Countermeasures

Countermeasures to increase seat belt and child restraint use are listed in the table below. The table is intended to provide a rough estimate of each countermeasure’s effectiveness, use, cost, and time required for implementation. Effectiveness is shown using a five-star rating system.

• Countermeasures that receive  or  have been determined to be effective.
• Countermeasures that receive  are considered promising, and likely to be effective.
• Countermeasures that receive ✩ or ✩✩ have NOT been determined to be effective, either because there has been limited or no high-quality evidence (✩) or because effectiveness is still undetermined based on the available evidence (✩✩).

States, communities, and other organizations are encouraged to use , and especially  or , countermeasures. They should use caution in selecting ✩ or ✩✩ countermeasures, since conclusive evidence is not available to demonstrate the effectiveness of these countermeasures. If they decide to use a new or emerging countermeasure that has not yet been studied sufficiently to demonstrate that the countermeasure is effective, they are encouraged to have the countermeasure evaluated in connection with its use.

Further details about the symbols and terms used are included after the table. Effectiveness, cost, and time to implement can vary substantially from State to State and community to community. Costs for many countermeasures are difficult to measure, so the summary terms are very approximate.

Each countermeasure to increase seat belt and child restraint use is discussed individually in this chapter. Full descriptions are included for ,  and  countermeasures. 

Countermeasures Targeting Adults

1. Seat Belt Use Laws

Countermeasure	Effectiveness	Cost	Use	Time
1.1 State Primary Enforcement Seat Belt Use Laws		$	Medium	Short
1.2 Local Primary Enforcement Seat Belt Use Laws		$	Low	Short
1.3 Increased Seat Belt Use Law Penalties	†	$	Low	Short

†Effectiveness has been demonstrated for increased fines but has not yet been demonstrated for driver’s license points.
 

2. Seat Belt Law Enforcement

Countermeasure	Effectiveness	Cost	Use	Time
2.1 Short Term, High-Visibility Seat Belt Law Enforcement		$$$	Medium†	Medium
2.2 Integrated Nighttime Seat Belt Enforcement		$$$	Unknown	Medium
2.3 Sustained Enforcement		Varies	Unknown	Varies

†Used in many jurisdictions but often only once or twice each year
 

3. Communications and Outreach

Countermeasure	Effectiveness	Cost	Use	Time
3.1 Supporting Enforcement		Varies	Medium	Medium
3.2 Strategies for Low-Belt-Use Groups	†	Unknown	Unknown	Medium

†For programs supporting enforcement
 

Countermeasures Targeting Children and Youth

4. Child/Youth Occupant Restraint Laws

Countermeasure	Effectiveness	Cost	Use	Time
4.1 Strengthening Child/Youth Occupant Restraint Laws		$	High	Short

 

5. Child Restraint/Booster Seat Law Enforcement

Countermeasure	Effectiveness	Cost	Use	Time
5.1 Short High-Visibility CR Law Enforcement		$$$	Medium	Medium

 

6. Communications and Outreach

Countermeasure	Effectiveness	Cost	Use	Time
6.1 Strategies for Older Children		Varies	Unknown	Medium
6.2 Strategies for Child Restraint and Booster Seat Use	†	Varies	Unknown	Medium

† For stand-alone programs not supporting enforcement
 

7. Other Strategies

Countermeasure	Effectiveness	Cost	Use	Time
7.1 School-Based Programs		Varies	Unknown	Varies
7.2 Inspection Stations		$$	High	Short

 

Effectiveness:
			Demonstrated to be effective by several high-quality evaluations with consistent results
			Demonstrated to be effective in certain situations
			Likely to be effective based on balance of evidence from high-quality evaluations or other sources
✩✩			Effectiveness still undetermined; different methods of implementing this countermeasure produce different results
✩			Limited or no high-quality evaluation evidence
Effectiveness is measured by reductions in crashes or injuries unless noted otherwise.   See individual countermeasure descriptions for information on effectiveness size and how effectiveness is measured.
Cost to implement:
$$$	Requires extensive new facilities, staff, equipment, or publicity, or makes heavy demands on current resources
$$	Requires some additional staff time, equipment, facilities, and/or publicity
$	Can be implemented with current staff, perhaps with training; limited costs for equipment or facilities
These estimates do not include the costs of enacting legislation or establishing policies.
Use:
High		More than two-thirds of the States, or a substantial majority of communities
Medium		One-third to two-thirds of States or communities
Low		Less than one-third of the States or communities
Unknown		Data not available
Time to implement:
Long		More than 1 year
Medium		More than 3 months but less than 1 year
Short		3 months or less
These estimates do not include the time required to enact legislation or establish policies.

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