Objective: To increase teen seat belt use among drivers at a rural high school by implementing the Drive Alive Pilot Program (DAPP), a theory-driven intervention built on highway safety best practices.

Methods: The first component of the program was 20 observational teen seat belt surveys conducted by volunteer students in a high school parking lot over a 38-month period before and after the month-long intervention. The survey results were published in the newspaper. The second component was the use of incentives, such as gift cards, to promote teen seat belt use. The third component involved disincentives, such as increased police patrol and school policies. The fourth component was a programmatic intervention that focused on education and media coverage of the DAPP program.

Results: Eleven pre-intervention surveys and nine post-intervention surveys were conducted before and after the intervention. The pre- and post-intervention seat belt usage showed significant differences (p<0.0001). The average pre-intervention seat belt usage rate was 51.2%, while the average post-intervention rate was 74.5%. This represents a percentage point increase of 23.3 in seat belt use after the DAPP intervention.

Conclusion: Based on seat belt observational surveys, the DAPP was effective in increasing seat belt use among rural high school teenagers. Utilizing a theory-based program that builds on existing best practices can increase the observed seat belt usage among rural high school students. [West J Emerg Med. 2010; 11(3): 280-283.]