U.S. Department of Transportation 1200 New Jersey Avenue SE., Washington, DC 20590

National Highway Traffic Safety Administration

Number 379 October 2009

Traffic Safety Facts

Traffic Tech – Technology Transfer Series

Increasing Seat Belt Use Through State-Level 

Demonstration Projects: A Compendium of 

Initial Findings

This report summarizes the efforts and results from four 

of six State-level demonstration projects supported with 

cooperative agreements from the National Highway Traffic Safety Administration. The projects were intended 

to increase seat belt use Statewide in low-belt-use States 

through innovative approaches. They are the first of a series 

of innovative demonstration projects funded by NHTSA. A 

future report will cover the results from the next series of 

demonstration grants.

The States covered by this report are Idaho, Kansas, Massachusetts, and North Dakota. The processes used and outcomes in each State are contained in separate case studies that 

are appendices to the report. The case studies describe how 

each specific State problem was identified, how the demonstration project relates to the State’s Click It or Ticket (CIOT) 

program, the countermeasures selected for the program, the 

methods used to evaluate the program, and the evaluation 

results obtained. Each State also produced a detailed report 

of its activities available from the State directly.

History of NHTSA Seat Belt Efforts

It has long been recognized that the use of seat belts can 

reduce injuries and fatalities resulting from crashes. The 

problem has been to convince Americans to use the occupant restraints that are factory-installed in vehicles or readily 

available for young children. NHTSA engages in an ongoing national effort to save lives, prevent injuries, and reduce 

the societal costs of traffic crashes by increasing occupant 

restraint use.

Perhaps the most recognizable NHTSA seat belt campaign 

is the CIOT enforcement mobilization conducted at least 

annually, typically for two weeks around Memorial Day. 

A CIOT mobilization is a Selective Traffic Enforcement 

Program focused on occupant protection use. The police 

activity is supported with intensive paid and earned publicity that focuses primarily on enforcement of occupant 

restraint laws.

To enhance CIOT and other NHTSA efforts, NHTSA 

awarded six cooperative agreements to States with secondary laws and/or low belt use. These cooperative agreements 

were funded by Section 403 under 23 U.S.C., which provides 

funds for demonstration projects (in addition to other programs) to develop new ways to reduce motor vehicle related 

deaths and injuries including identifying and developing 

model strategies to increase seat belt use.

In addition to having secondary laws or low belt use (belt 

use below the national average), the States receiving the 

funding were selected because they faced significant challenges to increasing belt use, such as low fines, political limitations, and cultural impediments. The goal of the projects 

funded by the agreements was to offset these often difficult 

circumstances and resistance from various entities in those 

States through the use of a variety of traditional and innovative techniques.

The four States covered by this report (Idaho, Kansas, Massachusetts, and North Dakota) shared a common goal in using 

the funds from their cooperative agreement to increase seat 

belt use Statewide. Most of the States used enforcement and 

focused public education as the core of their interventions. 

These more traditional efforts were supplemented by innovative and individualized approaches.

State Program Summaries and Results

Idaho: Idaho developed innovative strategies based on feedback from its evaluation to focus on increasing belt use in 

the eastern part of the State where use was traditionally low. 

The Idaho program was designed to appeal to rural families and young males, and focused its supplemental education efforts under the demonstration project primarily on a 

“family values” message. In addition to the standard highvisibility enforcement and associated media activities, the 

demonstration project included three activities that were carried out only in the eastern part of the State—provision of a 

law enforcement liaison to improve the quality and quantity 
of tickets written and stops made, newspaper articles that 

provided local statistics on serious injury and fatal crashes, 

and weather/road reports with family values taglines. The 

increase of 5.2 percentage points in seat belt use in eastern 

Idaho, an area previously resistant to State seat belt mobilizations, was noteworthy. 

Kansas: Kansas used its demonstration project funding to 

mount a special enforcement program that tested corridor enforcement as a potentially cost-effective strategy for 

deployment of police resources. The aim was to increase 

seat belt use on selected high traffic roadways or corridors 

or at least to sustain the gain achieved by the statewide May 

mobilization. Tests of two different corridor approaches were 

made—the first one using a short intervention period on several corridors and the second using a longer intervention 

period on a single corridor. The tests suggested that short 

intervention periods on select corridors were not effective in 

increasing seat belt use, but possibly succeeded in helping 

Kansas maintain its four-percentage point gain from their 

May mobilization. 

During the four-day intense enforcement effort on the single corridor, seat belt use increased on the first day. By the 

post-intervention measurement, seat belt use returned to the 

pre-intervention rate. The more aggressive intervention did 

produce an effect in the desired direction, but it appeared to 

wear off relatively quickly. Thus, this demonstration project did not produce any substantial support for the corridor 

enforcement approach. 

Massachusetts: Massachusetts concentrated on extra enforcement and special localized education campaigns supported 

by police agencies to increase belt use above what was 

accomplished by the CIOT mobilization. The Massachusetts 

demonstration project tested three interventions: Statewide 

paid and earned media plus “normal” enforcement; Statewide media plus special (basically overtime) enforcement; 

and statewide media plus special enforcement plus localized 

education. Seat belt use increased statewide by 11 percentage points, but it appeared that the effects of the innovative 

approaches may have been enhanced by the strength of the 

State and national CIOT mobilizations.

North Dakota: North Dakota focused on increasing belt use by 

pickup drivers, particularly male pickup drivers—a group 

with notoriously low restraint use rates across the Nation. 

In the year prior to this project (2002), seat belt use in rural 

areas was 79 percent in passenger cars compared to only 54 

percent in pickups. Pre-campaign evaluation research confirmed that belt use was lower for pickup truck drivers in 

North Dakota as well and appropriate messages for reaching 

the target audience were developed. Statewide, belt use by 

pickup drivers went from 44.4 percent to 50.8 percent and 

for pickup drivers and passengers combined from 44.0 percent to 50.9 percent. Thus, although belt use by occupants of 

pickup trucks remained lower than that for any other vehicle type, substantial gains in belt use were achieved among 

those on whom the campaign was focused. In particular, the 

goal of achieving a 50-percent use rate by pickup truck drivers was achieved. 

Conclusion

The four State demonstration projects covered in this 

report were four of the first six in a series of similar projects 

designed to examine the benefits of adding locally derived 

and implemented innovative methods to supplement CIOT. 

The findings from the four case studies strongly suggest that 

the basic approach is sound and assisted each of the States 

in boosting seat belt use. A final conclusion must, however, 

await the completion of the second round of demonstration 

projects that are nearing completion as this report is being 

written. If these later projects continue to show benefits such 

as those discussed here, it will be reasonable to finalize the 

conclusion that adding innovative approaches to CIOT is a 

productive activity.

How to Order

To order Increasing Seat Belt Use Through State-Level Demonstration Projects: A Compendium of Initial Findings (48 pages), 

prepared by Dunlap and Associates, write to the Occupant 

Protection Division, NHTSA, NTI-112, 1200 New Jersey Avenue SE., Washington, DC 20590, fax 202-366-2766, or download from www.nhtsa.gov. Jennifer Warren was the task 

order manager for this project.

TRAFFIC TECH is a publication to disseminate information about 

traffic safety programs, including evaluations, innovative programs, and new publications. Feel free to copy it as you wish. If you 

would like to receive a copy, contact Angela H. Eichelberger, Ph.D., 

Editor, fax 202-366-7394, e-mail: angela.eichelberger@dot.gov.

1200 New Jersey Avenue SE., NTI-132

Washington, DC 20590