Reducing the burden of road traffic injury: translating high-income country interventions to middle-income and low-income countries.
OBJECTIVE
To increase seat belt restraint use in Guangzhou City, People's Republic of China.


METHODS
Comparison group pre-test, post-test design.


METHODS
Guangzhou City.


METHODS
Interventions to increase the prevalence of seat belt use in high-income countries (enhanced training and enforcement practices along with raising of public awareness) were adapted and implemented in Guangzhou. The prevalence of seat belt use was determined before and after the introduction of the 12-month intervention. Seat belt prevalence was also examined over the same time period in the neighboring city of Nanning, and an incremental cost-effectiveness analysis of the intervention was undertaken.


METHODS
Prevalence rates and incremental cost effectiveness ratios.


RESULTS
A 12% increase in seat belt use was observed in Guangzhou over the study period, increasing from a prevalence of 50% before (error range 30-62%) to 62% after (error range 60-67%) (p<0.001) the intervention; an absolute change difference between the intervention and reference city of 20% was achieved. The incremental cost-effectiveness ratio of the intervention was yen 3246 (US dollars 418) per disability-adjusted life year saved.


CONCLUSIONS
This city-wide intervention demonstrates that it is possible to increase the prevalence of seat belt use using similar methods to those used in high-income countries and, importantly, that such an approach is cost-effective.
The George Institute for International Health, University of Sydney, Sydney, Australia. mstevenson@george.org.au
M
M
Stevenson
J
J
Yu
D
D
Hendrie
L-P
LP
Li
R
R
Ivers
Y
Y
Zhou
S
S
Su
R
R
Norton
D000063:Accidents, Traffic / Q000191:economics / Q000517:prevention & control* / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D003362:Cost-Benefit Analysis; D005260:Female; D006293:Health Promotion / Q000191:economics / Q000379:methods; D006801:Humans; D035846:Law Enforcement / Q000379:methods; D008297:Male; D016495:Police / Q000193:education; D015397:Program Evaluation; D012622:Seat Belts / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data*; D040241:Social Marketing; D012959:Socioeconomic Factors; D014504:Urban Health / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*