastrophic or not.

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Drugs or Driving? You Might Have to Choose

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

The Ontario Trial Lawyers Association (OTLA) Blog recently posted this very interesting and informative article on the legalization of marijuana and how this may specifically impact the drivers of Ontario.  The proposed reforms to Impaired Driving Laws, as listed in the article, include:

For the first time, the Government of Canada has proposed prescribing limits to the amount of THC – an inebriating component of cannabis – detected in a person operating a motor vehicle. The Government is also proposing prohibiting any detectable levels of many other drugs while operating a motor vehicle.

The proposed changes include attempts to close loopholes in our current laws and providing for easier roadside testing by authorities, including:

  • allowing mandatory roadside saliva swab testing;
  • allowing blood tests taken by professionals on the scene who are not doctors;
  • allowing breathalyser testing of any driver (omitting to the current requirement for “reasonable suspicion” of impairment); and
  • changing the definition of impaired driving with blood alcohol levels over 80mg/100ml from “while operating a motor vehicle” to “within two hours of operating a motor vehicle” (an attempt to close legal loopholes where people claim to have drunk alcohol immediately before driving or immediately following an accident to account for an anticipated failed sobriety test).

People operating motor vehicles will be committing a criminal offence if they are found to have THC levels in their blood above 2ng/ml. Drivers with levels above 5mg/ml or levels above 2.5ng/ml combined with blood alcohol levels over 50mg/100ml will face more significant penalties.

The penalties are also generally going up, especially in the case of repeat offenders who may now be sentenced up to 10 years (up from the current five), and will now be eligible to be deemed “dangerous offenders” in appropriate circumstances.

So why is this so significant?  As an Occupational Therapist it is common for many of my clients to require the use of medication to manage their symptoms.  While most (or all) would love to be able to go without regular use of these drugs, it is typical for medications to be prescribed to help people manage initial and acute symptoms for things like sleep, depression, anxiety, pain, headaches, and spasms.  Often, that usage continues beyond the acute phase of recovery to help with the management of more chronic and relentless problems that don’t resolve in time.  It is no secret then that people with disabilities tend to be high consumers of medication.

More recently, as the benefits of medical marijuana become studied and well known, my clients are choosing to forgo the gut-wrenching and highly addictive narcotics for the milder but often effective marijuana option.  My clients that use medical marijuana report better sleep and more stability in their symptoms without the intense side-effects they experienced on other drugs. 

So my clients tend to use medication, some are switching to marijuana, but most concerning with this legislation change is that most of my clients are also drivers.  Very few actually don’t resume driving and in fact returning to driving is often one of their main objectives.  Driving provides freedom and convenience, and people who end up stranded at home tend to decompensate emotionally due to the isolation that comes from not being able to enter the community often and independently.  Sure, many places offer public transit options, but try having pain, reduced tolerances for activity, standing or sitting restrictions and then be expected to walk to, wait for, and then sit on a bus that has jerky starts and stops every few blocks.  Public transit is just not a great option for people that don’t tend to feel well.

I am all for the safety of Ontario drivers and I can appreciate how the laws in Ontario need to evolve with the introduction of new policies that can impact driving.  However, I am concerned that these changes unfairly target an already marginalized portion of our population without providing suitable alternatives to allow people to get around their community.  How will my clients who currently drive while medicated be able to continue to get around? 

Further, there is also a potential change to the mandatory reporting requirements for professionals around driving.  Currently, only doctors are required by law to report potentially unsafe drivers to the Ministry of Transportation.  There is talk that Occupational Therapists will also have this responsibility soon.  So, if I know that my client is taking narcotic medication and also drives to work daily, will I be required to report this?  If that is the case, then what about the doctor that prescribes the medication in the first place?  Is he going to give people the option of:  drugs or driving? 

Personally, I think the bigger problem on the roads is non-prescription related.  Drinking and texting seem to be causing more injuries and deaths than the use of properly prescribed and consumed medications.  I hope the lawmakers of Ontario are considering all the risks on the roads and working to develop solutions fair to all of us.

 

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Be Prepared on the Road

While driving is usually simply an adventure of fighting traffic to get from point A to point B, sometimes circumstances beyond our control can get in the way.  Weather conditions, breakdowns, accidents and more can leave you stranded at the side of the road.  As a driver it’s important to be prepared for these situations by having emergency items in your vehicle at all times.  Many kits can be purchased online and at local retailers, or you can create your own emergency car kit, but ensuring you have these basic items in your trunk.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For more helpful tools visit our Printable Resources Page.

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Ontario’s Auto Insurance Industry Needs More Than a Quick Pit Stop!

Though recent stats show Ontario’s rate of injury and fatality due to motor vehicle accidents are some of the lowest in the country, Ontario drivers are paying the highest rates of insurance in the country.  With high premiums you would think the benefits are the best possible, right?  Wrong.  As previously discussed in our post, The Government Gets it Wrong– AGAIN, premiums may be on the rise, but accident benefits have been cut once again.  A recent government report by David Marshall discusses these and other flaws in Ontario’s substandard auto insurance industry and provides recommendations on how it can improve.  Learn more about this report and its findings in the following Editorial from the Toronto Star.

The Toronto Star:  Time to fix Ontario’s broken auto insurance system

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Wash Your Car – Save a Life!

Julie Entwistle, MBA, BHSc (OT), BSc (Health / Gerontology)

Previously posted February 2014

Working in auto insurance makes me slightly paranoid about issues of vehicle safety.  Ideally, it would be great if car accidents could become extinct and people could go about their business without running the risk of becoming injured in their travels, but currently these remain one of the main causes of adult and child injury, death and disability.  May is National Car Care Month and maximizing car safety should be on the top of everyone’s list year-round.

Years ago, in the middle of winter, I was driving home from seeing a client at night.  I was on back roads that were not lit.  My headlights were on, but I could barely see the road in front of me.  I struggled with this, assuming I had a headlight out, and managed to get to a gas station.  There, I investigated the problem and realized my headlights were just covered in the road sludge so common in Ontario winters.  I cleaned up my headlights with a window squeegee and voila!  I could see again

Prior to this, the thought of washing my headlights never occurred to me.  Why would it?  Unless you encounter a problem, this is not something I remember being taught in driver’s ed, nor something my parents mentioned to look for as I was learning to drive.  Some things we just learn in life the hard way – hoping to not be hurt in the process.

I remember when cars started to be manufactured to have headlights on automatically and all the time.  I said to my brother “I don’t get why headlights should be on during the day, they won’t help a driver to see better” and he responded with “it is so other people can see you better”, I am sure adding a brotherly “dummy” in there too.

The other day I was reminded of these lessons again.  It was a sunny day, but the roads had been a mess a few days prior.  I was driving in the right lane and needed to change into the left lane to make an upcoming left turn.  I glanced in my dirty side mirror and my rear mirror which was looking out my dirty back window, and I didn’t see anyone.  I checked my side mirror again, and noticed something that looked odd.  I focused more clearly and realized that there was another car to the left of me after all.  This was a black car, covered in the grey muck from the roads.  The lights weren’t on, and what struck me was how much this car was essentially the color of the road.   The road was a grey, dirt covered mess, and this car blended right in.  Had the lights been on, or the car clean, I would have spotted this easily.

Really, both these issues with visibility when driving – to see and be seen – could be tackled with a simple car wash.  Even if this seems futile with changing weather conditions, the short-term benefits are immense.  A clean car is easier for others to see, gives you better visibility when the windows and side mirrors are clear, and washes your headlights to make sure these are most effective.  Besides, of course, the other benefits of washing road salt and dirt from your paint job.  Many gas stations have a quick car wash adjacent to the pump, and allow you to pay at the pump for convenience.  Or, some car washes are even a drive-thru format and you don’t even have to leave your car.  In the end, when it comes to road and driving safety, the added expense of giving your car a rinse could be “priceless”.

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The Role of Occupational Therapy in Trauma Recovery

Guest Blogger: Carolyn Rocca, Student Occupational Therapist, 2017

Motor vehicle accidents account for countless injuries annually and are one of the most common traumas individuals experience. Trauma can be understood as one’s unique experience of an extremely stressful event or enduring conditions that overwhelms their ability to cope. These experiences can often disconnect us from our sense of safety, resourcefulness, and coping. As a result, survivors of severe and traumatic motor vehicle accidents are at increased risk for experiencing mental health difficulties, with posttraumatic stress disorder, depression, and anxiety being the most common.

Post-traumatic stress disorder (PTSD) is a mental health condition that can follow a traumatic event involving actual or threatened death, serious injury, or threat to the physical integrity of oneself or others. Although every individual experiences PTSD differently, following a motor vehicle accident PTSD symptoms can involve:

·       Psychologically re-experiencing the trauma through distressing thoughts or dreams about the accident,

·       Avoidance of thoughts or situations associated with the accident, including a reluctance to return to driving,

·       Extremes in emotional responsiveness, by either having greatly reduced or heightened emotions, and

·       Increased physical arousal, such as hypervigilance, exaggerated startle, irritability, and disturbed sleep (Beck & Coffey, 2007).

The symptoms associated with PTSD can leave individuals to feel emotionally, cognitively, and physically overwhelmed. Naturally, this can result in difficulties in one’s daily functioning, including one’s ability to care for themselves and others, as well as their ability to successfully engage in their life roles of being a spouse, parent, employee, student, or volunteer, to name a few. For these reasons it is recommended that those experiencing PTSD seek help from a team of healthcare providers and consider occupational therapy.

Using a trauma-informed care approach, occupational therapists can support clients through the following three Phases of Trauma Recovery:

Phase I – Safety-stabilization:

Since trauma often results in a sense of helplessness, isolation, and loss of control, the aim is to restore a sense of safety and empowerment. Following trauma, creating a sense of safety is the foundation of one’s recovery process.

The first step to building and creating safety is to first identify things that help us feel safer. Occupational therapists can help their clients to identify objects that bring about a personal sense of safety and imbed them into their daily routines. These safety objects may include: special people such as a trusted friend, engaging in certain activities like looking at photographs or making crafts, or being in a certain place, such as being outdoors in the sunlight.

Occupational therapists can also assist in establishing safety through practices such as meditation, mindfulness, deep breathing exercises, yoga, and Thai chi, as these approaches have been shown to be effective at decreasing stress and soothing the nervous system (Manitoba Trauma Information & Education Centre, 2013).

Phase 2 – Remembrance and Mourning:

A traumatic event like a motor vehicle accident is often associated with a form of loss. One might feel they have lost their independence, sense of identity, or purpose following a car accident.

Counselors and occupational therapists are well-equipped to guide individuals on their recovery by allowing them time to grieve and morn their own personal losses. This is often achieved through individual or group-based therapy by processing the trauma, putting words and emotions to it, and making meaning of it.

Phase 3 – Reintegration:

The goal of the third stage of recovery is that the person affected by trauma recognizes the impact of their experience but is now ready to take concrete steps towards a lifestyle that is no longer controlled by the trauma. Recovery and reintegration will look different for everyone, but often involves resuming important life roles and responsibilities, and returning to a lifestyle that is meaningful to them.

Occupational therapists can assist during this phase of recovery by supporting their clients in re-establishing healthy routines, building strong support systems, learning and practicing coping strategies during their day to day activities, and gradually increasing their exposure to anxiety provoking triggers, ultimately enabling them to reintegrate into their communities and preferred lifestyles.

For more information about PTSD, trauma informed care, and how healthcare professionals can support someone following trauma, be sure to take a look at the Trauma Toolkit or call an Occupational Therapist to start the process of recovery.

 

References & Resources:

Beck, J. G., & Coffey, S. F. (2007). Assessment and treatment of posttraumatic stress disorder after a motor vehicle collision: Empirical findings and clinical observations. Professional Psychology: Research and Practice, 38(6), 629.

Manitoba Trauma Information & Education Centre (2013). Retrieved from http://trauma-recovery.ca/

The Trauma Toolkit: A resource for service organizations and providers to deliver services that are trauma-informed (2013). Retrieved from http://trauma-informed.ca/wp-content/uploads/2013/10/Trauma-informed_Toolkit.pdf

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Scary Study on Texting and Driving

Results from an ongoing study on texting and driving by the Sudbury District Health Unit and Laurentian University have produced scary results, but researchers are optimistic these results put them closer to improving strategies to reduce this dangerous behaviour.  Research shows: “They admit to doing it, but they feel bad about doing it, they know it’s wrong and they don’t feel safe when someone else is texting and driving. Learning that information gives us a bit of leverage to empower passengers to stand up and say, ‘No, this is wrong,’ against their peers.”  Learn more about this research and the ongoing efforts to reduce texting and driving in the following article from the Sudbury Star.

The Sudbury Star:  Sudbury researchers target distracted driving