EXECUTIVE SUMMARY

Despite the overwhelming evidence that safety belts save lives, millions of Americans still do not buckle up every time they are in a motor vehicle. In order to substantially raise the safety belt usage rate, NHTSA has emphasized enactment and enforcement of strong safety belt laws because of the proven effectiveness of those interventions. However, there is interest in augmenting those approaches with other interventions in order to enhance the comprehensiveness of safety belt programs. This project provides information to consider when devising such complementary approaches.

Among the population that does not always wear a belt, a small proportion never wears a safety belt. However, the vast majority are “situational safety belt users,” wearing a belt only when they think it is necessary. Previous research has suggested that unconscious defense mechanisms (i.e., repression, denial, rationalization, and fatalism) may suppress conscious thought of the consequences of being in a crash. Thus, these unconscious defense mechanisms may interfere with the adoption of the appropriate coping behavior (i.e., buckling up).

NHTSA commissioned this study to explore whether unconscious defense mechanisms can be overcome to encourage the full-time use of belts. The research took part in two phases. In the first phase, a literature review was conducted on the role of unconscious motivators in response to safety threats. Approximately 60 citations were reviewed. In the second phase, an expert panel meeting was held. Over the course of this one-day meeting, eight subject matter experts in fields such as psychology, communication, and sociology discussed the role of unconscious defense mechanisms, and provided suggestions to NHTSA on how to overcome these defenses to promote the full-time use of safety belts.

Major Results

The literature review identified several techniques to overcome unconscious motivators. These included: increased mindfulness, enhanced efficacy, increasing the social desirability of compliance, disrupting resistance, and encouraging anticipatory regret.

The expert panelists identified several factors that make belt use a unique behavior (e.g., belt use challenges personal freedom). Panelists highlighted the importance of recognizing the uniqueness of belt use and of knowing as much as possible about part-time wearers to design successful interventions. Suggested techniques to promote belt use included:

• Develop campaigns that focus on the behaviors of “other drivers” as a reason to wear your belt; this helps to overcome a false sense of control.
  
  
• Consider campaigns that move away from telling people to wear their belts. Instead, create campaigns that lead people to the conclusion that wearing a belt is a good idea without actually using these words.
  
  
• Consider focusing on milder negative outcomes of belt nonuse (e.g., getting a ticket versus death), and promote the immediate benefits of belt use (e.g., spare others from worrying, relieve yourself from worrying about getting a ticket, and exercise positive control).

Conclusions

This research suggests that unconscious motivators play an important role in situational belt use, and offers ideas for how to address these motivators while noting that there is no one solution. There are a variety of remedies that may be helpful, depending on the defense mechanism being employed. NHTSA is advised to conduct additional research to identify the best defense mechanisms to target, i.e., ones explaining a substantial portion of belt nonuse and where the technique to overcome these defenses is easy to implement at a mass level.