Motivating signage prompts safety belt use among drivers exiting senior communities

Senior drivers are vulnerable to automobile crashes and subsequent injury and death. Safety belts reduce health risks associated with auto crashes. Therefore, it is important to encourage senior drivers to wear safety belts while driving. Using an AB design, replicated five times, we evaluated the short- and long-term effects of a sign with the message "BUCKLE UP, STAY SAFE" attached to a stop sign at the exits of five different senior communities. Safety belt use was stable during two pretreatment assessments averaged across the five sites and 250 drivers (72% and 68% usage), but significantly increased following installation of these signs (94% usage). Six months after installation of the signs, the effect persisted (88% usage). Use of such signs may be a cost-effective way of promoting safety belt use.     

Rewarding safety belt usage at an industrial setting: Tests of treatment generality and response maintenance

An incentive program to motivate seat belt use was implemented at a large munitions plant. Seat belt usage was assessed daily at an entrance/exit gate of the industrial complex when employees arrived for work in the morning and departed in the afternoon. During treatment incentive fliers, which prompted seat belt usage and gave belt wearers opportunities to win prizes, were distributed only in the afternoon. Seat belt wearing increased from baseline means of 20.4% and 17.3% during the morning and afternoon, respectively, to averages of 55.5% during afternoon departures and 31.1% during morning arrivals. During follow-up, mean belt use dropped almost to baseline levels. Categorizing vehicles according to driver sex and license plate number enabled a study of belt wearing practices of individuals, and revealed that the incentive program influenced some drivers to wear their seat belts during morning arrival when incentives were not distributed (i.e., treatment generalization) and during a follow-up period after the incentives were withdrawn (i.e., response maintenance).     

Active prompting to decrease cell phone use and increase seat belt use while driving

Automobile crashes are the leading cause of death for those aged 3 to 33, with 43,005 (118 per day) Americans killed in 2002 alone. Seat belt use reduces the risk of serious injury in an accident, and refraining from using a cell phone while driving reduces the risk of an accident. Cell phone use while driving increases accident rates, and leads to 2,600 U.S. fatalities each year. An active prompting procedure was employed to increase seat belt use and decrease cell phone use among drivers exiting a university parking lot. A multiple baseline with reversal design was used to evaluate the presentation of two signs: "Please Hang Up, I Care" and "Please Buckle Up, I Care." The proportion of drivers who complied with the seat belt prompt was high and in line with previous research. The proportion of drivers who hung up their cell phones in response to the prompt was about equal to that of the seat belt prompt. A procedure that reduces cell phone use among automobile drivers is a significant contribution to the behavioral safety literature.     

Improving the driving practices of pizza deliverers: Response generalization and moderating effects of driving history

A practical intervention program, targeting the safety belt use of pizza deliverers at two stores, increased significantly the use of both safety belts (143% above baseline) and turn signals (25% above baseline). Control subjects (i.e., pizza deliverers at a third no-intervention store and patrons driving to the pizza stores) showed no changes in belt or turn signal use over the course of 7-month study. The intervention program was staggered across two pizza stores and consisted of a group meeting wherein employees discussed the value of safety belts, received feedback regarding their low safety belt use, offered suggestions for increasing their belt use, and made a personal commitment to buckle up by signing buckle-up promise cards. Subsequently, employee-designed buckle-up reminder signs were placed in the pizza stores. By linking license plate numbers to individual driving records, we examined certain aspects of driving history as moderators of pre- and postintervention belt use. Although baseline belt use was significantly lower for drivers with one or more driving demerits or accidents in the previous 5 years, after the intervention these risk groups increased their belt use significantly and at the same rate as drivers with no demerits or accidents. Whereas baseline belt use was similar for younger (under 25) and older (25 or older) drivers, younger drivers were markedly more influenced by the intervention than were older drivers. Individual variation in belt use during baseline, intervention, and follow-up phases indicated that some drivers require more effective and costly intervention programs to motivate their safe driving practices.     

A behavioral analysis of incentive prompts for motivating seat belt use

The seat belt usage of drivers was observed at the entrance to two campus parking lots during morning arrival times. After 11 days of baseline, fliers which prompted seat belt wearing were handed to drivers of incoming vehicles. At one parking lot all fliers offered a chance to win a prize (noncontingent rewards); while at the second lot only those fliers given to seat belt wearers included a chance to win a prize (contingent rewards). After 24 consecutive observation days, these interventions were removed for 14 days of withdrawal. The recording of vehicle license plates enabled an analysis of belt usage per individual over repeated exposures to the experimental conditions. At the lot with the contingent reward intervention, mean belt usage was 26.3% during baseline, 45.7% during treatment, and 37.9% during withdrawal. At the noncontingent reward lot, the mean percentage of belt wearing was 22.2% during baseline, 24.1% during treatment, and 21.8% during withdrawal. The analysis of repeated exposures per individual verified that only contingent rewards influenced substantial increases in belt wearing, and showed that most of the influence occurred after the initial incentive prompt.     

Incentives and Seat Belts: Changing a Resistant Behavior Through Extrinsic Motivation

Because previously-attempted methods of increasing automobile seat belt usage have proven to be either ineffective or unworkable, a series of field experiments was carried out to test a technique of behavior influence utilizing a modest, positive incentive. In three separate studies, seat belt use of 4,745 drivers was observed as they drove out of a parking lot, after receiving one of several safety reminder leaflets. Some versions of the leaflet offered a gift certificate to a certain proportion of drivers who wore seat belts; other versions offered no incentive. The results showed that an incentive, regardless of the probability of payoff, raised belt use from about 15% to nearly 40%. Implications for future research and applications are discussed.     

Seat belt usage: A potential target for applied behavior analysis

Results of 1,579 observations of cars entering or exiting campus parking lots showed direct relationships between seat belt wearing and the intrusiveness of the engineering device designed to induce belt usage, and between device intrusiveness and system defeat. For example, all drivers with working interlocks or unlimited buzzer reminders were wearing a seat belt; but 62% of the systems with interlocks or unlimited buzzers had been defeated, and only 15.9% of the drivers in these cars were wearing a seat belt. The normative data indicated marked ineffectiveness of the negative reinforcement contingencies implied by current seat belt inducement systems; but suggested that unlimited buzzer systems would be the optimal system currently available if contingencies were developed to discourage the disconnection and circumvention of such systems. Positive reinforcement strategies are discussed that would be quite feasible for large-scale promotion of seat belt usage.     

Using accelerator pedal force to increase seat belt use of service vehicle drivers

This study evaluated a device that applied a sustained increase in accelerator pedal back force whenever drivers exceeded a preset speed criterion without buckling their seat belts. This force was removed once the belt was fastened. Participants were 6 commercial drivers who operated carpet-cleaning vans. During baseline, no contingency was in place for unbuckled trips. The pedal resistance was introduced via a multiple baseline design across groups. On the first day of treatment, the device was explained and demonstrated for all drivers of the vehicle. The treatment was associated with an immediate sustained increase in seat belt compliance to 100%. Occasionally, drivers initially did not buckle during a trip and encountered the force. In all instances, they buckled within less than 25 s. These results suggest that the increased force was sufficient to set up an establishing operation to reinforce seat belt buckling negatively. Drivers indicated that they were impressed with the device and would not drive very long unbelted with the pedal force in place.     

ENFORCEMENT OR INCENTIVES? PROMOTING SAFETY BELT USE AMONG MILITARY PERSONNEL IN THE NETHERLANDS

During a nationwide campaign to promote safety belt use among military personnel, a field study was conducted at 12 different military bases in the Netherlands. Amount of enforcement, type of publicity, and incentive strategies were varied among military bases. Observations of safety belt use among servicemen in their personal vehicles were conducted before the campaign, immediately following the campaign, and 3 months later. Safety belt use increased from 65% during baseline to 73% directly after the campaign and to 76% 3 months later. An overall 28.6% increase in safety belt use (from 63% to 81%) was observed at seven bases, whereas no changes were found at five bases (68% on all occasions). To a large degree the effects were due to a 37.7% increase among young drivers. These results confirmed that enforcement, as well as incentives, can be effective in promoting safety belt use. However, treatment effects were not systematic, thereby complicating the interpretation of the results. Implications of these varied outcomes are discussed.     

PARTICIPATIVE EDUCATION FOR CHILDREN: AN EFFECTIVE APPROACH TO INCREASE SAFETY BELT USE

Vehicle license plate numbers and the shoulder belt use of front-seat occupants were recorded unobtrusively when parents delivered and picked up their children at a Montessori school during 5-day baseline, intervention, and follow-up phases. Practicing and presenting a 15-min safety belt skit increased the safety belt use of those 6 kindergarten children who were not consistent belt users 82% above their preintervention baseline belt use mean of 47%. The belt use of these children's parents (who watched the skit) increased to 56% above their baseline mean of 36%. Also, mean safety belt use of 11 primary school children who watched the skit increased to 70% above their baseline of 28%. Mean safety belt use of the older children's parents (who didn't watch the skit) remained at approximately 31% for each phase, regardless of whether children were vehicle occupants. The follow-up observations, taken 3 months after the intervention, revealed 60% belt use for the kindergartners, 48% for the primary school children, and 71% for the kindergartners' parents when the children were vehicle occupants but only 30% when the parents were driving alone.     

PROMPTING PATRON SAFETY BELT USE AT A SUPERMARKET

We used a reversal (ABAB) design to assess the effects of a personal prompt on safety belt usage by grocery store patrons. A personal prompt delivered by grocery carriers resulted in a 12% increase in the number of patrons exiting the parking lot with their safety belts buckled. This simple, low-cost intervention offers potential savings to society from increased safety belt use.     

The behavioral impact of an advertising campaign to promote safety belt use.

Safety belt use was observed at one restaurant during McDonald''s "Make It Click" promotional campaign. Following baseline, the program was monitored without intervention. During the final 2 weeks of the campaign an incentive strategy was added providing a large soft drink contingent on safety belt use. Safety belt use did not change from baseline levels before the incentive phase. The rate of belt use increased under contingent reward and declined during follow-up. The effects of a verbal prompt could not be assessed because of the almost nonexistent use of the "Make It Click" stickers throughout the study.     

PROMOTING AUTOMOBILE SAFETY BELT USE BY YOUNG CHILDREN

A program using behavioral practice, assertiveness training, and social and contrived reinforcers was developed to establish and maintain automobile safety belt use by young children. Sixteen children (ages 4.8 to 7 years) who never used their safety belts during a 5-day preexperimental observation period were randomly assigned to two groups of eight each. A multiple baseline design across groups was used to evaluate the effectiveness of the training program. During the 8-day baseline period for Group 1, no children used their safety belts when unobtrusively observed while being driven from school. During the 26-day intervention period, the children were buckled up on 96% of the observations. Follow-up probes conducted 2–3 months after program discontinuance found safety belt use to range from 86% to 100%. For Group 2, the 14-day baseline safety belt use averaged 6% and increased to a mean of 81% during the 20-day training and maintenance program. Follow-up probes 2–3 months later found safety belt use to occur during 75% to 96% of the observations. Parent questionnaires indicated the generalizability and social validity of the program.     

An experimental approach towards the evaluation of a seat belt campaign with an inside view on the psychology behind seat belt use

A Belgian national safety belt campaign was evaluated by means of a questionnaire survey in an adolescent sample. The evaluation was done through a three group after-only design with the use of one control group and two experimental groups. The first experimental group, the attentive group, was exposed to the campaign material in a very direct, attentive way, whereas the second experimental group, the pre-attentive group, was exposed rather inattentively. The framework of the Theory of Planned Behaviour (TPB) was applied and extended with a habit and a past behaviour variable in order to verify whether seat belt usage is to be understood as an automaticity mechanism (i.e., habitual or repeated past behaviour) or as planned behaviour. In terms of campaign effect, the comparison of the pre-attentive group and the control group revealed no significant differences. However, the attentive group and the control group differed significantly regarding two basic dimensions of perceived behavioural control (i.e., confidence and motivation), habit, past behaviour, behavioural intention and behaviour. In terms of explaining seat belt usage, linear regression models were fitted and gave most support for the repeated past behaviour approach. According to the latter, using seat belts is recycling an originally reasoned behaviour, yet without systematically going through the whole underlying reasoning every time a situation in which the decision to wear a seat belt (or not) presents itself. The practical implications of these findings are discussed more in detail.     

Increasing seat belt use in service vehicle drivers with a gearshift delay

This study evaluated a device that prevents drivers from shifting vehicles into gear for up to 8 s unless seat belts are buckled. Participants were 101 commercial drivers who operated vans, pickups, or other light trucks from the U.S. and Canada. The driver could escape or avoid the delay by fastening his or her seat belt before shifting out of park. Unbelted participants experienced either a constant delay (8 s) or a variable delay (M = 8 s). A 16‐s delay was introduced for those U.S. drivers who did not show significant improvement. Seat belt use increased from 48% to 67% (a 40% increase) for U.S. drivers and from 54% to 74% (a 37% increase) for Canadian drivers. The fixed delay was more effective for U.S. drivers than the variable delay, but there was no difference between these two delay schedules for Canadian drivers. After the driver fastened his or her seat belt, it tended to remain fastened for the duration of the trip.     

Relationship of seat belt use to health and driver behaviors

Seat belts are effective safety devices for protecting car occupants from injuries and fatalities in road vehicle accidents. Seat belt use has been reported to be related to some health and driving-related behaviors. The aim of the present study was to investigate to what degree seat belt use can be seen as health behavior or driver behavior. Participants were 252 licensed Turkish drivers (180 males, 72 females) with the mean age of 30.8 (SD = 12.15). A questionnaire including questions related to health-related behaviors, driver behaviors and seat belt use was used. Results of factor analysis showed that seat belt use in front seat grouped with driver behaviors (e.g., driving errors and violations) but not with health-related behaviors (e.g., healthy diet and sports participation). Regression analyses showed that seat belt use in back seat; and, regular walking and adequate sleep were positively related to seat belt use in front seat, whereas being male, driving errors and smoking frequency were negatively related to seat belt use in front seat. The present findings suggest that seat belt use can be considered in the context of driver behaviors such as driving errors and violations.     

The safety performance of connected vehicles on slippery horizontal curves through enhancing truck drivers’ situational awareness: A driving simulator experiment

Although drivers can adequately adjust their operating speed according to the road curvature, they show a lack of recognition regarding the pavement friction conditions. In this regard, inappropriate speed selection on Horizontal Curves (HCs) with reduced surface friction can lead to a remarkable rate of run-off-road, sideswipe, head-on, and rollover crashes, especially on rural highways. Aligned with the Connected Vehicle (CV) Pilot Program on Interstate-80 in Wyoming, this study scrutinizes how CV advisory/warning messages can enhance traffic safety on slippery HCs. To this aim, a roadway consists of two HCs with regular and slippery pavement conditions was designed in a high-fidelity driving simulator experiment. A total of 24 professional truck drivers were recruited to drive the simulated roadway under CV and non-CV environments. In the CV scenario, drivers were informed about the pavement conditions and the advisory speeds before entering HCs. In contrast, no messages were given to non-CV drivers. Truck drivers' behaviors in both scenarios were quantified using four Kinematic-based Surrogate Measures of Safety (K-SMoS), including deviation from the pathway, instantaneous acceleration, lateral speed, and steering angle. CVs’ trajectories were statistically compared to non-CVs in terms of the central tendency and dispersion using the Wilcoxon Signed-Rank Test (WSRT) and Median Absolute Deviation (MAD), respectively. The results of WSRT depicted, under the effect of CV advisory/warning messages and throughout the slippery HC, the central tendency of four K-SMoS could be shifted toward zero by 23% up to 99%. This shifting is associated with a significant safety enhancement that potentially can reduce the likelihood of curve-related crashes on slippery HCs. It was revealed that the variation in drivers’ behavior on the slippery HC could be minimized in the CV environment, where 54% up to 95% reduction in the dispersions of four K-SMoS were observed, leading to more certainty in drivers’ behavior.     

PROMOTING SAFETY BELT USE WITH TRAFFIC SIGNS AND PROMPTERS

Two studies were conducted examining the stimulus-control effects of conventional traffic signs as prompts for motor vehicle driver safety belt use. Following pilot research which suggested that a traffic sign reading “Fasten Safety Belt” posted at a parking lot exit was effective in producing small increases in safety belt use, Study I demonstrated the superiority of having human prompters display such signs compared to simply posting the signs. Study II replicated the findings of Study I and found that posted signs became more effective in prompting safety belt use if simple posting was preceded by a period involving human prompters who displayed the signs. The results bear upon the development of more effective use of traffic signs in promoting safety belt use and in viewing such use as an instance of rule-governed behavior.     

A single-subject approach to evaluating vehicle safety belt reminders: Back to basics

A single-subject ABA reversal design was applied to evaluate the effectiveness of a limited 8-s safety belt reminder system and two modified reminder systems (a delayed and second reminder) to increase the safety belt use of 13 drivers. The research was conducted with a specially equipped research vehicle that permitted the manipulation of different safety belt reminder stimuli and the unobtrusive recording of a driver's belt use. For 2 subjects, the limited 8-s reminder increased safety belt use. For another 2 subjects, the second reminder markedly increased belt use. Some subjects were uninfluenced by the reminder systems presented; others always buckled up during both baseline and intervention conditions. The approach and results are discussed with regard to the application of behavior analysis methodologies (e.g., cumulative records) and principles (e.g., schedules of reinforcement) to advance the utility and investigation of safety belt reminder systems.     

Promoting safety belt use among state employees: the effects of prompting and a stimulus-control intervention.

This study assessed the effects of dashboard stickers and signature sheets on safety belt use among occupants of state-owned vehicles in three Florida agencies. The stickers and signature sheets contained information regarding a regulation requiring safety belt use and a consequence of a 25% reduction in benefits for noncompliance if the driver were to become involved in an accident. Safety belt use significantly increased during the intervention phase in all three agencies and maintained variable but high levels for 5 months. In Agency 1 and Agency 2 (stickers plus signature sheets) safety belt use increased from averages of 10.8% and 9.4% during baseline to 57.4% and 47.0%, respectively, during intervention. In Agency 3 (stickers only) the rates of safety belt use averaged 9.7% during baseline and 38.0% during intervention. Some increases in private vehicle use were observed. A substantial reduction in workers'' compensation claim costs was shown for the target agencies with some reductions also shown in the nontarget agencies.