Rear Seat Belt Use Research Articles

Prediction of rear-seat belt use: Application of extended theory of planned behavior

Objectives Rear-seat belts have been shown to significantly reduce the severity of road vehicle collisions and fatalities. However, their use by rear-seat passengers is significantly less than that by front-seat passengers. Thus, the psychological factors underlying individuals’ decision to wear a seat belt in the rear seat require further investigation. Methods An extended theory of planned behavior (eTPB) was used to examine individuals’ behavior of wearing a rear-seat belt. An online survey was conducted and a total of 515 valid questionnaires were collected in China. Results While attitude, descriptive norms, and law enforcement all have a significant effect on individuals’ intention to wear a seat belt in the rear, subjective norms and perceived behavioral control do not. Individuals’ attitudes toward wearing a seat belt in the rear seat are significantly influenced by law enforcement and behavioral intention, but not by perceived behavioral control. The mediation effect analysis reveals that law enforcement has the greatest overall effect on behavior, followed by attitude and descriptive norms. Conclusions The results of this paper contribute to more effective recommendations to improve the use of rear seat belts and to safeguard rear seat passengers.

A naturalistic study of passenger seating position, posture, and restraint use in second-row seats

Objective The objective of the current study was to increase scientific understanding of rear-seat passenger seating position, postures, CRS use, and belt use through a naturalistic study. A secondary objective was to compare data from vehicles used in ride-hailing with data from other vehicles. Method Video cameras were installed in the passenger cabins of the vehicles of 75 drivers near the center of the windshield. The video data were downloaded after the vehicles were operated by their owners for two weeks. Video frames were sampled from near the ends and in the middle of each trip, and at five-minute intervals in trips longer than 15 min. A total of 7,323 frames with second-row passengers were manually coded. Results A total of 444 unique second-row passengers were identified in video frames from 1,188 trips taken in 65 of the 75 vehicles in the study. Two of the vehicles that were driven for commercial ride-hailing during the study period accounted for 199 (45%) of the passengers. Considering multiple passengers in some trips, a total of 1,899 passenger-trips were identified. For passengers not using child restraint systems (CRS), the belt use rate was 65% in the non-ride-hailing vehicles versus 32% among passengers in the ride-hailing vehicles. No CRS use was observed in the ride-hailing vehicles. Among children using backless boosters, the shoulder belt was lateral to the clavicle or under the arm in 26% of frames. Among belted passengers not using CRS, the belt was lateral to the clavicle or on the neck about 6% of the time. Belted passengers not using CRS were observed leaning to the left or right about 27% of the time, with leaning away from the shoulder belt more common than leaning into the belt. Conclusions This study is the first to report seating position, posture, and belt fit observations for a large naturalistic sample of second-row passengers that includes adult occupants. The data suggest that low rear seat belt use rates remain a concern, particularly in ride-hailing vehicles. Non-nominal belt placement and posture may also be common in second-row seating positions.

Rear-seat seatbelt use in urban Southeast Asia: results from Bandung and Bangkok

Road traffic injuries (RTIs) remain a leading cause of morbidity and mortality in Southeast Asia. We aim to estimate the prevalence and predictors of rear seatbelt use, a key behavioural risk factor for RTI, in Bandung and Bangkok, two cities in Southeast Asia. Roadside observational studies were conducted to provide a representative picture of the prevalence in each city. From eight rounds of observations (July 2015 to April 2019), 39,479 and 7,207 rear-seat passengers were observed in Bandung and Bangkok. Across all rounds, 4.2% of rear-seat passengers used seatbelts in Bandung, compared to 8.4% in Bangkok. In both cities, males and adults, as compared to females and adolescents (aged 12-17 years), had higher odds of rear seatbelt use, as did passengers with a restrained driver. Findings highlight the need for rear seatbelt laws in Bandung and improved enforcement of existing rear seatbelt laws in Bangkok.

Erratum to “Self-reported factors that influence rear seat belt use among adults” [J. Saf. Res. 70C (2019) 25–31

Erratum to “Self-reported factors that influence rear seat belt use among adults” [J. Saf. Res. 70C (2019) 25–31

Factors that Associate Japanese University Students' Use of Rear Seat Belts on General Roads and Expressways.

This study clarifies the prevalence of rear seat belt use among university students and explores the factors that influence seat belt use on general roads and expressways. Questionnaires were distributed to 1,091 students who attended health education lectures: 893 students (81.9%) agreed to participate and met the criteria; among them, 660 (73.9%) provided complete responses. While one-third (33.0%) of rear seat passengers "always" used seat belts on general traffic roads, three-fourths (73.2%) "always" used them on expressways. Multivariate analysis revealed that being male and the perception of obligation and recognition of the benefits of rear seat belt use were associated with use on general roads, whereas the possession of a driver's license and recognition of benefits were associated with use on expressways. Finally, we suggest that educational programs on seat belt use be developed and delivered to general road and expressway users to promote seat belt use.

Psychological predictors of seat belt usage among university student passengers and an examination of the differences between the front and rear seats

Objective: This study aimed to analyze the cognitive psychological process and to understand the decision-making process involved in university student passengers’ seat belt usage behavior and the difference between front and rear seat belt use. Based on the Theory of Planned Behavior (TPB), two extended variables, namely, perceived accident severity and safety consciousness, were introduced. From the perspective of social psychology, we explored the psychological factors influencing university student passengers’ seat belt usage behavior and the relationship between these factors.Methods: The reliability and validity of 544 valid questionnaires were tested, and the differences were analyzed in the scores of the TPB variables between university student transportation majors and other majors. Finally, structural equation models were established to compare the factors affecting seat belt usage in the front and rear seats.Results: The results show that the TPB could effectively explain and predict university student passengers’ seat belt usage behavior. Significant differences were observed in the TPB variables, the extended variables and the behavioral intention scores between the university students majoring in transportation and those with other majors. In addition, significant differences were observed between front and rear seat belt usage. All psychological factors had significant positive effects on the seat belt usage behavior of the university student passengers, and all factors directly or indirectly affected seat belt usage behavior.Conclusions: The present research adds further empirical evidence regarding the ability of the TPB to predict seat belt usage behavior. In addition, the current research results may provide a theoretical basis for policy-making aiming to improve university students’ seat belt usage.

Warning signs to fasten seat belts result in higher rates of rear seat belt use in rideshare vehicles

Using seat belts reduces traffic injuries and fatalities. Passengers in the rear seat typically use their seat belts less often than drivers or front-seat passengers. Seat belt use in the back is even less frequent in vehicles for hire such as taxi cabs and rideshare vehicles than in private passenger vehicles. This observational study of adult passengers video-recorded in rideshare vehicles in San Francisco found that a sign mounted at rear passenger seated eye level, and that warned of the risks of failing to wear a seat belt, resulted in significantly higher rates of seat belt use than for rear seat passengers not exposed to the warning sign. Results also showed that age, gender, and trip duration did not have a significant effect on rear seat belt use. Implications for future research and other countermeasures are discussed.

Self-reported factors that influence rear seat belt use among adults

Introduction: While seat belt use among front seat occupants has significantly increased overtime a substantial usage gap still exists between front and back seat occupants. This study aims to identify factors that predict rear seat belt use among adult back seat passengers. Methods: We examined data from the 2016 Motor Vehicle Occupant Safety Survey, conducted by the National Highway Traffic Safety Administration, to determine the influence of front seat belt use, support of and belief of rear seat belt use laws, peer perception of seat belt use, nighttime belt use, and demographic factors on self-reported rear seat belt use. Rao-Scott chi-squared tests were used to determine significant associations between self-reported rear belt use and each predictor. Multivariate logistic regression was used to calculate adjusted odds ratios and determine the influence of significant predictors on rear seat belt use. Sampling weights were applied to produce nationally representative estimates; all statistical significance tests accounted for the complex survey design. Results: Among adults who reported riding in the back seat, 63% reported always using a rear seat belt. Front seat belt use, support and belief of state seat belt laws, nighttime seat belt use, age, and education were significantly associated with rear seat belt use. Multivariate regression results showed that adults who supported rear seat belt laws, reported front seat belt use and believed their state has a rear seat belt law were significantly more likely to report full-time use in the back seat. Conclusions: Seat belt laws and front seat belt use had the strongest association with reporting full-time use in the back seat. Practical Applications: Increasing familiarity with existing laws directed towards rear seat belt use as well as increasing awareness about the benefits of seat belts in all seating positions may help improve rear seat belt use.

Rear seat belt use in the United Arab Emirates

Wearing seat belts by all vehicle passengers minimizes human and financial losses due to traffic collisions. Little is available in the literature on seat belt wearing rates among rear seat passeng...

Estimating the Effect of Standard Enforcement of a Rear Seat Belt Law for Rear Seat Fatality Prevention

Data were collected from the NHTSA’s Fatality Analysis Reporting System to analyze the link between primary enforcement of rear seat belt use and injury severity in fatal vehicle collisions. Specifically, this study predicted the amount of fatalities that may have been prevented had there been standard enforcement of a rear seat belt law in effect. Previous literature concludes that increasing seat belt use will decrease injury severity in collisions and the primary enforcement of seat belts laws will increase seat belt use by approximately 14%. This study recorded and compared the number of rear seat fatalities in states that did and did not have primary enforcement laws for rear seat occupants. The results indicated that, on average, for every properly restrained rear seat fatality there are 0.45 more rear seat fatalities in states without primary enforcement than states with primary enforcement. It also predicts that the states that do not practice standard seat belt enforcement could have seen approximately 772 to 1,032 fatalities prevented from 2011 to 2015, had there been primary rear seat belt enforcement. This corresponds to an estimated national crash cost savings of $8.6 billion, or $1.7 billion annually.

The Characteristics of Pregnant Women Who Use Rear Seats and the Factors Associated with Rear Seat Belt Use in a Suburban Area of Japan

Abstract Objective: This study was conducted to identify high-risk pregnant women by examining the characteristics of pregnant women who do not normally use rear seat belts in automobiles during pregnancy among actual rear seat users in a provincial city of Japan. Methods: We employed a descriptive analysis of cross-sectional survey data collected via self-administered questionnaires at seven obstetric facilities in Maebashi. We analyzed the data of 1,085 pregnant women. Results: A total of 72.1% (782/1,085) of the women rode in the front passenger seat during pregnancy, and 27.9% (303/1,085) rode in the rear passenger seat. The percentages of nulliparous and parous women who used front passenger seats before and during pregnancy were 69.6% (536/770) and 30.4% (234/770), respectively. The percentages of those who used the rear passenger seats before and during pregnancy were 3.2% (8/248) and 96.8% (240/248), respectively. The factors associated with rear seat use by parous pregnant women before and during pregnancy were having one child and an educational attainment of a bachelor’s degree or above. The factors associated with starting, maintaining, or increasing regular rear seat belt use by parous pregnant women after pregnancy began were having a higher education, having one child, and perceiving that seat belt use during pregnancy is compulsory. Conclusion: These results suggest that targeting the health education of parous women and encouraging them to wear seat belts during pregnancy may lead to an increase in the number of rear seat belt users in further longitudinal studies.

Passenger use of and attitudes toward rear seat belts

Objectives: This study sought to identify attitudes toward belt use in the rear seat and to gain insight into the experiences of rear-seat passengers. Method: A telephone survey conducted between June and August 2016 targeted adult passengers who had recently ridden in the rear and who did not always wear their seat belt when doing so. Respondents were questioned regarding their reasons for not buckling up and possible conditions under which they would be more likely to buckle up during rear-seat travel. Results: Of 1163 recent rear-seat passengers, 72% reported always using their seat belt in the rear. Full-time belt use was lower among passengers who primarily travel in the rear of hired vehicles compared with personal vehicles. The most common explanation for not buckling up was that the back seat is safer than the front. Four out of five agreed they do not buckle up because of type of trip; two-thirds forget or do not see the need; and two-thirds agreed with reasons related to design, comfort, or usability issues. Nearly 40% agreed that they sometimes do not buckle up in the rear because there is no law requiring it. Conclusion: Many reasons for not using belts in the rear are similar to reasons in the front, such as forgetfulness, inconvenience, or discomfort. One difference is that many rear-seat passengers perceive using the belt is unnecessary because the back seat is safer than the front. More than half of part-time belt users and nonusers reported interventions such as rear seat belt reminders, stronger belt-use laws, and more comfortable belts would make them more likely to use their seat belt in the rear seat. Practical applications: This study identifies barriers to rear seat belt use that point to the need for a multi-faceted approach to increase belt use.

Prevalence of rear seat belt use among pregnant women in a suburban area of Japan.

The aim of this study was to clarify the prevalence and influencing factors of rear seat belt use among pregnant women. Questionnaires were given to 1546 pregnant women who visited obstetrics clinics and hospitals for prenatal checkups from October to December 2013. A total of 1494 pregnant women (96.6%) agreed to participate in this study and completed the questionnaire. Fewer than 20% of the rear-seat passengers 'always' used seat belts before and during pregnancy, whereas a third 'never' used a seat belt before or during pregnancy. There was no significant decrease in seat belt use by rear-seat passengers during compared to before pregnancy. Multivariate analysis revealed that age, knowledge of how to use a seat belt during pregnancy, belief in the compulsory use of a rear seat belt and driver behavioral characteristics before pregnancy were associated with rear seat belt use during pregnancy. The prevalence of fastening seat belts was substantially low. The provision of information regarding proper seat belt use and its role in protecting the fetus may increase use.

Seat belt use by adult rear seat passengers in private passenger, taxi, and rideshare vehicles

Using seat belts reduces traffic injuries and fatalities. There are no observational studies comparing use of seat belts by front and rear seat adult passengers in the United States (U.S.), and no comparisons of rear seat belt use by adult passengers in private, taxi, and rideshare vehicles. This observational study of drivers and adult passengers in two cities, one with a primary and the other with a secondary seat belt enforcement law, found the laws affected seat belt use by drivers but not by rear seat passengers, and that rear seat passengers wore seat belts more in private vehicles than in taxis. The latter result was not because of lack of seat belt availability in taxis. Results also showed that modeling of seat belt use by drivers had little effect on seat belt use by rear seat passengers. Results from rideshare vehicles was mixed. Implications for future research and countermeasures are discussed.

Restraint use in the Eastern Province of the Kingdom of Saudi Arabia

ABSTRACTObjectives: This study set out to examine seat belt and child restraint use in the Dammam Municipality of the Kingdom of Saudi Arabia, based on the premise that an increase in seat belt use would significantly reduce personal injury in traffic crashes. It was expected that local data would help identify intervention strategies necessary to improve seat belt use in the region.Methods: The research involved 2 methodologies. First, 1,389 face-to-face interviews were conducted with male and female adults in regional shopping plazas regarding their own and their children's restraint use in their vehicles and reasons for these attitudes and beliefs. Second, 2 on-road observation studies of adult and child restraint use were conducted by trained observers. Occupants of approximately 5,000 passenger vehicles were observed while stopped at representative signalized traffic intersections.Results: The findings showed front seat belt use rates of between 43 and 47% for drivers and 26 to 30% for front seat passengers; rear seat belt use rates were lower. While there seemed to be some knowledge about the purpose and reasons for restraining both adults and children in suitable restraints, this failed to be confirmed in the on-road observations.Conclusions: Reasons for these rates and findings are discussed fully, and recommendations for improving seat belt use in the Dammam Municipality are included.

Predictors of rear seat belt use among U.S. adults, 2012

IntroductionSeat belt use reduces the risk of injuries and fatalities among motor vehicle occupants in a crash, but belt use in rear seating positions is consistently lower than front seating positions. Knowledge is limited concerning factors associated with seat belt use among adult rear seat passengers. MethodsData from the 2012 ConsumerStyles survey were used to calculate weighted percentages of self-reported rear seat belt use by demographic characteristics and type of rear seat belt use enforcement. Multivariable regression was used to calculate prevalence ratios for rear seat belt use, adjusting for person-, household- and geographic-level demographic variables as well as for type of seat belt law in place in the state. ResultsRear seat belt use varied by age, race, geographic region, metropolitan status, and type of enforcement. Multivariable regression showed that respondents living in states with primary (Adjusted Prevalence Ratio (APR): 1.23) and secondary (APR: 1.11) rear seat belt use enforcement laws were significantly more likely to report always wearing a seat belt in the rear seat compared with those living in a state with no rear seat belt use enforcement law. Conclusions and practical applicationsSeveral factors were associated with self-reported seat belt use in rear seating positions. Evidence suggests that primary enforcement covering all seating positions is an effective intervention that can be employed to increase seat belt use and in turn prevent motor vehicle injuries to rear-seated occupants.

Seat-belt use still low in Kuwait: self-reported driving behaviours among adult drivers

Kuwait mandated seat-belt use by drivers in 1976 and by front seat passengers in 1994. The study objectives were to identify and estimate current factors associated with seat-belt use and levels of potentially unsafe driving behaviours in Kuwait. In 2010, 741 adults were surveyed regarding driving habits and history. Only 41.6% of drivers reported always using a seat belt. Front seat passenger belt use was more common (30.5%) than rear seat belt use (6.5%). Distracted driving behaviours were common, including mobile phone use (‘always’ or ‘almost always’: 51.1%) and texting/SMS (32.4%). Logistic regression indicated that drivers who were young (18–19 years), male, Kuwaiti nationals or non-Kuwaiti Arabs, drove over the speed limit, had traffic violation tickets or >1 car crashes in the last year, were less likely to use seat belts. Targeted initiatives to increase public awareness and to enforce car-safety legislation, including use of seat belts, are necessary to decrease the health burden of car crashes in Kuwait.

Rear seat belt use as an indicator of safe road behaviour in a rapidly developing country

Injuries from road traffic accidents are set to become the second highest cause of disability-adjusted life years lost in developing countries by 2020. The number of injuries and deaths are disproportionately high in low income countries, which account for only 40% of all motor vehicles. Human behaviour is thought to be a major factor in most accidents. In Oman wearing a seat belt is compulsory in the front seats but not in the rear. Wearing a seat belt can reduce the severity of injuries when sitting in rear seats. This study examines the use of seat belts in cars entering a university and hospital campus in Oman to determine the degree of seat belt wearing in the rear. At peak times on a selected day, cars were stopped at the university's entrance barrier. The type of driver was identified - student, employee, hospital patient or visitor - and the degree of seat belt wearing among driver and passengers was noted. A total of 1,066 cars were stopped. Of this total, 90.1% of drivers and 80.9% of front seat passengers were wearing a restraint complying with Local traffic regulations. However, only 1.4% of back seat passengers wore a seat belt. Only 3.7% of children under the age of five were restrained in a child seat and only 16.7% of five- to 12-year-olds were strapped in. A third (34.6%) of under-fives were sitting in the front seat. In cars with child occupants, 40% of the time parents wore seat belts but the children did not. Occupants conformed to the law but behaviour indicated a lack of awareness of the dangers of not wearing seat belts, especially towards children. Traffic regulations need to be updated and the public educated about the need to wear seat belts. Health agencies could be more active in educating the public about road safety behaviour and should also be involved in the overall strategy to reduce injuries and deaths.

Seat belt use among teenagers in two Israeli family practices.

Motor vehicle accidents are the leading cause of deaths among Israeli teenagers. Despite the efficacy of seat belt use in reducing mortality, and legislation requiring seat belt use in all car positions, a large proportion of Israeli adolescents do not consistently use seat belts. Differential data regarding front and rear seat belt use in this population are not available. The objective of this study was to determine the rates of front and rear seat belt use among a sample of Israeli teenagers in the primary care setting. Seventy-eight teenagers attending preventive adolescent health visits in two Israeli family practice clinics completed questionnaires that included questions regarding seat belt use. Structured counseling by the family nurse was provided following completion of the questionnaire. Sixty-four percent of the teenagers reported using front seat belts all of the time, while only 8% used rear seat belts all of the time. Infrequent or non-use of rear seat belts was more prevalent among 10th than among 7th graders. It is concluded that public health strategies in addition to legislation are needed to optimize seat belt use among Israeli teenagers. Health education regarding seat belt use--with an emphasis on rear seat belts--can and should be incorporated into adolescent preventive health visits in the primary care setting.

Mortality of front-seat occupants attributable to unbelted rear-seat passengers in car crashes

The risk of death of unbelted rear-seat occupants is obviously increased in car crashes. However, there is little epidemiological evidence that unbelted rear-seat occupants will also increase the risk of death of front-seat passengers. We compared risk of death and severe injury of front-seat occupants in car crashes with belted or unbelted rear-seat passengers. The risk of death of belted front-seat occupants with unbelted rear-seat passengers was raised nearly five-fold. If rear seatbelts had been used, almost 80% of deaths of belted front-seat occupants could have been avoided. Rear seatbelt use should be encouraged for the safety of all car occupants.