Challenging Dogma - Spring 2008

...Using social sciences to improve the practice of public health

Monday, April 21, 2008

Click It Or Ticket: Why a National Campaign for Seat Belt Use Fails to Deliver Its Message to Rebellious Teens – Leslie Chen

Seat belt use is the most effective countermeasure available to passenger vehicle occupants to prevent fatalities and serious injuries in highway motor vehicle traffic crashes. Statistics from the National Highway Traffic Safety Administration (NHTSA) show that 15,383 lives were saved in 2006 by the use of seat belts. Despite the benefits attributed to the device, seat belt use in the United States remains low. Data from the NHTSA shows that of occupants who died in motor vehicle crashes in 2006, only 66% of drivers and 61% of all passengers were wearing seat belts when the accident happened (1).

In 1993, to combat the lack of seat belt use, Governor Jim Hunt of North Carolina launched the ‘Click It or Ticket’ campaign in conjunction with a ‘Primary safety belt law’ (2). This law allows law enforcement officers to issue a safety belt citation without observing another offence. As of January 2006, 26 states and the District of Columbia have followed in the footsteps of North Carolina by adopting the campaign and enacting the primary safety belt law. A number of other states have adopted the campaign but have left the safety belt law as secondary. Thus, law enforcement officers can issue a citation for a seat belt infraction only if another traffic violation is observed. Since the ‘Click It or Ticket’ campaign was first launched, the national average for seat belt usage increased from 58% in 1994 to 81% in 2006 (3).

Despite the overall success of the campaign, it seems the message has not infiltrated into some segments of the population. In 2005, the Youth Risk Behavior Surveillance Survey (YRBSS) revealed that the proportion of high school students who rarely or never wore a seat belt ranged from a low of 4.8% in Hawaii to 19.6% in South Dakota. If analyzed by sex, the proportions among male students (6.1%-27.4%) are substantially higher than among female students (3.4%-14.1) (4). Though teens accounted for only 8% of the driving population, in 2005 drivers aged 15-20 years accounted for 12.6% of fatal crashes with 62% of the drivers not wearing a seat belt at the time of crash (1).

These findings illustrate the campaign messages were not effectively reaching adolescents, especially teenage boys. The ‘Click It or Ticket’ campaign was ineffective in regards to increasing seat belt use among adolescents because the designers of the program failed to account for differences between the general population and teenagers, thus the approach they used to apply market segmentation was wrong. They also lacked a creative strategy to promote the message to the teenage population. Finally, they failed to provide tools for teens to improve self-efficacy.

Using a wrong approach for market segmentation
The ‘Click It or Ticket’ campaign appears to incorporate the principles of social marketing theory. One important construct of this theory is market segmentation, which refers to the segmentation of a target population into meaningful subgroups so that messages and campaigns can be appropriately channeled (5,6). Since the inception of the ‘Click It or Ticket’ campaign in 1993, NHTSA has gradually built a set of marketing tools, namely the Law Enforcement Action Kit. It includes instructional template materials: a press release, high school outreach materials, poster clip art, fact sheets and a proclamation. As a result of these detailed instructions, most of the local campaigns strictly followed the program design.

These detailed instructions were helpful for local agencies to identify the materials necessary to initiate a campaign. However, they neither help with how to target different populations nor with how to customize campaign messages to individual groups. A successful social marketing campaign needs to accurately group people into different segments by identifying their demographic characteristics, risk factors, engagement in risk behaviors and their shared attitudes about certain behaviors (5,6). If the ‘Click It Ticket’ campaign followed these principles, they would have recognized adolescents as a unique group. They would have studied the traits of this teenage group and understood that teens rebel against authority, tend to listen to peers more than parents or authoritative figures and want to be listened to instead of being talked to. It is in their nature to be rebellious and independent from authorities.

Due to the unique traits of the adolescents, a campaign should customize its messages to prevent triggering teens’ natural rebellious tendencies which can cause laws such as this to backfire. However, across the nation, most advertising videos in this campaign showed unbelted drivers and passengers getting caught by police officers. Some campaigns would use authoritative figures such as governors to point out that such a law is in effect. The themes of these ads are based mainly on scare tactics--showing law enforcement everywhere watching over drivers. Because of their inability to recognize the differences between teens and the general population, many campaigns wrongly assumed that using different age groups in these videos to deliver the same message is equivalent to segmenting the targeted population, thus the goal of applying market segmentation has achieved. However, the campaigns need to understand that not only teens should be involved in delivering the campaign message, the message itself needs to be tailored to teens. Surveys and studies had suggested that teens tend to listen to peers more than authority figures. Thus, a more effective campaign would have used teens to deliver positive message instead of depicting them as the ones being caught.

Lack of creative strategies to promote campaign messages
The Social Marketing Theory focuses on four Ps - Product, Price, Place, and Promotion. In this campaign, ‘Product’ was defined as using a seat belt not only to save one’s life, but also to avoid being ‘busted’ by police. ‘Price’ was defined as a financial fine or jail time when not wearing a seat belt. ‘Place’ was defined as checkpoints in various locations. ‘Promotion’ was the advertising of the new law and its consequences. While the campaign has correctly identified each of the core elements, it fails to think outside of the box for innovative promotional methods for reaching teens.

In its May 2007 TV program summary, NHTSA indicated that they bought air time in all major television networks and in selected popular television programs. In addition, warning signs were posted on billboards on major highways. A few television ads were also made available on the You Tube website. We should give credit to the campaign for its comprehensive promotion coverage through traditional media channels and its use of the internet to distribute its message more broadly. However, the current generation of teens, also known as the ‘Millennial Generation’ or ‘Generation Y’, has different life styles than previous generations as they have lived their entire lives immersed in digital technologies and spend more time in the internet than in television (7). Data from Pew Internet & American Life Project’s report on Teens and Social Media revealed that 93% of teens use the internet, and many of them treating it as a venue for social interaction – a place where they can share creations, tell stories and interact with others (8). They also use internet as their primary source for news (9). Thus, given the flexibility of the internet and the amount of time that teens spend online, the campaign should focus more on using the internet as the promotional tool than using traditional media. Popular teen websites such as You Tube and MySpace are free and do not have limits on air time. The campaign can create films in short story or documentary format with messages more appealing to or emotionally relevant for teens.

Falling short on providing tools to improve self-efficacy
The manner in which young people drive is influenced by many different factors such as personality characteristics, demographic and developmental factors, driving ability, perceived environment and driving environment (10). Among all factors, perceived environment is perhaps the largest and most complex influence on adolescents’ driving behaviors. During their young life, teenage drivers develop perceptions that relates to what ‘normal’ or ‘expected’ driving behaviors through observation of how their parents, their peers, and even peoples in their community drive. These perceptions have direct influence on their own driving behavior. As the result, studies shown people drive in ways similar to their parents (11). Peer pressure is also an important factor that influence teen’s driving behavior. A 2003 study showed that teens that are susceptible to peer pressure have more offenses and crashes (12). Having friends involved with alcohol at an early age is also related to problematic driving in teens (13, 14).

Young people today are also driving in a more complex traffic environment than ever before. There are more cars, more congestion, more complex intersections and roadways, and today’s drivers are rude, aggressive and distracted (9). Given the all the challenges a young driver have to face, the ‘Click It or Ticket’ campaign rarely provides advices or guidance on how to handle all the challenges. It assumes young drivers have the ability to correct inappropriate driving behaviors that they have observed through their life. It also assumes that teens have the self-efficacy to stick to ‘good’ driving behaviors even social norms tell them otherwise. Lacking guidance and fail to recognize all the challenges adolescents are facing would leaves teens feel lost, and even angry on being left alone and misunderstood.

Undeniably, the ‘Click It or Ticket’ campaign has successfully increased seat belt use on the national level. However, given the health impact, economic costs and reduced life expectancy for society as whole, current levels of seat belt use are still unsatisfactory especially among young drivers. The ‘Click It or Ticket’ campaign needs to improve their market segmentation so that custom messages can be delivered to its targeted audience. They need to think outside of the box to create innovative promotional tools to not only change teens’ minds, but also to touch their hearts. Providing tools and methods to resist peer pressure can also improve teens’ self-efficacy so that they can try new behaviors safely and with the support needed for success.

1. National Highway Traffic Safety Administration (NHTSA), 2006 Traffic Safety Fact Sheet.
2. Success Stories. Click It or Ticket. Social marketing Institute
3. National Occupant Protection Use Survey
4. Youth Risk Behavior Surveillance – United States, 2005
5. Mark Edberg. Essentials of Health Behavior, Social and Behavioral Theory in Public Health.
6. W A Smith. Social marketing: an overview of approach and effects. Inj Prev. 2006 Jun;12 Suppl 1:i38-43.
7. Wikipedia. Generation Y. Wikimedia Foundation Inc.
8. Teens and Social Media: The use of social media gains a greater foothold in teens life as they embrace the conversational nature of interactive online media. Pew Internet & American Life Project
9. Connecting to the Net.Generation: What higher education professionals need to know about today's students, NASPA; First edition (March 29, 2007.)
10. J T Shope. Influences on youthful driving behavior and their potential for guiding interventions to reduce crashes. Inj. Prev.2006;12:9-14.
11. Ferguson SA, Williams AF, Chapline JF, et al. Relationship of parent driving records to the driving records of their children. Accid Anal Prev 2001;33:229 34
12. McCartt AT, Shabanova VI, Leaf WA. Driving experience, crashes and traffic citations of teenage beginning drivers. Accid Anal Prev 2003;35:311–20.
13. Lang SW, Waller PF, Shope JT. Adolescent driving: characteristics associated with single-vehicle and injury crashes. J Safety Res 1996;27:241–57.
14. Shope JT, Waller PF, Lang SW. Alcohol-related predictors of adolescent driving: gender differences in crashes and offenses. Accid Anal Prev 1996;28:755–64.

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