Motor Vehicle-Related Injury Prevention: Use of Safety Belts

Research Gaps

What are Research Gaps?

Prior to and during the literature review and data analysis, the review team and the Community Preventive Services Task Force attempt to address the key questions of what interventions work, for whom, under what conditions, and at what cost. Lack of sufficient information often leaves one or more of these questions unanswered. The Community Guide refers to these as "research gaps." Research gaps can be pulled together in the form of a basic set of questions to inform a research agenda for those in the field.

Identified Research Gaps

Results from the Community Guide review indicate that there is strong evidence for the effectiveness of the three interventions reviewed. However, important research issues related to the effectiveness of these interventions remain.

Safety Belt Laws

• To what extent does the level of enforcement and publicity influence the effectiveness of safety belt laws?
• Does the severity of fines have any bearing on the effectiveness of the laws?
• Do other penalties (e.g., license demerits) add to the effectiveness of the laws?
• Do exemptions for certain vehicles and occupants reduce the effectiveness of the laws?

Primary Safety Belt Laws

• What are the age, gender, and racial differences between violators in primary and secondary law states?
• Are primary enforcement laws more or less effective in certain populations?

Enhanced Enforcement

• How does the length and frequency of enhanced enforcement programs influence their effectiveness?
• Does the effectiveness of enhanced enforcement programs vary based on the scale of the interventions (e.g., single community vs. multi-community programs)?
• How do publicity, public education, and news coverage affect enhanced enforcement programs?

Applicability

All three interventions appear to be effective in most populations and settings. Although some differences in effectiveness for subgroups have been identified in these reviews, other questions regarding differential effectiveness of these interventions remain.

• What penalties for violations of laws (e.g., fines, license demerits) are most effective among high-risk drivers (e.g., teenagers, drinking drivers)?
• What are the most effective methods of publicizing enhanced enforcement to reach high-risk drivers?

Other Positive or Negative Effects

Research on the positive and negative effects of each intervention might include:

• Do primary safety belt laws increase or decrease risky driving?
• Do enhanced enforcement programs for safety belt use decrease risky driving?
• Do primary laws or enhanced enforcement programs deter alcohol-impaired driving?
• Are primary laws associated with changes in frequency of traffic stops for ethnic and racial minorities relative to the general population?

Economic Evaluations

Little economic evaluation information was available. Research is warranted to answer the basic economic questions:

• What are the cost-benefit, cost utility, and cost-effectiveness of interventions to increase safety belt use?

Barriers

A number of barriers impede effective implementation of each intervention reviewed. Research into the following areas may help to overcome these barriers.

• How can communities increase public acceptance of primary safety belt laws?
• Do enhanced enforcement programs divert police from other crimes?

Evidence Review

Dinh-Zarr TB, Sleet DA, Shults RA, et al. Reviews of evidence regarding interventions to increase the use of safety belts. [PDF - 2.85MB] Am J Prev Med 2001;21(4S): 48-65.