INTRODUCTION

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.

Many passengers and drivers wear safety belts on an irregular basis. A term used to describe this portion of the population is “situational safety belt users.” These occasional wearers tend to use a safety belt only when they think it is needed (e.g., on high-speed roads or in bad weather). Unfortunately, it is impossible to predict when crashes will occur. Numerous lives could be saved if these “part-time” users would adopt the “full-time” habit of wearing their safety belts.

NHTSA research has identified different psychological reactions to safety belt use among full-time and part-time users. Full-time users feel discomfort if they are not buckled up; thus, not wearing a safety belt leads to anxiety. Part-time users do not feel the same anxiety in response to not wearing a safety belt. Instead, part-time users often express fatalistic beliefs or utilize other defense mechanisms (e.g., repression, denial, or rationalization) to suppress thoughts about the consequences of being in a crash. NHTSA researchers have hypothesized that these unconscious defense mechanisms interfere with the conscious consideration of the consequences of not buckling up and with the adoption of appropriate coping responses (e.g., buckling up). Moreover, these defense mechanisms may counteract messages that encourage buckling up.

This project represents a unique undertaking by NHTSA to establish the role that unconscious fear, anxiety, or discomfort about anticipated crash outcomes play in belt use behaviors, and to generate ideas for possible countermeasures that may overcome this unconscious resistance. The research entailed two phases. The first phase was a review of the theoretical literature on anxiety, risk perceptions, and fatalism in response to safety threats. While this report primarily focuses on the findings from an expert panel meeting (discussed below), a brief summary of the literature review is included here to provide context (the complete literature review is included as Appendix C to this report). In the second phase, a group of eight experts in various fields (i.e., risk communication, risk perceptions, social marketing, cognitive psychology, and psychodynamic psychology) met to discuss these issues and to make recommendations to overcome these unconscious barriers. While few of these expert panelists had specific experience changing behaviors motivated by unconscious thoughts (e.g., via work as a psychodynamic psychologist), all of the panelists deal with unconscious motivators in some way professionally (e.g., via work in behavior change). Thus, each panelist had distinct expertise to contribute to the discussion.