A literature search was conducted to analyze programs designed to increase safety belt use among drivers. Forty three articles were selected, based on the scope of the studies reported. The interventions were grouped into five categories: law, education, incentive, monitoring, prompt, and multicomponent. The average length of an intervention was 41.5 days, and the average length of the follow up period was 77 days. Of the programs researched, 96% resulted in increased safety belt use. The median safety belt use percentage point increase was 17%, significant evidence that interventions were effective. Law and incentive interventions resulted in the largest increases in safety belt use. Within the law category, the largest increase in usage occurred when fines were enforced. Neither the length of the intervention, nor the number of interventions within a program, significantly affected this increase. During the follow up period, the median safety belt use percentage point declined 3.1%, indicating that after the intervention, safety belt use declined and stabilized. Studies addressing gender differences found that, while females had higher baseline and follow up use rates, there was not a significant difference between males and females in safety belt use increase due to the interventions. The authors conclude that a combination of law and incentive interventions is the most effective way to increase safety belt use. More research is needed to understand the effects of combined interventions and user characteristics.
Division of Safety Research, National Institute for Occupational Safety and Health, 944 Chestnut Ridge Road, Morgantown, WV 26505-2888, U.S.A.