Abstract
Texting while driving (TWD) is a leading cause of distracted driving-related crashes, especially among college students. This study applied the Multi-Theory Model (MTM) of health behavior change to predict initiation and sustenance of refraining from TWD among university students. A cross-sectional survey was conducted among 164 students from a Southwestern U.S. public university using a 49-item validated MTM-based questionnaire. Structural equation modeling and hierarchical multiple regression analyses were employed to assess reliability, construct validity, and predictors of behavioral initiation and sustenance. Cronbach's alpha coefficients ranged from 0.71 to 0.93, indicating strong reliability. The MTM demonstrated good fit (CFI = 0.950, RMSEA = 0.057 for initiation; CFI = 0.992, RMSEA = 0.039 for sustenance). Behavioral confidence (β = 0.30, p < 0.001) significantly predicted initiation, explaining 51.5% of the variance, while emotional transformation (β = 0.41, p < 0.001) and practice for change (β = 0.27, p = 0.0105) predicted sustenance, accounting for 61.5% of the variance. The MTM effectively explained both initiation and sustenance of refraining from TWD among college students. Interventions aimed specifically at reducing texting while driving should prioritize strengthening behavioral confidence for initiating change and supporting emotional transformation and practice-for-change strategies to sustain long-term abstinence from TWD. MTM-based approaches hold strong potential for designing theory-driven, culturally relevant distracted driving prevention programs.