title: Improving seat belt use among teen drivers: findings from a service-learning approach.
abstract: BACKGROUND
  Low seat belt use and higher crash rates contribute to persistence of motor vehicle crashes as the leading cause of teenage death. Service-learning has been identified as an important component of public health interventions to improve health behavior.
  
  
  METHODS
  A service-learning intervention was conducted in eleven selected high schools across the United States in the 2011-2012 school year. Direct morning and afternoon observations of seat belt use were used to obtain baseline observations during the fall semester and post-intervention observations in the spring. The Mann-Whitney U test for 2 independent samples was used to evaluate if the intervention was associated with a statistically significant change in seat belt use. We identified factors associated with seat belt use post-intervention using multivariable logistic regression.
  
  
  RESULTS
  Overall seat belt use rate increased by 12.8%, from 70.4% at baseline to 83.2% post-intervention (p<0.0001). A statistically significant increase in seat belt use was noted among white, black, and Hispanic teen drivers. However, black and Hispanic drivers were still less likely to use seat belts while driving compared to white drivers. Female drivers and drivers who had passengers in their vehicle had increased odds of seat belt use.
  
  
  CONCLUSIONS
  A high school service-learning intervention was associated with improved seat belt use regardless of race, ethnicity, or gender, but did not eliminate disparities adversely affecting minority youth. Continuous incorporation of service-learning in high school curricula could benefit quality improvement evaluations aimed at disparities elimination and might improve the safety behavior of emerging youth cohorts.
authors.affiliation: Meharry Medical College, Nashville, TN, USA.
authors.forename: Irwin A
authors.initials: IA
authors.lastname: Goldzweig
authors.forename: Robert S
authors.initials: RS
authors.lastname: Levine
authors.forename: David
authors.initials: D
authors.lastname: Schlundt
authors.forename: Richard
authors.initials: R
authors.lastname: Bradley
authors.forename: Gennifer D
authors.initials: GD
authors.lastname: Jones
authors.forename: Roger J
authors.initials: RJ
authors.lastname: Zoorob
authors.forename: O James
authors.initials: OJ
authors.lastname: Ekundayo
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D001334:Automobile Driving / Q000193:education*; D005260:Female; D015438:Health Behavior / Q000208:ethnology*; D006293:Health Promotion / Q000379:methods*; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D012309:Risk-Taking; D012622:Seat Belts / Q000706:statistics & numerical data*; D012737:Sex Factors; D018709:Statistics, Nonparametric; D014481:United States; D044465:White People / Q000706:statistics & numerical data
keywords: Seat belt use; Service-learning; Teen drivers