Self-reported safety belt use among emergency department patients in Boston, Massachusetts.
BACKGROUND
Safety belt use is 80% nationally, yet only 63% in Massachusetts. Safety belt use among potentially at-risk groups in Boston is unknown. We sought to assess the prevalence and correlates of belt non-use among emergency department (ED) patients in Boston.


METHODS
A cross-sectional survey with systematic sampling was conducted on non-urgent ED patients age > or = 18. A closed-ended survey was administered by interview. Safety belt use was defined via two methods: a single-item and a multiple-item measure of safety belt use. Each was scored using a 5-point frequency scale. Responses were used to categorize safety belt use as 'always' or less than 'always'. Outcome for multivariate logistic regression analysis was safety belt use less than 'always'.


RESULTS
Of 478 patients approached, 381 (80%) participated. Participants were 48% female, 48% African-American, 40% White, median age 39. Among participants, 250 (66%) had been in a car crash; 234 (61%) had a valid driver's license, and 42 (11%) had been ticketed for belt non-use. Using two different survey measures, a single-item and a multiple-item measure, safety belt use 'always' was 51% and 36% respectively. According to separate regression models, factors associated with belt non-use included male gender, alcohol consumption >5 drinks in one episode, riding with others that drink and drive, ever receiving a citation for belt non-use, believing that safety belt use is 'uncomfortable', and that 'I just forget', while 'It's my usual habit' was protective.


CONCLUSIONS
ED patients at an urban hospital in Boston have considerably lower self-reported safety belt use than state or national estimates. An ED-based intervention to increase safety belt use among this hard-to-reach population warrants consideration.
Fernandez
William G
WG
Department of Emergency Medicine, Boston University School of Medicine, Boston, Massachusetts, USA. william.fernandez@bmc.org
Mehta
Supriya D
SD
Coles
Tara
T
Feldman
James A
JA
Mitchell
Patricia
P
Olshaker
Jonathan
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000331:legislation & jurisprudence; D001900:Boston; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006784:Hospitals, Teaching; D006786:Hospitals, Urban; D006801:Humans; D035846:Law Enforcement; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012309:Risk-Taking; D012449:Safety; D012622:Seat Belts / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D012650:Self Disclosure