title: Perceived risk and other predictors and correlates of teenagers' safety belt use during the first year of licensure.
abstract: OBJECTIVE
  Teenagers have the lowest rate of safety belt use and the highest crash rate compared to other age groups. Past studies on teenagers' belt use have mostly been cross-sectional. The first goals of this study were to examine, at licensure, teenagers' and parents' perceptions of risk of crash/injury for newly licensed teenagers when driving unbelted and teenagers' perceived and parents' intended consequences for safety belt rule violations. In addition, the comparability of these variables to other risky driving behaviors was explored. The second goal was to evaluate the importance of these variables in the prediction of teenagers' belt use during the first year of licensure, relative to other factors related to belt use, including demographics and substance use.
  
  
  METHODS
  More than 2,000 parent-teenager dyads were interviewed by telephone, parents at permit and licensure and teenagers at permit, licensure, and 3, 6, and 12 months after licensure.
  
  
  RESULTS
  Approximately a third of the teenagers reported at least once at 3, 6, or 12 months post-licensure not always using their safety belt in the past week. At licensure, participants' perceived risk of safety belt non-use was high and ranked among the behaviors most related to crash/injury for newly licensed teenagers, behind driving under the influence of alcohol or drugs. Parent-imposed consequences for safety belt rule violations were not as highly rated as parent-imposed consequences for driving under the influence of alcohol or drugs. Sequential logistic regression modeled the relationship between safety belt use and perceived risk and consequences of non-use, as well as other prospective predictors assessed at permit and licensure, and driving correlates measured after licensure. Teenagers' extreme perceived risk and parents' intended sure consequences for non-use were significant prospective predictors of regular use during the first year of licensure. Other significant predictors and correlates were race (White), high school grade average of "A," not smoking cigarettes, driving a passenger vehicle, and never receiving a traffic citation or engaging in risky driving behaviors, including driving under the influence of alcohol or drugs and running a red light.
  
  
  CONCLUSIONS
  While the effect size was small for perceived risk of non-use, it is a modifiable factor and focused intervention contrived to enhance perceived risk could increase teenagers' belt use. Perceived risk is discussed as a target for intervention in relation to the Protection Motivation Theory. This theory appears helpful in guiding future research into the modifiable factors studied here as well as other factors, including perceived rewards and costs associated with non-use.
authors.affiliation: Prevention Research Branch, Division of Epidemiology, Statistics and Prevention Research, National Institute of Child Health and Development, National Institutes of Health, Bethesda, Maryland 20892-7510, USA. ouimetm@mail.nih.gov
authors.forename: Marie Claude
authors.initials: MC
authors.lastname: Ouimet
authors.forename: Bruce G Simons
authors.initials: BG
authors.lastname: Morton
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Noelcke
authors.forename: Allan F
authors.initials: AF
authors.lastname: Williams
authors.forename: William A
authors.initials: WA
authors.lastname: Leaf
authors.forename: David F
authors.initials: DF
authors.lastname: Preusser
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Hartos
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control* / Q000706:statistics & numerical data; D000293:Adolescent; D000294:Adolescent Behavior / Q000523:psychology; D001333:Automobile Driver Examination; D001334:Automobile Driving / Q000331:legislation & jurisprudence* / Q000523:psychology; D016001:Confidence Intervals; D003237:Connecticut; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008004:Licensure; D016015:Logistic Models; D008297:Male; D010290:Parents; D012307:Risk Factors; D012309:Risk-Taking; D012622:Seat Belts / Q000706:statistics & numerical data*; D012737:Sex Factors; D013997:Time Factors