Abstract

Objective: To explain low seat belt use prevalence results of observation and interview surveys in Nanjing, Jiangsu Province, and Zhoushan, Zhejiang Province, and to extend knowledge on associated seat belt use determinants. Method: Ten focus groups comprising professional, owner, and taxi drivers; passengers; van drivers (Nanjing); or police (Zhoushan) were conducted to capture a range of experiences, attitudes, and opinions. Results: There was common agreement in all focus groups on the need to use seat belts on highways in the front seat but not to use in the rear seat regardless of road type. Participants generally agreed with the apparent practice of fines for drivers and warnings for front seat passengers, especially on highways. Lack of seat belt comfort was elaborated on. Professional and taxi drivers were inconvenienced by the effort involved for short trips to put on seat belts and discomfort was greater for those who did not have or could not afford to operate air conditioning. There was lack of agreement on the need to use seat belts in the city areas. Crash video clips on the nonuse of seat belts were judged by participants as potentially effective for promotion of seat belt use, especially if scenarios were associated with relatively low speeds. Conclusions: The benefits of seat belt use for all seating positions and at low and medium speeds and awareness of passenger seat belt responsibility need to be promoted. Enforcement should be applied more consistently.

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