Determinants of seat belt use among drivers: a BRFSS study from a middle-income country (Vojvodina, Serbia).

Rajčević, S; Radić, I; Tomašević, T; Čanković, S; Harhaji, S; Ukropina, S; Mašić, K; Kukić, D; Štrbac, M; Petrović, R; Pustahija, T; Petrović, V · 2026 · PubMed Central

DOI: 10.3389/fpubh.2026.1834226

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Summary

This study investigates the prevalence of seat belt use and its sociodemographic determinants among drivers in the Autonomous Province of Vojvodina, Serbia, a middle-income region in Central and Southeast Europe. The research addresses a gap in local data regarding driver behavior, motivated by the global burden of road traffic injuries and the need for targeted public health interventions to improve compliance with safety regulations. While seat belt use is legally mandated in Serbia, adherence varies significantly across demographics and regions, necessitating evidence-based strategies to reduce preventable injuries. The researchers conducted a cross-sectional survey between 2023 and 2024, utilizing the Surveillance of Behavioral Risk Factors for Non-Communicable Diseases system. Data were collected via Computer-Assisted Personal Interviews (CAPI) from 6,726 adult drivers recruited from 44 primary healthcare centers across 45 municipalities. Participants were selected using stratified sampling based on age, sex, and settlement type to ensure representativeness. The questionnaire, adapted from the CDC’s Behavioral Risk Factor Surveillance System, assessed self-reported seat belt use (consistent vs. inconsistent) alongside sociodemographic variables, including education, employment, and body mass index. Binary logistic regression was employed to identify independent predictors of inconsistent seat belt use, controlling for potential confounders. The results indicate that 83.1% of drivers reported always wearing a seat belt, while 16.9% exhibited inconsistent use. Multivariable analysis revealed that inconsistent use was significantly associated with male gender (Adjusted Odds Ratio [AOR] 0.54 for females), urban residence (AOR 1.34), and specific districts, particularly Srem (AOR 1.94). Lower educational attainment was a strong predictor of non-compliance, with university graduates showing significantly lower odds of inconsistent use (AOR 0.27) compared to those with incomplete primary education. Employment status also played a critical role; self-employed individuals (AOR 1.69) and those unemployed for more than a year (AOR 1.54) had higher odds of inconsistent use, whereas retirees were more compliant (AOR 0.68). Age, marital status, BMI, and self-assessed financial status were not significant predictors in the final model. The study concludes that while seat belt use in Vojvodina is relatively high, significant disparities exist based on gender, location, education, and employment. These findings highlight the need for targeted public health measures and enforcement strategies, particularly for men, younger drivers, and high-risk occupational groups such as the self-employed. The research underscores the utility of standardized surveillance systems in identifying at-risk populations and informs policy efforts aimed at achieving the United Nations’ road safety targets by addressing specific sociodemographic barriers to compliance.

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Summary generated by qwen3.6-27b-prismaquant on 2026-06-26; verification: verified.

Topics

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• seat belt use
• demographic disparities

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• Empirical Findings: observational prevalence