Modelling the factors related to the seatbelt use by the young drivers of Athens

Understanding the Factors Associated with the Temporal Variability in Crash Severity before, during, and after the COVID-19 Shelter-in-Place Order

The COVID-19 travel restriction orders have significantly reduced travel and generally lowered the risk of road traffic collisions, but many accounts suggest an increase in risky driving behaviors and consequent fatal crashes during the shelter-in-place period. Risky driving behaviors including failure to wear a seatbelt, speeding, and drunk driving were observed to be the leading contributing factors of the fatalities. Whereas the fatal crashes that characterized the shelter-in-place period has become a topical issue, the high number of crashes that occurred as a result of the panic shopping and increased travel activities in the weeks before the shelter-in-place order have not received much attention. In this study, we investigated the differences and similarities in the effects of the factors that were associated with crash injury severity before, during, and after the shelter-in-place order. The study used crash data from the state of Alabama for the 2020 calendar year. Preliminary data analysis revealed interesting variations in crash trends across the three periods. It was found that the highest weekly crash frequency occurred in the immediate week before the shelter-in-place order, and a higher proportion of crashes that occurred between 6 p.m. and 6 a.m. and those that occurred in residential areas happened during the shelter-in-place period while shopping area crashes, manufacturing/industrial area crashes, rear-end collisions, and crashes involving female drivers occurred mostly before the shelter-in-place period. Three injury severity models were developed using random parameters logit with heterogeneity in means and variances approach. The results showed that major injury crashes occurred mainly in rural areas and occurred due to speeding, fatigue driving, and failure to use a seatbelt. The effects of these factors on crash outcome did not vary across the year, indicating that the shelter-in-place order did not impact the driving behaviors of the driver population that got into major injury crashes. The results further revealed that the effects of some crash factors, such as road type and manner of collision, varied across the periods. The findings of the study provide a deeper, data-driven understanding of how driving behaviors and associated crash outcomes may be affected by extreme events such as the COVID-19 shelter-in-place.

How did the COVID-19 pandemic affect road crashes and crash outcomes in Alabama?

With the rising number of cases and deaths from the COVID-19 pandemic, nations and local governments, including many across the U.S., imposed travel restrictions on their citizens. This travel restriction order led to a significant reduction in traffic volumes and a generally lower exposure to crashes. However, recent preliminary statistics in the US suggest an increase in fatal crashes over the period of lockdown in comparison to the same period in previous years. This study sought to investigate how the pandemic affected road crashes and crash outcomes in Alabama. Daily vehicle miles traveled and crashes were obtained and explored. To understand the factors associated with crash outcomes, four crash-severity models were developed: (1) Single-vehicle (SV) crashes prior to lockdown order (Normal times SV); (2) multi-vehicle (MV) crashes prior to lockdown order (Normal times MV); (3) Single-vehicle crashes after lockdown order (COVID times SV); and (4) Multi-vehicle crashes after lockdown order (COVID times MV). The models were developed using the first 28 weeks of crashes recorded in 2020. The findings of the study reveal that although traffic volumes and vehicle miles traveled had significantly dropped during the lockdown, there was an increase in the total number of crashes and major injury crashes compared to the period prior to the lockdown order, with speeding, DUI, and weekends accounting for a significant proportion of these crashes. These observations provide useful lessons for road safety improvements during extreme events that may require statewide lockdown, as has been done with the COVID-19 pandemic. Traffic management around shopping areas and other areas that may experience increased traffic volumes provide opportunities for road safety stakeholders to reduce the occurrence of crashes in the weeks leading to an announcement of any future statewide or local lockdowns. Additionally, increased law enforcement efforts can help to reduce risky driving activities as traffic volumes decrease.

The relationship between driver and passenger's seatbelt use: a bivariate probit analysis

Vehicle seatbelt has been shown to have a beneficial impact on occupants. However, some occupants do not use the seatbelt when inside a moving vehicle. Despite the numerous investigation on the risk factors associated with seatbelt use by occupants, little is known about the relationship between driver and passenger seatbelt use. This gap is analyzed with road side observational survey data on driver and front-right seat passenger's seatbelt use behaviour using bivariate probit model. The use of the bivariate probit model is based on the premise that the front-right passenger's seatbelt use is endogenously related to that of the driver. Out of the 5,433 vehicles observed, the prevalence rate of driver and front-right passengers' seatbelt use were 81% and 33%, respectively. In addition, there is a positive relationship between driver and passenger's seatbelt use with correlation coefficient of 0.53. Thus, the unobserved factors that influence the probability of a driver seatbelt use also influence their front-right passenger's seatbelt use propensity.

Factors that Associate Japanese University Students' Use of Rear Seat Belts on General Roads and Expressways

This study clarifies the prevalence of rear seat belt use among university students and explores the factors that influence seat belt use on general roads and expressways. Questionnaires were distributed to 1,091 students who attended health education lectures: 893 students (81.9%) agreed to participate and met the criteria; among them, 660 (73.9%) provided complete responses. While one-third (33.0%) of rear seat passengers "always" used seat belts on general traffic roads, three-fourths (73.2%) "always" used them on expressways. Multivariate analysis revealed that being male and the perception of obligation and recognition of the benefits of rear seat belt use were associated with use on general roads, whereas the possession of a driver's license and recognition of benefits were associated with use on expressways. Finally, we suggest that educational programs on seat belt use be developed and delivered to general road and expressway users to promote seat belt use.

The role of perceived risk, reasons for non-seat belt use and demographic characteristics for seat belt use on urban and rural roads

Despite the well-documented benefits of seat belt use, a large number of drivers fail to fasten their seat belts in Iran. Efforts to improve seat belt use can be enhanced by identifying factors that motivate seat belt use. The main aims of this study were to assess the relationship between perceived risk of being ticketed and seat belt use among adult drivers on urban and rural roads and to identify reasons for not wearing a seat belt while exploring the relationship between these reasons and demographic information of adult drivers. An additional aim was to explain seat belt use on these two types of roads based on the perceived risk of being ticketed, demographic characteristics of drivers and the reasons for not wearing a seat belt. A total of 546 questionnaires were distributed including demographic information, items measuring the perceived risk of being ticketed and inquiry about the reasons for refusing to wear a seat belt. The results from valid questionnaires (n = 397) revealed that the perceived risk of being ticketed was not a predictor of seat belt use on urban and rural roads while controlling for age, gender, the influence of being ticketed and discomfort were predictors of seat belt use on urban roads. Meanwhile, older drivers, being ticketed in the past 3 years, having vehicle crashes in the past 3 years and discomfort were sole predictors of seat belt use on rural roads. Also, the findings suggested that there were differences between groups of respondents based on their demographic characteristics in the perceived risk of being ticketed and reported reasons for not wearing seat belts. The findings of this article extended the outcomes of previous studies in factors affecting seat belt use separately for drivers on urban and rural roads, which can help policy-makers promote seat belt use rates.

Correlates of front-seat passengers' non-use of seatbelts at night

When properly worn, seatbelts can save lives. They are designed to prevent occupants from hitting objects inside their vehicle and from being ejected out of their vehicle in the event of a crash. Despite their proven effectiveness in reducing the severity of injuries, seatbelt non-use among passengers still remains a problem, especially at night. Although the factors associated with not using a seatbelt have been widely studied, research studies documenting this behavior at night are limited in the literature. The primary objective of this paper is to explore the factors related to front-seat passengers' seatbelt non-use at night using a 2015-2016 longitudinal observation survey conducted in five counties in East Tennessee. The Generalized Estimating Equation, a rigorous modeling technique, is employed for the data analysis. The findings show that front-seat passengers who are most likely to not wear seatbelts at night are males, traveling in passenger cars and pickup trucks, traveling during the first half of the year (January to June), traveling late at night (after 10 p.m) and on local streets. The findings also indicate that drivers may have the greatest influence on their accompanying passengers' seatbelt use. That is, when drivers fail to wear seatbelts at night, their accompanying front-seat passengers are more likely to fail as well. The model results show that there are many consistent correlations between the non-use of seatbelts and personal, vehicle and environmental characteristics. Accounting for these factors may be important when developing intervention strategies that promote nighttime seatbelt use.

Impacts of helmet law on the changes in potential years of life lost due to traffic injury: a multiple-province evaluation in Vietnam

INTRODUCTION

This study aimed to evaluate the impact of the helmet law on the changes in potential years of life lost (PYLL) due to traffic mortality and to examine modification effects of socioeconomic factors on the impacts in Vietnam.

METHODS

We applied an interrupted time series design using the Bayesian framework to estimate the impact of the law at the provincial level. Then, we used random effects meta-analysis to estimate the impact of the law at the country level and to examine the modification effects of socioeconomic factors.

RESULTS

The results indicate that the impacts varied among the provinces. These impacts could be classified by four main groups comprising positive impact, and positive impact without sustainability, possible positive impact, negative or inconsistent impact. For the country-level impact, the results reveal a significantly consistent change in monthly PYLLs at the level of 18 per 100 000 persons, and the post-trend was stable without significant change. The results of meta-regression show that 1 unit increase in the population density (persons/km²), migration rate (%) and income (×1000 dong) are non-significantly associated with increases of PYLLs at 1.3, 27 and 27 per 100 000 person-months, respectively, whereas 1% increase in literacy associated with a decrease of PYLL at 44 per 100 000 person-months.

DISCUSSION

Further studies should be warranted to provide a comprehensive evaluation of the law implementation, including its acceptability, adoption, appropriateness, feasibility, cost-effectiveness and sustainability.

Neighborhood-level factors affecting seat belt use

Despite the well-known safety benefits of seat belt use, some vehicle occupants still do not use them. This is a challenge in Tennessee, which has a lower seat belt use rate compared to the United States national average. Roadside observations and interviews are the two main sources for estimating seat belt use rate and have several limitations (e.g., small sample size, social desirability bias). To address these limitations, we attributed seat belt use of individuals who were involved in traffic crashes (N = 542,776) to their corresponding home-addresses. Home-addresses were retrieved from police crash reports and were geocoded, and assigned to their corresponding census tract revealing added information about the spatial distribution of seat belt use and socioeconomics of the areas surrounding the crash victim's home. The average seat belt use rate in the metropolitan area was 88% and for the non-metropolitan area was 87%. A Tobit model was used to evaluate the relationship between the seat belt use rate for both drivers and passengers over 16 years old, with neighborhood sociodemographic variables. Population, age cohorts, race, household vehicles' ownership, household size, and education were among the predictors of the seat belt use rate. Results of this analysis could be used in safety campaign design to reach specific geographic areas and groups with a lower seat belt use rate.

"Seatbelts don't save lives": Discovering and targeting the attitudes and behaviors of young Arab male drivers

The paper presents a two-part study that discovered then targeted beliefs and attitudes towards seatbelt use in young Arab men. The purpose of part one was to discover their safe driving beliefs, attitudes and behaviors as well as their responses to safe driving campaigns to ascertain message elements that could incite reactance. Part two targeted selected beliefs and attitudes in a message that was designed based on the results from part one to both address relevant beliefs and attitudes as well as avoid reactance. One belief, that seatbelts are not necessary in the back seat, and two attitudes, avoidance of wearing the seatbelt to prevent clothing from being wrinkled and to avoid friends' derision, were targeted. Because the participants reported reactance to common safe driving campaigns, the options for the message were quite limited. Using fear appeals, shocking content or depicting the consequences of accidents was deemed likely to be ineffective, rather a novel approach was called for. Utilizing the collectivist and masculine nature of the culture, the resulting message featured a group of young Arab men who are convinced by a personified Seatbelt to wear their seatbelts after an adventure. The message succeeded in eliciting statistically reliable belief and attitudinal change on all three dependent variables after one exposure, suggesting that tailored messages that avoid triggering reactance and are culturally contextualized while aimed at specific beliefs and attitudes can be persuasive. Although risk taking behavior can result from group pressure, our message used culturally specific group pressure but depicted it as being against the risky behavior and positively reinforced the less risky behavior, demonstrating that such approaches can be effective. The film was not a typical safe driving message, utilized social norms from the target audience and was carefully matched to their attitudes and beliefs while not being an overtly persuasive. We argue that message campaigners can utilize both the method and results for subsequent campaigns aimed at young Arab men.

Prediction of safe driving Behaviours based on health belief model: the case of taxi drivers in Bandar Abbas, Iran

BACKGROUND

Road accidents are among the main causes of mortality. As safe and secure driving is a key strategy to reduce car injuries and offenses, the present research aimed to explore safe driving behaviours among taxi drivers based on the Health Belief Model (HBM).

METHODS

This study was conducted on 184 taxi drivers in Bandar Abbas who were selected based on a multiple stratified sampling method. Data were collected by a questionnaire comprised of a demographic information section along with the constructs of the HBM. Data were analysed by SPSS ver19 via a Pearson's correlation coefficient and multiple regressions.

RESULTS

The mean age of the participants was 45.1 years (SD = 11.1). They all had, on average, 10.3 (SD = 7/5) years of taxi driving experience. Among the HBM components, cues to action and perceived benefits were shown to be positively correlated with safe driving behaviours, while perceived barriers were negatively correlated. Cues to action, perceived barriers and perceived benefits were shown to be the strongest predictors of a safe drivers' behaviour.

CONCLUSIONS

Based on the results of this study in designing health promotion programmes to improve safe driving behaviours among taxi drivers, cues to action, perceived benefits and perceived barriers are important. Therefore, advertising, the design of information campaigns, emphasis on the benefits of safe driving behaviours and modification barriers are recommended.

Cross-sectional study of road accidents and related law enforcement efficiency for 10 countries: A gap coherence analysis

OBJECTIVE

Road crashes are considered as the eighth leading causes of death. There is a wide disparity in crash severity and law enforcement efficiency among low-, medium-, and high-income countries. It would be helpful to review the crash severity trends in these countries, identify the vulnerable road users, and understand the law enforcement effectiveness in devising efficient road safety improvement strategies.

METHOD

The crash severity, fatality rate among various age groups, and law enforcement strategies of 10 countries representing low-income (i.e., India and Morocco), medium-income (i.e. Argentina, South Korea, and Greece), and high-income (i.e., Australia, Canada, France, the UK, and the United States) are studied and compared for a period of 5 years (i.e., 2008 to 2012). The critical parameters affecting road safety are identified and correlated with education, culture, and basic compliance with traffic safety laws. In the process, possible road safety improvement strategies are identified for low-income countries.

RESULTS

The number of registered vehicles shows an increasing trend for low-income countries as do the crash rate and crash severity. Compliance related to seat belt and helmet laws is high in high-income countries. In addition, recent seat belt- and helmet-related safety programs in middle-income countries helped to curb fatalities. Noncompliance with safety laws in low-income countries is attributed to education, culture, and inefficient law enforcement.

CONCLUSION

Efficient law enforcement and effective safety education taking into account cultural diversity are the key aspects to reduce traffic-related injuries and fatalities in low-income countries like India.

Restraint use in the Eastern Province of the Kingdom of Saudi Arabia

OBJECTIVES

This study set out to examine seat belt and child restraint use in the Dammam Municipality of the Kingdom of Saudi Arabia, based on the premise that an increase in seat belt use would significantly reduce personal injury in traffic crashes. It was expected that local data would help identify intervention strategies necessary to improve seat belt use in the region.

METHODS

The research involved 2 methodologies. First, 1,389 face-to-face interviews were conducted with male and female adults in regional shopping plazas regarding their own and their children's restraint use in their vehicles and reasons for these attitudes and beliefs. Second, 2 on-road observation studies of adult and child restraint use were conducted by trained observers. Occupants of approximately 5,000 passenger vehicles were observed while stopped at representative signalized traffic intersections.

RESULTS

The findings showed front seat belt use rates of between 43 and 47% for drivers and 26 to 30% for front seat passengers; rear seat belt use rates were lower. While there seemed to be some knowledge about the purpose and reasons for restraining both adults and children in suitable restraints, this failed to be confirmed in the on-road observations.

CONCLUSIONS

Reasons for these rates and findings are discussed fully, and recommendations for improving seat belt use in the Dammam Municipality are included.

Hierarchical Bayesian random intercept model-based cross-level interaction decomposition for truck driver injury severity investigations

Traffic crashes occurring on rural roadways induce more severe injuries and fatalities than those in urban areas, especially when there are trucks involved. Truck drivers are found to suffer higher potential of crash injuries compared with other occupational labors. Besides, unobserved heterogeneity in crash data analysis is a critical issue that needs to be carefully addressed. In this study, a hierarchical Bayesian random intercept model decomposing cross-level interaction effects as unobserved heterogeneity is developed to examine the posterior probabilities of truck driver injuries in rural truck-involved crashes. The interaction effects contributing to truck driver injury outcomes are investigated based on two-year rural truck-involved crashes in New Mexico from 2010 to 2011. The analysis results indicate that the cross-level interaction effects play an important role in predicting truck driver injury severities, and the proposed model produces comparable performance with the traditional random intercept model and the mixed logit model even after penalization by high model complexity. It is revealed that factors including road grade, number of vehicles involved in a crash, maximum vehicle damage in a crash, vehicle actions, driver age, seatbelt use, and driver under alcohol or drug influence, as well as a portion of their cross-level interaction effects with other variables are significantly associated with truck driver incapacitating injuries and fatalities. These findings are helpful to understand the respective or joint impacts of these attributes on truck driver injury patterns in rural truck-involved crashes.

Interaction between socio-demographic characteristics: traffic rule violations and traffic crash history for young drivers

Young drivers' high traffic violation involvement rate and significant contribution to traffic crashes compared to older drivers creates the need for detailed analyses of factors affecting young drivers' behaviors. This study is based on survey data collected from 2,057 18-29 year old young adults. Data were collected via face-to-face questionnaire surveys in four different cities in Turkey. The main objective of this study is to identify the relationship between socio-demographic characteristics, traffic rule violations, and traffic crashes among young drivers. Four main traffic rule violations are examined: red light violations, seat belt violations, speeding, and driving under the influence of alcohol, which are decisive in determining driving behavior and traffic crashes. The survey investigates the socio-demographic characteristics, traffic rule violation behavior and traffic crash histories of young adults. Four hypothetical scenarios were prepared for each traffic rule violation and data from the scenarios were modeled using the ordered probit model. Significant variables affecting each traffic rule violation are stated. Finally, significant variables that interact with crash involvements were investigated with binary logit models. According to the data analysis, 23.9% of drivers stated that they were involved in at least one traffic crash within the last three years. This crash rate increases to 38.3% for those who received at least one traffic citation/violation in last three years and peaks to 47.4% for those who were fined for seat belt violations in last three years.

The impact of seat-belts in limiting the severity of injuries in patients presenting to a university hospital in the developing world

BACKGROUND

Road traffic injuries are major public health problems and a leading cause of death and injury around the world. Approximately 1.2 million people are killed each year in road crashes worldwide, with up to 50 million more injured. Over 95% of these deaths and injuries occur in the low- and middle-income countries of the world. The aim of this study is to evaluate the impact of the use of seat-belts in reducing the severity of injuries from road traffic crashes and to determine the compliance and awareness of the importance of the use of seat-belts among Nigerian motorists.

PATIENTS AND METHODS

The injury patterns and outcome of care in 140 patients who were seen at the emergency department of our tertiary hospital were evaluated. Initial care and resuscitation was carried out on all patients using the advanced trauma life support protocol.

RESULTS

A total of 81 (57%) patients used seat-belts, while 59 (42.1%) did not. Nineteen (13.6%) patients died as a result of their injuries; 4 (21.1%) of these had used seat-belts, while 15 (79%) had not (P = 0.001). The mortality rate of 79% for patients who did not use seat-belt was statistically significant.

CONCLUSIONS

The seat-belt is an effective safety tool that not only saves lives, but also significantly reduces the severity of the injury that a vehicle occupant may have sustained if they were not wearing the device. More public enlightenment is needed to increase the awareness and compliance of use of seat-belts among Nigerian motorists.

Influence of traffic enforcement on the attitudes and behavior of drivers

Traditionally, traffic enforcement has been an important means of improving traffic safety. Many studies have provided evidence of connections between the level of police enforcement and both driving behavior and the number of traffic accidents. In Northern Kosovo, there has been little, if any, traffic enforcement during the last 13 years. This situation has created a very rare research opportunity - it is now possible to directly study the influence of traffic enforcement on the attitudes and behavior of drivers by comparing two regions, one with traffic enforcement and one without it (Serbia vs. Northern Kosovo). The sample in the present study consisted of 424 drivers (204 from Serbia and 220 from Northern Kosovo). Questionnaires included items about the behaviors of the drivers (e.g., speeding, seat belt, drunk driving) and their attitudes. We also conducted field observations of driving behavior. The results indicated that the lack of enforcement affects almost every type of behavior that we examined. Compared with drivers in Serbia, drivers in Northern Kosovo drive faster, exceed speed limits more frequently, use seat belts less frequently, drive after exceeding the legal limit for alcohol more often, commit aggressive and ordinary violations more frequently and are generally involved in more risky situations.

Spanish Young Adults' Perceptions of the Costs and Benefits of Risky Driving Behaviors

We used an open-ended survey to elicit Spanish young adults' perceptions of the benefits and drawbacks of speeding and not wearing a seatbelt (or helmet).Around half of the sample reported past engagement in these two risky behaviors, although forecasted engagement was low. Past and forecasted risk taking were positively correlated. Participants provided more drawbacks than benefits of each risky behavior. Drawbacks typically referred to a combination of behavioral acts and social reactions (e.g., accident, punishment) that occurred during the journey. By contrast, benefits largely referred to personal effects (e.g., save time, comfort) that occurred after the journey had ended (speeding) or during the journey (not wearing a seatbelt/helmet). These findings contribute to our theoretical understanding of young adults' risk taking on the road, and to the development of road safety programs.

Prediction of seat belt use among Iranian automobile drivers: application of the theory of planned behavior and the health belief model

OBJECTIVE

Seat belt use plays an important role in traffic safety by reducing the severity of injuries and fatality rates during vehicle accidents. The aim of this study was to investigate predictors of self-reported seat belt use in a sample of automobile drivers in Bandar Abbas, Iran. The theory of planed behavior and the health belief model served as the conceptual framework for the study.

METHODS

The convenience sample consisted of 284 eligible automobile drivers who frequented 8 petrol stations in different geographical areas of the city. Of the drivers approached to participate in the study, 21 declined to take part in the study and 12 other questionnaires were incomplete. Thus, a total of 251 questionnaires were analyzed (response rate=88.4%). A self-administered questionnaire including demographic characteristics and items arising from the theory of planed behavior and health belief model constructs were used to collect data. Data were analyzed using SPSS 16 (version 16, Chicago, IL, USA).

RESULTS

The subjects' mean age was 31.6 years (SD=8.7), mostly male (72.9%), and 53.4 percent of them reported that they used their seat belt "often." Multiple regression analyses revealed that from the theory of planed behavior, attitude, subjective norms, and perceived behavioral control significantly predicted intention to use a seat belt (R2=0.38, F=51.1, p<.001); and subjective norms, perceived behavioral control, and behavioral intention significantly predicted seat belt use (R2=0.43, F=45.7, p<.001). Arising from the health belief model, perceived benefits and perceived barriers significantly predicted seat belt use (R2=0.39, F=26.2, p<.001).

CONCLUSION

This study revealed that automobile drivers who perceived more subjective norms, more behavioral control, greater intention to use seat belts as well as more benefits and fewer barriers were more likely to use their seat belts.

Exploring the effects of lifestyle, sleep factors and driving behaviors on sleep-related road risk: a study of Greek drivers

PURPOSE

The present study explored the effect of various lifestyle patterns and sleep-related factors on the sleep-related road risk. Sleep-related factors included daytime sleepiness, drowsy driving and quality/quantify of sleep.

METHODS

A sample of 1366 non-professional drivers aged 19-65 was selected from the broader Athens area of Greece, using stratified random sampling. The questionnaire solicited information on the participants' socio-demographic characteristics, driving background, lifestyle patterns, sleep quality and quantity, daytime sleepiness, drowsy driving behavior and sleep-related road risk.

RESULTS

Sleep-related road risk was affected by gender, quantity of night sleep and drowsy driving behavior. Drowsy driving behavior was shown to be related to gender, daytime sleepiness, sleep quality and the lifestyle of "amusement". Daytime sleepiness was correlated with sleep quality and the lifestyles of "amusement" and "sport". Finally, sleep quality and quantity were significantly affected by the lifestyles of "amusement" and "yuppies-workaholic".

CONCLUSION

The current study has identified a number of risk factors in sleep-related crash risk in the general population of drivers. By raising public awareness the health and safety community can play an important role in reducing, if not preventing, the consequences of this public health problem.

Why Turks do not use seat belts? An interview study

Despite the effectiveness of seat belt use and legislation, seat belt use rate is low in Turkey. The aim of this study was to investigate the motives to use and not to use a seat belt in different traveling conditions in a sample of car drivers and passengers. Interviews were made face to face with 221 interviewees from different age and occupation groups. Frequently reported reasons for using a seat belt were traveling conditions, safety, situational conditions, habit of using a seat belt, and avoiding punishment. Frequently reported reasons for not using a seat belt were situational conditions, not believing in the effectiveness, discomfort and having no habit. Safety was the strongest predictor of reported seat belt use in both low and high risk traveling conditions. Findings suggest that seat belt campaigns should mainly emphasize seat belt's safety impact and aim at habit formation.

Environmental and psychosocial factors affecting seat belt use among Turkish front-seat occupants in Ankara: two observation studies

OBJECTIVE

Low seat belt use rate among car occupants is one of the main problems contributing to low driver and passenger safety in Turkey, where injury and fatality rates of car occupants are very high in traffic crashes. The present article consists of two observation studies, which were conducted in Ankara. The first study aimed at investigating environmental factors and occupant characteristics affecting seat belt use among front-seat occupants, and the objective of the second study was to investigate the relationship between driver and front-seat passenger seat belt use.

METHOD

In the first study, 4, 227 front-seat occupants (drivers or front seat passengers) were observed on four different road sides and, in the second study 1, 398 front seat occupants were observed in car parks of five different shopping centers in Ankara. In both observations, front-seat occupants' seat bet use (yes, no), sex (male, female), and age (< 30 years, 30-50 years, > 50 years) were recorded.

RESULTS

The data were analyzed using chi-square statistics and binary logistic regression techniques. Results of the first study showed that seat belt use proportion among observed front seat occupants was very low (25%). Being female and traveling on intercity roads were two main factors positively related to use a seat belt among front-seat occupants. High correlations between seat belt use of the drivers and front-seat passengers were found in the second study.

CONCLUSIONS

Overall, low seat belt use rate (25%) among the front-seat occupants should be increased urgently for an improved driver and passenger safety in Turkey. Seat belt campaigns especially tailored for male front-seat occupants and for the front-seat occupants traveling on city roads are needed to increase seat belt use rates among them. Also, both drivers and passengers may have an important role in enforcing seat belt use among themselves.

Applying the concept of lifestyle in association with aggression and violence in Greek cohabitating couples

The current study investigated the role of lifestyle as a significant factor related to the aggression and violence between cohabitating partners. Based on previous research, lifestyle was defined as a special reflection of socialization into society and working life, where different lifestyles should also be able to produce different patterns of socialization into people's roles as partners. It was found that gender and years of cohabitating were significantly related to Emotional aggression and Sexual violence; lifestyle patterns were associated with specific forms of violence. More specifically, the lifestyles of Pleasure & Elegance and the one of Culture-Intellectualism were found to promote Emotional aggression. Also, the lifestyle of Yuppies/Workaholic and that of Physical activities stimulated the appearance of Sexual violence between partners. Moreover, individuals with Tradition-Religiousness lifestyle were more likely to show lower levels of Physical & Sexual violence while the adherents of the Substance abuse lifestyle pattern appeared to have an inclination towards Physical & Sexual Violence. Finally, the occurrence of one form of violent behaviour was likely to be related to the other forms of violent behaviour.

A maternity hospital-based infant car-restraint loan scheme: public health and economic evaluation of an intervention for the reduction of road traffic injuries

AIMS

The results of an infant car-restraint loan scheme and evaluate its cost-effectiveness are presented.

METHODS

The intervention programme was initiated in 1996. Car-restraints, donated by manufacturers, were lent for a six-month period to eligible prospective parents for a modest fee. Specially trained health visitors performed in-person interviews with the participating parents. The data were collected and recorded on a pre-coded questionnaire. Cross-tabulations and multiple logistic regression were performed to analyse the data. Subsequent purchase of a next-stage car restraint, suitable for older children (up to four years of age) was considered as a proxy measure of the success of the programme. This information, along with the detailed operational and financial data collected during the implementation phase of the programme, was used to develop a model to assess the cost-effectiveness of a countrywide intervention.

RESULTS

During a two-year period 188 families participated in a survey. On return of the infant car restraint, 92% of the participants reported proper use of the device and 82% had already purchased the second-stage car restraint. Parental age, gender, or educational status was not predictive of positive parental road safety practices for the newly born, whereas history of parental seat-belt use--as a proxy of personal road safety behaviour--was positively correlated with the likelihood of purchasing a second-stage car-restraint device. The cost-effectiveness ratio varies between 418.00 euro and 3,225.00 euro per life-year saved, depending on whether the modest administrative fee is considered.

CONCLUSIONS

On the basis of plausible assumptions, a loan programme of infant car-restraints was shown to be particularly cost effective.

A spatial and temporal analysis of safety-belt usage and safety-belt laws

Safety-belt usage has increased significantly in the US since the introduction of mandatory safety-belt usage laws in the 1980s. This paper analyzes the impact of these laws on increasing safety-belt usage while controlling for other state-specific variables. A fixed effects cross-sectional time-series analyses shows the relative significance of various state-level attributes in explaining safety-belt usage, including whether or not primary or secondary safety-belt laws have been passed. To further explore these relationships we employ spatial analyses techniques and find spatial autocorrelation in the data. Spatial correlation also exhibits a clear east-west direction. When the analyses is further corrected for temporal autocorrelation we find that the spatial autocorrelation is greatly diminished and that many variables lose their statistical significance, though safety-belt laws are still statistically significant. Results suggest that for this data, it is critical to control for temporal autocorrelation while spatial autocorrelation is less important. We also find that our spatial analyses does provide interesting information on similarities between various regions on the effectiveness of safety-belt laws.

An investigation of factors reducing seat belt use amongst Spanish drivers and passengers on urban roads

Seat belt use on Spain's highways is more than 80%, while on the urban roads this figure is around 50%. As there was little information available to explain the difference in seat belt use rates, the main aim of this study was to investigate why there is a lower rate of seat belt use on urban roads. A number of perceptions, beliefs and expectancies about seat belt use were examined to identify variables that discriminated between seat belt users and non-users on urban roads. The subjects were 398 undergraduate students (aged 17-47) studying at the University of Girona, Spain. On the urban roads reported discomfort from using the seat belt was higher, while perceptions of risk (for non-users), safety perceptions (for those using a seat belt), beliefs about the seriousness of a crash or the effectiveness of the seat belt were all lower than on the highway. Perceptions of safety, discomfort, and social influence predicted seat belt use on urban roads. Concern about being fined for not using a seat belt did not predict seat belt use. The results of this research suggest that in order to increase seat belt use on urban roads, the issue of discomfort must be addressed. In addition, prevention campaigns should include information about the effectiveness of the seat belt in preventing/reducing injuries or deaths on urban roads. The results also highlight the importance of social influence for determining seat belt use/non-use and the potential role social influence could play in increasing seat belt usage.

Car seatbelt use during pregnancy in Japan: determinants and policy implications

CONTEXT

Pregnant women are exempted from the current seatbelt legislation in Japan despite the fact that seatbelt use is essential to reduce the risk of fatalities for these women and their fetuses in car crashes.

OBJECTIVE

To examine factors that might influence seatbelt use during pregnancy.

METHODS

A cross sectional study, with data collected via an anonymous, self administered questionnaire at obstetric clinics in suburban areas of Japan. Altogether 880 pregnant women receiving prenatal care in July 2001 were recruited. The relative effects of factors that might influence seatbelt use during pregnancy were estimated using logistic regression analysis.

RESULTS

Almost 70%-80% of pregnant women were consistent seatbelt wearers before pregnancy but seatbelt compliance was reduced by about half at 20 weeks or more gestation. Only 20% had received information on maternal seatbelt use, with one third reporting that seatbelt use is beneficial during pregnancy. Those who perceived that maternal seatbelt use is beneficial tended to maintain use, but daily car users and those who knew that they were exempted from seatbelt legislation were more likely to reduce use.

CONCLUSIONS

Knowledge of the legislative exemption for pregnant women, misunderstanding of the benefits, and daily car use contributed to the reduction in seatbelt use after pregnancy.

Seatbelt use, attitudes, and changes in legislation: an international study

BACKGROUND

The use of seat belts is among the most effective methods of reducing injury in motor vehicle crashes. We examined trends in seat belt use by university students from 13 European countries between 1990 and 2000, in relation to changes in legislation, attitudes, and hazardous driver behaviors.

METHODS

Data were collected via an anonymous standardized questionnaire from university students in Belgium, England, France, Germany, Greece, Hungary, Iceland, Ireland, Italy, the Netherlands, Poland, Portugal, and Spain. There were 10,576 respondents in 1990, and 10,294 in 2000. Data were also collected from 1672 students in the United States in 2000. Analyses were performed in early 2002.

RESULTS

Reported seat belt use increased from 63% to 73% in male students, and from 66% to 77% in female students over the decade. There were marked increases in seat belt use in countries with changes in legislation or enforcement from 1990 to 2000, with 24% to 64% more respondents reporting seat belt use in 2000. The prevalence of use and noted changes during this period correlated with findings from national surveys (r= 0.91). Attitudes to seat belt use were associated with behavior both within and between countries. Nonuse of seat belts was positively related to alcohol-impaired driving and failure to obey speed limits.

CONCLUSIONS

Legislation has a substantial impact on the use of vehicle seat belts, but additional gains require efforts to change attitudes within the university student population.

Aggressive behavior while driving as predictor of self-reported car crashes

PROBLEM

In Greece, there is a lack of scientific evidence on the relationship between aggressive behavior while driving and young drivers' involvement in car crashes; this study examined this potential relationship.

METHODS

The randomly selected samples of 356 young drivers (18-24 years old) were interviewed through a questionnaire of self-reported car crash involvement, which mainly focused on their behavior on the road and the number of car crashes in which they had been involved.

RESULTS

The statistical methods used were principal components analysis (PCA) and multiple regression analysis. Two factors relevant to aggressive driving emerged: (a) driving violations and (b) irritability while driving. The multivariate model suggested that driving just for fun (joyriding) and irritability were predictors of young drivers' involvement in car crashes. It was found that younger age was negatively associated with young drivers' involvement in car crashes. IMPACT ON GOVERNMENT AND INDUSTRY: The findings of this study can contribute in the formation of public policies aiming to prevent young drivers' car crashes. These findings can also be the starting point of some health promotion interventions trying to reduce car crashes and casualties on the road. Finally, the insurance companies may be interested in applying these findings into their field of interest.