Effectiveness of Ford's belt reminder system in increasing seat belt use

Seat belt use among pregnant women in the United Arab Emirates: the Mutaba'ah Study

INTRODUCTION

Motor vehicle collisions are a major cause of death and injury among pregnant women and their fetuses. Seat belt use compliance during pregnancy varies in different populations. We aimed to study seat belt use among pregnant women and factors affecting seat belt use during pregnancy in Al Ain City, the United Arab Emirates.

METHODS

This cross-sectional analysis used the baseline data collected from pregnant women participating in the Mutaba'ah Study from May 2017 to November 2022. Data were collected using self-administered questionnaires. Variables included sociodemographic, gestation periods and seat belt-related information. All pregnant women who responded to the questions related to seat belt use were included (N=2354).

RESULTS

Seat belt use before and during pregnancy was estimated at 69.7% (95% CI 67.9% to 71.6%) and 65.5% (95% CI 63.6% to 67.4%), respectively. The reasons for not using seat belts during pregnancy included being uncomfortable to wear, habitual non-use and considering them unsafe for pregnancy. Age, higher levels of education of the pregnant woman or her spouse, being employed, having a sufficient household income, lower gestational age, and using a seat belt before pregnancy were positively associated with using a seat belt during pregnancy in the bivariate analyses. Pregnant women in their third trimester had independently significant lower odds of using a seat belt compared with those in the first trimester (OR 0.42, 95% CI 0.24 to 0.76).

CONCLUSIONS

The findings indicate decreased compliance with seat belt use during pregnancy and as gestation progressed. The decrease was related to several reasons, including feeling uncomfortable wearing seat belts, habitual non-use and unsafe for pregnancy, necessitating appropriate measures to increase awareness. Raising public awareness about the advantages of wearing seat belts during pregnancy and the involvement of healthcare professionals in educating pregnant women are warranted.

Quantifying and recommending seat belt reminder timing using naturalistic driving video data

INTRODUCTION

To better understand the timing of when people buckle their seat belt, an analysis of a naturalistic driving study was used. The study provided a unique perspective inside of the vehicle where the entire seat belt was visible from the time the driver entered the vehicle to one minute of driving forward or 32 kph.

METHOD

Seat belt buckling behavior was identified for 30 drivers. An additional 10 drives for 13 of these drivers were identified for a seat belt sequencing, which identified the points when the vehicle was put into ignition, shifted, when vehicle movement began, and when the seat belt was buckled. The speed at belt closure was also identified. The timing from ignition to buckle and to shifting into forward gear were examined to identify the speed and appropriate timing for seat belt reminders.

RESULTS

The data show that drivers were buckled in over 92% of the 3,102 drives. In addition, in 70% of those total drives, the drivers were buckled before the vehicle began movement. Of greater interest for seat belt reminders/interlocks are those drives when drivers buckle after movement. When considering time from ignition to seat belt closure, the mean was 27.5 s. Because higher speeds are typically reached when traveling forward rather than reverse, it was important to know the time duration from shifting into drive to buckling. With this consideration, the mean to buckle dropped to 16.2 s. The mean speed at buckling when traveling forward was 15.3 kph. From the regression analysis, the input variables 'Age,' 'Sex,' 'Weight,' 'Environment,' and 'Weather' are significant contributors in predicting the log odds of a driver putting on seatbelt.

CONCLUSIONS

With the understanding that higher speeds lead to an increased risk of injury and/or death and with the results of the analysis, a recommendation of a 30 s time from forward shift and a 25 kph (6.9 m/s) threshold for reminder systems should be implemented. The regression analysis also validates that most of the predicted seat belt buckling times are within 30 s. Practical Applications: This would reduce perception of nuisance alerts and protect the driver from higher speed unbuckled crashes. The seat belt buckling time prediction model also demonstrates good potential for developing tailored buckling warning system for different drivers.

The effects of persistent audible seat belt reminders and a speed-limiting interlock on the seat belt use of drivers who do not always use a seat belt

INTRODUCTION

Vehicle technologies that increase seat belt use can save thousands of lives each year. Kidd, Singer, Huey, and Kerfoot (2018) found that a gearshift interlock was more effective for increasing seat belt use than an intermittent audible reminder, but interlocks may not be more effective than persistent audible reminders lasting at least 90 seconds.

METHOD

Forty-nine part-time belt users with a recent seat belt citation who self-reported not always using a seat belt drove two vehicles for 1 week each. Thirty-three drove a Chevrolet with an intermittent audible reminder followed by either a BMW with a persistent 90-second audible reminder (n = 17) or a Subaru with an incessant audible reminder (n = 16). The other 16 participants experienced the BMW persistent reminder followed by an interlock that limited speed to 15 mph during unbelted driving. These data were combined with data from 32 part-time belt users in Kidd et al. (2018) who experienced the intermittent reminder for 2 weeks or the intermittent reminder for 1 week and a gearshift interlock the next.

RESULTS

Relative to the intermittent reminder, seat belt use was significantly increased an estimated 30% by the BMW persistent reminder, 34% by the Subaru incessant reminder, and 33% by the speed-limiting interlock. Belt use was increased an estimated 16% by the gearshift interlock, but this change was not significant. More participants circumvented the speed-limiting interlock to drive unbelted than the audible reminders. Responses to a poststudy survey indicated that interlocks were less acceptable than reminders.

CONCLUSIONS

Audible reminders lasting at least 90 seconds and a speed-limiting interlock were more effective for increasing seat belt use than an intermittent audible reminder, but reminders were found more acceptable. Practical applications: Strengthening existing U.S. safety standards to require audible reminders lasting at least 90 seconds for front-row occupants could save up to 1,489 lives annually.

The effect of a gearshift interlock on seat belt use by drivers who do not always use a belt and its acceptance among those who do

INTRODUCTION

Seat belts reduce the risk of fatal injury in a crash, yet in 2015, nearly 10,000 people killed in passenger vehicles were unrestrained. Enhanced seat belt reminders increase belt use, but a gearshift interlock that prevents the vehicle from being placed into gear unless the seat belt is used may prove more effective.

METHOD

Thirty-two people with a recent seat belt citation and who admitted to not always using a seat belt as a driver were recruited as part-time belt users and asked to evaluate two new vehicles. Sixteen drove two vehicles with an enhanced reminder for one week each, and 16 drove a vehicle with an enhanced reminder for one week and a vehicle with a gearshift interlock the following week. Sixteen full-time belt users who reported always using a seat belt drove a vehicle with a gearshift interlock for one week to evaluate acceptance.

RESULTS

Relative to the enhanced reminder, the gearshift interlock significantly increased the likelihood that a part-time belt user used a belt during travel time in a trip by 21%, and increased the rate of belt use by 16%; this effect approached significance. Although every full-time belt user experienced the gearshift interlock, their acceptance of the technology reported in a post-study survey was fairly positive and not significantly different from part-time belt users. Six part-time belt users circumvented the gearshift interlock by sitting on a seat belt, waiting for the system to deactivate, or unbuckling during travel.

CONCLUSION

The gearshift interlock increased the likelihood that part-time belt users buckled up and the rate of belt use during travel relative to the enhanced reminder but could be more effective if it prevented circumvention.

PRACTICAL APPLICATIONS

An estimated 718-942 lives could be saved annually if the belt use of unbuckled drivers and front passengers increased 16-21%.

Driver and front passenger injury in frontal crashes: Update on the effect of unbelted rear occupants

PURPOSE

This is a study of the influence of an unbelted rear occupant on the risk of severe injury to the front seat occupant ahead of them in frontal crashes. It provides an update to earlier studies.

METHODS

1997-2015 NASS-CDS data were used to investigate the risk for severe injury (Maximum Abbreviated Injury Score [MAIS] 4+F) to belted drivers and front passengers in frontal crashes by the presence of a belted or unbelted passenger seated directly behind them or without a rear passenger. Frontal crashes were identified with GAD1 = F without rollover (rollover ≤ 0). Front and rear outboard occupants were included without ejection (ejection = 0). Injury severity was defined by MAIS and fatality (F) by TREATMNT = 1 or INJSEV = 4. Weighted data were determined. The risk for MAIS 4+F was determined using the number of occupants with known injury status MAIS 0+F. Standard errors were determined.

RESULTS

The risk for severe injury was 0.803 ± 0.263% for the driver with an unbelted left rear occupant and 0.100 ± 0.039% with a belted left rear occupant. The driver's risk was thus 8.01 times greater with an unbelted rear occupant than with a belted occupant (P <.001). With an unbelted right rear occupant behind the front passenger, the risk for severe injury was 0.277 ± 0.091% for the front passenger. The corresponding risk was 0.165 ± 0.075% when the right rear occupant was belted. The front passenger's risk was 1.68 times greater with an unbelted rear occupant behind them than a belted occupant (P <.001). The driver's risk for MAIS 4+F was highest when their seat was deformed forward. The risk was 9.94 times greater with an unbelted rear occupant than with a belted rear occupant when the driver's seat deformed forward. It was 13.4 ± 12.2% with an unbelted occupant behind them and 1.35 ± 0.95% with a belted occupant behind them.

CONCLUSIONS

Consistent with prior literature, seat belt use by a rear occupant significantly lowered the risk for severe injury to belted occupants seated in front of them. The reduction was greater for drivers than for front passengers. It was 87.5% for the driver and 40.6% for the front passenger. These results emphasize the need for belt reminders in all seating positions.

Prevalence of rear seat belt use among pregnant women in a suburban area of Japan

AIM

The aim of this study was to clarify the prevalence and influencing factors of rear seat belt use among pregnant women.

METHODS

Questionnaires were given to 1546 pregnant women who visited obstetrics clinics and hospitals for prenatal checkups from October to December 2013. A total of 1494 pregnant women (96.6%) agreed to participate in this study and completed the questionnaire.

RESULTS

Fewer than 20% of the rear-seat passengers 'always' used seat belts before and during pregnancy, whereas a third 'never' used a seat belt before or during pregnancy. There was no significant decrease in seat belt use by rear-seat passengers during compared to before pregnancy. Multivariate analysis revealed that age, knowledge of how to use a seat belt during pregnancy, belief in the compulsory use of a rear seat belt and driver behavioral characteristics before pregnancy were associated with rear seat belt use during pregnancy.

CONCLUSIONS

The prevalence of fastening seat belts was substantially low. The provision of information regarding proper seat belt use and its role in protecting the fetus may increase use.

Health by Design: Interweaving Health Promotion into Environments and Settings

The important influence of the environmental context on health and health behavior—which includes place, settings, and the multiple environments within place and settings—has directed health promotion planners from a focus solely on changing individuals, toward a focus on harnessing and changing context for individual and community health promotion. Health promotion planning frameworks such as Intervention Mapping provide helpful guidance in addressing various facets of the environmental context in health intervention design, including the environmental factors that influence a given health condition or behavior, environmental agents that can influence a population’s health, and environmental change methods. In further exploring how to harness the environmental context for health promotion, we examine in this paper the concept of interweaving of health promotion into context, defined as weaving or blending together health promotion strategies, practices, programs, and policies to fit within, complement, and build from existing settings and environments. Health promotion interweaving stems from current perspectives in health intervention planning, improvement science and complex systems thinking by guiding practitioners from a conceptualization of context as a backdrop to intervention, to one that recognizes context as integral to the intervention design and to the potential to directly influence health outcomes. In exploring the general approach of health promotion interweaving, we examine selected theoretical and practice-based interweaving concepts in relation to four key environments (the policy environment, the information environment, the social/cultural/organizational environment, and the physical environment), followed by evidence-based and practice-based examples of health promotion interweaving from the literature. Interweaving of health promotion into context is a common practice for health planners in designing health promotion interventions, yet one which merits further intentionality as a specific health promotion planning design approach.

Translational Research in Child and Adolescent Transportation Safety

Motor vehicle crash (MVC)–related injury is the leading cause of death among youths age 1 to 19 years. Advances in MVC and injury prevention depend on interrelated combinations of technology, policy, and education, and research on these topics can inform policy and lead to improvement in safety. This article presents two examples of translational research in transportation injury prevention. In the first example of child passenger protection, the authors describe a program of research designed to reduce the gap between the theoretical and practical effectiveness of safety methods. In the second example of novice teen drivers, the authors examine translational research related to two complementary approaches to reducing the exposure of novice teen drivers to high-risk driving conditions—graduated driver licensing policy and parental management of novice teen drivers. The examples suggest the utility of systematic programs of research designed to improve the translation into practice of MVC and injury prevention technology and policy.

The European New Car Assessment Programme: A historical review

Established in 1997, the European New Car Assessment Programme (Euro NCAP) provides consumers with a safety performance assessment for the majority of the most popular cars in Europe. Thanks to its rigorous crash tests, Euro NCAP has rapidly become an important driver safety improvement to new cars. After ten years of rating vehicles, Euro NCAP felt that a change was necessary to stay in tune with rapidly emerging driver assistance and crash avoidance systems and to respond to shifting priorities in road safety. A new overall rating system was introduced that combines the most important aspects of vehicle safety under a single star rating. The overall rating system has allowed Euro NCAP to continue to push for better fitment and higher performance for vehicles sold on the European market. In the coming years, the safety rating is expected to play an important role in the support of the roll-out of highly automated vehicles.

Attitudes toward seat belt use and in-vehicle technologies for encouraging belt use

OBJECTIVES

In-vehicle seat belt reminders and interlocks can encourage belt use, but widespread adoption of these features depends on the degree of acceptance among both belted and unbelted occupants. The current study collected information about attitudes toward belt use and in-vehicle technologies for encouraging belt use.

METHODS

A national telephone survey of 1218 adult drivers and passengers was conducted using random samples of landline and cell phone numbers. Part-time belt users and nonusers were oversampled. All respondents were asked about frequency of belt use, buckling routines, and support for different types of belt interlocks. Part-time belt users and nonusers were queried in more depth about different types of reminders and reminder strategies.

RESULTS

Almost all respondents said that they always use their seat belts (91%). Few said that they did not always (8%) or never (1%) used belts. Driving a short distance (67%), forgetting (60%), and comfort (47%) were common reasons why part-time belt users do not buckle up; comfort (77%), not needing a seat belt (54%), and disliking being told what to do (50%) were most frequently cited among nonusers. When asked about various types of belt interlocks, part-time belt users and nonusers most often said that ignition interlocks would make them more likely to buckle up (70% and 44%, respectively). However, only 44 to 51 percent of all respondents, including full-time belt users, supported using the different types of interlocks to increase belt use. A larger proportion of part-time belt users and nonusers said that they would be more likely to buckle up in response to auditory and haptic reminders than visual reminders. More than two thirds of part-time belt users and at least one third of nonusers said that they would be more likely to buckle up in response to belt reminders that become more intense or continue indefinitely; these reminders would be acceptable to about half of part-time belt users and around one fifth of nonusers.

CONCLUSIONS

The Moving Ahead for Progress in the 21st Century (MAP-21) law allows the National Highway Traffic Safety Administration to strengthen minimum requirements for belt reminders or allow the use of interlocks to meet federal safety standards. Even though most people always buckle up, belt interlocks are supported by only about half of full-time belt users and by fewer part-time belt users and nonusers. Enhanced reminder systems are more acceptable than belt interlocks and are viewed as almost as effective as interlocks if persistent enough. Supplemental materials are available for this article. Go to the publisher's online edition of Traffic Injury Prevention to view the supplemental file.

Drivers' attitudes toward front or rear child passenger belt use and seat belt reminders at these seating positions

OBJECTIVE

Passengers, especially those in rear seating positions, use seat belts less frequently than drivers. In-vehicle technology can inform drivers when their passengers are unbuckled and encourage passengers to use belts. The current study collected information about drivers' attitudes toward passenger belt use and belt reminders for front passengers and children in back seats.

METHODS

A national telephone survey of 1218 people 18 and older was conducted, of which 477 respondents were drivers who transport a front seat passenger at least once a week and 254 were drivers who transport an 8- to 15-year-old child in the back seat. Respondents were asked about their attitudes toward belt use by their front passengers or rear child passengers and preferences for different passenger belt reminder features.

RESULTS

Ninety percent of drivers who regularly transport front seat passengers said that the passengers always use seat belts. Reported belt use was even higher among 8- to 15-year-old children in the back seat (97%). Among the drivers whose children do not always buckle up, about half said their child unbuckled the belt during the trip. Almost every full-time belt use driver (96%) would encourage front passengers to buckle up if not belted, compared to 57 percent of part-time belt users and nonusers. In contrast, nearly every driver who transports children in the back seat would encourage their belt use, regardless of the driver's belt use habits. Most drivers who transport front passengers wanted passenger belt reminders to encourage passengers to buckle up. Most of these drivers wanted a chime/buzzer or warning light or text display and wanted the reminder to last indefinitely. Most drivers who transport child passengers in the rear seat wanted the vehicle to indicate whether child passengers are unbuckled. A large majority of these drivers wanted notifications via a visual diagram of seating positions and belt use, a chime/buzzer, and a warning light or text display. These drivers also wanted the vehicle to provide belt use information until the child buckled up.

CONCLUSIONS

Many drivers, especially those who always use seat belts, said they would encourage unbuckled passengers to buckle up and supported auditory and visual belt reminders for passengers, particularly for children sitting in the back seat. Front and rear passenger reminders that last indefinitely would be acceptable to most drivers who transport these passengers. An auditory alert may be especially useful to alert drivers to children unbuckling in the back seat during a trip.

Fatal crashes of 16- to 17-year-old drivers involving alcohol, nighttime driving, and passengers

OBJECTIVE

The objective of this study was to provide a contemporary analysis of the alcohol-impaired driving problem among 16- to 17-year-olds and to consider the potential role of night and passenger restrictions in dealing with the alcohol problem by determining how many of the alcohol-related crashes take place at night or with passengers.

METHODS

The data were derived from the Fatality Analysis Reporting System for 16- to 17-year-old passenger vehicle drivers in fatal crashes during 2005-2009.

RESULTS

During the 5-year period, 15 percent of the 8664 16- to 17-year-old drivers in fatal crashes had positive blood alcohol concentrations, most of which were 0.08 percent or greater. Drivers in alcohol-related crashes were more likely than those in non-alcohol-related crashes to be male, unbelted, in single vehicles, and speeding, and their crashes were more likely to occur on Saturday or Sunday, at night, and when passengers were present. Of the alcohol-related crashes, 88 percent took place at night or with passengers present or both, as did 67 percent of the non-alcohol-related crashes.

CONCLUSIONS

Stronger night and passenger restrictions with increased compliance and greater application of alcohol-specific policies would likely be effective in reducing the alcohol-related and non-alcohol-related crashes of 16- to 17-year-olds. Increasing the licensing age beyond age 16 would supplement the effectiveness of these actions.

An evaluation of graduated driver licensing effects on fatal crash involvements of young drivers in the United States

OBJECTIVE

Graduated driver licensing (GDL) systems are designed to reduce the high crash risk of young novice drivers. Almost all states in the United States have some form of a 3-phase GDL system with various restrictions in the intermediate phase. Studies of the effects of GDL in various states show significant reductions in fatal crash involvements of 16- and 17-year-old drivers; however, only a few national studies of GDL effects have been published. The objective of this national panel study was to evaluate the effect of GDL laws on the fatal crash involvements of novice drivers while controlling for possible confounding factors not accounted for in prior studies.

METHODS

The Fatality Analysis Reporting System (FARS) was used to examine 16- and 17-year-old driver involvement in fatal crashes (where GDL laws are applied) relative to 2 young driver age groups (19-20, 21-25) where GDL would not be expected to have an effect. Dates when various GDL laws were adopted in the states between 1990 and 2007 were coded from a variety of sources. Covariates in the longitudinal panel regression analyses conducted included 4 laws that could have an effect on 16- and 17-year-old drivers: primary enforcement seat belt laws, zero-tolerance (ZT) alcohol laws for drivers younger than age 21, lowering the blood alcohol concentration limit for driving to 0.08, and so-called use and lose laws where drivers aged 20 and younger lose their licenses for underage drinking violations.

RESULTS

The adoption of a GDL law of average strength was associated with a significant decrease in fatal crash involvements of 16- and 17-year-old drivers relative to fatal crash involvements of one of the 2 comparison groups. GDL laws rated as "good" showed stronger relationships to fatal crash reductions, and laws rated as "less than good" showed no reductions in crash involvements relative to the older driver comparison groups.

CONCLUSIONS

States that adopt a basic GDL law can expect a decrease of 8 to 14 percent in the proportion of 16- and 17-year-old drivers involved in fatal crashes (relative to 21- to 25-year-old drivers), depending upon their other existing laws that affect novice drivers, such as those used in these analyses. This finding is consistent with recent national studies that used different outcome measures and covariates. The results of this study provide additional support for states to adopt, maintain, and upgrade GDL systems to reduce youthful traffic crash fatalities.

The contribution of fatal crashes involving teens transporting teens

OBJECTIVE

We determined the proportion of all fatal crashes of 16- and 17-year-old drivers that involved the presence of teenage passengers from 2004 to 2008.

METHODS

Data on fatal crashes of 16- and 17-year-old drivers were derived from the Fatality Analysis Reporting System for the years 2004-2008.

RESULTS

For both 16- and 17-year-old drivers, in each of the 5 years examined, at least 39 percent of all their fatal crash events involved the presence of 13- to 19-year-old passengers and no one younger or older. For 16- to 17-year-olds combined, the proportion of crashes involving drivers with teen passengers changed little from 2004 (43%) to 2008 (41%), despite the growth in the number of states with passenger restrictions from 23 to 37 during this period.

CONCLUSION

A high proportion of teen crashes involve the presence of other teens as passengers at the time of the crash. There is a need to find effective ways to reduce these crashes.

Effect of enhanced seat belt reminders on driver fatality risk

OBJECTIVE

Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.

METHOD

Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.

RESULTS

Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.

CONCLUSIONS

Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.

IMPACT ON INDUSTRY

Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible.

Preventing Traffic Injuries: Strategies That Work

Motor vehicle crashes result in more than 40 000 deaths and 4.3 million nonfatal injuries annually. Many known effective strategies to address these preventable deaths and injuries are closely related to lifestyle factors. Clinicians can play a large part in supporting effective interventions in their practice, for example, by counseling patients about seat belt use. Clinicians can also have an impact in their community by supporting positive public policy change.

Analysis of teenage seat belt use: from the 2007 Missouri high school seat belt survey

INTRODUCTION

This study analyzed high school teenagers' seat belt use based on the observational surveys of more than 15,000 teenagers at 150 schools and was conducted in the state of Missouri, U.S., in 2007. Since fatal car accidents involving high school teenagers are disproportionately high, and increased seat belt use saves lives in what would otherwise be fatal accidents, it is imperative that teenagers' safety be protected through an increase in use.

METHOD

This study investigated various personal, vehicle, school, and locational factors associated with high school teenagers' seat belt use. Descriptive and binary logit analyses were conducted.

RESULTS

We find that low seat belt use is associated with males, African-Americans, pick-up trucks, accompanying occupants, weekends, inclement driving conditions, small size of school, lower socio-economic status, and rural county school locations. Several factors influencing teenage seat belt use are quite similar to those affecting adult seat belt use, in addition to certain risky behaviors to which teenagers are prone, supporting the importance of early intervention.

CONCLUSIONS

Programs in schools, the adoption of primary seat belt laws, GDL provisions requiring seat belt use, targeted education and campaign efforts for African-American teenagers, seat belt reminder systems, and more resources for rural counties on safety education and enforcement may help increase seat belt use in this vulnerable age group, though other research questions are implied.

Intelligent seat belt reminders-do they change driver seat belt use in Europe?

OBJECTIVE

Many modern cars have seat belt reminders (SBRs) using loud and clear sound and light signals. These systems have developed over the last few years. This study investigates how these modern systems influence the seat belt use in real-life traffic in built-up areas in some European cities.

METHODS

The data were collected by field observations in major cities in six European countries and in five cities around Sweden. A selection of car models having seat belt reminders (SBR) were compared to a fleet of similar car models without such reminders.

RESULTS

A significant difference in seat belt wearing rate was found in the cars with seat belt reminders. For all observations, the total seat belt wearing rate was 97.5% +/- 0.5% in cars with SBR, while it was 85.8% +/- 0.8% in cars without. There were differences in seat belt use in the different observation locations. The lowest seat belt use was found in Brussels/Belgium with a use rate of 92.6 +/- 2.2% in cars with seat belt reminders and 69.6 +/- 3.1% in cars not fitted with reminders. The highest seat belt use was found in Paris/France where 99.8 +/- 0.4% of the drivers used the seat belt in cars with reminders and 96.9 +/-1.1% were belted in cars without reminders.

CONCLUSION

Seat belt reminders fulfilling Euro NCAP's seat belt reminder protocol are increasing the seat belt use in daily traffic significantly. Around 80% (82.2% +/- 8.6%) of the drivers not putting the belt on without a seat belt reminder do so in cars equipped with an SBR that has a light signal and an associated loud and clear sound signal.

Licensing teenagers: nontraffic risks and benefits in the transition to driving status

OBJECTIVE

The initiation of teen driving, which occurs between ages 15 and 17, has generally been studied primarily in relation to crash injury reduction. However, it may be the most important period influencing development between puberty and emerging adulthood because, once the teens are driving on their own or riding with other teens, parental control over social behavior is greatly reduced and opportunities for risk-taking are substantially increased. The noncrash risks and benefits of licensing during this critical transition period are the subject of this paper.

METHODS

We identify "transition teens" as a subgroup of all 15-to 17-year-olds who reside in middle-class suburban and rural areas where families can afford a car and where a vehicle is needed for reasonable mobility. In this paper, we review recent studies on the effect of driving on non-traffic-related behaviors of teen drivers. Our analysis suggests that there are two environments that affect behavior and development: the home environment and the extended environment. Before driving age, the home environment influences are omnipresent in the life of the developing child. However, once teens can move more readily within the community and travel outside the home environment on their own or with a peer, they have access to locations where many or all the local controls on risky behavior may be absent.

RESULTS AND CONCLUSIONS

This article introduces the concept of "transitional teens" and provides a rough model that explains the possible risks encountered by this group when they begin to drive a vehicle or to ride with a peer. We offer this model to the research community with a challenge to hypothesize, test, and explore this proposed transitional period so that we can better understand and mitigate its associated risks.

Parent attitudes toward integrating parent involvement into teenage driver education courses

OBJECTIVE

The widespread adoption of graduated driver licensing (GDL) policies has effectively reduced crash risk for young drivers; however, parents must support, reinforce, and enforce GDL for it to be effective, and research indicates that parents need better information and instruction for adhering to GDL requirements, conducting supervised practice driving, and restricting independent teenage driving. Because teenagers in most states must take driver education to enter the licensing process prior to age 18, integrating parent involvement into driver education may be an effective way to inform and instruct parents on a large scale about teen driver safety. This study assessed parent attitudes (overall and by rural status, minority status, and income level) toward integrating parent involvement into teenage driver education classes.

METHODS

In this study, 321 parents of teenagers enrolled in driver education classes across the state of Montana completed surveys about current involvement in driver education and attitudes toward required involvement.

RESULTS

The results indicated that parents were not very involved currently in their teenagers' driver education classes, but 76% reported that parents should be required to be involved. If involvement were required, parents would prefer having written materials sent home, access to information over the Internet, or discussions in person with the instructor; far fewer would prefer to attend classes or behind-the-wheel driving instruction. There were few differences in parent attitudes by rural or minority status but many by income level. Compared to higher income parents, lower income parents were more likely to endorse required parent involvement in teenage driver education classes and to want parent information from driver education about many teen driving issues.

CONCLUSIONS

That the majority of parents are open to required involvement in their teenagers' driver education classes is promising because doing so could better prepare parents to understand and adhere to GDL policies, supervise teenagers' practice driving, and manage teen independent driving, all of which could further increase teen driver safety.

Effectiveness and driver acceptance of the Honda belt reminder system

OBJECTIVE

Prior research suggests that vehicle-based seat belt reminder systems can produce moderate increases in belt use rates. However, these findings were based on a limited set of Ford vehicles in one geographic location. As more vehicles with reminder systems enter the market, it is important to determine their effectiveness as well as acceptance by consumers. The present study investigated the effectiveness of Honda's belt reminder system.

METHODS

Driver belt use was observed unobtrusively as drivers brought their Honda vehicles to dealerships for service. Drivers also were asked to complete a mail-in survey designed to elicit their experience with the system.

RESULTS

Belt use was significantly higher among drivers of vehicles with belt reminders compared with drivers of vehicles without reminders (90 vs. 84 percent). Use rates in vehicles with reminders were higher among both male and female drivers and in all vehicle types observed. Drivers of the Honda vehicles with belt reminders viewed the system very favorably, and nearly 90 percent said they would want one in their next vehicle. The reminder was perceived to be most effective by part-time belt users; 81 percent of part-time users said they now use belts more often, compared with 32 percent of respondents who said they always use belts and 18 percent who use belts occasionally.

CONCLUSION

Belt reminders in Honda as well as Ford vehicles are increasing. Although the increase is moderate (5.6 percentage points), on a national level it could have prevented at least 736 driver deaths in 2004.

Traffic safety in the U.S.: re-examining major opportunities

INTRODUCTION

This article examines five major road-safety risk factors: exceeding posted speed limits, not using safety belts, driving while intoxicated, nighttime driving, and young drivers.

METHOD

The importance of each of these factors is documented, known effective countermeasures (both policy and technology based) are discussed, and impediments to the implementation of these countermeasures in the United States are examined.

RESULTS

Based on current understanding of the five major risk factors, and of the available countermeasures, there appear to be a variety of opportunities to make substantial gains in road safety using existing knowledge. The limited implementation of a variety of known countermeasures therefore appears to be inconsistent with high-level, strategic goals to improve road safety. Consequently, a recommendation is made to comprehensively re-examine the balance between the countermeasures discussed in this article and economic, mobility, and privacy concerns. IMPACT ON PUBLIC SAFETY: Such a re-examination is likely to result in broad support for these countermeasures, with a consequent major improvement in road safety.

Do recommended driving limits affect teen-reported traffic violations and crashes during the first 12 months of independent driving?

OBJECTIVES

Motor vehicle crashes are highly elevated among newly licensed teenage drivers. Limits on high-risk driving conditions by driver licensing policies and parents can protect novice teens from negative driving outcomes, while they experience and driving proficiency. The purpose of this research was to evaluate the effects of strict parent-imposed driving limits on driving outcomes during the first year of licensure.

METHODS

A sample of 3,743 Connecticut teens was recruited and randomized to the Checkpoints Program or comparison condition. Assessments conducted at baseline, licensure, 3-, 6-, and 12-months postlicensure included parent-imposed driving limits, traffic violations, and crashes. Bivariate and multivariate analyses were conducted to assess the effects of strict parent limits on traffic violations and crashes during the first year of licensure.

RESULTS

Thirty percent of teens reported at least one traffic violation and 40% reported at least one crash. More strict parent-imposed limits at licensure, 3-, 6-, and 12-months postlicensure, were associated with fewer violations and crashes in multivariate analyses. Notably, adherence to recommended night curfew was consistently associated with fewer violations and crashes.

CONCLUSIONS

The findings indicate that strict parent-imposed limits may protect novice teen drivers from negative driving outcomes.

The use of seat belts in cars with smart seat belt reminders--results of an observational study

Recently, smart seat belt reminders (SBR) have been introduced in cars. By increasingly reminding drivers and passengers if they are not using the seat belt, the intention is to increase the belt use to almost 100%.

OBJECTIVE

The objective was to study if there were differences in driver's seat belt use between cars with and without SBR.

METHODS

Drivers of cars with and without SBR were observed concerning seat belt use. The case (cars with SBR) and the control group (cars without SBR) were similar in all major aspects except SBR. In all, more than 3,000 drivers were observed in five cities in Sweden.

RESULTS

In cars without SBR, 82.3 percent of the drivers used the seat belt, while in cars with SBR, the seat belt use was 98.9 percent. The difference was significant. In cars with mild reminders, the use was 93.0 percent.

CONCLUSION

It is concluded, that if the results can be generalised to the whole car population this would have a dramatic impact on the number of fatally and seriously injured car occupants.

Persistence of effects of the Checkpoints program on parental restrictions of teen driving privileges

OBJECTIVES

We describe intervention effects on parent limits on novice teenage driving.

METHODS

We recruited parents and their 16-year-old children (n = 469) with learner's permits and randomized them from August 2000 to March 2003. Intervention families received persuasive newsletters related to high-risk teenage driving and a parent-teenager driving agreement; comparison families received standard information on driver safety. We conducted interviews when the adolescents obtained a learner's permit, upon licensure, and at 3, 6, and 12 months postlicensure.

RESULTS

Intervention parents and teenagers reported stricter limits on teen driving compared with the comparison group at 12 months, with direct effects through 3 months and indirect effects through 12 months postlicensure.

CONCLUSIONS

A simple behavioral intervention was efficacious in increasing parental restriction of high-risk teen driving conditions among newly licensed drivers.

Benefits of seat belt reminder systems

This study sought to determine whether fitting a more aggressive seat belt reminder system to new vehicles would be cost-beneficial for Australia. While seat belt wearing rates have been observed around 95% in the front seat, non-wearing rates in casualty crashes are as high as 33% among persons killed and 19% among seriously injured occupants. Benefits were computed for three device options (simple, simple-2 and complex) and three introduction scenarios (driver-only, front seat occupants and all occupants). Four levels of effectiveness were assumed, from 10% to 40%, depending on the type of device fitted. Unit benefits were computed assuming a 5% discount rate and a 15yr fleet life. Various industry experts provided the costs. The findings showed that Benefit-Cost-Ratios ranged from 4.0:1 at best (simple device for the driver only) to 0.9:1 for all seating positions. These figures are conservative, given the assumptions made and the discounted human capital methods used.