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Effectiveness: 5 Star Cost: Varies
Use: Medium
Time: Medium

Effective, high-visibility communications and outreach are an essential part of successful seat belt law HVE programs (Solomon et al., 2003). Paid advertising can be a critical part of the media strategy. Paid advertising brings with it the ability to control message content, timing, placement, and repetition (Milano et al., 2004).

Use: All HVE programs include communications and outreach strategies that use some combination of earned media (news stories, social media) and paid advertising. Communications and outreach can be conducted at local, State, regional, or national levels.

Effectiveness: The May 2002 Click It or Ticket campaign evaluation demonstrated the effect of different media strategies. Belt use increased by 8.6 percentage points across 10 States that used paid advertising extensively in their campaigns. Belt use increased by 2.7 percentage points across 4 States that used limited paid advertising and increased by only 0.5 percentage points across 4 States that used no paid advertising (Solomon et al., 2002). Milano et al. (2004) summarize an extensive amount of information from national telephone surveys conducted in conjunction with each national campaign from 1997 to 2003. While the campaign is still used widely, there have not been recent effectiveness evaluations that consider communications and outreach changes such as the prevalence of social media and changing media mode shares.

Costs: Paid advertising can be expensive. On average participating States’ paid advertising costs were about $2,200,000 for the 2013 campaign (Nichols, Chaffe, Solomon, & Tison, 2016).

Time to implement: An effective media campaign requires 4 to 6 months to plan and implement.

Other Issues:

  • Social media: NHTSA and some States use social networking sites to reach the general public with messages concerning seat belt use. Although sites such as Facebook, Twitter, and YouTube can effectively and inexpensively reach large numbers of people, there are no evaluations of seat belt use campaigns that use this approach. The CDC offers tools to help with using social media, including a social media toolkit and guide for writing social media ( In addition, there is information available on NHTSA’s traffic safety marketing website (