SUMMARY AND CONCLUSIONS

This report has identified a variety of approaches to overcoming the interference of unconscious defense mechanisms in the use of safety belts. An overarching conclusion is that there is no one solution to overcoming unconscious defense mechanisms. Instead, there are a variety of remedies that may be helpful, depending on the mechanism being employed. Table 1 lists several common reasons offered to explain nonuse of safety belts, the defense mechanism associated with each reason, and suggestions provided by the expert panelists for overcoming these defense mechanisms and promoting belt use.

Some of the techniques suggested in this report and Table 1 have been attempted previously by NHTSA. (This is not surprising given that the expert panelists were specifically chosen for their naiveté in regard to safety belt issues.) However, even the suggestions that have been attempted previously may be worth revisiting in light of this discussion, as previous attempts may not have been informed by this kind of analytical approach and may have included or left out critical aspects.

Table 1: Suggestions for Overcoming Defense Mechanisms Related to Belt Use

Defense Mechanism	Reason for Not Wearing a Safety Belt	Suggestion
Repression	Wearing a belt causes you to think about death.	•  Do not focus on fatalities; focus on milder outcomes like getting a ticket or being injured. •  Tie belt wearing to promotion outcomes, not prevention outcomes (e.g., wear a belt to give other people peace of mind, or do it for your friends or children). •  Flip the cognitive story about belt wearing; make it future-oriented. •  Market belts as serving a different purpose; e.g., fashion statements. •  Market belts as a way to overcome fear; e.g., show racecar drivers wearing belts.
Repression	I don't have the habit; I never think about it.	•  Use shock or surprise to break through the repression (hard in a mass setting); humor may help.
Denial	Any expression of denial.	•  Don't challenge the particular belief (e.g., “I'm a good driver). Instead, work with that belief to move people in a different direction.
Rationalization	Any rationale; e.g., other people may need a belt, but not me. I'm special.	•  Determine if the rationale is causal; i.e., is the excuse the real reason or a post facto explanation? If it is a real reason, break the rationale by poking holes in it and causing people to run out of excuses. If it is only a nice-sounding explanation, probe for the real reason (e.g., repressed fear of death) and act accordingly.
Denial/ Rationalization	Belts are not helpful.	•  Show visualizations of people in crashes both with and without a belt. •  Ask people to think through “what if” scenarios about being in a crash and ask whether they would want a belt on in that situation.
Denial/ Rationalization	Wearing a belt is admitting that you are not in control of your life.	•  Reframe belts as something that frees you from mild anxiety (e.g., worrying about getting a ticket). •  Reframe belts as way to exercise positive control (e.g., over what happens to you in a crash). •  Reframe belts as a way to give you more control over the driving experience (e.g., enjoying the ride). •  Connect pleasure with the notion of control (e.g., via an attractive spokespeople). •  Gently remind people that they are not always in control (see next item).
Denial/ Rationalization	I'm a good driver, so I won't get in a crash.	•  Encourage cognition about scenarios where other people cause a crash, or use virtual reality to create the experience of being hit by someone else. •  Gently remind people that others are not always good drivers. For example, show others engaging in bad driving behaviors, have people talk about the experience of being hit by someone else, or ask the question, “Do you think you will never be in an accident caused by someone else?”
Denial/ Rationalization	I can decide when a belt is needed.	•  Encourage anticipatory regret. That is, ask people to think about how much regret they would feel if they always wore a belt and never got in a crash vs. if they were not wearing a belt and did get in a crash. •  Ask people to think about loved others engaging in such behavior to highlight the hazard.
Rationalization	Wearing a belt is something “dorks” do.	•  Change the image of who wears belts: belts are fun, easy, popular, and cool. Be a part of the tribe. •  Replace the counterfactual: only idiots don't use belts. •  Show heroes/tough guys wearing belts. •  Provide positive rationale for wearing belts, e.g., “My mother loves me.”
Fatalism	The hour of my death is fixed.	•  Encourage people to see good behavior as diagnostic, e.g., wearing a belt is one way to show that you are marked for a long life.
Other issues panelists believed were important	People resist being told what to do.	•  Don't say wear your belt; it is not necessary (people know they are supposed to wear their belts). •  Use humor and unexpected approaches. •  Give positive reinforcements for belt wearing.
Other issues panelists believed were important	Existing messages have to do with the experts' reasons for wearing a belt, not the audience's reasons.	•  Market belts as a way to reach driver's goals, e.g., getting to your destination without any problems. •  Market belts to be consistent with the self-image of non-wearers (e.g., belts make you dependable for your friends).
Other issues panelists believed were important	Belt wearing is an automatic behavior.	•  Do things to encourage people to be more conscious of the decision making process in the moment they fasten a belt; e.g., use reminders. •  Ask people to think about their “zones of safety” and why such zones exist. •  Capitalize on moments where people may be more open to this message (e.g., after a close call).

A next step is to conduct additional research to determine which reasons for non-use of belts make sense as an intervention point, and then to proceed with targeted interventions for specific audience segments. The following factors should be considered in making such a selection: (1) the likelihood of the intervention being successful; (2) the ease of implementation; (3) the size of the target audience likely to be reached by the intervention; and, (4) whether other segments of the population are likely to be affected (either positively or negatively) by the intervention. For example, the best intervention points are ones where a substantial portion of nonusers offer the same reason for not wearing belts, where the intervention is likely to be successful and easy to implement, and where the campaign/message will have a neutral or positive impact on the belt wearing behaviors of people outside the target audience.

The research team’s initial assessment of these suggestions is that some are likely to be actionable sooner rather than later, either because they can be implemented relatively easily or because they are likely to have immediate positive impacts. A “short list” of suggestions for immediate consideration includes:

• Identify new terminology for belts that is less threatening to personal control. In particular, avoid the word “restraint” in all public communications
  
  
• Develop campaigns that focus on “other drivers’ bad behaviors” as a reason to wear your belt.
  
  
• Consider campaigns that move away from telling people to wear their belts. Both the literature review and the panel discussion suggest that telling people to buckle up may engender resistance. Instead, create campaigns that lead people to the conclusion that wearing a belt is a good idea without actually using these words (e.g., show people watching other drivers engage in “bad behaviors” and then buckling up).
  
  
• Consider a campaign that pokes holes in the rationalization that “I can decide when I need to wear a belt” by demonstrating the fallacy of this idea; i.e., people who claim to hold this belief likely would not buckle and unbuckle their loved ones as they move through traffic situations.
  
  
• Consider focusing on milder negative outcomes of non-belt use, and even switching to a promotion focus (e.g., wear a belt to give other people peace of mind).
  
  
• Consider reframing belts in a more positive light. For example, belts relieve you from worrying, allow you to be in control over what happens to you, and give you more control over the driving experience.

While the research team believes the other suggestions offered by the panelists have merit, it appears that these suggestions require additional research before they can be implemented. A research program addressing some of these issues could benefit NHTSA by providing useful insights to better target messages for part-time safety belt users. As noted by the panelists, given the long period over which NHTSA has been promoting the use of safety belts, these remaining part-time users likely represent a hard to reach portion of the population. Reaching this group of people may require new and different approaches. A research program focused on unconscious defense mechanisms may provide the data needed to create such approaches. Such a research program might begin with the suggestions offered by the panelists. As discussed in the previous section of this report, these suggestions include: (1) examine the actual moment of decision-making (as opposed to recollections) to better determine motivators related to belt use; (2) concurrently, examine the reasons part-time users currently offer for non-use of belts (this research can be used to suggest which defense mechanisms may be most frequent, guiding future research directions); and, (3) describe what it is about safety belts that make this a unique behavior. Once this initial phase of research is conducted, additional research can be conducted as needed.