Documenting the sustainability of a mature Click It or Ticket program: the North Carolina experience

North Carolina was the first United States jurisdiction to implement a statewide program (called Click It or Ticket) coupling concentrated enforcement with massive publicity to increase seat belt use. After a successful pilot program in three very different North Carolina communities, the statewide program was launched in October 1993, and has been most active and productive as well as imitated by many other states over the past decade. This paper explores the combination of ingredients that have been employed and sustained over that period of time. These include: (a) a basic coalition of critical public-private agencies (central to the planning, execution, and publicity of the many Click It or Ticket programs); (b) critical top-down commitments (starting with the governor); (c) pervasive and innovative media events/press releases/ PSAs/ web site information; (d) vigorous and well-publicized law enforcement; (e) feedback on results with solid, updated data; (f) related statewide and local programs/activities; and last but not least (g) continuous funding.     

Ninety five percent: an evaluation of law, policy, and programs to promote seat belt use in Washington state

Seat belt use in Washington state was 83% in 2001. In 2002, a series of law, policy, and program initiatives coalesced to produce a dramatic increase in seat belt use. Washington enacted a primary enforcement seat belt, the Chief of the Washington State Patrol made safety belt enforcement one of the core missions of that agency, and Washington participated in the national Memorial Day Click It or Ticket program during May 2002 and continued the program into 2003. Evaluation of these initiatives was accomplished through observation surveys of seat belt use, analysis of seat belt violation data, and analysis of data on traffic deaths of motor vehicle occupants. The major findings were that there was a two- to three-fold increase in enforcement of the seat belt law, belt use rates increased to 93% in 2002 and again to 95% in 2003, and motor-vehicle occupant fatalities decreased by 13%. IMPACT ON PRACTICE AND POLICY: The primary seat belt law and Click It or Ticket program activities were critical factors in increasing belt use in Washington state. Media and enforcement programs targeting seat belt use can be very effective in raising the belt use rate, but a long-term commitment to continuation of these program activities is essential. Other states implementing new primary seat belt laws should consider delivering a Click It or Ticket campaign prior to the effective date of the primary law and continuing these activities during subsequent months and years.     

A research agenda for increasing safety belt use in the United States

On November 13-14, 2003, a symposium on high-visibility safety belt use enforcement in Raleigh, NC: (a) celebrated the 10th anniversary of North Carolina's Click It or Ticket program; (b) documented current knowledge regarding safety belt use; (c) proposed strategies to increase use further; and (d) discussed research to support these strategies.     

A direct observation study of nighttime safety belt use in Indiana

INTRODUCTION: Nearly all direct observation studies of safety belt use are conducted exclusively during daylight hours. Recent work has suggested that safety belt use at night may differ from daytime belt use. METHODS: An observational study of nighttime safety belt use, utilizing specialized night vision equipment, was conducted in Indiana surrounding the Click It or Ticket 2006 safety belt mobilization activities. A pre- and a post-mobilization statewide direct observation survey was conducted at night coinciding with daytime safety belt use data collection conducted by the state of Indiana. Daytime and nighttime belt use rates were compared. RESULTS: The comparisons across the mobilization period revealed a significant increase during the day, but a significant decrease at night. Comparisons between daytime and nighttime belt use revealed no overall difference during the pre wave, but a significant difference during the post wave. Finally, many common daytime trends in belt use were also found at night, with the exception of the typical age and seating position effects. DISCUSSION: The mobilization activities had a positive effect on daytime belt use, but no effect on nighttime belt use, likely resulting in the differences between daytime and nighttime belt use observed during the post wave. IMPACT ON INDUSTRY: The findings of this study suggest that safety belt mobilizations implemented only during the day do not influence nighttime safety belt use. Changes to how these programs are implemented or additional programs specifically targeting belt use at night should be considered, along with continued monitoring of nighttime belt use.     

The effects of graduated driver licensing on hospitalization rates and charges for 16-and 17-year-olds in North Carolina

OBJECTIVE: To mitigate the high risk of motor vehicle crashes for young beginning drivers, over 40 states and the District of Columbia have implemented graduated driver licensing (GDL) systems that gradually and systematically ease teen drivers into higher risk driving conditions. Evaluations of GDL programs using motor vehicle crash data have demonstrated marked declines in crashes. The objective of this study is to examine the association between the implementation of the North Carolina GDL program and the rate of hospitalization, as well as hospital charges, for 16-and 17-year-old drivers. METHODS: Data were obtained from the North Carolina Hospital Discharge Database for the 26 months before and 46 months after the December 1, 1997, implementation of the GDL program. ARIMA interrupted time series analyses were used to model monthly hospitalization rates, controlling for the hospitalization rates of 25-to 54-year-old drivers. ARIMA analyses were also used to determine whether changes occurred in monthly total hospital charges. RESULTS: Among the 568 16-year-old hospitalized drivers, GDL was associated with a 36.5% decline in the hospitalization rate per population and a 31.2% decline in the total monthly driver hospitalization charges. Although a 12% reduction in the rate of hospitalizations was observed among the 615 17-year-old drivers, the analysis lacked sufficient power to be statistically reliable. No consistent change was observed in the 16-year-old driver total monthly hospital charges. CONCLUSIONS: The North Carolina GDL program was associated with a marked decline in the rate of hospitalizations and hospital charges for 16-year-old drivers. Following the implementation of GDL, over $650,000 in hospital charges have been averted each year for 16-year-old drivers. Analyses suggest these reductions were primarily the result of reduced exposure rather than an improvement in teen driving.     

Graduated driver licensing in the United States: evaluation results from the early programs

BACKGROUND: Seventeen states enacted graduated driver licensing (GDL) programs that were implemented from 1996 through 1999 and for which evaluations are of interest. METHODS: We received evaluation results reported for six states for which data were available. Summarizing results is difficult in other than the most global terms because of differences in pre-GDL programs, differences in GDL programs, and differences in evaluation methodology. RESULTS: All states identified some crash reduction among teen drivers following GDL implementation. This positive effect was observed across different geographic regions, and with different GDL programs. Simple counts are down-fewer teens are experiencing crashes and becoming injured. After calculating crash rates to adjust for changes over time in populations or licensed drivers, reductions generally were still found. Population-adjusted risks of injury/fatal crash involvement of 16-year-old drivers in Florida and Michigan were reduced by 11% and 24%, respectively. Population-adjusted risks of any crash involvement of 16-year-old drivers in Michigan and North Carolina were reduced by 25% and 27%, respectively. Reductions in night (restricted hours) crash risk were impressive in Florida, Michigan, and North Carolina. A comparison state design was only possible in the Florida evaluation, and results showed greater crash reductions under GDL. Change-point analyses of Michigan's crash data trends over time provided additional support of GDL's effectiveness in reducing crashes. DISCUSSION: Taken as a whole, and including the preliminary findings from California, Ohio, and Pennsylvania, these reports demonstrate the early effectiveness of GDL in reducing the crash risk of teen drivers. The impact of these studies and others to come will guide future research, practice, and policy.     

Evaluation of a high visibility enforcement project focused on passenger vehicles interacting with commercial vehicles

Introduction

In 2004, Washington State applied NHTSA's High Visibility Enforcement model used in the Click It or Ticket seat belt campaign in an attempt to reduce unsafe driving behaviors around commercial motor vehicles (CMVs). The program was called Ticketing Aggressive Cars and Trucks (TACT). This paper details the methods used to evaluate the program's effectiveness and the results of the evaluation.

Method

Four high-crash interstate highway corridors, each approximately 25 miles in length, were selected. Two of these corridors received TACT media messages and increased enforcement over an 18-month period while two comparison corridors did not receive any increased media or enforcement.

Results

A total of 4,737 contacts were made with drivers during the two enforcement waves, and 72% of these contacts led to a citation. Drivers at the intervention sites who said they saw or heard any of the TACT messages increased from 17.7% in the pre period to a high of 67.3% in the post periods. Drivers at the intervention sites also reported increased exposure to the core message of leaving more space when passing trucks (14% pre to 40% post period). The percentage of drivers who said they leave more room when passing trucks than when passing cars rose from 16% in the pre period to 24% in the post period at the intervention sites, while comparison sites showed no change. Over 150 hours of video recorded by law enforcement officers in unmarked vehicles were utilized to examine violation rates and severity of violations before and after the intervention campaigns. Statistical analyses showed that violation rates were reduced significantly at the intervention sites (between 23% and 46%), while remaining constant at the comparison sites. Analyses of the video data also showed that the seriousness of the residual violations at the intervention sites decreased.

Conclusions

Overall, the evaluation results provide a consistent picture of the effectiveness of the TACT pilot project. Success was demonstrated at every step - messages were received and understood, knowledge was changed in the intended direction, self reported driving behavior around large trucks improved, and observed driving behaviors confirmed the self reports.

Impact on Industry

After this initial success in Washington State, the TACT model will continue to be implemented and evaluated by FMCSA in an attempt to validate the program. Based on the results of this study and the consistent positive results found for other sTEP projects, it is likely that TACT will show continued success in a variety of settings and will help reduce the number and severity of crashes involving CMVs. Future research should attempt to use many of the methods described here to further validate the methods for not only evaluations of TACT programs, but also for any other highway safety programs that require measurements of the program's effectiveness.     

Tennessee's Novice Driver Safety Project: a program to increase parental involvement

Graduated licensing has been implemented in many U.S. states to reduce teenage driver crash involvement. The goal is to introduce teenagers gradually to driving before allowing full, unrestricted licensure. Tennessee, one of the states that introduced graduated licensing, implemented a program to influence both driving by teenagers during the learner stage and restrictions imposed by parents after licensure. In addition to a standard welcome letter, booklets and reminder cards were mailed to parents of teenagers who had just obtained their learner's permits. The booklets and cards were designed to assist parents in becoming more actively involved in their children's driving experiences. The effects of three different approaches (welcome letter only, letter plus booklet, and letter plus booklet plus reminder cards) on parental involvement, teenage crashes, and teenage citations were assessed based on telephone interviews with parents. Although the parents said the booklets and reminder cards were helpful and should continue to be sent to other parents, there were no discernible effects on teenage practice driving and reported parental involvement during the learner stage. Nor was there any measurable influence on restrictions imposed by parents after licensure. It is unknown whether the standard welcome letter affected parental involvement, but overall supervised driving exceeded the state requirements by a substantial margin.     

Post-license education for novice drivers: evaluation of a training programme implemented in Spain

INTRODUCTION: This study evaluated the implementation of a second phase training program for novice drivers in Spain, which puts the primary focus of the training on the higher hierarchical levels of driver behavior. METHOD: Two hundred and sixty-three participants took part throughout the study, which was implemented as an experimental design with the test and control groups assessed before and after the one day safety training. Measurement of the impact of the training program focused on the participants' self-evaluation and self-reporting of some driving behavior indicators related to accident risk. RESULTS: Data analysis showed a change in the expected direction in the scale related to the skills for careful driving, but not for the other four scales considered. A feedback survey about the training course offered some important input for evaluating the organization, contents, tuition, and results of the three parts of the training program (discussion group, on-road and track training) as reported by the participants in the test group. CONCLUSIONS AND SUGGESTIONS: The results of the experiment show that using a one day driver safety course, it is possible to change some of the drivers' evaluations connected to safe driving style into safe direction. The follow-up period was exceptionally long (9 months) and the design (randomly divided experimental and control groups with before and after measurements) was reliable. More effort should be devoted to improving the on-road part of the training, which was often perceived as a typical driving lesson rather than a feedback drive. IMPACT ON INDUSTRY: The findings suggest consideration of a mandatory 2nd phase driver training programme as a means to raise awareness of the full range of risks encountered by novice drivers, and as already introduced in 5 EU countries: Austria, Estonia, Finland, Luxembourg and Switzerland.     

Implementation of participatory organizational change in long term care to improve safety

Introduction: Long Term Care (LTC) facilities are fast-paced, demanding environments placing workers at significant risk for injuries. Health and safety interventions to address hazards in LTC are challenging to implement. The study assessed a participatory organizational change intervention implementation and impacts. Methods: This was a mixed methods implementation study with a concurrent control, conducted from 2017 to 2019 in four non-profit LTC facilities in Ontario, Canada. Study participants were managers and frontline staff. Intervention sites implemented a participatory organizational change program, control sites distributed one-page health and safety pamphlets. Program impact data were collected via Survey (self-efficacy, control over work, pain and general health) and observation (Quick Exposure Checklist). Interviews/focus groups were used to collect program implementation data. Results: Participants described program impacts (hazard controls through equipment purchase/modification, practice changes, and education/training) and positive changes in culture, communication and collaboration. There was a statistically significant difference in manager self-efficacy for musculoskeletal disorder (MSD) hazards between the control and intervention sites over time but no other statistical differences were found. Key program implementation challenges included LTC hazards, staff shortage/turnover, safety culture, staff time to participate, and communication. Facilitators included frontline staff involvement during implementation, management support, focusing on a single unit, training, and involving an external program facilitator. Conclusion: A participatory program can have positive impacts on identifying and reducing MSD hazards. Key to success is involving frontline staff in identifying hazards and creating solutions and management encouragement on a unit working together. High turnover rates, staffing shortages, and time constraints were barriers as they are for all organizational change efforts in LTC. The implementation findings are likely applicable in any jurisdiction. Practical Application: Implementing a participatory organizational change program to reduce MSD hazards is feasible in LTC and can improve communication and aid in identification and control of hazards.     

Encouraging compliance with graduated driver licensing restrictions

PROBLEM: Although graduated driver licensing (GDL) programs have reduced the high crash rates for 16-and 17-year-old drivers, research suggests that some teenagers fail to comply with restrictions on nighttime driving and carrying passengers. METHOD: A program to encourage compliance with GDL restrictions and seat belt requirements was implemented in Guilford County, North Carolina. The program combined increased enforcement with a multi-faceted publicity campaign drawing attention to the enforcement activity. A comparison community was studied to assess whether changes over time could be reasonably attributed to the program. RESULTS: Several measures indicate that greater enforcement did occur in the intervention community and that teenagers perceived the increase. However, self-reported data and direct observations of young drivers in the intervention and comparison communities showed the program resulted in only modest changes in compliance with GDL restrictions. DISCUSSION: The program put in place the mechanisms known to produce changes in driver behavior, but these may have been insufficient to alter the behavior of the minority of teenagers (and parents) who were not already complying with restrictions. However, the modest changes in young driver behavior plus the clear changes in both actual and perceived enforcement suggest that high visibility enforcement programs merit further use and evaluation in other communities, particularly those where compliance with GDL provisions is lower than in Guilford County.     

WalkSafe: a school-based pedestrian safety intervention program

OBJECTIVE: To evaluate the effectiveness of the WalkSafe program, an elementary school-based pedestrian safety program in a single high-risk district in Miami-Dade County. METHODS: Sixteen elementary schools were identified in a single high-risk district and enrolled in a one-year study. All schools implemented the WalkSafe program on the last week of January 2003. A pre, post, and three-month post testing of pedestrian safety knowledge was conducted. An observational component was also implemented at four schools that were randomly chosen. Engineering recommendations and law enforcement initiatives were also performed. RESULTS: A total of 6467 children from K-5th grade from 16 elementary schools participated in the program. Of these 5762 tests were collected over three different testing times. A significant difference (p-value < 0.001) was found between the pre and post testing conditions across all grade levels. There was no significant difference found between the post and three-month post testing conditions across all grade levels (p-value > 0.05). The observational data collected at four schools across the different testing times demonstrated a significant difference found between pre and post testing conditions for Group A (stop at the curb and look left, right, left) and also for Group B (midstreet crossing and darting out) (p-value < 0.05). There was no difference found between comparing the pre-test or post-test condition with the three-month post-test time. There were many environmental modifications that were recommended and actually performed. CONCLUSION: The WalkSafe program implemented in a single high-risk district was shown to improve the pedestrian safety knowledge of elementary school children. The observational data demonstrated improved crossing behaviors from pre-test to post-testing conditions. Future research will focus on sustaining the program in this district and expanding the program throughout our county.     

An evaluation of the implementation of ignition interlock in California

Problem: This study evaluates the degree to which courts have implemented California's ignition interlock program, and surveys judges and district/city attorneys to identify barriers to implementing a successful interlock program. Method: There are three parts to the evaluation. In the first, a sample of drivers arrested for driving on a driving under the influence (DUI)-suspended driver license was examined to calculate the rate at which courts order interlocks for DUI-suspended drivers, as required by California law. The second part of the study used Department of Motor Vehicle (DMV) records to count the statewide rate of court-ignition interlock device (IID) orders across time and jurisdictions. The final part surveyed judges, district/city attorneys, and offenders installing an interlock to obtain information about their use of interlock, barriers to implementing an interlock program, and the effectiveness of the devices in preventing drinking and driving. Results: It was found that conviction rates for driving while suspended are low; that judges order interlocks for only a fraction of the convicted driving-while-suspended (DWS) offenders who should receive such an order; and that the majority of offenders who are ordered by the court to install an ignition interlock in their vehicle do not do so. Impact on Industry: Any successful interlock program will need to find a way to balance the inability of many offenders to pay for the devices, with the need for the industry to remain economically viable.     

Connecticut statewide sTEP wave evaluation

INTRODUCTION: Selective Traffic Enforcement Programs (sTEPs) are a proven method to change motorists' behavior. Since 1997, the Connecticut DOT's Division of Highway Safety has organized a statewide seat belt enforcement program, with sTEP waves every three or four months. To date, 28 waves have been implemented. METHOD: Pre-wave and post-wave seat belt observation surveys are conducted by both state and municipal police across the state. Survey results, as well as a summary of all enforcement activity during the wave, are submitted for evaluation. RESULTS: Connecticut seat belt use has continued to rise from one wave to the next in a predictable "saw blade" pattern. CONCLUSIONS: The data clearly demonstrate that agencies that have participated in a greater number of waves have experienced the greatest increase in belt use. Belt use has not yet plateaued and additional sTEP enforcement seems indicated. However, evidence from other states suggests that a plateau may occur somewhere in the mid 80% range. IMPACT ON INDUSTRY: Should this occur, Connecticut will work toward strengthening the round the clock model, emphasizing the importance of aggressive primary enforcement.     

Implementing risk management to reduce injuries in the U.S. Fire Service

IntroductionRisk management, a proactive process to identify and mitigate potential injury risks and implement control strategies, was used to reduce the risk of occupational injury in a fire department. The objective of this research was to study the implementation of the risk management process for future replication. A second objective was to document changes in fire personnel's knowledge, attitudes, and behaviors related to the selected control strategies that were implemented as part of the risk management process.MethodA number of control strategies identified through the risk management process were implemented over a 2-year period beginning in January 2011. Approximately 450 fire personnel completed each of the three cross-sectional surveys that were administered throughout the implementation periods. Fire personnel were asked about their awareness, knowledge, and use of the control strategies.ResultsFire personnel were generally aware of the control strategies that were implemented. Visual reminders (e.g., signage) were noted as effective by fire personnel who noticed them. Barriers to use of specific control strategies such as new procedures on the fireground or new lifting equipment for patient transfer included lack of knowledge of the new protocols, lack of awareness/access to/availability of the new equipment, and limited training on its use. Implementation challenges were noted, which limited self-reported adherence to the control strategies.ConclusionsFire personnel generally recognized the potential for various control strategies to manage risk and improve their health and safety; however, implementation challenges limited the effectiveness of certain control strategies. The study findings support the importance of effective implementation to achieve the desired impacts of control strategies for improving health and safety.Practical applicationsEmployees must be aware of, have knowledge about, and receive training in safety and health interventions in order to adopt desired behaviors.     

安全生产规划体系框架探讨

阐述了建立安全生产规划体系的必要性,探讨了安全生产规划的定义、研究对象、目的和内容,指出安全生产规划是为使安全生产与经济社会协调发展而预先对未来一段时间内各项安全生产工作所做的时间和空间的合理安排,具有整体性、综合性、动态性、前瞻性、信息密集和政策性强等特征。同时设计了"四级、三层"的安全生产规划体系,即在行政层级上分为国家级、省级、市级和县级四个层级,在协调作用上分为宏观指导层、项目布局层和方案实施层三个层次。国家安全生产规划从宏观上对全国安全生产工作做出谋划与部署,省级安全生产规划要接受国家安全生产规划宏观指导性的引导和要求,并结合各地实际进行项目布局,同时借助专项规划分解内容,制定市、县级规划实施方案。     

Longer-term effects of Washington, DC, law on drivers' hand-held cell phone use

OBJECTIVES: To determine whether the substantial short-term declines in drivers' use of hand-held phones achieved in the District of Columbia (DC) were sustained 1 year after a ban. METHODS: Drivers' daytime hand-held cell phone use was observed in DC and nearby areas of Virginia and Maryland, states without bans. Observations were conducted several months before the ban, shortly after, and 1 year later. The number of vehicles observed in all three surveys combined was 51,945 in DC, 36,796 in Maryland, and 43,033 in Virginia. RESULTS: The rate of talking on hand-held phones declined significantly from 6.1 percent before the law to 3.5 percent shortly after; when measured 1 year later, use was 4.0 percent, still significantly lower than baseline. Based on increases in rates of talking on hand-held phones in Maryland and Virginia, longer-term phone use in DC was estimated to be 53 percent lower than would have been expected without the ban. Declines in DC were identified for drivers of vehicles registered in all three jurisdictions. CONCLUSIONS: In DC, there was an initial decline of about 50 percent in drivers talking on hand-held cell phones following a ban, and this decline was sustained about 1 year later. After a similar ban in New York, there was an initial decline in phone use comparable with the initial decline in DC, but the decline a year after the New York ban took full effect was only about 21 percent and not statistically significant. The potential difference in sustained effectiveness for the DC ban may reflect tougher enforcement in DC. Even if full compliance with hand-held phone bans can be achieved, the risks from drivers' use of hands-free phones will remain.     

Specific and long-term effects of Nova Scotia's graduated licensing program

A graduated licensing (GL) program was introduced in Nova Scotia, Canada, in October 1994. Previous research has shown that it reduced collisions in the short term. The present study examined the relative contribution of each stage of the program (i.e., learner and intermediate levels) and the program's impact after beginning drivers graduated to full licensure. The research focused on teenage beginning drivers (age 16-17), but the effects on older beginners also was examined. Per-driver crash rates of two groups of novices selected from driver records in Nova Scotia were compared. One group (pre-GL) received their learner's permits during the 2 years before the program was implemented, and the second group (GL) received their learner's permits during the 2 years after implementation. The findings clearly establish that most of the collision reduction in Nova Scotia's program occurred during the first year of the program, particularly during the first 6 months when the majority of novices were driving under supervision. The collision rate for 16 to 17-year-old GL novices was 50% lower than the rate for pre-GL novices during the 6 months after they received their learner's permits, and about 10% lower during their first 2 years of licensure when unsupervised driving from midnight to 5 A.M. was prohibited. Much of this improvement for 16 to 17-year-olds occurred during restricted night hours. Collision rates also were lower during nonrestricted hours in the initial 6 months of licensure. The 3-month "time discount" for driver education provided no safety benefit, and GL novices with driver education had collision rates that were not lower than pre-GL novices. There was no long-term effect found for the program after 16 to 17-year-olds graduated to full licensure. For older beginning drivers, crash rates during the first year after obtaining a learner's permit showed a 31% reduction. This effect diminished rapidly. There was only a 2% reduction during the first year of licensure, and crash rates increased during the following 2 years. Overall the data indicate substantial benefits of graduated licensing for 16 to 17-year-old beginners, but no benefits beyond the learner stage for older beginners.     

水电厂电力设备事故应急响应FPN-MC模型及效能分析

为更好地利用信息技术研究水电厂电力设备事故应急效能,提高应急救援效率和应急处置能力,综合考虑应急响应过程中各个环节时间的随机性与模糊性,运用模糊Petri网（FPN）和马尔科夫链（MC）理论,构建水电厂电力设备事故应急响应FPN-MC模型,求解模糊稳态概率值并分析系统效能指标。最后,以ZLB水电厂电力设备事故Ⅲ级应急响应作为实例,进一步剖析应急流程信息拥挤的瓶颈环节及事件应急处置的关键节点。结果表明:应急资源使用完毕、相关人员现场处置到位、确定完善的处置方案时的状态最为繁忙;利用资源实施救援、相关人员进行现场处置、完善处置方案等实施过程需要重点监督和管理。