title: Predictors of intrinsic motivation behind seatbelt use in a country where current use is low.
abstract: BACKGROUND
  Seatbelt use is a major determinant of a driver's safety on the road. In Turkey and other middle-income countries, seatbelt use is lower than in high-income countries and contributes to the higher burden of road traffic injuries. Assessing factors behind drivers' motivations to wear seatbelts can help determine appropriate interventions for specific subpopulations.
  
  
  OBJECTIVE
  To analyze the factors predictive of whether drivers who wear seatbelts in Afyonkarahisar and Ankara, Turkey do so because they believe seatbelts can save their lives.
  
  
  METHODS
  As part of the monitoring and evaluation of the Bloomberg Philanthropies Global Road Safety Programme, 817 drivers were randomly recruited in Afyonkarahisar and Ankara, Turkey, to participate in roadside interviews. Logistic regression was run on data from 408 drivers who claimed they always wore seatbelts. Predictors were driver's city, driver's age group (30 and younger, 31 to 40, and over 40 years), whether at least one passenger was in the car, and an interaction term between age group and whether passengers were in the car. The outcome variable of interest was whether drivers wore seatbelts because they believed seatbelts can save their lives, referred to in this paper as "selection of Reason 3."
  
  
  RESULTS
  The odds of selecting Reason 3 were 2.45 (95% CI: 1.40-4.31) times higher in Ankara than in Afyonkarahisar, 2.52 (95% CI: 1.38-4.60) and 3.65 (95% CI: 1.92-6.95) times higher for drivers aged 31-40 and drivers over the age of 40 than for drivers 30 years of age and younger, respectively, and 5.89 (95% CI: 2.02-17.23), 7.22 (95% CI: 1.61-32.42), and 0.83 (95% CI: 0.32-2.19) times higher for drivers traveling with passengers who were 30 years of age and younger, between 31 and 40, and over 40 than for drivers traveling without passengers in these age groups, respectively.
  
  
  CONCLUSIONS
  Drivers with passengers had higher odds of selecting Reason 3, especially younger drivers who are more likely to succumb to peer pressure. Older drivers had higher odds of selecting Reason 3. Peer groups and peer education campaigns may have an impact. Education interventions combined with extrinsic campaigns can be aimed at younger drivers to increase and maintain adherence in the population.
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Caitlin M
authors.initials: CM
authors.lastname: Milder
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: sgupta@jhsph.edu.
authors.forename: Shivam
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Psychology, Middle East Technical University, Turkey.
authors.forename: Türker
authors.initials: T
authors.lastname: Ozkan
authors.affiliation: Johns Hopkins International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Connie
authors.initials: C
authors.lastname: Hoe
authors.affiliation: Department of Psychology, Middle East Technical University, Turkey.
authors.forename: Timo
authors.initials: T
authors.lastname: Lajunen
mesh_terms: D000063:Accidents, Traffic / Q000331:legislation & jurisprudence / Q000517:prevention & control / Q000523:psychology*; D000328:Adult; D017677:Age Distribution; D001334:Automobile Driving / Q000331:legislation & jurisprudence / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009042:Motivation; D016017:Odds Ratio; D010379:Peer Group; D012622:Seat Belts / Q000706:statistics & numerical data*; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014342:Truth Disclosure; D014421:Turkey / Q000453:epidemiology
keywords: Behavior; Injury prevention; Intrinsic; Road safety; Seatbelt; Turkey