SeatbeltsR4U Multicultural Pathways to Seat Belt Excellence!

1. SeatbeltsR4U Multicultural Pathways to Seat Belt Excellence! Developed by Meharry Medical College Nashville, Tennessee, 2009 Funded by National Highway Traffic Safety Administration

2. Toolkit Development Team Irwin A. Goldzweig, MSc Project Director Nathaniel C. Briggs, MD, MSc Toolkit Preparation  Ken West, MA Web Design & Development  Contributors Dawn Bishop-McLin, PhD Virginia M. Brennan, PhD Michael Golden, MPH Paul D. Juarez, PhD Celia Larson, PhD Robert S. Levine, MD David Schlundt, PhD Pat Everage-Smith Nathan Stinson, Jr., MD, DrPH

3. Priorities for this Toolkit • Information about cultural competence • Linkages to multicultural resources • Information about evidence-based interventions • Comprehensive compendium of tools & resources • Addresses 4 groups (NHTSA: African Americans, Latino, American Indian, Asian/PI) • Useful for diverse groups with wide range of skills

4. Students at Glencliff HS, Nashville, TN Mayor of Jackson, Mississippi

5. What’s Different About This One? • Compliments other toolkits • Each of the 8 sections discussed from multicultural perspective • > 300 links to multicultural resources in each section & in appendix • Extensive inclusion of multicultural photos, diagrams, figures and logos • Seatbelt Ringtone • Seatbelt Ringtone in Spanish

6. Access SeatbeltsR4U in 3 Formats • Hard copy • Flash drive - Word document & PowerPoint with links to internet • Web site – download and email to others

7. Toolkit Organization 1. Toolkit Purpose 2. Community Coalitions 3. Community Assessment 4. Cultural Competence 5. Evidence-Based Interventions 6. Multicultural Adaptations of Evidence-Based Interventions 7. Evaluating Interventions & Disseminating Results 8. Program Funding & Sustainability 9. Appendix

8. Three Approaches to each Section • Text • Visual material • Links to the internet

9. 1. TOOLKIT PURPOSE

10. Provide multicultural communities with resources for developing and implementing community-based seat belt safety programs, especially for motorists at greatest risk for nonuse of seat belts: • Race/ethnicity • Teens & young adults • Males • Lower income • Rural • Pickup trucks • Rear seat • Secondary states

11. Primary Sources • Meharry-State Farm Alliance • NHTSA Safe Communities Program • NHTSA 2009 CIOT Campaign Planner Global Resources • FIA Seat Belt Campaign Toolkit (2004) • Developed by UK Transport Research Laboratory in consultation with > 50 countries

12. "Por Amor, Use El Cinturón" ("For Love, Use Your Seat Belt") was the cornerstone of a successful campaign to promote seat belt use in Costa Rica and Peru. The campaign was based on the concepts of love and responsibility, with a campaign logo featuring a traffic sign with a heart secured by a seat belt. [Source: FIA Foundation, 2004]

13. Sticker from Japanese Auto Federation, “rear occupant buckled up.” – attached to rear window Source: FIA Foundation 2004 Taxi driver in Kigali Rwanda buckles up Source: World Health Organization

14. 2. COMMUNITY COALITIONS

15. What’s a Multicultural Community Coalition? • Different types of people working together • Provides basic foundation for developing and implementing an effective community-based seat belt safety campaign • Ensure that community leaders and concerned citizens from all racial/ethnic groups and language-isolated cultures are included from the earliest stages • Helps to assure cultural sensitivity and understanding in developing interventions to effectively deliver the seat belt safety message • Guide to Choosing and Adapting Culturally and Linguistically Competent Health Promotion Materials(National Center for Cultural Competence) • Building Coalitions of Color: A Multicultural Approach

16. Seat Belt Coalition Meeting, Mayor’s Office Jackson MS

19. Automotive Coalition for Traffic Safety, MS State Senator and MS Highway Patrol Officer Join Hands for Primary Legislation in MS

20. Helpful Links • NHTSA Multicultural Outreach Program - gives examples of organizations representing four major multicultural populations(Black/African American, Latino/Hispanic, American Indian/Alaska Native, Asian American/Pacific Islander) • Safe Communities Service Center • Health: Asian & Pacific Islander American Health Forum • Faith community: Protecting our Future: Promoting Seat Belt Use in the African American Community; • Increasing the Use of Child Restraints in Motor Vehicles in a Hispanic Neighborhood

23. Goldzweig Model of Dynamic Relationships Between Community Coalition Members Core Members: injury prevention advocates, law enforcement, school departments Technical Support Groups: local university, health department, state highway safety office and others Supporting Organizations: church leaders, NAACP, Hispanic coalition, chambers of commerce education committees, minority organizations • Core members show up at most meetings and do most of the work. • Technical support groups provide technical assistance as needed. • Supporting organizations have limited involvement but endorse coalition mission.

24. State Highway Safety Offices Partnering with State Highway Safety Offices: Tips and Tactics for Success • Colorado Office of Traffic Safety • Missouri Hwy Safety Division • New Jersey Division of Hwy Traffic Safety • North Carolina Governor's Hwy Safety Prog • Ohio Traffic Safety Office • Tennessee Governor's Hwy Safety Office • Washington Traffic Safety Commission

25. 3. Community Assessment

26. Multicultural community assessment involves collecting and analyzing data about the community's demographic composition, motor vehicle injury and fatality rates and, most importantly, frequency of seat belt use by motorists in the community

27. Describing Who Lives in the Community Once geographic boundaries of the community are defined, data can be obtained using the [US Census Bureau – American Fact Finder] to describe community residents by age, sex, race/ethnic group, nationality, immigration status, language usually spoken, education, socioeconomic status and other important variables.

28. Identifying Multicultural Subpopulations A demonstration project for Travis County, Texas describes how the American Community Surveycan be used to create multicultural community

29. Assessing Seat Belt Use in the Community - How is it Done? Self Report Surveys- members of the community are asked about frequency of seat belt use Direct Observation Surveys- trained observers record frequency of seat belt use by motorists in transit Because each approach has advantages and disadvantages, it is important to combine both approaches.

30. Additional Resources 1.A Guidebook for Observing Occupant Restraint Use and Misuse–AAA Foundation for Traffic Safety publication that describes how to conduct community-based direct observations surveys of seat belt use. 2. Injury Surveillance Guidelines- World Health Organization publication that provides practical advice on setting up systems for collecting, coding and processing data when staff and technology resources are limited.

31. 4. Cultural Competence

32. Who should deliver the message? - sports, entertainment figure? - faith leader? - law enforcement officer? Which media? - television? - radio? - billboard? - presentation in school or workplace? - traffic citation? Best time to deliver the message? - holidays? - weekdays vs. weekends? General Multicultural Considerations

34. Cool Kids Buckle Up! So, you are invited to a presentation by Metro Police May 13 at 8:22-8:52 am (during Advisory) in the auditorium. *Please accompany and remain with students during the presentation. ¡Abrocharte el cinturón de seguridad! ¡¡¡Estás cordialmente invitado a asistir a una presentación de usar el cinturón de seguridad el 13 de Mayo a las 8:22-8:52!!! El CINTURÓN DE SEGURIDAD puede salvar una vida, la tuya. Por eso siempre acuérdate de usarlo. استخدم حزام الامان, your Advisory مختارة لحضور عرض حول استعمال حزام الامان. يرجى حضور. ، ونحن على وعد بأن ستكون مفيدة بالنسبة لك!!! نريد أن نراكم هناك!   13 مايو ، من 8:22-8:52

35. Adapted from Community Tool Box, by the Meharry-State Farm Alliance

36. Specific Multicultural Differences • Example 1: NHTSA focus group studies on reasons for nonuse of seat belts found that young Black men often reported that it was not “cool” to wear seatbelts, whereas young Hispanic men tended to report that seatbelt use indicated a lack of confidence in one’s driving ability. • Example 2: With regard to seat belt law enforcement (established as a highly effective approach to increase seat belt use in the general population), concerns about differential enforcement and profiling exist among many multicultural subpopulations including Blacks, Hispanics and teens.

37. Source: Indian Health Service Tribal Injury Prevention Program

38. Key Resources 1. Building Culturally Competent Organizations (Community Toolbox) 2. Click It or Ticket: Model for Boosting Belt Use in Minority Communities 3. Culturally and Linguistically Competent Health Promotion Materials (NCCC)

39. 5. Evidence-Based Interventions for Promoting Seatbelt Use

40. Summary of Major Approaches • Seat belt laws • Primary enforcement of seat belt laws • Enhanced enforcement of seat belt laws • Mass media campaigns • School-based education - service learning • Combinations of above

41. IL State senator John Cullerton (now President of the IL State Senate), Advocates for Highway and Auto Safety president Judie Stone, and IL state senator Barack Obama (now President of the United States) in 2004 at Seat Belt Champion Award ceremony sponsored by the Meharry-State Farm Alliance.

42. Addressing Racial Profiling while Passing Primary Legislation • Classic example = 2003 IL passed primary legislation and anti-profiling legislation • Text of the anti-profiling legislation: • Public Act 093-0209 - State Police-Culture Diversity (see Sec. 11-212. Traffic stop statistical study)

43. Achieving a High Seat Belt Use Rate: A Guide for Selective Traffic Enforcement Programs Minnesota state and local law enforcement officers collaborate

44. Mass Media Communications • Public education campaigns and advertising promotions alone appear • to have limited impact on seat belt use but play a strong role in • supporting multifaceted approaches to promoting seat belt use. • Integrated Marketing Communications - most effective approach to • delivering public health messages like seat belt safety. Messages are • delivered through multiple communications channels including: • - paid advertising • - public service announcements (PSA) • - earned media • - sponsorship of events • - promotional materials

46. Law enforcement officers from every culture are united in their support for Enforcement of seat belt safety laws. [Source: NHTSA CIOT 2009]

47. Combination Approaches Numerous studies have shown that no single approach is effective for inducing a lasting change in belt use behavior among nonusers A combination of seat belt law enforcement and multiple community-based interventions including mass communication and school-based education is considered to be the most effective approach NHTSA: Increasing Teen Safety Belt Use: A Program and Literature Review. 2005

48. Key Resources 1. US Community Preventive Services Task Force Recommendations: a.Seat Belt Laws b. Primary Enforcement c. Enhanced Enforcement 2. A Guide for Increasing Seatbelt Use: AASHTO Strategic Highway Safety Plan. 3. Initiatives to Increase Seat Belt Use (NHTSA) 4. Implementing a Primary Seat Belt Law in Your State: A How-to-Guide (NHTSA) 5. Achieving a High Seat Belt Use Rate: A Guide for Selective Enforcement Programs- summarizes strategies for publicizing and achieving high-visibility enforcement to help enable communities to reach a 90 percent belt use goal.

49. 6. Multicultural Adaptations of Evidence-Based Interventions

50. Examples of community-based programs to promote seat belt safety among: • African Americans, Hispanics, and Native Americans • Links to programs for: • teens • rural motorists • pickup truck drivers • the elderly