Number 366 March 2009

Traffic Safety Facts

Traffic Tech – Technology Transfer Series

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

National Highway Traffic Safety Administration

Motor vehicle crashes are the leading cause of injury and

death among children and teenagers in the United States.

Proper use of vehicle restraints is an effective means to prevent many of these injuries. The objective of this project was

to identify the best approaches for increasing seat belt usage

among 8- to 15-year-olds.

Methods

This was a three-phased research project. The first phase

was a systematic review of published literature to identify

interventions that encourage seat belt use among children in

the 8-15 age range. In addition, information was gathered on

each component of the theoretical model guiding this project,

which was derived from the theory of reasoned action and

theory of planned behavior. Areas were isolated where little

research exists and future primary research will be needed.

The second phase ofresearch entailed conducting 28 in-home

immersion sessions with families having at least one child

8 to 15 years old living in their household. The immersions

involved questioning the parents and children while also

observing the extent to which attention to safety was incorporated within the home environment. During a 90-minute

visit, the contractors probed youth motivations for wearing

or not wearing seat belts, as well as parents’ impressions of

how their children could be influenced to wear seat belts.

The third and final phase of qualitative research involved

building intervention concepts based upon the model and

results from the immersion sessions, and testing the viability of these concepts with youth, parents, and adult and teen

influencers. Atotal of 293 youth 8 to 15 years old participated

in 96 triad sessions (mini focus groups) of usually 3 children

each. Triad participants were matched by sex, age/grade,

and race, and included regular and non-regular belt wearers. Each triad session ran about 75 minutes. Also, six focus

groups were conducted with parents and two focus groups

were conducted with otherinfluencers. One influencer group

consisted of adult influencers (e.g., teachers, youth leaders,

caregivers) and the otherinfluencer group was teen influencers (e.g., friends, relatives). Each focus group was approximately two hours in length.

Major Results

The literature review revealed a dearth of information on the

factors influencing child safety restraint use, particularly for

“tweens” and teens 8 to 15. The few studies that focused on

child safety restraint use tended to present the results of interventions aimedat changing non-use behaviors, without necessarily addressing specific attitudes or motivations associated

with restraint use or non-use. The message strategies guiding

these interventions were also rarely described in any detail.

The immersion sessions were conducted to begin to fill these

gaps in information. Among the major findings:

n In general, younger tweens (8 to 10) demonstrated a

simpler understanding of why they wore seat belts and

were typically driven by parental influence and a desire

to comply with the rules. Older tweens (11 and 12) began

to show a more sophisticated understanding of why they

wore safety restraints and were more likely to begin making independent decisions to wear their seat belts. Young

teens (13 to 15) were the most likely to be willing to ask

their friends to buckle up.

n	 Regardless of age, tweens and teens in the 8- to 15-year–

old group were still largely influenced by their parents.

Yet there appeared to be a gap in messages on seat belt

safety directed to parents.

n	 The majority of children who were regular seat belt users

indicated that wearing a seat belt was a habit.

n	 There were several barriers identified by parents and children that undermined the development of habitual seat

belt use. For both parents and children the main set of barriers was the absence of conditions conducive to developing the habit – sporadic/no reminders, lack of modeling by

parents, and exceptions to the rule. Other barriers included

lack of seat belts or properly functioning ones, and the feeling that seat belts were restricting or uncomfortable.

The immersion sessions led to a variety of conclusions that

guided development of 13 intervention concepts that were

presented to children in the 96 triad sessions. Two concepts

clearly surpassed the others in perceived effectiveness:

Concept A (Assembly conducted by peers in schools): You are at 

school, and your class attends an assembly in the auditorium. The 

speaker is a kid your age. They talk about the importance of wearing a seat belt to prevent injuries. They were injured in a car accident because they were not wearing their seat belt, and want other 

kids to learn from their experience.

Concept R (Radio interlock device): You get into the car and when the 

car starts up you don’t hear the radio like usual. In this car, the radio 

doesn’t go on until everyone riding in the car buckles their seat belt.

Increasing Seat Belt Use Among 8- to 15-

Year-Olds
Across age groups, the main reason youth reacted favorably

toward Concept A was because the speaker in the assembly

would be someone their age or slightly older. Respondents

explained that they were more likely to pay attention at an

assembly where the speaker was young because they could

relate to the person. Therefore, children said that to hear

about a child’s or teenager’s experience in a car crash would

probably have a greater impact on their perceptions and

behaviors regarding seat belt use than an adult’s experience.

Concept R received mostly positive reactions from youth,

while some said that they would dislike an interlock device.

Oldertweens and youngerteens said an interlock that did not

enable them to listen to music until they buckled up would

motivate them to do so. However, some said they would not

like having the device in the car because it would be irritating if they did not always buckle in or someone else in the

car refused to wear their seat belt. Regardless, most youth

agreed it would be effective. (Note: There are possible limitations to the concept in the future as in-car technology and

music delivery channels are constantly evolving and may

result in obsolescence of the interlock).

The children also expressed interest in other intervention

concepts. Children differed in the concepts toward which

they gravitated according to their sex, age, and race/ethnicity.

Of the four main concepts tested among parents in focus

groups, three concepts earned relatively strong positive reactions. Concept O was a communications intervention called

“In the blink of an eye you can fasten your seat belt. In a blink

of aneye youcanlose your child.”Mostparents reactedfavorably to this idea, saying the message was powerful and realistic. Some said if they saw this on a billboard, it would remind

them of the need to protect their children and to consistently

demand that their children wear their seat belts. Concept I

(insurance discount) was favored because parents said that

saving money was a strong motivatorfor seat belt use. However, if a tracking device monitored the families’ seat belt use,

some respondents said that they would feel like “big brother”

was watching and would be concerned about their privacy.

Parents said they liked Concept R because a radio interlock

device was relevant to their children. Although respondents

said it might not work for them personally, they said that it

would help their children, especially teenagers, wear their

seat belt more frequently. They also said it would be even

better if the interlock device were controlled by the parent.

Of the youth-targeted concepts, parents reacted most favorably to several concepts, but liked Concept A(Assembly conducted by peers) and S (safety promotion by Sports Coaches)

most because they leveraged outside influences on their

children. Parents said the assembly was good peer-to-peer

influence for their children. Parents also said that their children sometimes listened to other adults or coaches more than

their parents. Therefore, hearing about seat belt safety from a

coach could be beneficial.

Adult and teen influencers said that Concept I (Insurance

Discount) was good because it gave a monetary discount on

your car insurance for buckling up. However, some adult

influencers raised a concern over the cost of the tracking

device or the cost of cars that would be manufactured with

this device. In general, if the device were free, influencers

said they would consider using it. Concept O (Blink of an

Eye message) struck adult and teen influencers as it did the

parents. Teen influencers said that although it would not

affect them, it would definitely draw attention to seat belt

safety amongst their parents. Adult influencers envisioned

the message on a billboard with a strong visual to support

the statement.

Recommendations

Suggestions for future directions included the following:

n	 Target some portion of safety restraint interventions for 8-

to 15-year-olds to parents, as they still retain considerable

influence over their children.

n	 Address barriers that undermine the development of

habitual seat belt use by children.

n	 Direct interventions to this age group through both traditional and newer media channels.

n Introduce a continuous stream of seat belt campaigns and

interventions to keep restraint use top-of-mind for youth.

n	 Specifically target interventions to youth by age/grade,

sex,race/ethnicity, and usage status. While some concepts

tested well among all children, others tested well among

more specific groups.

n	 Explore additional interventions that capitalize on

the effectiveness of negative consequences to seat belt

non-use.

n	 Create interventions to alert adult and teen influencers

about the roles they can play.

n	 Explore the possibility of insurance discounts for seat belt

use.

How to Order

For a copy of Increasing Seat Belt Use Among 8- to 15-

Year-Olds, Volume I, Findings (34 pages) and Volume II, 

Appendices (121 pages), prepared by Aeffect, Inc., write to

the Office of Behavioral Safety Research, NHTSA, NTI-130,

1200 New Jersey Avenue, SE., Washington DC 20590 or send

a fax to 202-366-7394 or download www.nhtsa.dot.gov. Alan

Block was the Contracting Officer’s Technical Representative

on 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 Dr. Angela Eichelberger, Editor, fax

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

1200 New Jersey Avenue SE., NTI-130

Washington, DC 20590