Sustaining Seat Belt Use in a High-Use State

Hawaii has been a high-use state for seat belts since 1985. For the past decade, the state has averaged well over 95% overall compliance. Efforts to maintain or even increase this exceptional use rate are challenging. Hawaii has a large tourist population. Nonusers may come from demographic and social groups that are difficult to reach. This paper summarizes two decades of monitoring, research, and evaluation of programs in Hawaii and suggests several aspects of the state's success in promoting seat belt use. A key component involves understanding the geography of seat belt use and the relationships between enforcement activities and public outreach and education. Although it may be difficult or impossible to attain universal use, some directions for further effort in promoting seat belt use in high-use communities are clearly possible. This research will be increasingly important as other communities achieve higher use rates and transition to efforts geared toward sustaining seat belt use. Enforcement is part of an overall program for increasing seat belt use and traffic safety.