Evaluation of a participative education process for increasing tween restraint use in Virginia: The Make it Click initiative

- Make it Click is a school-based program promoting 8-12 year-old (tween) car safety.
- Multi-component program engaged tweens using principles of behavioral psychology.
- Evaluated in a pre-post control-group design in four public elementary schools.
- Intervention group tweens were 3 times more likely to wear belts at follow-up.
- Theory-driven participative education programs can improve tween safety practices.

IntroductionNearly half of 8-12 year-old tweens killed in car crashes every year in the US are completely unrestrained, and the majority sit in the front seat. The purpose of this study was to develop and evaluate a school-based program targeting increased safety restraint and back-seat use among tweens.Design and settingThe multi-component school-wide program was evaluated via a pre-post control-group design in four public elementary schools in an economically disadvantaged, multi-ethnic urban community in southeastern Virginia. Study schools had 1184 students enrolled in third through sixth grades.InterventionThe Make it Click Initiative was developed with input from student focus groups, surveys, and school personnel. Grounded in social cognitive theory and principles of behavioral psychology, the participative education program included: (a) competition to achieve a high rate of students buckled in the back; (b) a creativity contest with entries illustrating a car safety theme; (c) a series of parent education flyers; (d) car safety assignments that support state learning objectives; (e) a safety-themed play; (f) teacher newsletters; and (g) educational presentations.Main outcome measuresBehavioral observations (N = 762) of children's restraint and back seat use.ResultsMake it Click intervention schools' observed safety belt use increased from 31.9% to 67.9%, and students in intervention schools were 3.3 times more likely to wear their belts at follow-up than students in control schools, X2(1) = 19.72, p < 0.001. Further, increases in belt use were maintained in study observations longer than those resulting from the highly publicized national Click it or Ticket enforcement program. Significant differences were not observed in back seat use.ConclusionsThe program resulted in significant improvements in observed safety belt use that outlasted results observed locally from the national high visibility enforcement program alone. Theory-driven participative education programs can improve the safety practices of school-age children.