Results

The following results address: (1) how much media and enforcement activity occurred as part of the RDP and CIOT; (2) changes in public awareness and perceptions; and (3) changes in observed seat belt use associated with each phase of the mobilization.

A. Program Activity

Table 5 shows that, about $1.3 million was spent on rural paid media during the RDP (about 12¢ per capita) and that an additional $3.1 million was spent on statewide media during CIOT (about 6¢ per capita). During the RDP, per capita expenses ranged from a high of 44¢ in Ohio to a low of 6¢ in Illinois.

Table 5
Funding Allocations for Paid Media
During Both the RDP and CIOT Phases

During the RDP, expenditures were higher for television than for any other medium, accounting for about 61 percent of all media funds (Table 6). Radio had the next highest level of spending, accounting for about 33 percent of such funds. Very little was spent on other media (i.e., billboards, banners, theatre ads, etc.). During CIOT, the use of television was even more prominent. Five States spent at least 70 percent of their media budgets on television (including cable). Indiana spent far less (38%). On average, about 23 percent of CIOT media funds were spent on radio.

Table 6
Funding Allocations by Medium During RDP and CIOT Phases

Table 7a
Paid Media Coverage by State

Table 7b
Number of Ads and Gross Rating Points (GRPs) by State
During the RDP and CIOT Phases

Table 7a shows the relative number of markets, counties, and residents targeted in the RDP, compared with the CIOT phase. With regard to number of ads, Table 7b shows an average of 4,000 television ads and 2,300 radio ads were purchased in each of five reporting States during the RDP, resulting in an estimated 6,300 ads per State in the electronic media (about 42 ads per 10,000 residents). There was considerable variation between the States, ranging from 100 ads (per 10,000) in Indiana, to 33 in Michigan and Wisconsin, 24 in Minnesota, and 17 in Illinois. Based on per capita expenditures, it is likely that Ohio ranked high on this index. GRP data available for Illinois, Michigan, Minnesota, and Wisconsin showed an average of more than 550 GRPs per market. Data was not available for Indiana and Ohio.

Table 8
A Summary of Indices of Media Activity During the RDP and CIOT
(States are listed in rank order, from highest to lowest, for each index)

With regard to enforcement, there was intensified activity in three States during the RDP and in all six States during CIOT. Table 9 summarizes this activity for both phases. During the RDP, Illinois reported the most citations per capita (32); followed by Indiana (21) and Ohio (13).¹⁰ Using number of enforcement zones per 10,000 residents as an index of intensity, Illinois conducted about 6 and Indiana conducted about 3. Ohio did not conduct EZs. With regard to reported hours devoted to enforcement per 10,000 residents, Ohio reported 18 hours during the RDP, followed by Illinois (17) and Indiana (8).

During the CIOT phase, nearly 2,300 enforcement agencies participated in the GLR mobilization, representing an average of about 65 percent of all relevant agencies in each State. Illinois, Indiana, and Michigan conducted a total of 5,070 EZs (plus special and regular patrols). Minnesota, Ohio, and Wisconsin conducted special patrols. Nearly 120,000 citations were issued for seat belt and child restraint violations across the region (about 23 per 10,000 residents). Michigan had the highest citation rate (32 per 10,000 residents), followed by Illinois and Indiana (25), Minnesota (24), Wisconsin (20) and Ohio (15). Ohio reported 83 hours worked per 10,000 residents, followed by Wisconsin (59), Michigan (44), Indiana (23), Minnesota (16) and Illinois (11).¹¹ Finally, Illinois implemented 2.3 enforcement zones per 10,000 people, followed by Indiana (2.2), and Michigan (1.8).

Table 9
Enforcement Activity: RDP and CIOT Phases¹²

Click It or Ticket (CIOT).

B. Awareness of Media and Enforcement Activity
Telephone and motorist surveys were conducted to measure changes in awareness and perceptions regarding media and enforcement activity. Results across all six States are summarized for the following key issues:¹³

General Seat Belt Messages

• Awareness of recent messages that encourage people to buckle up.
• Perception of more than usual messages in past 30 days.
• Recognition of the Click It or Ticket slogan.

Enforcement-Related Messages and Activity

• Awareness of special efforts by police to ticket for seat belt violations.
• Awareness of specific enforcement activities (e.g., enforcement zones).
• Perception that police are issuing more tickets for seat belt violations.
• Perceived risk of receiving a ticket if riding unbuckled.

Source(s) and Formats of Messages Received

• Medium where seat belt and enforcement-related messages were seen or heard (television, radio, newsprint, outdoor, or other).
• Format of seat belt or enforcement-related messages (ads or news stories).

1. Awareness Levels

Rural Targeted Areas

Figure 2 shows RDP-related increases (w2-w1) in all three general awareness indices: buckle up (13 points); more than usual messages (26 points), and recognition of CIOT (14 points). Increases in these indices were significant in nearly all States. In addition, increases in awareness of special efforts by police to ticket were significant in all five States that provided data on this index (average increase = 19 points; p ≤ 0.05).¹⁴ There were smaller increases in the remaining indices: specific enforcement efforts (8 points), police writing more tickets (4 points); and risk of receiving a ticket (3 points). These latter changes, while consistent, generally did not reach significance during the RDP. ¹⁵

Figure 2
A Summary of Baselines and Changes in Awareness of
General Seat Belt and Enforcement-Related Messages:

Following CIOT, all States reported increases regarding all indices in their targeted rural areas. This was the case for both general and enforcement-related messages. The largest average change (+22 points) was in awareness of special efforts by police to ticket. This is consistent with the fact that all States intensified enforcement and implemented their CIOT paid media efforts during this phase. Figures 3 and 4 show changes in awareness of general and enforcement-related messages, respectively. General message awareness tended to increase more during the RDP while awareness of enforcement-related messages tended to increase more during CIOT. Awareness of special police efforts to ticket increased in a nearly linear fashion throughout the mobilization.

Figure 3
Awareness of General Seat Belt Messages
Results of Telephone Surveys in Rural Targeted Areas¹⁶

Figure 4
Awareness of Enforcement-Related Messages and Activities

Statewide

Nearly every State experienced significant overall increases in every index (for which data were available). The only exception involved perceived risk of receiving a ticket, where 4 of 6 States reported a significant increase. Awareness of special efforts by police to ticket and of specific enforcement efforts (e.g., enforcement zones or road checks) increased more than perceptions of more tickets being issued or increased risk of receiving a ticket. ¹⁷

Figure 5
A Summary of Baselines and Changes in Awareness of
General Seat Belt and Enforcement-Related Messages:



Figure 6
Awareness of Enforcement-Related Messages and Activities

Statewide versus Rural Targeted Areas.

Overall, statewide changes were similar to those in targeted rural areas. Three waves of statewide and rural surveys in Michigan provided indices of change after each phase in this State, which did not intensify enforcement during the RDP.¹⁸ Figure 7 shows similar rural and statewide trends for two enforcement-related indices. Each increased more during CIOT than during the RDP.

Figure 7
Awareness of Special Efforts to Ticket and Enforcement Zones

Motorist surveys in Illinois, Indiana, and Wisconsin also provided information regarding awareness changes. Figure 8 shows that rural awareness of general seat belt messages increased during the RDP (average = 13 points; p ≤ 0.05) with little or no change during CIOT (average = 4 points; p = ns). Statewide, there was little change during the RDP, but there were significant increases during CIOT (average = 18 points; p ≤ 0.05).

Figure 8
Results of Motorist Surveys in Illinois, Indiana, and Wisconsin

Targeted versus Non-targeted Rural Areas.

Indiana conducted three waves of targeted and nontargeted rural telephone surveys. Figure 9 shows the results of these surveys for the three general seat belt indices. It shows RDP-related increases in targeted areas and CIOT-related increases in both areas.

Figure 9
Awareness of General Seat Belt Messages

Figure 10
Change in Two Indices of Enforcement Awareness

2. Message Sources

Surveys in Illinois, Minnesota, and Wisconsin found television to be the dominant message source, followed by radio and newspapers. The prevalence of television increased during the RDP; then did not change much during CIOT. The prevalence of radio, on the other hand, did not change much during the RDP, but increased during CIOT. Rural trends are shown in Figure 11. Similar trends were found statewide.

Figure 11
Source of Message Awareness
General SB Messages versus Enforcement Issues

3. Message Format

Advertisements (ads) were part of paid and public service media efforts. News stories were generated by earned media efforts. Figure 12 shows that ads were reported as the source of information about four times as often as news stories.¹⁹ Similar trends were found statewide.

Figure 12
Advertisements versus News Story as Sources of Information
(Averages of Survey Results in IL, MI, and MN)

C. Seat Belt Usage

1. Statewide and Rural Area Changes
Observational surveys measured seat belt usage statewide, in targeted rural areas, and in nontargeted rural areas in two States.²⁰ As indicated previously, the basic evaluation design involved three waves of surveys (w1, w2, w3), conducted statewide and in rural areas. Statewide results are shown in Table 10 and rural results are shown in Table 11.

Table 10
Observed Seat Belt Usage by Phase
Results of Statewide Observational Surveys

Statewide Changes

Seat belt use increased significantly in all GLR States. As Table 10 shows, there was a median overall increase of 4.8 percentage points (range: 3.2 to 7.7).²³ Significant RDP-related increases (w2-w1) were found in Illinois, Minnesota, and Ohio, and significant CIOT-related increases (w3-w2) were found in all States except Ohio. Figure 13 shows trends for each State, differentiating between primary-law States (solid lines) and secondary-law States (dotted lines). The median increase (w3-w1) was about 5 points for both law types.

Figure 13
Observed Seat Belt Use in GLR States
May, 2005 Mobilization

Conversion Rates

Another way to express these changes is in terms of percentage of nonusers converted to users. Figure 14 shows that the greatest change was in Michigan (33%); followed by Illinois (29%), Wisconsin (22%), Indiana and Minnesota (both 21%), and Ohio (13%). The median conversion rate was 29 percent in primary law States and 21 percent in secondary law States, due in part to smaller proportions of nonusers in primary States.

Figure 14
Percent of Nonusers Converted to Seat Belt Use:

Rural Targeted Areas.

Table 11 shows that, following the RDP, the States with significant increases in usage were Illinois (3 points), Indiana (2.5 points), and Ohio (8 points), each of which intensified enforcement during this period. Following CIOT, five States reported significant increases in usage. They were Illinois (4 points), Indiana (7 points), Michigan (2 points), Ohio (4 points), and Wisconsin (8 points). Included among these States were the three RDP-enforcement States and the three States that employed enforcement zones and/or roadside checkpoints (Illinois, Indiana, and Michigan).

Table 11
Observed Seat Belt Usage by Phase
Results of Observational Surveys in Rural Targeted Areas²⁴

Statewide versus Rural Areas

Figure 15 shows a median 7-point increase in usage in rural targeted areas (w3-w1), compared with a median 5-point statewide increase, possible evidence of additional impact in the rural areas. Perhaps more importantly, there were clear differences between States that intensified enforcement during the RDP and States that did not. As Figure 15 shows, there was a 9-point median increase in the targeted areas of the three RDP-enforcement States (w3-w1), compared with a 3-point increase in the nonenforcement States. Thus, the rural estimates of change in the three enforcement States were considerably greater than the statewide estimates, an even stronger indication that two waves of enforcement (RDP and CIOT) were associated with a greater impact on usage than one wave (CIOT only).

Figure 15
Overall Change in Seat Belt Usage (w3-w1)
Rural Targeted Areas versus Statewide
(entries represent absolute change, rounded to nearest whole percent)

*Enforcement during RDP media period

Looking at individual State results more closely, Ohio reported the largest increase in RDP-related usage in a rural targeted-area. These targeted-area increases were greater than statewide increases following during the RDP and they continued through CIOT, a period when statewide usage did not increase. Regression analysis of statewide and rural data found this greater rate of increase in the rural targeted areas to be significant (Wald = 39.57; df = 1; p = 0.000). The trends for Ohio are shown in Figure 16.

Figure 16
Changes in Seat Belt Usage:
Statewide and in Rural Targeted Areas in Ohio

In Illinois and Indiana, as in Ohio, increases in rural targeted areas were greater than statewide increases (Illinois: 7 points rural versus 4.8 points statewide; Indiana: 9 points rural versus 4.9 points statewide). In addition, as Figure 17 shows, increases in rural targeted areas of Indiana were greater than increases in nontargeted areas (9 points versus 2.4 points). As would be expected, statewide usage in both States increased during CIOT, making rural and statewide trends more similar than in Ohio.²⁵ Sufficient raw data were not available from these two States to conduct regression analyses.

Figure 17
Changes in Seat Belt Usage in Illinois and Indiana:
Statewide and in Rural Targeted Areas

In Michigan, a comparison of rural and statewide trends was possible only for the CIOT phase. Figure 18 shows that the statewide increase that was greater than the rural increase during that phase and regression analysis of the Michigan data found this difference in rate of increase to be significant (Wald = 8.45; df = 1; p = .004). Thus, the Michigan data support the expectation that there would be significant statewide increases during CIOT. They also suggest that the impact of CIOT was greater statewide than in rural areas.

Figure 18
Changes in Seat Belt Usage:
Statewide and in Rural Targeted Areas in Michigan

In Minnesota, estimated changes in neither of two targeted area surveys reached statistical significance (during either phase). However, a 4.5 point statewide increase was significant (Χ2 = 55.3; df = 1; p < .001). Figure 20 shows the trends for the statewide survey and for both targeted-area surveys. Regression analyses, using data from the statewide survey, the southeast target area sample, and the nontarget area sample, found a significant aggregate increase for the three groups (Wald = 8.1; df = 1; p = 0.088) but there was no significant difference in the rates of increase for the three groups. As in Indiana, baseline usage for one group (the nontargeted sample) was significantly lower than baselines for the other groups, making it less useful as a control condition.

Figure 19
Changes in Seat Belt Usage:
Statewide and in Rural Targeted Areas in Minnesota and Wisconsin

Figure 19 shows that, in Wisconsin, rural and statewide trends were similar, with possible declines during the RDP and significant increases during CIOT, statewide and in rural areas. Regression analyses, using statewide, targeted and nontargeted area data, found a significant upward shift in aggregate usage during CIOT (Wald = 7.5; df = 1; p = .006), but no evidence of different rates of increase.²⁶

2. Changes Among Various Sub-Groups

Table 12 provides median usage rates and changes for various sub-groups included in observational surveys. The last column indicates how many States contributed data regarding each sub-group. In general, this table shows that there were substantial differences in the usage rates of males versus females, younger versus older occupants, and occupants in pickups versus other vehicles. With regard to change, the largest changes occurred during CIOT. Changes within the various categories (age, sex, etc.) are similar. However, this table masks the considerable differences between when enforcement was present and when it was not. Those differences are shown in Table 13.

Table 12
Results of Observational Surveys in Rural Targeted Areas
Usage Rates and Change in Rates, by Subgroup and by Phase

Table 13
Results of Observational Surveys in Rural Targeted Areas
Change in Usage Rates Among Various Groups, by RDP Enforcement Status²⁷

Table 13 shows median changes in usage relative to the status of enforcement during the RDP. All data are from observational surveys conducted in rural targeted areas. These data show that, during the RDP (w2-w1) and overall (w3-w1), increases were consistently greater in States that intensified enforcement.
27 Enforcement refers only to whether or not the state intensified enforcement during the RDP phase. All States intensified enforcement during CIOT.

Following are additional highlights regarding rates and changes among the various sub-groups. Again, all data are from observation surveys conducted in rural targeted areas.

Role in Vehicle. About 80 percent of observations involved drivers. In nearly every State, there was little difference between driver and passenger use or change in use associated with the mobilization. Indiana provided the one exception in that driver use was substantially lower than that of passengers, before and after the mobilization.

Sex. About 55 percent of occupants surveyed were males and had substantially lower usage rates than females. Changes associated with the mobilization were similar for both groups. Here again, differences were greatest in Indiana, where usage among males was 19 points lower than among females. Usage increased significantly for both groups but males appeared to be most affected during CIOT. The smallest sex differences were in Michigan. Baseline usage among males was 8 points lower than among females and this difference declined to 2 points after CIOT. In Ohio, the sex gap declined from 13 points to 4 points, with much of the increase among males occurring during the RDP. In Wisconsin, where male usage was 12 points lower than female usage, CIOT-related increases were similar among both groups.

Age. On average, 22 percent of those observed were categorized as young adults (ages 16-29); 56 percent as adults (ages 30-64); and 22 percent as seniors (age 65+). Usage was consistently lower among the youngest occupants. In Ohio, usage among this group increased by 15 points and the gap between younger and older groups decreased by 4 points. These increases occurred during both phases of the mobilization.

Race. Only three States provided data by race and, in most cases, the samples were too small to make meaningful comparisons between blacks and whites. In Michigan, however, there were sufficient data to examine changes among blacks and there was evidence of a significant CIOT-related increase in usage among that group.

Vehicle Type. Usage by vehicle type was reported by all six States. Nearly half of those observed (46%) were in passenger cars; 25 percent were in pickup trucks; 16 percent were in SUVs; and 13 percent were in vans. At baseline, the highest rates were found among occupants of vans (81%), followed by cars and SUVs (76% and 74%, respectively) and pickup trucks (56%). The lowest rate among pickup occupants was found in Indiana (33% at baseline).²⁸ The next lowest rates were in Minnesota, Ohio, and Wisconsin (about 55%).²⁹ Significant RDP-related increases in pickups were found in Illinois (3 points) and Ohio (7 points).³⁰ CIOT-related increases were found in Illinois, Indiana, Michigan, Ohio, and Wisconsin.

Table 14 shows States, RDP versus CIOT phases, and the occurrence of significant increases in usage for three target groups (occupants of pickup trucks, males, and young occupants). These target groups were examined because they consistently represent lower-use groups. All shaded cells represent conditions in which enforcement was present. Nonshaded areas represent conditions under which no enforcement was present. There were no instances where significant increases resulted when enforcement was absent. By comparison, there were significant increases in 70 to 80 percent of the situations in which enforcement was present. Two-by-two chi-square analyses found these differences in proportions to be significant in each case.

Table 14
Results of Observational Surveys in Rural Targeted Areas
Significant Effects, by Subgroup, and by Presence of Enforcement

¹⁰Ohio data are for State Police activity only.

¹¹ This index of enforcement intensity is likely subject to wide variation in methods of reporting.

¹² The estimates provided in this table were derived from RDP and CIOT reports submitted by the states. Some of the variation among the states likely results from differences in reporting criteria (e.g., with regard to enforcement hours). The (%) under “EZs” refers to the percent of hours dedicated to enforcement zones. The term “cites” refers to citations for seat belt violations (1st row) and child restraint violations (2nd row).

¹³ An example of one state’s telephone survey can be found in Appendix C and State-by-State telephone survey results for key questions can be found in Appendix D.

¹⁴ In each case, averages include all States for which data were available for that index.

¹⁵ Only Illinois and Indiana conducted specifically named enforcement efforts such as road checks, safety checks, or enforcement zones during the RDP.

¹⁶ All entries are averages for all states for which data were available

¹⁷ In five States, only overall statewide changes (w3-w1) could be examined. That is because in all States, other than Michigan, only two statewide awareness surveys were conducted.

¹⁸ Michigan was not an RDP-enforcement State, but it did implement paid media during the RDP (ranking 4th in expenditures per capita and 2nd in ads per capita). During CIOT, it was a strong enforcement state, with 781 enforcement zones, and with a CIOT media campaign ranking 2nd in expenditures per capita.

¹⁹ These data represent averages of survey results in Illinois, Indiana, and Minnesota. There were some differences within these three States.

²⁰ All States conducted surveys in rural targeted areas. In Indiana and Minnesota surveys were conducted in rural nontargeted areas by the regional evaluation contractor; limited data regarding nontargeted rural areas was also extracted from surveys conducted in Wisconsin but this was a small sample and it involved a baseline that was significantly higher than that in the targeted rural areas.

²¹ Michigan did not conduct a statewide survey prior to the start of the RDP (w1).

²² Because of differences in mini-survey designs, results are summarized in terms of median and range.

²³ Michigan results are shown separately because a pre-RDP statewide survey was not conducted.

²⁴ Minnesota results are from the 28-site sub-sample of a statewide mini-survey. Results from this survey are shown because they covered a broader geographical area than the mini-survey conducted in southeast Minnesota. Also, while the estimated increase in Minnesota (+2.9) was larger than that in Michigan (+2.3), it did not reach statistical significance due to the much smaller number of observations in Minnesota.

²⁵ Baseline usage in rural areas of Indiana was significantly lower than baseline usage statewide (65% versus 76%). This difference in baseline rates makes comparisons more tenuous.

²⁶ Here again, the baseline rate of the control group was significantly different (in this case higher) than that of the other groups, making it less appropriate as a control condition. In addition, the Wisconsin control was small, consisting of only eight rural sites in a nontargeted media market.

²⁷ Enforcement refers only to whether or not the state intensified enforcement during the RDP phase. All States intensified enforcement during CIOT.

²⁸ Indiana has a primary law that exempts occupants of pickup trucks from the seat belt use requirement.

²⁹ Minnesota, Ohio, and Wisconsin have secondary laws.

³⁰ An 8-point increase in Minnesota did not reach significance due to a small sample size.