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Liu L, Liu J. Prediction of rear-seat belt use: Application of extended theory of planned behavior. TRAFFIC INJURY PREVENTION 2024; 25:698-704. [PMID: 38648014 DOI: 10.1080/15389588.2024.2341384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/07/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVES Rear-seat belts have been shown to significantly reduce the severity of road vehicle collisions and fatalities. However, their use by rear-seat passengers is significantly less than that by front-seat passengers. Thus, the psychological factors underlying individuals' decision to wear a seat belt in the rear seat require further investigation. METHODS An extended theory of planned behavior (eTPB) was used to examine individuals' behavior of wearing a rear-seat belt. An online survey was conducted and a total of 515 valid questionnaires were collected in China. RESULTS While attitude, descriptive norms, and law enforcement all have a significant effect on individuals' intention to wear a seat belt in the rear, subjective norms and perceived behavioral control do not. Individuals' attitudes toward wearing a seat belt in the rear seat are significantly influenced by law enforcement and behavioral intention, but not by perceived behavioral control. The mediation effect analysis reveals that law enforcement has the greatest overall effect on behavior, followed by attitude and descriptive norms. CONCLUSIONS The results of this paper contribute to more effective recommendations to improve the use of rear seat belts and to safeguard rear seat passengers.
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Affiliation(s)
- Lihua Liu
- School of Civil and Transportation Engineering, Henan University of Urban Construction, Pingdingshan City, China
| | - Jianrong Liu
- School of Civil Engineering and Transportation, South China University of Technology, Guangzhou City, China
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Kargar S, Ansari-Moghaddam A, Ansari H. The prevalence of seat belt use among drivers and passengers: a systematic review and meta-analysis. J Egypt Public Health Assoc 2023; 98:14. [PMID: 37528241 PMCID: PMC10393920 DOI: 10.1186/s42506-023-00139-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Seat belts might save people's lives in car accidents by preventing severe collision damage and keeping passengers safe from critical injuries. This meta-analysis was performed to assess the prevalence of seat belt use among drivers and passengers. METHODS The databases of PubMed, Web of Science (WOS), and Google Scholar were searched from the beginning of 2000 to late December 2020 to identify studies that investigated the prevalence of seat belt use among drivers and passengers. The pooled prevalence was calculated using a random-effects model. The STATA-v14 software was used to perform data analysis. RESULTS Sixty-eight studies that met the inclusion criteria and were suitable for this meta-analysis were identified. The pooled prevalence of seat belt use was 43.94% (95% CI: 42.23-45.73) among drivers, 38.47% (95% CI: 34.89-42.42) among front-seat passengers, and 15.32% (95% CI: 12.33-19.03) among rear-seat passengers. The lowest seat belt use among drivers and passengers was observed in Asia, the Middle East, and Africa, while the highest use was reported in Europe and America. Moreover, the prevalence of seat belt use was higher among women drivers [51.47% (95% CI: 48.62-54.48)] than men drivers [38.27% (95% CI: 34.98-41.87)] (P < 0.001). Furthermore, the highest prevalence of seat belt use was seen among drivers (68.9%) and front-seat passengers (50.5%) of sports utility vehicles (SUVs); in contrast, the lowest prevalence was observed among drivers and passengers of public vehicles such as buses, minibuses, and taxis. CONCLUSIONS In general, the prevalence of seat belt use was not high among drivers and was even lower among passengers. Moreover, drivers and passengers in Asia, the Middle East, and Africa had the lowest prevalence of seat belt usage. Additionally, drivers and passengers of public transportation (buses, minibuses, and taxis) had a lower rate of seat belt use, especially among men. Therefore, effective interventional programs to improve seat belt use should be designed and implemented, particularly among these at-risk populations in Asia, the Middle East, and Africa.
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Affiliation(s)
- Shiva Kargar
- Health Promotion Research Centre, Zahedan University of Medical Sciences, Zahedan, Iran
| | | | - Hossein Ansari
- Health Promotion Research Centre, Zahedan University of Medical Sciences, Zahedan, Iran
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Merali HS, Campbell SC, Inada H, Vecino-Ortiz AI, Bachani AM. 10 city analysis of child passenger helmet use. Injury 2022; 53:2478-2484. [PMID: 35400488 DOI: 10.1016/j.injury.2022.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 03/08/2022] [Accepted: 03/22/2022] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Road traffic injuries are the leading cause of death in children over age five. Most of these deaths occur in low- and middle-income countries. Vulnerable road users, such as motorcyclists and their passengers, are at higher risk. Helmets have significantly decreased morbidity and mortality for motorcyclists; however, they are often unused. The second phase of the Bloomberg Philanthropies Initiative for Global Road Safety was launched in 2015 to improve road safety in 10 cities. This study focuses on child passenger helmet use data from that study to understand the prevalence of helmet use and factors that are associated with helmet use. METHODS The 10 cities selected were Accra, Addis Ababa, Bandung, Bangkok, Bogota, Fortaleza, Ho Chi Minh City, Mumbai, Sao Paulo, and Shanghai. Eight rounds of roadside observational data were collected from February 2015 to April 2019. Observers noted correct child motorcycle passenger helmet use and other site observations including weather patterns, traffic volume, and road surface conditions. A multivariable Poisson regression model was used to examine correct helmet use trends over time. A multivariable logistic regression model was fitted for correct child passenger helmet use in all cities controlling for weather, observation time, number of passengers, and driver's correct helmet use. RESULTS This dataset contained 99,846 motorcycle child passenger observations across the 10 cities. The highest prevalence of correct child passenger helmet use was in Sao Paulo at 97.33%. Six cities had under 25% correct helmet use for child passengers. Examining helmet use over time, only five cities had a significant increase, four cities had no change, and Ho Chi Minh City demonstrated a decrease. In the multivariable regression model, child passengers had higher odds of wearing helmets in adverse weather conditions, early mornings, if the driver wore a helmet, and if there were fewer passengers. CONCLUSIONS The prevalence of correct child passenger helmet utilization shows large variation globally and is concerningly low overall. Enhanced enforcement in combination with media campaigns may have contributed to increasing helmet use prevalence over time. Further research is needed to understand reasons for low child passenger helmet use in most cities.
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Affiliation(s)
- Hasan S Merali
- Department of Pediatrics, McMaster Children's Hospital, Master University, 1280 Main St W., Hamilton, ON, Canada L8S 4K1; Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
| | - Sachalee C Campbell
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
| | - Haruhiko Inada
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
| | - Andres I Vecino-Ortiz
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States
| | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe Street, Suite E8132, Baltimore, MD 21205, United States.
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Sutanto E, Zia N, Taber N, Rinawan FR, Amelia I, Jiwattanakulpaisarn P, Bachani AM. Rear-seat seatbelt use in urban Southeast Asia: results from Bandung and Bangkok. Int J Inj Contr Saf Promot 2021; 29:247-255. [PMID: 34902287 DOI: 10.1080/17457300.2021.1998135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Road traffic injuries (RTIs) remain a leading cause of morbidity and mortality in Southeast Asia. We aim to estimate the prevalence and predictors of rear seatbelt use, a key behavioural risk factor for RTI, in Bandung and Bangkok, two cities in Southeast Asia. Roadside observational studies were conducted to provide a representative picture of the prevalence in each city. From eight rounds of observations (July 2015 to April 2019), 39,479 and 7,207 rear-seat passengers were observed in Bandung and Bangkok. Across all rounds, 4.2% of rear-seat passengers used seatbelts in Bandung, compared to 8.4% in Bangkok. In both cities, males and adults, as compared to females and adolescents (aged 12-17 years), had higher odds of rear seatbelt use, as did passengers with a restrained driver. Findings highlight the need for rear seatbelt laws in Bandung and improved enforcement of existing rear seatbelt laws in Bangkok.
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Affiliation(s)
- Edward Sutanto
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Nukhba Zia
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Niloufer Taber
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Indah Amelia
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Health Systems Program, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Chen T, Bachani AM, Li Q. Child restraint use in motor vehicles in Shanghai, China: a multiround cross-sectional observational study. BMJ Open 2021; 11:e050896. [PMID: 34845069 PMCID: PMC8634021 DOI: 10.1136/bmjopen-2021-050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES While appropriate child restraint use in motor vehicles can reduce the risk of injuries or deaths, few previous studies have assessed child restraint practice in China. We aim to describe the prevalence of child restraint use and investigate risk factors affecting child restraint practice in Shanghai, China. DESIGN AND SETTING A cross-sectional observational study was conducted near children's hospitals, kindergartens, entertainment places and shopping malls in Shanghai, China. PARTICIPANTS Eight rounds of data were collected between October 2015 and April 2019 with a total sample size of 12 061 children. PRIMARY OUTCOME MEASURES At each site, trained field workers observed and recorded child restraint use in all passing motor vehicles with at least one child passenger. RESULTS The overall child safety restraint use rate was 6.42%. Child restraint use rate rose over time, from 5.12% in round 1% to 8.55% in round 8 (p<0.001). Results from the adjusted logistic regression model showed that children occupants with the following risk factors had a higher likelihood of child restraint use: children younger than 5 years compared with those aged 5-12 years (OR 2.12; 95% CI 1.78 to 2.53; p<0.001), sitting in rear seat compared with those in front seat (OR 31.80; 95% CI 4.45 to 227.14; p=0.001), children occupants observed near entertainment places (OR 2.34; 95% CI 1.67 to 3.28; p<0.001) or near shopping malls (OR 1.86; 95% CI 1.36 to 2.55; p<0.001) compared with those near children's hospitals and transportation in the morning compared with afternoon (OR 1.30; 95% CI 1.04 to 1.62; p=0.021). CONCLUSIONS The overall child safety restraint use rate was low in Shanghai. Our findings may shed light on monitoring child restraint practice and have implications for intervention programmes for children occupants with the identified risk factors, which may help to promote child restraint use in motor vehicles and prevent road traffic injuries or deaths.
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Affiliation(s)
- Ting Chen
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abdul M Bachani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Qingfeng Li
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Li Q, Adetunji O, Pham CV, Tran NT, Chan E, Bachani AM. Helmet use among motorcycle riders in Ho Chi Minh City, Vietnam: results of a five-year repeated cross-sectional study. ACCIDENT; ANALYSIS AND PREVENTION 2020; 144:105642. [PMID: 32580063 DOI: 10.1016/j.aap.2020.105642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/01/2020] [Accepted: 06/06/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE In Vietnam, motorcycle riders comprise about three-quarters of road traffic fatalities, the most common cause of which is head injuries that can be prevented by wearing a helmet. This study aims to assess helmet-wearing behaviors in Ho Chi Minh City, the largest city in Vietnam. METHODS Eight rounds of observational studies were conducted in six randomly selected locations between July 2015 and April 2019. Given the multinomial nature of the outcome measure (not wearing a helmet; wearing a substandard helmet; wearing an unstrapped standard helmet; wearing a strapped standard helmet), a multinomial model was developed to estimate the level and trend of helmet use and identify the related individual and environmental factors. FINDINGS A total of 479,892 motorcycle riders were observed, over 90 % of whom were wearing helmets (range over the eight rounds: 92.5 %-96.0 %). However, the prevalence of correct helmet use (defined as wearing a strapped standard helmet) gradually declined from 80.8 % in round 1-55.6 % in round 8. Results from a multinomial model showed the probability of wearing a strapped standard helmet had declined by 22.4 percentage points from round 3 to round 8 while holding other factors constant (95 % CI: 21.8-23.0). The prevalence of correct use is 11.3 percentage points higher for adults than for children (95 % CI: 10.5-12.1). During the same period, unstrapped standard helmet use increased by 24.5 percentage points (95 % CI: 24.1-24.9); substandard helmet use declined but remained high. CONCLUSION The upward trend of incorrect helmet wearing behaviors and wearing substandard helmets sends a rallying call for multisectoral interventions.
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Affiliation(s)
- Qingfeng Li
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Oluwarantimi Adetunji
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | - Edward Chan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Abdulgafoor M Bachani
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Adetunji O, Li Q, Pham CV, Thi NT, Bachani AM. Seatbelt and child restraint use among vehicle occupants in Ho Chi Minh City: an observational study in Vietnam. Int J Inj Contr Saf Promot 2020; 27:319-326. [PMID: 32496908 DOI: 10.1080/17457300.2020.1774620] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This paper presents the trend of seatbelt use, disaggregated by vehicle occupants, in Ho Chi Minh City between 2016 and 2018. We conducted statistical analyses to identify the determinants of seatbelt use, including the effect of a new fine imposed against seatbelt law violation in the rear seats that became effective in January 2018. Seatbelt use was observed in at least half of all vehicle occupants, and drivers were more likely to use seatbelts than passengers. Only 4.4% of children younger than 5-years and 2.5% of 5 to12-year-olds used a child restraint system. Seatbelt use increased among all occupants after the imposed fine, especially among rear-seat passengers. Imposing new or increasing fixed penalties, with enforcement and public education, may increase seatbelt use to prevent road traffic injuries.
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Affiliation(s)
- Oluwarantimi Adetunji
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Qingfeng Li
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Cuong Viet Pham
- Center for Injury Policy and Prevention Research (CIPPR), Hanoi University of Public Health, Hanoi, Vietnam
| | - Ngan Tran Thi
- Center for Injury Policy and Prevention Research (CIPPR), Hanoi University of Public Health, Hanoi, Vietnam
| | - Abdulgafoor M Bachani
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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