• Marcus Houston, Vicky Cassabaum, Susan Matzick, Theresa Rapstine, Shirley Terry, Phyllis Uribe, Jeri Harwood, Steven Moulton, and Mile-High Regional Emergency Medical and Trauma Advisory Council (MHRETAC).
• Mile-High Regional Emergency Medical and Trauma Advisory Council (MHRETAC), Denver, Colorado, USA.
• J Trauma. 2010 Mar 1; 68 (3): 511-4.

Background: Motor vehicle crashes are the leading cause of death among teenagers because of higher crash rates per mile driven and low seat belt use rates.Methods: An educational program aimed at increasing seat belt use among teens was implemented at five area high schools in the spring of 2007 and six high schools in the fall of 2007. Observational studies were conducted as students arrived at school. Resources and incentives were provided to generate peer-to-peer motivation. Schools competed against one another to see which could achieve the highest seat belt usage rate during a 7-week period. Observational studies were repeated, and success of the safety campaign was measured by an increase in seat belt usage at the participating high schools.Results: At the beginning of the safety campaign, average seat belt use among teen drivers was 47% and 59% for the spring and fall, respectively. Teen passengers had an average usage of 40% and 57% for the spring and fall. In the spring campaign, seat belt use increased by 36% and 19% for teen drivers and passengers, respectively. Similar results were seen in the fall, with increases of 26% and 13% for teen drivers and passengers, respectively. Overall seat belt use in both campaigns increased by 20%, to an average use rate of 71%.Conclusions: Social pressure and poor comprehension of the risks of injury were identified as barriers to seat belt usage among teenage high school students. A friendly, competitive approach to openly discussing and educating teens about these risks led to a 20% increase in seat belt usage among teen drivers and their passengers.

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