The health care sector was selected to lead the Partners for Rural Traffic Safety campaign effort for three reasons. First, traffic safety issues are clearly a health promotion and injury prevention activity. In fact, all of us bear the cost of treating injuries caused by crashes through higher vehicle insurance costs and payments for Medicaid, Medicare, and private insurance. These shared costs, along with the actual treatment of the injuries, results in traffic safety moving from largely a law enforcement issue to a public health issue.

Second, enforcement of laws to change behavior is an important factor in traffic safety, but one that is strictly punitive. Punitive means punishment. And while punishing people does have an effect on behavior, the Partners for Rural Traffic Safety program is designed to be encouraging and helpful. Health care is a helping and healing profession, not one associated by the public with punishment. Thus, health care professionals provide a different perspective that receives an altogether different public reaction. By bringing public attention to the health-related aspects of traffic crashes, health professionals can harness community support for enforcement and counteract backlash by those opposed to strong enforcement. Police need to know that the community believes the law is important before they will enforce it.

Third, health care institutions, particularly nonprofit and public organizations, have an obligation to benefit the community. While many health care organizations believe that being in the community and available to treat illness, regardless of ability to pay, is enough of a community benefit, there is more to community service than that. Caring for the health of the entire population and not just those people who walk through the door is what community benefit is all about. Traffic safety provides an excellent vehicle for health care organizations to demonstrate a commitment to the overall health of the community. Accreditation organizations seek these types of community activities during reviews of health care organizations. In addition, it is simply the right thing to do. Community development and involvement build support for the overall activities and good will for your organization.

Public health, private physician offices, home health, federally funded community health clinics, and hospitals-nonprofit, public and private-all have been leaders of past efforts. Any health care organization can initiate this effort and provide leadership.

The first step involves the decision by a health care organization to assume leadership for the campaign. This may be as simple as getting administrative approval from a department head or executive. In some cases, it will require approval by the board of directors or the elected officials who govern the organization.

Good boards and executives will expect a thorough explanation of the activity before they approve the campaign in order to make an informed decision. Therefore, we suggest that the person forwarding this idea be familiar with the contents of this kit and be able to respond effectively to questions. As such, when presenting this idea to decision makers anticipate questions and concerns and address them before they arise. Below are some of the common issues that should be addressed during the presentation to help you successfully promote the campaign to the decision makers.

Typically the first question from a decision maker is, “What is this campaign going to cost?” Good question. The primary cost associated with campaign activities is time. This includes a commitment on the part of the Community Partner Team leader as well as other Community Partner Team members and community participants.

In actual cash outlays, this project can be successfully completed for $1,500 to $3,000, depending on the number of activities selected. That is not expensive considering that losing one life or incurring an injury would cost thousands of dollars more. This cash outlay includes expenses for postage and shipping, meetings, copying, purchasing campaign materials, prizes for contest winners and promotions. Most of the materials and resources are available at no charge, if reasonable quantities are requested, and are available from NHTSA and your state’s Highway Safety Office (see Appendices C and D for listings and additional contact information).

The 15 rural communities that took part in the pilot projects, nine in phase one and six in phase two, had budgets between $1,500 and $4,000, with most closer to $1,500. The community with the largest budget used fund-raising activities and donations to bolster its effort and was rewarded by increasing their seat belt usage by more than 120 percent. How did they raise these funds? They sent letters to state-based law enforcement associations (sheriff’s association, state police association, etc.), their local governments (city council, county commission, etc.), health care organizations (doctors offices, referral hospitals in nearby communities, emergency medical service associations, public health organizations, etc.), and local businesses indicating the purpose of the project and requesting donations. The amount requested in these letters was unspecified.

The Community Partner Team raised more than $2,000 through donations that were largely between $50 and $100 each. The donations were used to purchase such things as permanent road signs, banners on main streets, enhanced prizes (savings bonds) for children’s contests, and child car seats (that were given away). Money should not be a deterrent to conducting the Partners for Rural Traffic Safety campaign.

Other questions raised by decision makers typically include “Will it work?” and “How hard is it to do?” The nine communities that took part in the first phase of the pilot project averaged a 13.8 percent increase in seat belts usage while the six communities in phase two of the project averaged a 20.2 percent increase. As such, the six communities that conducted campaigns in the second year of the program benefited from the experiences of the nine first-year demonstration sites. The lessons learned from the 15 demonstration communities are included this kit. First, determine your community’s values regarding traffic safety issues and match them with existing ideas. Of course, you may come up with even better ideas on your own.

Another question raised by decision makers might be “What about the other community organizations that are involved in traffic safety?” Again, another good question. This 30-day campaign is designed to supplement existing efforts-not to supplant them. Law enforcement agencies, Mothers Against Drunk Driving, Students Against Destructive Decisions, traffic safety councils, and Safe Communities coalitions will welcome the opportunity to participate fully in this type of activity. The campaign is an intensive short-term intervention, not an ongoing activity so it does not replicate what other organizations do. You will want to involve these organizations in your campaign planning because their presence will enhance the effectiveness and efficiency of your efforts. Broad-based coalition and partnership building is a basic premise of community development, and successful interventions require it. You will not be invading the “turf” of other organizations in conducting your campaign.

For example, hospital maternity discharge planners and Women, Infant and Children clinics already discuss the importance of infant and child safety seat use with clients. Your intervention can supplement their activities by conducting child car seat installation checks, providing copies of current brochures and information about car safety seats, or organizing car seat exchange programs to ensure that all children have safety seats. You are not duplicating what hospitals and clinics do; your intervention simply enhances their ability to do their job better and supports them by sending the same valuable safety message to the community.

Finally, decision makers might ask “Can we effectively communicate why we, as a health organization, want to lead this effort?” The answer to this question was addressed earlier in terms of community benefit and improving the health status of the population. Traffic safety is not only the concern of law enforcement; it is a public health issue. To help orient your Community Partner Team, Chapter 5 includes a presentation that provides detailed information that can be used to address concerns that may be raised by health care leaders regarding their traffic safety policy positions.

The remainder of the Partners for Rural Traffic Safety Action Kit is organized chronologically, providing steps in logical order to help your project succeed. While creative approaches and differences in the way communities do things is recognized throughout this kit, it is important that the main steps of the campaign be completed in an orderly manner. Take advantage of the insights gained from the demonstration projects because it will make your job easier and more productive.

Once leadership is established, the team leader will have the go-ahead to get things underway and move on to Step 2 of the Partners process.