Running head: SEAT BELT USE 1

Seat Belt Use in Drivers and Front Seat Passengers in Madison County

Sarah Skousen

Brigham Young University-Idaho

N433-01

Sister Orchard

September 28, 2017

SEAT BELT USE 2

Seat Belt Use in Drivers and Front Seat Passengers in Madison County

Part 1: Defining the Population

Seat belts began to come standard in vehicles beginning in 1964, followed by

shoulder belts in 1968, and combination shoulder and lap belts by 1974 (Center for

Disease Control and Prevention, 2017a). Since the introduction of seat belts, there has

been a focus on effective seat belt use. In the year 2015, the National Highway Traffic

Safety Administration reports 35,092 people were killed in motor vehicle crashes. At the

time of the crash, over half of those killed were unrestrained (Center for Disease Control

and Prevention, 2017b). When seat belts are used correctly, they reduce the risk of fatal

injury to front seat passengers by 45% (Insurance Information Institute, 2015). The

Center for Disease Control also noted that 2.5 million drivers and passengers in motor

vehicle accidents required treatment for injuries in 2015. Moderate to critical injury risks

are reduced by 50% when seat belts are used (Insurance Information Institute, 2015).

There are factors that decrease an individuals chance of wearing a seat belt. Among

these are being 18-24 years old, male, driving in a rural area, and living in a state with

secondary enforcement seat belt laws rather than primary enforcement laws (CDC,

2017b).

(CDC, 2014)
SEAT BELT USE 3

(CDC, 2014)

The National Highway Traffic Safety Administration reported 13,941 saved lives

due to seat belt use (2015). In addition, 2,804 more lives could have been saved if seat

belts had been bucked correctly (NHTSA, 2015). An increase in seat belt use translates

into fewer fatalities in motor vehicles and less serious injuries. This can result in lower

healthcare costs, disability needs, and mortality rates.

Healthy People Goal

Healthy People Objective IVP-15 plainly states the goal of increase[d] use of

safety belts (Healthy People, 2013). The primary populations of this objective are

drivers and front seat passengers as there are other Healthy People Objectives that focus

on age- appropriate child restraints. The baseline began at 84% with an end target of

92%, as seen in the chart below (Healthy People, 2013).

SEAT BELT USE 4

If one looks specifically at the state of Idaho in regard to seat belt wearing

compliance, a much lower percentage is presented. This is an 11% dissonance between

the Healthy People Objective and the State of Idaho statistics.

(CDC, 2017e)

Specific Population

The specific population to be assessed is individuals of the age to drive a car and

ride in the front passenger seat within Madison County. It is difficult to pinpoint an exact

beginning age for this assessment because in the state of Idaho, teenagers can begin

driving at 14 years old (Department of Motor Vehicles, 2017a). For front seat

passengers, the state of Idaho does not mandate how old they must be. The only

stipulation for passengers is that they must be in the back seat if 6 years of age or younger

(DMV, 2017b).

There is a wide dispersion of ages within Madison County with ages 18-24

comprising almost one third (31.75%) of the population (Community Health Needs

Assessment, 2015). This is important to note, as this age group is most at risk for not

wearing seat belts in a motor vehicle accident. The next closest age group is ages 5-17 at

16.88%. Interestingly, though, there are more individuals over 65 than those in the 55-64-
SEAT BELT USE 5

age range (CHNA, 2015). As far as gender dispersion, there is an almost even split

between females and males within Madison County (CHNA, 2015).

(CHNA, 2015)

Two interesting points of data about Madison Countys driving and passenger

population come from Data USA (2015). One point outlines the average commute time.

Most individuals in Madison County have a commute time of 19 minutes or less. This

can contribute to people not feeling the need to buckle up because it is a short trip. There

is also the fact that 65% of commuters drive alone, where only 10.8% carpool.

Comparatively, 9.6% walked with public transit being nearly non-existent (Data USA,

2015). This means that approximately 75% of Madison County workers are in a vehicle

to and from work on any given day.

SEAT BELT USE 6

Commute

Another point is that Madison County has an average ratio of 2 cars to every one

household. Compared to the national average though, there are slightly more households

with only one car. So there will be cars that have both a driver and front seat passengers

within this specific population.

Car Ownership

Community

Madison County is comprised of two cities: Rexburg and Sugar -Salem. Rexburg

is the county seat due to its larger, denser population. The total population of Madison
SEAT BELT USE 7

County is 37,916, where 71% of Madison County is considered urban and 28% is rural

(CHNA, 2015).

(CHNA, 2015)

The median annual income is $32,233 (Data USA, 2015). As seen on the graph, a

disproportionate amount of the county makes less than $10,000 a year. However, there is

an unemployment rate of 2.6%, which is less than half of to the national unemployment

rate (CHNA, 2015). Within Madison County, the three most common job clusters are

administrative, education, and sales (Data USA, 2015). As well, one of the biggest

aspects of the community is Brigham Young University-Idaho, a four-year private

university. Due to the placement of the university, 98% of all university graduates in

Madison County are from BYU-Idaho (Data USA, 2015). In addition, the county has 5%
SEAT BELT USE 8

more individuals with a Bachelors Degree or higher-level education than the national

average (CHNA, 2015).

(Church News, 2013)

The primary religion of Madison County is the Church of Jesus Christ of Latter-

day Saints. Followers of this religion are commonly referred to as Mormons. This

religious group is also who funds BYU-Idaho, the private university. The LDS churchs

emphasis on marriage before sex as well as the importance of families and children

appears to have greatly impacted the community population. Madison County has 7,129

households with approximately 40% having children under the age of 18 (Madison

County, 2017). This is 7-8% higher than the state and national averages (CHNA, 15).

Plan

In order to gather assessment data, two key informants will be interviewed: a

nurse who rides on ambulances for Madison County EMS and an emergency room nurse

who works at Madison Memorial Hospital. A group of 8 Madison County residents

comprised of teens, early adults, middle aged adults, and elderly individuals will be

interviewed anonymously. A windshield survey will be completed at the following

locations: the intersection of Front and Center Street, US 20 at Exit 339 for Sugar
SEAT BELT USE 9

City/Driggs, and State Highway 33 at E 1st N as these are where the 2013 Idaho Seat Belt

Survey took place (Idaho Transportation Department, 2013). The sources used to provide

secondary data include the CDC: Restraint Use and Motor Vehicle State Data, the Idaho

Transportation Department, Idaho Department of Motor Vehicles, and Healthy People

2020.

Part 2: Assessment

Primary Data

Interviews were held with a paramedic and emergency room nurse to determine

their professional viewpoint of seat belts. As well, they were questioned about how seat

belt use can be improved in the community. Each informant was contacted and

interviewed separately. Each person was asked the same four questions:

1. What is your experience with car accidents where the driver or passengers were

wearing seat belts versus those who were not?

Paramedic Emergency Room Nurse

Most of the time those that are wearing There was a 30-year-old lady who was
seat belts fare much better. For example, 2- driving about 30 (mph), was texting and hit
3 weeks ago, girl rolled her pickup without a patch of ice and spun out. Another car hit
her seat belt on. She was flung around, but her head on and she flew through the
ended up okay (S. Butikofer, personal passenger side window because no seat
interview, October 3, 2017). belt. She was a vegetable for 10 years. She
recently passed away. Other driving had a
Most people do better when wearing a scrape and was wearing a seat belt (T.
seat belt. The reason why is because youre Sullenger, personal interview, October 7,
driving at a certain miles per hour and an 2017).
abrupt stop causes that kinetic energy. If
you dont have a seat belt on, you are going
to impact the windshield, the dashboard.
Almost every time, if you are wearing a
seat belt, you will be less banged up. A lot
less broken bones and bodily trauma (S.
Butikofer, personal interview, October 3,
2017).
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Granted, there are some accidents that it

does not matter whether you are wearing
seat belts or not. However, seat belts have
been proven to save lives (S. Butikofer,
personal interview, October 3, 2017).

2. When do you notice an increase in lack of seat belts, if any, in the community? Do you

ever notice an increased use of seat belts, if any, in the community?

Paramedic Emergency Room Nurse

Most of the time, we arrive on the scene
and interpret if they were wearing seat belts
or not. If we know they are wearing a seat
belt, we are looking for certain things
where their seat belts were. If they were
not, we will look for more facial and head
injuries. If theyre wearing a seat belt, we
know they have an increased chance of
survival (S. Butikofer, personal interview,
October 3, 2017).
I think it is just the persons personality.
Some people just dont like being told what
to do (T. Sullenger, personal interview,
October 7, 2017).
Usually there are less severe accidents in
winter because the snow cushions and
people drive slower (T. Sullenger,
personal interview, October 7, 2017).

I notice more non-seat belts when the

university in session. Mostly because more
people means more accidents. I think Ive
seen more people wearing seat belts. It is
mostly the younger people that I see not
wearing seat belts. The older population
seem to wear them more (S. Butikofer,
personal interview, October 3, 2017).

3. Accidents in the city versus the country roads?

Paramedic Emergency Room Nurse

In the city, accidents arent as bad. Less speed in the city. In the country, a lot
Usually a bumper or turning accident (S. of people do not know the roads (T.
Butikofer, personal interview, October 3, Sullenger, personal interview, October 7,
2017). 2017).

It seems like in the country setting, people In 1983, college students ran a stop sign
are driving faster because county roads and and my husband hit them. The passenger
there are fewer stops and stop signs. On the died and the driver was paralyzed. Large
SEAT BELT USE 11

highway, highway 20, I think we are seeing groups arent good because of distractions
more people wearing seat belts. Seems like (T. Sullenger, personal interview, October
most of the time, I see more people 7, 2017).
wearing their seat belts around town than in
the country. We have a lot of agricultural
stuff and theyre doing a lot of back and
forth. They may be less apt to strap on a
seat belt because they just hop in and go
(S. Butikofer, personal interview, October
3, 2017).

4. What do you think can be changed to encourage seat belt use?

Paramedic Emergency Room Nurse

I think if we did a health promotion at a Show people who have been in accidents
younger high school age, in the high to show what can happen (T. Sullenger,
schools through all four years. Youd get a personal interview, October 7, 2017).
lot better results. Weve done a very good
job on the fire side- fire extinguishers, Focus on family habits (T. Sullenger,
alarm and things like that. I think we need personal interview, October 7, 2017).
to focus on the first aid portion of that. A
health promotion would help that. If you It should be common sense, education
just talk about it more, especially with the probably wont help (T. Sullenger,
younger people, we can change habits. We personal interview, October 7, 2017).
need to hit that age group because once
they graduate, they are adults. I think we
can even pair it with the huge incidence of
distracted driving (S. Butikofer, personal
interview, October 3, 2017).

Resident Interviews

Five males and five females of varying ages, from 17 to 59 years old, residing in

Madison County were interviewed. Each individual was contacted and interviewed

separately. All reported consistently driving and riding in cars throughout Madison

County.

1. How do you feel about seat belts?

Teenage Female, Age 17 I feel like sometimes they can be

SEAT BELT USE
Teenage Male, Age 18
Young Adult Female, Age 21
Young Adult Male, Age 24
Middle Age Female, Age 46
Middle Age Male, Age 48
Older Adult Female, Age 59
Older Adult Male, Age 53
2. How often would you say you put on your seat belt?
Teenage Female, Age 17
12
annoying, but one actually saved my life so
I definitely think theyre necessary
(Teenage female, age 17, personal
interview, October 5, 2017).
(What happened?) I was driving a full
potato truck and I was going down the
canyon in the dark and it tipped (Teenage
female, age 17, personal interview, October
5, 2017).
(Were you okay?) It ended up completely
ruining the truck, but I was fine (Teenage
female, age 17, personal interview, October
5, 2017).
They are useful and good for safety
(Teenage male, age 18, personal interview,
October 7, 2017).
I feel like they keep you safe, but I dont
like wearing them. If Im the only one on
the road, I dont want to wear it (Young
adult female, age 21, personal interview,
October 5, 2017).
I think seat belts are very important in
keeping us safe while we drive. I think they
are a great invention (Young adult male,
age 24, personal interview, October 6,
2017).
I think they are extremely important and
save lives (Middle age female, age 46,
personal interview, October 7, 2017).
I see them as a device that can save my
life. Its proven. Im happy to put my seat
belt on (Middle age male, age 48, personal
interview, October 7, 2017).
Mandatory. You just do it! Its not an
option (Older adult female, age 59,
personal interview, October 6, 2017).
I like them (Older adult male, age 53,
personal interview, October 10, 2017).
Like 80% of the time (Teenage female,
age 17, personal interview, October 5,
SEAT BELT USE
Teenage Male, Age 18
Young Adult Female, Age 21
Young Adult Male, Age 24
Middle Age Female, Age 46
Middle Age Male, Age 48
Older Adult Female, Age 59
Older Adult, Age 53
3. Are there things that make you more likely to put on your seat belt versus not?
Teenage Female, Age 17
Teenage Male, Age 18
Young Adult Female, Age 21
13
2017).
(Were you that consistent before your
accident?)
Ha ha, no (Teenage female, age 17,
personal interview, October 5, 2017).
Most of the time (Teenage male, age 18,
personal interview, October 7, 2017).
At my parents home, maybe 20%. Up in
Rexburg, I usually wear it. I dont trust
people in Rexburg driving, especially in
winter. There are lots of college kids that
are stupid (Young adult female, age 21,
personal interview, October 5, 2017).
All the time without fail. I do no start
driving without my seat belt on. Even at
my job where I was constantly in and out
of the car, I would still always put my seat
belt on (Young adult male, age 24,
personal interview, October 6, 2017).
Every time (Middle age female, age 46,
personal interview, October 7, 2017).
Every time Im in a car (Middle age
male, age 48, personal interview, October
7, 2017).
Probably 100%. If I pull out of the
driveway without it on, I put it on by the
next block (Older adult female, age 59,
personal interview, October 6, 2017).
Always (Older adult male, age 53,
personal interview, October 10, 2017).
Yeah, I think when Im just with my
friends Im less likely to wear a seat belt
versus when Im with my family (Teenage
female, age 17, personal interview, October
5, 2017).
If my parents are in the car (Teenage
male, age 18, personal interview, October
7, 2017).
If its snowy I do. In a bigger city, I will.
Or if I know Im going on a faster road, I
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will (Young adult female, age 21, personal

Young Adult Male, Age 24
Middle Age Female, Age 46
Middle Age Male, Age 48
Older Adult Female, Age 59
Older Adult Male, Age 53
interview, October 5, 2017).
I wear my seat belt regardless. I remember
to remind others more when theyre in the
car. I dont start driving my car until
everyone in the car has put their seat belt
on (Young adult male, age 24, personal
interview, October 6, 2017).
I just dont want to chance it. I have kids,
who I always make wear seat belts, and
why should I risk my life when something
so easy could save it? (Middle age female,
age 46, personal interview, October 7,
2017).
I just always do, even driving around
campus for my job (Middle age male, age
48, personal interview, October 7, 2017).
Ive been in 6 accidents. Three of them
were rollovers. Ive had seat belts on
during all of them. I do have back issues
from a car accident, but I did have my seat
belt on (Older adult female, age 59,
personal interview, October 6, 2017).
Its just a habit Ive been in since I was a
teenager. I always do it (Older adult male,
age 53, personal interview, October 10,
2017).

Windshield Survey

The intersection of Front and Center Street in Sugar City, US 20 at Exit 339 for

Sugar City/Driggs, and State Highway 33 at E 1st N in Rexburg, were all observed during

some of the busiest traffic times. Data about both drivers and front seat passengers was

collected to evaluate the use of seat belts in Madison County.

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Front and Center Street, Sugar City

October 12, 2017

4:00-4:45
Driver Front Seat Passenger

Seat belt No Seat belt Seat belt No Seat belt

78 48 12 8

Notes: Due to tinted windows and different angles, only those vehicles in which seat belts
were clearly seen, whether in use or not, were counted.
No commercial vehicles or tractor-trailers were counted.

US 20 at Exit 339
October 13, 2017
9:15-10 am
Driver Front Seat Passenger

Seat belt No Seat belt Seat belt No Seat belt

39 31 8 10

Notes: Due to tinted windows and difficult angles, only those vehicles in which seat belts
could be clearly seen, whether in use or not, were counted.
No commercial vehicles or tractor-trailers were counted.

State Highway 33 at E 1st N

October 10, 2017

12:15-1:00 pm
Driver Front Seat Passenger

Seat belt No Seat belt Seat belt No Seat belt

113 47 28 17

Notes: Due to tinted windows and difficult angles, only those vehicles in which seat belts
could be clearly seen, whether in use or not, were counted.
SEAT BELT USE 16

Data Results
A. Total Drivers Wearing Seat belts 230
B. Total Drivers Not Wearing Seat belts 126
C. Total Front Seat Passengers Wearing Seat belts 48
D. Total Front Seat Passengers Not Wearing Seat belts 35
E. Total Number of Drivers Observed 326
F. Total Number of Front Seat Passengers Observed 83
G. Percent of Seat belt Wearing Drivers (A divided by E) 70.5%
H. Percent of Seat belt Wearing Passengers (C divided by F) 57.8%

Secondary Data

Secondary sources revealed data that included: Idahos current seat belt laws,

national, state, and local information regarding factors that affect seat belt use, and

strategies and recommendations regarding improving seat belt use.

Idaho Seat Belt Law

Currently throughout the United States, each state has a unique seat belt law. The

laws are split into primary and secondary enforcement laws (CDC, 2017a). A primary

enforcement law operates on the premise that people can be pulled over for not wearing

seat belts, independent of any other citation (CDC, 2017a). For example, in primary

enforcement states, a person who is going the speed limit, has the appropriate registration

on their car, and is obeying all other traffic laws can be pulled over by police simply

because they are not wearing a seat belt. In secondary enforcement states, individuals can

only be cited for seat belt violations after being stopped for another violation (CDC,

2017a). This means that an individual who is driving the speed limit, has appropriate car

registration, but is not wearing a seat belt cannot be pulled over. Of the fifty states, thirty

states have primary enforcement laws where twenty have secondary enforcement laws

(CDC, 2017a). Idaho is among the twenty secondary enforcement law states. The fifth

section of the motor vehicle statutes state that, Enforcement of this section by law
SEAT BELT USE 17

enforcement officers may be accomplished only as a secondary action when the operator

of the motor vehicle has been detained for a suspected violation of another law (Idaho

Legislature, 2017).

According to Idaho statutes, safety restraints need to be used whenever a vehicle

is in motion (Idaho Legislature, 2017). There are some exceptions to this law. Among

these exceptions are those who have medical conditions that prevent the wearing of seat

belts, mail carriers, emergency response vehicle drivers, and vehicles where every seat

belt is already in use (DMV, 2017b; Idaho Legislature, 2017).

(CDC, 2017a)

When an individual is cited in Idaho for a seat belt violation, the maximum fine is

$10 (CDC, 2017a). There is no difference in fines between those younger than 18 and

those older than 18 (Idaho Legislature, 2017). Only the driver is ticketed for seat belt

violation, even if the passengers are the ones who are not wearing a seat belt.

National and State Data

Healthy People 2020 reports overall national seat belt use at 90% (2013). In

contrast, the 2016 Annual Evaluation by the Idaho Transportation Department observed

seat belt use in Idaho at 81%. This is lower than the beginning national baseline of

Healthy People 2020 (2013). Madison Countys 2013 usage of seat belts was at an even

lower 71.6% (Idaho Transportation Department, 2014).

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In addition, the Idaho Transportation Department reports that only 38% of

individuals killed in a crash were wearing seat belts (2016). This means that there were

62% of Idahoans killed that were not wearing seat belts. If everyone involved in an

accident had been wearing seat belts in 2016, 47 of the 97 unbelted occupants would still

be alive today (Idaho Transportation Department, 2016). As the chart below

demonstrates, Idaho also has a higher mortality rate in motor vehicle accidents than the

national average (Idaho Transportation Department, 2016).

(Idaho Transportation Department, 2016)

As previously mentioned, certain age groups and genders were more likely to be

involved in serious crashes. The Idaho Transportation Department compiled a report that

broke down the gender and age of fatal and injury crashes across the state (2013). The

only age group in which females were at a higher percentage of involvement in crashes

was 16-year-olds. Every other age group reported a higher accident rate by the males.
SEAT BELT USE 19

(Idaho Transportation Department, 2016)

Click It Dont Risk It

The Click It Dont Risk It campaign has become Idaho State Polices newest

slogan, originally starting in 2003 (Idaho State Police, 2013). In cooperation with the

Idaho Transportation Department, the Idaho State Police have released flyers, radio spots,

and advertisements to bring awareness to the need for seat belt use in Idaho. The flyer

plainly outlines the seat belt laws, regulations about child restraints, and the statistics

behind the need for seat belt use (Idaho State Police, 2013).

An additional boost to the Click It Dont Risk It

campaign is the seat belt mobilization put out by the

Office of Highway Safety in Idaho for 2017. It is

part of a national push by the National Highway

Traffic Safety Administration for increased seat belt

use and safety (NHTSA, 2016). The mobilization has two parts. The first, entitled Click It

or Ticket, occurred from May 22 from June 4 of this year (Idaho Transportation
SEAT BELT USE 20

Department, 2017). It is meant to encourage seat belt use over one of the busiest road

holidays- Memorial Day. Click it or Ticket involves more visibility of the state police for

drivers on the road (Idaho Transportation Department, 2017). The Buckle Up America is

the second part of the mobilization and will occur from November 17 to November 27

this year (Idaho Transportation Department, 2017). It also occurs over a busy traveling

holiday- Thanksgiving. It too is nationally observed and again enforced through increased

state police visibility (Idaho Transportation Department, 2017). Currently, there is no

data on the effect these particular campaigns are having across Idaho.

Part 3: Data Interpretation

Comparison of the primary and secondary data reveals that seat belt use is a

problem on the national, state, and local level. The primary data confirmed that local use

of seatbelts is even lower than the state and national level.

Three similarities in the gathered data

1. In less populated areas, there was decreased seatbelt use.

2. Males were more likely to not wear seatbelts.

3. Teenagers and young adults had low rates of seatbelt use, especially when with

their peers.

From the windshield survey, passengers were more likely to wear their seat belt if the

driver was wearing their seatbelt. If the driver was not wearing their seat belt, the

passenger was more likely to not wear their seatbelt either. In addition, many of the truck

drivers appeared to not be wearing seat belts. However, individuals driving mini vans and

suburbans were much more consistent in wearing their seat belts, whether they were

male or female.
SEAT BELT USE 21

Strengths of the Population

1. Compared to Jefferson and Bonneville counties, Madison has 6-9 fewer motor

vehicle crash deaths per year (County Health Rankings, 2017).

2. Rexburg has a reputation as Americas Family Community with an emphasis on

safety and security. (Smith, 2017).

3. Rexburg Police Department has a dedicated traffic officer per shift to respond to

all traffic crashes, beginning in February of 2016 (Idaho Transportation

Department, 2016).

The Rexburg Police also pairs up with the Fire Department regularly to give

presentations at the local high school about safe driving- including distracted driving. In

addition, the Rexburg Police Department offers a program called Alive at 25 which is

available to all drivers 16-25 to reduce automobile crashes.

Challenges of the Population

1. The age range of the observed population was so vast- from 16 years to the

elderly. Due to this range, improving overall seat belt use is harder than focusing

on smaller age groups.

2. The high influx of 18 to 24 year olds due to the presence of BYU-Idaho as one of

the most common populations with decreased seat belt use.

3. Agriculture is a large part of the culture in Madison County, which could explain

the decreased seat belt use.

SEAT BELT USE 22

Significant information that validates the health issue

1. The low percentage of seat belt usage from the windshield survey and the

observational survey done by the Idaho Transportation Department within

Madison County (2014).

2. Madison has a large percentage of individuals of age 18 to 24, males, and rural

areas. All these factors contribute to decreased seat belt use.

3. The state of Idaho operates under a secondary enforcement law in regards to seat

belt use. Secondary enforcement states report an 83% compliance rate with seat

belts where primary enforcement states report 92% compliance rate (CDC,

2017b).

Part 4: Population Health Plan

Areas of Improvement in the Population

1. Education: There is so much emphasis at the moment on distracted driving

through cell phone use. However, there is limited to no awareness of the

importance of wearing seat belts. The population of Madison County, from the

small infants to the elderly lady, need to understand that often seat belts are the

line between life and death. Education about seat belts could include:

Statistics of motor vehicle accidents that result in death or injury

without seat belts as well as with seat belts

The current law in Idaho regarding seat belts

Hearing real life stories of those impacted by people not wearing

seat belts
SEAT BELT USE 23

Recommendations for this problem:

Currently in Idaho, the Alive at 25 drivers awareness program is typically only

offered to those who have already been in a serious accident or received a citation. While

those are appropriate times to enroll in the class, it would also be appropriate for others

who have never been in an accident or received a citation to enroll in it. As the police

department already spends time presenting at the school annually, they could advocate

for the Alive at 25 class during those presentations. This could boost enrollment in the

class. The class is offered for up to 24-year-olds so Alive at 25 flyers and posters could

be placed on Brigham Young Univeristy-Idahos campus to reach the high percentage of

18 to 24-year-olds in Madison County.

Within the current Click It Dont Risk It advertisements played on the radio,

pathos is primarily used to encourage buckling up through words like, getting home to

your family, arrive in one piece, etc. However, there is little to no logos within the

radio advertisement. The use of statistics to outline how many lives have been lost and

how many could have been saved if seat belts had been worn may prove more effective.

Also, the fact that the advertisements are played on the radio may reach a larger

population than just the teenagers and 18 to 24-year-olds.

Buckle Up for Bobby is a non-profit organization started by Duke and Sheri

Rogers after their high school age son, Bobby, was killed in an accident. Police officers

told Bobbys parents that if Bobby had worn his seat belt, he would still be alive (Rogers,

S., 2015). Day reports in her interview with Rogers that Duke and Sherri speak about

Bobbys story and the difference a seat belt makes at high schools, youth rallies, and fun

runs across the state of Idaho (2017). Rogers was quoted by Day as saying, I show some
SEAT BELT USE 24

fairly graphic videos in my presentation that demonstrate how easily people can be

ejected from a vehicle if not buckled (2017). Buckle Up for Bobby could be invited to

speak at Madison High School as well as at a community event, like a fun run. In this

way, the teenage population could be reached as well as those of varying ages in the

community.

2. Few signs display reminders to buckle up: Within Madison County, there is one

overhead sign on the highway. At most, there are one or two signs to remind

people to buckle up.

Recommendations for this problem:

Improve the use of the overhead sign in Madison County to include seat belt

reminders, especially during heavy traffic flow times.

(Wasser, 2015)
SEAT BELT USE 25

Placing smaller signs around the community in various

places to reach more of the population is another

recommendation. To reach parents and children, these signs

should be placed in school parking lots and parks in Madison

County. To reach those without children, the signs could be

placed at parking lot entrances and slower moving traffic

ways, like downtown Rexburg and Sugar-Salem. (My Parking Sign, 2017)

3. Seat belt laws: Idaho currently has a secondary enforcement law so many people

are not concerned about being pulled over for not wearing a seat belt. The fine for

not wearing a seat belt when pulled over for another violation is only $10.

Recommendations for this problem:

Lobby the state government to change the current seat belt law to a primary

enforcement law. As previously mentioned, primary enforcement states report 92% seat

belt compliance rate compared to the secondary enforcement compliance rate of only

83% (CDC, 2017b). If Idaho implemented a primary enforcement law, more people may

buckle up because they can be pulled over just for not wearing their seat belt. Increasing

the fine for not wearing a seat belt would motivate people to buckle up as well, even if

the law was unable to change to primary enforcement.

Evaluation

Due to the wide variety of recommendation, each recommendations effectiveness

would have to be evaluated in several different ways:

Education: Three recommendations were given to increase education. The

effectiveness of the push for Alive at 25 could be measured through increased

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enrollment and attendance at the class. As well, tracking what age groups more

commonly come and how to more effectively reach those groups that do not come could

increase attendance. The Click It Dont Risk It advertisement effectiveness could be

evaluated through how many seat belt citations were given before the advertisement was

played and after. The Buckle Up for Bobby campaign can be evaluated by asking high

school students their thoughts about buckling up before and after the presentation. The

same could be done with community members who attend the fun run presentation.

Overall, all of these education interventions could be evaluated by a decreased overall

amount of accidents, citations, injuries, and fatalities. Doing another windshield survey at

the same three spots to note if there was an increase in seat belt use would provide further

evaluation of the educational interventions.

Increased Buckle Up Signs: Surveys, whether through qualtrics or windshield

surveys, could measure the effectiveness of more signs. A qualtrics survey could be sent

through some of the community Facebook groups like, Life in Rexburg after posting

additional signs. A windshield survey could be completed at one week, one month, and

then six months after the additional signs are placed. Also, evaluating if there were

decreases in injuries, fatalities, and accidents would provide more data evaluation.

Stricter seat belt laws: Initially, the effectiveness of the changed law would be

seen through an increase in drivers pulled over and seat belt citations given. The

increased income from seat belt violations could continue to go towards the catastrophic

health care cost funds or could be used to fund more Click It Dont Risk It signs and

advertisements, as well as the Alive at 25 educational program (Idaho Legislature,

2017). As more citations occurred, a decreasing number of accidents, injuries, and

SEAT BELT USE 27

fatalities would also ideally be seen. After some time, the citation numbers would

hopefully drop as more people followed the primary enforcement law. Measuring rates of

accidents, injuries, and fatalities to see if they continue to drop even after the law has

been in place for a few months could also evaluate the overall effectiveness of the law

change.

Conclusion

Madison County is a unique community filled with individuals who want the best

for themselves and their families. As the teenage and college students of Madison County

grow up, seek education, have families, and contribute to the community, Madison

County will continue to expand as Americas Family Community (Smith, 2017).

Middle aged and elderly residents of Madison County have ensured a foundation for the

younger people to build on. Together, the young through the old are building a

community to be celebrated and cherished. The population of Madison County struggles

as a whole in wearing seat belts. Not wearing seat belts contributes to more fatal

accidents, increased serious injuries, and additional medical costs for the state and the

community. Increasing education about the need for seat belt use would help this specific

community to not only reach the state goal, but the Healthy People 2020 goal for seat belt

use through primary prevention. Making the seat belt law in Idaho stricter and the

citations more expensive would increase incentive for people to change this unhealthy

behavior. Additional reminders through radio advertisements and street signs build upon

existing programs to bring about improved results. As each of these interventions is put

in place, the opportunities for people to live and accomplish great things in Madison

County will continue to grow.

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Reflection

The more I have studied this problem, the more I realize knowledge is important.

So many people that I talked to about my project were surprised at the statistics that just

wearing a seatbelt can improve. There are so many things that are emphasized when it

comes to driving, like distracted driving and texting while driving. However, I feel like

just putting on a seatbelt is not as emphasized as much as it could be. The importance of

informing people about the difference a seatbelt can make just astounds me. In the

workplace, I need to remember that simple knowledge can often times be more effective

than bringing out the newest and biggest slogan.

I can apply my learning by always wearing a seatbelt myself. Luckily, this is

already a pretty established habit for me. However, there are times when I am not going

that far where I reason it is okay to not wear my seat belt just this once. Those are the

times when I need to put on my seat belt the most. I can encourage the people who ride

with me to put on a seatbelt by not driving until seat belts are in place. When I am in a

vehicle with others driving, I can be a good example by buckling up and encouraging

them to do the same. Especially when I have children, if I can be consistent in buckling

up and assisting them, I will help them establish a positive habit that could save their life.

When I first heard of public health, I thought it was all about immunizations and

saving third world countries. As a result of this project, I realize community health is

about ensuring that each community has the resources and ability to have a high quality

of life. The little things, like wearing seat belts, can increase a communitys overall

health. I also learned that every community, no matter how good they look on paper,
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could be improved. There are so many aspects that constitute a community. The more

aware I can be of those aspects, the more I can contribute to a healthy community.
SEAT BELT USE 30

References

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Center for Disease Control and Prevention. (2017b). Seat belts: get the facts. Retrieved

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Center for Disease Control and Prevention. (2017c). Adult seat belt use. Retrieved from

https://www.cdc.gov/vitalsigns/seatbeltuse/index.html

Center for Disease Control and Prevention. (2017d). Policy impact: seat belts. Retrieved

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Center for Disease Control and Prevention. (2017e). Restraint use and motor vehicle

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Center for Disease Control and Prevention (2014). Buckle up: restraint use in Idaho.

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County Health Rankings (2017). Idaho. Retrieved from

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s=16_019%2016_051%2016_065

Data, USA. (2015). Demographics. Retrieved from

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Department of Motor Vehicles (2017a). Applying for a new license (teen drivers) in

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Healthy People, 2020. (2013). Injury and violence prevention. Retrieved from

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Insurance Institute for Highway Safety Highway Loss Data Institute (2017, Sept). Safety

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Madison County, Idaho (2017). Demographics. Retrieved from

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