title: Seatbelt and helmet depiction on the big screen blockbuster injury prevention messages?
abstract: BACKGROUND
  Injuries from vehicle crashes are a major cause of death among American youth. Many of these injuries are worsened because of noncompliant safety practices. Messages delivered by mass media are omnipresent in young peoples' lives and influence their behavior patterns. In this investigation, we analyzed seat belt and helmet messages from a sample of top-grossing motion pictures with emphasis on scene context and character demographics.
  
  
  METHODS
  Content analysis of 50 top-grossing motion pictures for years 2000 to 2004, with coding for seat belt and helmet usage by trained media coders.
  
  
  RESULTS
  In 48 of 50 movies (53% PG-13; 33% R; 10% PG; 4% G) with vehicle scenes, 518 scenes (82% car/truck; 7% taxi/limo; 7% motorcycle; 4% bicycle/skateboard) were coded. Overall, seat belt and helmet usage rates were 15.4% and 33.3%, respectively, with verbal indications for seat belt or helmet use found in 1.0% of scenes. Safety compliance rates varied by character race (18.3% white; 6.5% black; p = 0.036). No differences in compliance rates were noted for high-speed or unsafe vehicle operation. The injury rate for noncompliant characters involved in crashes was 10.7%. A regression model demonstrated black character race and escape scenes most predictive of noncompliant safety behavior.
  
  
  CONCLUSIONS
  Safety compliance messages and images are starkly absent in top-grossing motion pictures resulting in, at worst, a deleterious effect on vulnerable populations and public health initiatives, and, at minimum, a lost opportunity to prevent injury and death. Healthcare providers should call on the motion picture industry to improve safety compliance messages and images in their products delivered for mass consumption.
authors.affiliation: Department of Neurosurgery, University of Michigan Health System, Ann Arbor, Michigan 48109-0338, USA. jacowan@umich.edu
authors.forename: John A
authors.initials: JA
authors.lastname: Cowan
authors.forename: Nicole
authors.initials: N
authors.lastname: Dubosh
authors.forename: Craig
authors.initials: C
authors.lastname: Hadley
mesh_terms: D006260:Head Protective Devices / Q000706:statistics & numerical data*; D006266:Health Education / Q000706:statistics & numerical data*; D006801:Humans; D009040:Motion Pictures / Q000145:classification / Q000706:statistics & numerical data*; D012449:Safety / Q000706:statistics & numerical data; D012622:Seat Belts / Q000706:statistics & numerical data*; D014481:United States; D014600:Utilization Review / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000517:prevention & control*