Background MVCs are the leading cause of death among adolescents. Seat belts have been shown to decrease MVC-related death. The purpose of this retrospective cohort study was to evaluate the effectiveness of a community-supported, student-run campaign to increase safety belt use among adolescents in Southwest Florida.

Methods We reviewed results of campaigns at 14 high schools from 2012 to 2018. The primary outcome was change in rates of student-driver seat belt use over the course of each campaign. Secondary outcomes included trends in seat belt use and MVC-related fatalities over the study period. Wilcoxon signed-rank test was used to compare rates of seat belt use before and after each intervention and over the course of the study period. Multivariate logistic regression was used to estimate the independent effects of demographic covariates on outcomes.

Results Altogether, 85 campaigns were reviewed. A total of 8500 preintervention and 8500 postintervention observations of student seat belt use were assessed. The median rate of seat belt use increased from 82% prior to the intervention to 87% following the intervention (p<0.001). We did not detect a sustained trend in seat belt use or MVC-related fatalities over the study period. On multivariate analysis, schools with a higher proportion of minority students were less likely to experience a substantial increase in seat belt use following the intervention (OR=0.17, 95% CI 0.03 to 0.84, p=0.030).

Conclusion This collaborative campaign resulted in a modest, short-term increase in seat belt use among high school students. Future studies should evaluate which interventions are most effective and how short-term increases in seat belt use can be sustained.