Motor Vehicle Injury Safety Belts: Enhanced Enforcement Programs

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Findings and Recommendations

The Community Preventive Services Task Force (CPSTF) recommends enhanced enforcement programs to increase safety belt use and reduce deaths and injuries in a wide range of settings and among various populations.

The full CPSTF Finding and Rationale Statement and supporting documents for Motor Vehicle-Related Injury Prevention: Use of Safety Belts, Enhanced Enforcement Programs are available in The Community Guide Collection on CDC Stacks.

Intervention

Enhanced enforcement programs are added to normal enforcement practices and include publicity. They fall into two categories:

  1. Programs that increase citations along with increasing the number of officers on patrol (supplemental)
  2. Programs that promote more citations during an officer’s normal patrol (targeted)

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 15 studies (search period through June 2000).

The review was conducted on behalf of the CPSTF by scientists from CDC’s Division of Unintentional Injury Prevention with input from a team of specialists in systematic review methods and experts in research, practice and policy related to motor vehicle injury prevention.

Study Characteristics

  • Included studies focused on enhanced enforcement programs that specifically targeted safety belt use. Studies of programs targeting multiple unsafe driving practices were excluded from the review.
  • Included studies evaluated city, county, state, provincial, and national programs in the United States and Canada.
  • Evaluated programs varied in the amount of publicity they used. Studies were conducted in states with primary safety belt laws and states with secondary laws.

Summary of Results

The systematic review included 15 studies.

  • Observed safety belt use increased by a median of 16 percentage points (15 studies)
  • Increases in safety belt use were similar for supplemental and targeted patrols.
  • Deaths and injuries combined decreased by 7% and 15% (2 studies)

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.

Applicability

These findings should be generally applicable to all U.S. motorists covered by safety belt laws.

Evidence Gaps

  • 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 does publicity, public education, and news coverage affect enhanced enforcement programs?
  • 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?
  • Do enhanced enforcement programs for safety belt use decrease risky driving?
  • Do enhanced enforcement programs deter alcohol-impaired driving?
  • What are the cost-benefit, cost utility, and cost-effectiveness of enhanced enforcement programs?
  • Do enhanced enforcement programs divert police from other crimes?

Implementation Considerations and Resources

Enhanced enforcement programs may be intense efforts of short duration (called waves or blitzes). They may last for days or weeks, and they may be repeated periodically or maintained continuously over several weeks, months, or years.

  • Enhanced enforcement may lead to increased arrests for other crimes, such as possession of weapons or drugs, impaired driving, or license violations.
  • One potential barrier to implementation is the reluctance of state and community officials to implement these programs because of concerns about public opposition.
  • Police officers may be reluctant to participate in enhanced enforcement programs out of concern that they will be diverted from investigating more serious crimes. One study found, however, that crime rates do not increase during enhanced enforcement campaigns. Interviews with both police and members of the public revealed positive attitudes toward enhanced enforcement programs.

Crosswalks

Healthy People 2030 icon Healthy People 2030 includes the following objectives related to this CPSTF recommendation.