Technical Report Page

Executive Summary

Introduction

Defining the Problem

Fatalities

Gender and Other Characteristics

Laws Pertaining to Children and Cargo Areas

Focus Groups: Background

Moderator's Guide and Topics of Discussion

Focus Groups: Findings

Focus Group Participants' Attitudes Toward Safety Measures

Focus Group Participants' Safety Belt Use

Focus Group Participants' Responses to Specific Reasons/Approaches

Focus Group Responses to Existing Campaign Approaches - English-Speaking Group

Focus Group Responses to Existing Campaign Approaches - Hispanic Group

Campaign Component Development - English-Speaking Group

Campaign Component Development - Hispanic Group

Conclusions

References

List of Tables

List of Figures

Appendices

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Executive Summary

I. BACKGROUND

The reader is reminded that the following report presents findings based on data collected during the project period in the year 2000. The data was utilized when considering selection for the focus group sites, available material was utilized during the focus groups, and in general all the research was intended as a baseline analysis of what existed at the onset of this study. This report includes the most current data, were applicable, as of November 2003. The reader will note these insertions in boxes below charts or figures, noted as, Data Update. Data updates are intended only to provide the reader with current information.

II. INTRODUCTION

Occupants of pickup trucks consistently have lower safety belt use rates than occupants of automobiles, vans and Sport Utility Vehicles (SUVs). According to the 2003 National Occupant Protection Use Survey (NOPUS), the observed safety belt use rate among occupants of pickup trucks increased from 59 percent in 1998 to 69 percent in 2003. Despite this increase, the rate remains far below the overall national safety belt use rate of 79 percent for all vehicles. Occupants of pickup trucks are at a high risk for serious injury or death given their lower safety belt usage.

There have been a number of private and public strategies to increase safety belt use nationally. In 1997, The National Highway Traffic Safety Administration (NHTSA) established and promoted the Buckle Up America Initiative (BUA) to increase safety belt use. Since then, the national safety belt use rate increased when coordinated plans and efforts included the enactment of strong safety belt laws; enforcement of safety belt laws; expanded information and public education campaigns; and private and public partnerships. More recently, results of the Click It or Ticket campaign indicate that statewide safety belt use for drivers of all vehicle types increases with intensive enforcement of a State's safety belt law that is well publicized with paid advertising. Click It or Ticket conveys the simple, direct message: wear your safety belt or you will get a ticket. The campaign works in both primary and secondary safety belt law States. Primary safety belt laws permit law enforcement personnel to stop drivers when occupants are not wearing safety belts and issue citations as they do with other traffic law violations. Primary safety belt laws may vary regarding which vehicle seating positions are covered by the law. (For example, a primary safety belt law may apply to use of belts in front seats only.) Also, some laws do not apply to all vehicles and allow exemptions. Secondary safety belt laws require law enforcement to first stop the vehicle for some other violation before issuing a citation for not wearing a safety belt.

In an effort to establish effective avenues to increase safety belt use among pickup truck drivers and occupants, an identified hard-to-reach and high-risk population, NHTSA determined that more background information was needed to design effective public information and education campaigns for this population. This project, initiated in September 2000, was an initial step to assist NHTSA with future demonstration projects that will test strategies to raise safety belt use rates among pickup truck occupants. The objectives of this project were to:

• Identify safety belt use rates and fatality rates for pickup truck drivers and passengers;
• Identify important characteristics of pickup truck drivers and passengers;
• Inventory pickup truck safety belt laws and children in cargo area laws;
• Review public information campaigns intended for pickup truck drivers;
• Gather qualitative information about pickup truck drivers' knowledge and attitudes about safety belt use, and public information and educational campaigns; and,
• Make suggestions for the development of future campaign messages intended for pickup truck drivers.

III. DEFINING THE PROBLEM

NHTSA conducts NOPUS to gather detailed information about shoulder belt use for drivers and right front-seat passengers across America. While there have been steady increases in safety belt use rates for all types of vehicles, the belt use rate in pickup trucks lags about 12 percentage points below that of passengers cars, vans, and SUVs as shown in Table 1.

Also, safety belt usage is lower in secondary law enforcement States when compared with primary law enforcement States. Safety belt use rates for all vehicle types combined are 83 percent in primary law States versus 75 percent in secondary law States (NOPUS 2003). NHTSA provides a breakdown based on vehicle type and type of enforcement as shown in Table 2. As indicated, safety belt usage in pickup trucks in primary law States is 73 percent as compared to 63 percent in secondary law States. Interestingly, in two primary law States, Georgia and Indiana, the primary laws do not apply to pickup trucks. Despite the fact that the primary law in Indiana does not apply to pickup trucks, safety belt usage has increased for this group.

Source: NCSA, 2003

Safety belt usage varies by type of vehicle and occupant category. For NOPUS 2002, NHTSA noted belt use rate for drivers of passenger cars was 78 percent whereas belt use rate for passenger car passengers was 74 percent. Further, the rate for drivers of pickup trucks was noted at 66 percent and the rate for pickup truck passengers was 63 percent. Rural pickup truck drivers, based on the most recent data from NCSA (2002), are less likely to use safety belts than pickup truck drivers in urban and suburban areas. Male pickup truck drivers are less likely to use safety belts than female pickup truck drivers. Regardless of what year is examined, how the figures are broken out, there are consistent trends regarding pickup truck occupant safety belt use: pickup truck occupants have the lowest safety belt use rate of all vehicle types; pickup truck passengers have a slightly lower safety belt use rate than pickup truck drivers; pickup truck safety belt use rates among both driver and passengers are lower in secondary law States versus primary law States; and males have lower safety belt use rate than females regardless of vehicle type.

As an initial step to address the specific factors associates with low safety belt use, focus groups were conducted with rural, male pickup truck drivers to determine their knowledge and attitudes about safety belt usage. Before developing public information campaigns and testing strategies to change behaviors, it is important to determine how intended audiences perceive the public information and educational materials (see Glanz and Lewis for information about social marketing).

IV. SUMMARY OF STATE SAFETY BELT LAWS AS OF NOVEMBER 2000

Before selecting the States in which the focus groups would be conducted, data about State safety belt laws was compiled. This data was useful in helping the researchers to strategically select States in which the focus groups would be conducted. The researchers, in conjunction with NHTSA, made the final selection of the States chosen for the focus groups. Information about State safety belt laws was gathered from a variety of sources. Each State's department of motor vehicle (DMV) driver manual (as of November 2000) was reviewed to determine what information is provided to drivers about each State's safety belt laws. Also, State web sites were searched for information regarding safety belt laws. In addition, State Governors' Highway Safety Representatives were contacted.

As of November 2000, when this project was initiated, four States had laws that were different for pickup truck occupants as compared to other passenger vehicles. The States were Georgia (exempts pickup trucks altogether), Indiana (exempts trucks, including pickup trucks), Missouri (exempts trucks greater than 12,000 pounds, and occupants in cargo beds when all seats are occupied and vehicle is only means of immediate family transportation), and Oregon (trucks greater than 8,000 pounds and not considered to be a commercial vehicle). As of August 2002, a number of States such as Minnesota, Mississippi, Oklahoma, Texas, and Wisconsin exempt farm vehicles which may include pickup trucks from their laws. New Hampshire does not currently have an adult safety belt law for any type of vehicle.

Twenty States had no laws restricting occupant travel in the cargo area of a pickup truck. Twenty-five States had laws making it illegal for children to ride in the cargo area of pickup trucks, even when all seats are occupied. Seven of these States prohibited children under certain ages. A common exception to the safety belt law was to allow children to ride in the cargo area if all the seats of the pickup truck are filled with occupants. In some States, exemptions to the safety belt and cargo area laws still exist. (For more recent information about these laws, there are a number of excellent web sites including NHTSA's web site: www.nhtsa.dot.gov .) In conclusion, States still vary in the applicability of their safety belt laws to pickup trucks.

V. SUMMARY OF PUBLIC INFORMATION AND EDUCATION PROGRAMS

Before designing and implementing new strategies to enhance safety belt use among pickup truck drivers, researchers determined what public information and educational programs already existed that were designed for pickup truck drivers. Questionnaires about States' efforts to promote belt use in pickup trucks through public information and educational programs were sent to each Governor's Office of Highway Safety for the 50 States, District of Columbia, Guam, and Puerto Rico. Eighteen States reported that they had population specific initiatives with public information, education and/or enforcement campaigns about safety belt usage. Of these eighteen States, seven planned to develop more pickup truck campaigns in the future. Nearly half of the 50 States have never tried nor intend to specifically address the pickup truck occupant population through safety campaigns. There have been limited efforts designed specifically for the pickup truck driver population, a group with high risk for death and injury.

Five States provided samples of campaign materials that they have used. The campaign materials included radio scripts, bumper stickers, posters, television video, radio cassettes, and pamphlets. Materials from the five States were used during the focus group sessions. The existing materials were used in the focus groups to determine how the materials were perceived by a variety of groups of pickup truck drivers, and also to provide suggestions about the types of public educational appeals to use in future initiatives that are designed for pickup truck drivers. It is noted that the existing campaign materials were not identified as "best practice" types of materials. One of the main reasons for conducting the focus groups was to determine how pickup truck drivers perceived the existing materials. Based upon these focus group results, suggestions for future public information and educational campaign themes and approaches would be made available to States to incorporate into their initiatives designed to reach pickup truck drivers.

VI. FOCUS GROUPS

Eight focus groups were conducted with younger and older male pickup truck drivers who lived or worked in the rural areas of four States: Georgia, Michigan, Texas, and Montana. At the time of the study, Georgia, Michigan, and Texas were primary safety belt law States and Montana was a secondary law State.

There were several objectives for conducting the focus groups:

• To find out more about specific approaches and message themes that might convince male pickup truck drivers to use their safety belts;
• To determine attitudes about allowing children to travel in the cargo area of pickup trucks; and,
• To investigate any differences in these issues between Hispanic and non-Hispanic pickup truck drivers.

Focus group research is intended to gain insight about the perception of various themes and methods for public educational and information campaigns. The data are qualitative, rather than quantitative, and provide insight and understanding about particular issues. The findings are not a statistical representation of the attitudes of rural, male pickup truck drivers about safety issues and safety belt use.

The findings of the eight focus groups revealed consistency of thought, opinion, and ideas. The men gave clear reasons why they did not wear their safety belts, such as they felt protected by size of vehicle; different driving style in a pickup truck, nature of vehicle use (short, work-related trips); being "trapped" after the crash; and anger/resentment over mandatory safety belt laws. The men did indicate, however, that they are more likely to wear their safety belts when family or friends are with them; on interstate highways; in large cities; and in bad weather. Some of the participants indicated they were more likely to wear their safety belt in their car because of the presence of family members and less likely to wear their belt in their truck, especially when driving alone. Nearly all of the participants agreed on the best approaches and elements to use in educational and enforcement campaigns designed to encourage pickup truck drivers to wear their safety belts.

The participants pointed out inconsistencies between State safety belt laws and laws for other highway safety areas. For example, the men discussed the issue that many States lack motorcycle helmet laws and yet have laws that require safety belt use. Many of the men raised this example as a justification for ignoring safety belt laws. They also felt that governments should not be mandating safety belt use, especially if there are inconsistencies across safety areas.

Whether young or old, the men were not impressed with messages that used statistical facts about deaths and injuries as a motivator to increase safety belt use. There was a general consensus of distrust about the use of "numbers." It was thought that statistics could be used to prove whatever point one chooses to make.

When developing new public information and educational campaigns directed to male pickup truck drivers, there are a number of themes and issues that could be addressed in the messages. Based upon the qualitative findings of these focus groups, it is recommended that the messages address and "counter" the following misunderstandings and reasons given for nonuse of safety belts by male, rural pickup truck drivers:

• Safety belts are uncomfortable
• Safety belts are restrictive
• Safety belts are a "hassle" with frequent getting in and out of vehicles
• Skepticism about the benefits of safety belts
• Concerns about getting trapped in vehicle with the use of safety belts
• Freedom of choice to use/not use safety belts
• Safety belts are not needed on local roads and low speed limits
• Safety belts are not needed on short trips
• Safety belts are not needed in good weather
• Safety belt use is less critical when in a pickup truck because it is a safer vehicle due to its "sheer size"

A number of alternative messages and approaches to "counter" the reasons for non-use of safety belts could be included in new educational campaigns such as:

• Showing crash damage with low speed crashes
• Showing results of ejections and rollovers without the use of safety belts
• Emphasizing the benefits of using safety belts on short trips
• Presenting ways to make the use of safety belts a "habit"
• Presenting countermeasures to the "discomfort" issue such as adjustment of the belt for a better fit
• Countering the "mind set" of freedom to choose to wear a safety belt
• Comparing societal acceptance of DWI laws with societal benefit and acceptance to safety belt use
• Countering the Hispanic and youth "fate" approach to crashes and injuries
• Showing the increased risk of injury or death from rollovers and ejections among pickup trucks

New educational campaigns that emphasize crash fears should be carefully designed. The Hispanic men and all of the younger men were not concerned about dying in a crash. Messages for these men should not show crashes that are so severe that survival in any event would be questionable. Instead, message themes about crash fears should emphasize: paralysis and wheelchair use; loss of limb; and impact on family including feelings of sadness and leaving them behind.

Overall, pickup truck drivers recommended that messages be short and to the point, realistic, presented in "local" context, and translated appropriately. In summary, the participants of the focus groups recommend that new messages and campaigns should:

• Use realism
• Be short and to the point
• Show consequences to family members
• Show every day events, local areas, and real people
• Film messages in rural communities
• Use spokesperson from the local community, celebrities are not recommended
• Show real people who have been in crashes
• Use First Responders who have gone to crash scenes
• Stress "medical consequences" such as paralysis (for Hispanic and younger male audiences)
• Show the possibility of survival if safety belt had been used in a violent crash
• Film and record Hispanic versions that are not just language translations
• Be careful with use of statistics. If used express as odds, not percentages-use "1 out of 3," not 33 percent
• Refrain from using humor