High Five Rural Seat Belt Program Demonstration and Evaluation

Elliott, Kim R; Chiles, Andrew; Tison, Julie; Solomon, Mark G. · 2026 · ROSA P / United States. Department of Transportation. National Highway Traffic Safety Administration

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Summary

This report evaluates the "High Five Rural Seat Belt Program," a traffic safety initiative originally developed by Iowa’s Governor’s Traffic Safety Bureau in 2014 to address stagnant unrestrained occupant fatalities and lower seat belt usage in rural counties. The program employs a systemic, data-driven approach centered on three core elements: enforcement, education, and engineering. A key structural component is the Rural Traffic Safety Advisory Board (RTSAB), which coordinates multi-jurisdictional efforts among state and local agencies. The National Highway Traffic Safety Administration (NHTSA) sponsored a demonstration of this program in Arkansas and Kentucky during 2022–2023 to assess its replicability and effectiveness. The demonstration involved a 12-month implementation period in five counties per state, supported by mini-grants of up to $10,000 per county and up to $50,000 for state police. Program activities included monthly multi-jurisdictional seat belt enforcement, publicity and outreach campaigns, and Road Safety Audits (RSAs) to identify low-cost engineering improvements. County Sheriff’s Offices conducted observational seat belt surveys to monitor usage rates. The evaluation methodology compared pre- and post-program seat belt usage data in participating counties against control locations to isolate the program's impact. Results indicated mixed outcomes regarding seat belt usage. Both states showed increases in belt use from pre- to post-program periods; however, causal attribution was limited. In Arkansas, the combined program data approached statistical significance (p<.07), but individual county increases were not greater than those observed in control counties. In Kentucky, statistically significant increases were measured in several counties, but these could not be clearly tied to the program due to similar improvements in control areas. Qualitative findings highlighted strengthened interagency relationships and successful coordination between state and local law enforcement. While RSAs were completed in all counties, no engineering fixes were implemented during the demonstration timeframe due to funding restrictions. The study concludes that while the High Five model effectively fosters collaboration and increases enforcement visibility, its direct impact on seat belt usage is difficult to isolate from broader trends. The program demonstrates potential for improving rural traffic safety through integrated enforcement, education, and engineering planning, particularly in building rapport between disparate agencies. The report provides specific steps for replication, noting that sustained engagement and multi-jurisdictional enforcement details correlate with greater improvements. Future adjustments may focus on extending implementation periods or securing funding for engineering solutions to enhance long-term safety outcomes.

Key finding

Statistically significant increases in seat belt use were observed in some Kentucky counties, but the overall program impact could not be clearly distinguished from trends in control locations or background changes.

Methodology

field_study

Provenance

The full processing record for this entry. Every stage of this paper's journey through the pipeline is logged — what ran, with which tool and model, how many attempts it took, and when it last completed. Discovered via bulk_ingest_rosap on 2026-05-23 (5 acquisition events logged).

StageOutcomeToolModelPromptAttemptsCompleted
discover success rosap 2 2026-05-23
archive success 1 2026-05-23
extract success cached 2 2026-06-10
clean success 1 2026-06-01
chunk success 1 2026-06-01
embed success 1 2026-06-02
enrich success 1 2026-05-23
promote success 1 2026-05-23
summarize success llm qwen3.6-27b-prismaquant summ-v5 3 2026-06-10
tag success vector_similarity 23 2026-06-11
verify success 2 2026-06-10

Summary generated by qwen3.6-27b-prismaquant on 2026-06-10; verification: verified.

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