Multicultural Communities Belt Use Toolkit

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SeatbeltsR4U Multicultural Pathways to Seat Belt
Excellence!
Developed by Meharry Medical College Nashville,
Tennessee, 2009 Funded by National Highway
Traffic Safety Administration
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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
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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

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Students at Glencliff HS, Nashville, TN
Mayor of Jackson, Mississippi
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Whats Different About This One?

• Compliments other toolkits
• Each of the 8 sections discussed from
  multicultural perspective
• gt 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

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Access SeatbeltsR4U in 3 Formats

• Hard copy
• Flash drive - Word document PowerPoint with
  links to internet
• Web site download and email to others

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Toolkit Organization

• 1. 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

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Three Approaches to each Section

• Text
• Visual material
• Links to the internet

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1. TOOLKIT PURPOSE
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• 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

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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 gt 50 countries

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"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
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Sticker from Japanese Auto Federation, rear
occupant buckled up. attached to rear
window Source FIA Foundation 2004
Taxi driver in Kigali Rwanda buckles up Source
World Health Organization
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2. COMMUNITY COALITIONS
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Whats 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

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Seat Belt Coalition Meeting, Mayors Office
Jackson MS
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Table 2.1 Community Agencies and Organizations 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
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Automotive Coalition for Traffic Safety, MS State
Senator and MS Highway Patrol Officer Join Hands
for Primary Legislation in MS
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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

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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.
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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

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3. Community Assessment
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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
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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.

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Identifying Multicultural Subpopulations

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

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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.

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Additional Resources
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.
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4. Cultural Competence
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General Multicultural Considerations

• 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?

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Cool Kids Buckle Up! So, you are invited to a
presentation by Metro Police May 13 at 822-852
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 una presentación de usar el cinturón de
seguridad el 13 de Mayo a las 822-852!!! El
CINTURÓN DE SEGURIDAD puede salvar una vida, la
tuya. Por eso siempre acuérdate de
usarlo. ?????? ???? ??????, your Advisory ??????
????? ??? ??? ??????? ???? ??????. ???? ????. ?
???? ??? ??? ??? ????? ????? ??????? ??!!! ????
?? ????? ????!   13 ???? ? ?? 822-852
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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
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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 ones 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.

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Source Indian Health Service Tribal Injury
Prevention Program
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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)
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5. Evidence-Based Interventions for Promoting
Seatbelt Use
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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

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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.
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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)

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Achieving a High Seat Belt Use Rate A Guide for
Selective Traffic Enforcement Programs
Minnesota state and local law enforcement
officers collaborate
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Mass Media Communications
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
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Law enforcement officers from every culture are
united in their support for Enforcement of seat
belt safety laws. Source NHTSA CIOT 2009
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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
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Key Resources
1. 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.
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6. Multicultural Adaptations of Evidence-Based
Interventions
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• Examples of community-based programs to promote
  seat belt safety among
• African Americans, Hispanics, and Native
  Americans
• Links to programs for
• teens
• rural motorists
• pickup truck drivers
• the elderly

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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

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

• 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
  Community
• Franklin 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

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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

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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
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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
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Music Video Resources

• Friend
• Seat Belt Education Video Split Second To Die

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7. Evaluating Interventions and Disseminating
Results
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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.
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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)

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Approach to Results Dissemination

• 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

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8. Program Funding Sustainability
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Who are the Potential Funders?

• Sources of potential funding include
• Government Agencies
• Federal
• State
• Local
• Private Sector
• Health care organizations
• Insurance providers
• Other local businesses
• Non-profit Organizations

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Getting More Belt Use for Your Buck

• 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

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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

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Additional Resources

• Catalog of Federal Assistance
• 2. Grants.gov
• GrantsNet
• Establishing a Nonprofit Organization
• 5. www.form1023help.com

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Appendix

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

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Next Steps

• Pilot test in 2 communities
• Cleveland, OH
• Denver, CO
• Evaluate
• Adapt
• Disseminate

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Thank You!