SeatbeltsR4U

Multicultural Pathways to Seat Belt Excellence!

Developed by

Meharry Medical College

Nashville, Tennessee, 2009

Funded by

National Highway Traffic Safety Administration

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

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

Students at Glencliff HS, Nashville, TN

Mayor of Jackson, Mississippi

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

Access SeatbeltsR4U in 3 Formats

• Hard copy

• Flash drive - Word document & PowerPoint with links to internet

• Web site – download and email to others

Toolkit Organization1. 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

Three Approaches to each Section

• Text

• Visual material

• Links to the internet

1. TOOLKIT PURPOSE

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

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

"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]

Taxi driver in Kigali Rwanda buckles up

Source: World Health Organization

Sticker from Japanese Auto Federation, “rear occupant buckled up.” – attached to rear window

Source: FIA Foundation 2004

2. COMMUNITY COALITIONS

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

Seat Belt Coalition Meeting, Mayor’s Office Jackson MS

Table 2.1 Community Agencies and Organizations

• Multicultural organizations• State/national seat belt coalitions• Motor vehicle safety organizations• Local/state law enforcement • Local/state elected officials• State highway safety offices• School departments• Paramedics and EMS providers• Fire departments• Local/state public health agencies• Hospitals and clinics• Health professionals• Media (newspaper, radio, TV)• Traffic engineers

• Public transportation agencies• Chambers of commerce• Civic groups• Colleges and universities• Faith-based organizations• Fraternities and sororities• Attorneys• Businesses • Community service groups • Social service agencies • Seat belt use survivors• Community leaders• All other community members

Automotive Coalition for Traffic Safety, MS State Senator and MS

Highway Patrol Officer Join Hands for Primary Legislation in MS

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

Goldzweig Model of Dynamic Relationships Between Community Coalition Members

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.

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

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

3. Community Assessment

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

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.

Identifying Multicultural Subpopulations

• A demonstration project for Travis County, Texas describes how the American Community Survey can be used to create multicultural community

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.

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.

Additional Resources

4. Cultural Competence

• 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

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 unapresentación 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.

, االمان حزام . your Advisoryاستخدم االمان حزام استعمال حول عرض لحضور مختارة. حضور يرجى

!!! لك بالنسبة مفيدة ستكون بأن وعد على ونحن ،نر أن ! اكمنريد هناك

من 13  ، 8:52-8:22مايو

Table 4.1 - Cultural Competence Continuum

Cultural Ignorance - no knowledge about different racial/ethnic, language-isolated or other cultural groups

Cultural Knowledge - some knowledge about characteristics, history, values, beliefs and behaviors of different racial/ethnic, language-isolated or other cultural groups

Cultural Awareness - greater understanding of differences that can exist between cultural groups on multiple levels

Cultural Sensitivity - openness to differences between cultural groups without making value judgments (e.g., better or worse)

Cultural Competence - integration of cultural knowledge, cultural awareness and cultural sensitivity with the capacity to promote health and safety in cross-cultural community settings by developing and implementing effective, culturally appropriate interventions

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

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.

Source: Indian Health Service Tribal Injury Prevention Program

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)

5. Evidence-Based Interventions for Promoting Seatbelt Use

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

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.

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)

Achieving a High Seat Belt Use Rate: A Guide for Selective Traffic Enforcement Programs

Minnesota state and local law enforcement officers collaborate

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

Mass Media Communications

Law enforcement officers from every culture are united in their support for

Enforcement of seat belt safety laws. [Source: NHTSA CIOT 2009]

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

Key Resources1. 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.

6. Multicultural Adaptations of Evidence-Based Interventions

• Examples of community-based programs to promote seat belt safety among:

African Americans, Hispanics, and Native Americans

•Links to programs for:teensrural motorists pickup truck driversthe elderly

Program Examples

• African American: Buckle Up Faithfully

• Native American, Navajo: Building Safe Communities Newsletter Article on Improving Occupant Safety in the Navajo Nation

• Native American, Yakama Nation: Building Safe Communities Newsletter Article on Safety as Heritage

• Hispanics: Buckle the Border: NHTSA Traffic Safety Digest Project Summary - Texas, New Mexico, Arizona, California: Buckle the Border

Multiracial

Detroit, MI: Buckle Up Detroit/Neighborhood City Halls Campaign

African American

Denver, CO: Brother Keep It Together: Don't Risk It - Just Wear It

Seattle, WA: Protecting Our Future: Promoting Seat Belt Use in the African American CommunityFranklin County, OH: African American Church Call to Buckle Up Campaign

Hispanic

Houston, TX: Buckling Up For Life--Safety Week in Houston

Salt Lake City, UT: FIND Program

Native American

La Plata County, CO: Memory Tree Memorial

Mahnomen County, MN: Mahnomen County Cooperative Law Enforcement Agreement

Additional Examples of Successful Multicultural Community-Based Programs to Increase Belt Use

Over 50 Additional Examples of Adaptations of Evidence-Based Interventions

• African American, Hispanic, Native American

• Teens

• Rural

• Urban

• Elderly

• Language handicapped

• Occupational drivers

• Worksite campaigns

School-Based Education

Numerous studies have shown that school-based interventions can

effectively promote seat belt use among teen motorists.

Many successful school-based interventions incorporate a peer-to-

peer educational approach. A major advantage of this approach is

that both teens and racial/ethnic minorities are multicultural target

subpopulations that can be directly reached.

Service-learning is a more sophisticated peer-based approach in

which students play active leadership roles by both developing and

implementing interventions. Click here to access Service Learning Toolkit

Service-learning students at Central HS

in Louisville, KY use PDAs to record seat

belt use at the entrance to their school

parking lot

Meharry-State Farm Alliance teen

service-learning project at

Westwood HS in Mesa, AZ

Music & Video Resources

• Friend

• Seat Belt Education Video: Split Second To Die

7. Evaluating Interventions and Disseminating Results

Table 7.1 - General Approach to Evaluation of Change in Seat Belt Use

Pre-intervention data on seat belt use collected before start of program.

Interim data on seat belt use collected at selected time points after start of program (e.g., 3 months, 6 months, 1 year).

Post-intervention results compared with pre-intervention results using statistical tests to assess whether meaningful changes in seat belt use occurred.

Resources

• NHTSA Safe Communities: Evaluating and Monitoring Safe Communities

• Demonstrating Your Program's Worth: A Primer on Evaluation of Programs to Prevent Unintentional Injury (CDC)

• Community Toolbox

• Introduction to Evaluation (Community Toolbox)

• Results should be shared widely throughout the community:

- Presentation in public community forums - Local newspapers, local TV stations - Local radio talk shows

• Key stakeholders outside the community (e.g., state department of transportation)

• Presentations at local, regional and national safety and injury prevention conferences and published in newsletters, magazines and other publications

Approach to Results Dissemination

8. Program Funding & Sustainability

Sources of potential funding include:

• Government Agencies

Federal

State

Local

• Private Sector

Health care organizations

Insurance providers

Other local businesses

• Non-profit Organizations

Who are the Potential Funders?

• Obtain tax exemption status

• This can be done by establishing the coalition as a 501(c)3 organization:

- 4-6 months to complete - File articles of incorporation with state - Secure federal income tax exemption

with IRS - To find out if your coalition meets

requirements go to www.irs.gov

Getting More Belt Use for Your Buck

Funding Multicultural Community-Based Programs

• African American Association of Black Foundation Executives

• Hispanic Hispanics in Philanthropy

• Native American Native Americans in Philanthropy

• Asian American/Pacific Islander Asian Americans/Pacific Islanders in Philanthropy– AAPIP Chapter Locator

1. Catalog of Federal Assistance

2. Grants.gov

3. GrantsNet

4. Establishing a Nonprofit Organization

5. www.form1023help.com

Additional Resources

Appendix

• Thirty-four pages of all the links from each of the eight sections of the multicultural toolkit – SeatbeltsR4U

Next Steps

• Pilot test in 2 communities– Cleveland, OH

– Denver, CO

• Evaluate

• Adapt

• Disseminate