Teenagers and Seatbelt Safety: Identifying the reasons Why 16 to 19 Old High-School Students Do Not Wear Seatbelt
Melissa Simmons
Research Methodology
Prepared for Soheyl Amini PhD
September 2012

Objectives The aims and objectives of this study include the following: (1) to identify the percentage of teenagers between the ages of 16 to 19 that do not wear seat belts when in a car; and (2) to identify the reasons why teenagers between the ages of 16 to 19 do not wear seat belts when in a car; (3) to identify whether there is a correlation between sex and seat belt compliance among teenagers; and (4) to determine whether attendance of a driver’s education class increases seat belt compliance among teenagers. Once this information is known, strategies for teaching teenagers about the laws of the state with regards to seatbelt use; and the critical importance of wearing seat belts can be developed.
Research Questions
The research questions for this study include the following:
(1) What percent of teenagers between the ages of 16 to 19 do not wear belts when in a car?
(2) What are the reasons why teenagers between the ages of 16 to 19 do not wear seat belts when in a car?
(3) Is there a difference between male and female teenagers between the ages of 16 to 19 in terms of seat belt compliance?
(4) Does formal driver education attendance increase seat belt compliancy among teenagers between the ages of 16 to 19?

Purpose of Study
The purpose of this study is to identify the reasons for the lack of seat belt compliance among the teenagers between the ages of 16 to 19. In the state of Rhode Island those that are 18 years of age and above do not have to attend instructional driver’s education class; it is optional. Those 18 years of age and older are able to take an online exam; then 6 months later he or she takes the driving portion of the exam. No class time is required (www.DMV of Rhode Island). Therefore, this study also seeks to determine whether attendance of a driver’s education class increases seat belt compliance among this population. Once this information is known, strategies for teaching teenagers about the laws of the state with regards to seatbelt use; and the critical importance of wearing seat belts can be developed.
Which of the social paradigms presented in the reading does your inquiry set out to answer? Why do certain teenagers choose not to wear their seat belt? Applying the Micro-theory which deals with issues of social life of teens seems to be appropriate for this study; attempting to understand why teens make bad choice. Studying the social aspect of why teens do what they do and how as a society help them be compliant; at least follow the laws.
What type of things might inhibit objectivity? Teen are by nature rebellious of adult authority. Teens may object or refuse to participate in the survey. Teens may think they are too cool for a seat belt. Being aware of teen peer pressure and attempting to reach those teen with a survey research project will need to be short, informative and at their level of understanding. What is the best way to approach the subject without turning teen off with another boring lecture or presentation from an adult?
This research will attempt to understand why teens are refusing to wear their seat belt when it is the law. How as a society can it be addressed and taught to teens so they can be safe and be able to understand the consequences of not wearing a belt. This research survey will hopefully give insight on what can be done to change the statistics.

Literature Review
According to the literature overall, teens have a lower rate of seat belt use when compared to the general population. Whether they are driving or not, teens are less likely to wear a seat belt than adults. According to the National Highway and Transportation Safety Administration (2009), “teens have the highest fatality rate in motor vehicle crashes than any other age group.” In 2009 the majority 56% of young people 16 to 20 years of age involved in fatal crashes were not wearing seat belts (NHTSA, 2009). Motor vehicle crashes are the leading cause of death, accounting for more than one in three deaths. In 2010, the National Highway Traffic Safety Administration found that eight teenagers ages 16 to 19 died everyday from motor vehicle accidents. (NHTSA, 2010). Compared with other age groups, teens have the lowest rate of seat belt use. In 2005, 10% of high school students reported that they rarely or never wear seat belts when riding with someone else (NHTSA, 2010). 12.5% of male high school students were more likely than 7.8% of female students to rarely or never wear seat belts (NHTSA, 2010). African-American students 12% and Hispanic students 13% were more likely than white students 10.1% to rarely or never wear seat belts. In 2010, nearly three out of every four teen drivers were killed in motor vehicle crashes after drinking and driving and were not wearing a seat belt (Center of Disease Control: National Center for Injury Prevention Cited, 2010). Identifying the reasons why some teenagers do not obey laws or wear seat belts will help increase seat belt compliance among this age group. It is important to acknowledge that lack of partial reasoning in the area of a teenager’s cerebral cortex, including the parietal lobes, which are associated with logic and spatial reasoning are not developed (NHTSA, 2002). The ongoing growth in the frontal lobes, the very area that helps make teenagers do the right thing, are the last areas of the brain to reach a stable grown-up state, perhaps not reaching full development until well past age 20 (NHTSA, 2002). This makes teens more venerable, they are not able to understand the consequences of their actions due to their age and ability to understand the importance.
Graduated driver licensing (GDL) systems are proven effective in keeping teens safe on the road. They help new drivers gain experience under low-risk conditions by granting driving privileges in stages. As teens move through the stages of GDL, they are given extra privileges, such as driving at night or driving with passengers. Research indicates that the most comprehensive GDL systems prevent crashes and saves lives. While most states have a three stage GDL system, rules and requirements vary considerably. States can best protect teens by putting strong three-stage GDL systems in place. Existing policies can be strengthened and made comprehensive and new policies can be proposed. Improving policies will prevent crashes and safeguard teens; preventing others from needless injuries and death (CDC, 2009). Stronger safety belt laws can potentially make a difference. For instance the “Click it or Ticket” law is more effective in increasing safety belt use, because people are more likely to buckle up when there is the perceived risk of receiving a citation for not doing so. In June 2002, the average safety belt use rate in states with primary enforcement laws was 11 percentage points higher than in states without primary enforcement laws (NHTSA, 2002). In 2000, a nationwide survey was conducted to determine attitudes regarding primary safety belt laws. Of the more than 500 young people 16 to 20 years of age who were surveyed, 60 % voiced their support for primary enforcement laws (NHTSA, 2002).
Identify the reasons for the lack of seat belt compliance among the teenagers between the ages of 16 to 19. In order to help this vulnerable population as health care advocates it is important to understand why teens choose not to wear a seat belt. In the state of Rhode Island those that are 18 years of age and above do not have to attend instructional driver’s education class; it is optional. Those 18 years of age and older are able to take an online exam; then 6 months later he or she takes the driving portion of the exam. No class time is required (www.DMV of Rhode Island). Is class time important; making the difference of wearing a belt or not? Once this information is known, strategies for teaching teenagers about the laws of the state with regards to seatbelt use; and the critical importance of wearing seat belts can be developed. In Rhode Island, 64% of fatalities of motor vehicle deaths were not buckled (www.DMV of Rhode Island). Despite the surge in research activity on motor vehicle crashes and lack of seat belt use, the quantity of research falls short in comparison with that addressing other important adolescent health issues, such as alcohol and tobacco use. A rough indicator of this disparity is revealed, which identifies the most relevant research on a topic across the world of research. As of March 2009, 12,888 references were found for articles dealing with teen smoking and 7,730 for teen drinking during the years 1985 through 2009; by comparison only 1,601 references dealing with teen driving were found. The lack of research was the subject of extensive discussion in the recent articles published by the American Automobile Association Foundation for Traffic Safety, 2007. African American and Latinos have higher incidences of risky teen behaviors (Injury Prevention, 2006). The rates of seat belt use among teens vary based on age, gender, race, and urban/rural setting and region of the country. Teen seat belt use was found to be only 19% among male African Americans in Jackson, Mississippi (Injury Prevention, 2006). These findings suggest that not only are interventions to increase seat belt use by young people greatly needed, but also that targeted messages among teens based on age, gender, race, and urban/rural and regional differences are also needed. Community based strategies that engage the targeted populations in prevention efforts are likely to be most effective (Injury Prevention, 2006). Behavior change principles, as well as a review of the broader health education literature as to what works and what does not, indicate that there is little chance that standard driver education programs can influence crash likelihood (National Cooperative Highway Safety Research Program, 2007). Decades of research in the United States and elsewhere have confirmed this lack of effect on crashes (Williams & Ferguson S.A., 2004). The most appropriate goal for formal driver education is to teach basic driving skills and generally educate students about driving. It is clear, however, that neither the ability to handle a vehicle nor knowledge of rules of the road, equate to driving safety. Although the development of skills is largely dependent on experience, the actual driving behavior of young adolescence is shaped by many other factors. Some of these factors are personal dispositions, decision-making abilities, cognitive development, and the influence of parents and peers. This article deals primarily with laws and regulations of teen drivers. Parents that are involved in their teenagers driving from the beginning, teach them to drive, governing their access to vehicles, and setting rules (Morton & Hortos, 2002).
The association between teenage passenger presence and crash risk is well known, as is the fact that teen passengers are often victims in teenage driver crashes. Currently, more 16-year-old teens die as passengers than as drivers. Passengers can hinder drivers but also can help them. Among adult drivers passenger presence is associated with a lower crash risk (Williams, Ferguson S., & McCartt, 2007). The ways in which these positive or negative influences operate are not fully understood (Williams, Ferguson S., & McCartt, 2007). Consequently, approaches that might reduce the crash risk associated with carrying passengers are currently difficult to devise. In-vehicle studies using camera technology may provide some guidance in understanding the mechanisms by which passengers increase crash risk for teenage drivers. More information would be useful, in regard to passenger age, gender, relationship to the driver, and how these are associated with seat belt use for male and female teenage drivers. Currently, the literature indicates that it is not known whether passenger restrictions that allow no passengers are superior to those that allow one, because of differences in compliance. Both observational and experimental research in this topic is greatly needed (Williams, Ferguson S., & McCartt, 2007).
Research is needed because teens are still dying in motor vehicle accidents at an alarming rate. The literature suggests there is a need for more education. The best way is to enforce laws, and rules, and educate them on the importance of seat belt safety (NIHTA, 2010). It seems that the programs that are the most effective may be the ones that enlist peers to deliver the message. A friendly, competitive approach to openly discussing and educating teens about these risks led to a 20% increase in seat belt usage among teen drivers and their passengers (NHTSA, 2010). However, if more education is needed, what are the best tools for reaching out to teenagers? Health promotion entails activities directed towards developing resources that maintain or enhance a person’s well-being. Nurses play a major role in promoting health and wellness. Identifying measures to promote care that is appropriate for those teens from 16 to 19 years of age will increase seat belt use in this age group. These individual characteristics include interpersonal relationships with family, parents, teachers, peers, and driver’s education. Health promoting behaviors should result in improved health (Marrier, T. & Raile, A., 2005). Education for seat belt safety should begin long before student/teens start driving. The importance of well-being and making good decisions is important for making health promotion successful. Race and gender is important because studies have shown that African Americans and minorities are high risk as are males. Community based programs can target minorities and rural communities. Education may be the key to seat belt compliance. Behavior specific and cognitive affects include education, public safety announcements, videos, posters, MADD (mothers against drunk drivers), and driver safety campaigns may be the best way to reach out to teens. Teen respond well to rewards, for example, discounts on auto insurance for a clean driving record and good grades. Behavior specific outcomes (parental control, reward systems, videos) can lead to an increase in seat belt compliance, promoting a teen’s well-being. A majority of the literature methodology used was observance and survey questionnaires.
The population target group is teens in high school between the ages of 16-19 years old. The sample groups are teenagers who are in high school and who are driving or may be in the process of getting their drivers license. The purpose is to obtain information from teens about gender and education related to seat belt use. The setting is high schools throughout Rhode Island that are in grades 10 through 12 and between the ages of 16 to 19 years old. The research methodology that will be utilized in the study can be described is a quantitative design method. The research was designed to obtain information from teenagers that could provide development of a teaching plan. The research will focus on three areas: race, gender and whether or not students attended driver’s education. These three areas are the key to developing a health promotion plan which will increase seat belt compliance. The questionnaire survey will collect data from the focus group being targeted. The quantitative research plan will measure the data related to seat belt compliance within the target group. Descriptive statistics will be used to analyze the data.

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