OMB # 2127-0646
Expiration Date: June 30, 2008
VIRGINIA SEAT BELT SURVEY
State: ____________ County: _____________________ Metro Status: _____
Date: ________________ CATI ID: ____________________
Interviewer:_________________________________________
Telephone Number: __________________________________________________________
Time Start: _____________ Time End: _____________ TOTAL TIME: ___________
INTRODUCTION
Hello, I'm __________________ calling for the U.S. Department of Transportation. We are conducting a national study of Americans' driving habits and attitudes. The interview is voluntary and the information you provide us will be used for statistical purposes only. We will not collect any personal information that would allow anyone to identify you. The interview takes about 10 minutes to complete.. [Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 2127-0646] Could we begin now?
DUMMY QUESTION FOR BIRTHDAY QUESTIONS
Has had the most recent.......1
Will have the next................2
In order to select just one person to interview, could I speak to the licensed driver in your household, 18 or older, who (has had the most recent/will have the next) birthday?
Respondent is the person.................1 SKIP TO Q1
Other respondent comes to phone..............2
Respondent is not available..............3 ARRANGE CALLBACK
Refused...................................…………....4
B. Hello, I'm ______________ calling for the U.S. Department of Transportation. We are conducting a study of Americans' driving habits and attitudes. The interview is voluntary and completely confidential. It only takes about10 minutes to complete. [Please note that an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 2127-0646]. Could we begin now?
CONTINUE INTERVIEW............1
Arrange Callback………….....................2
Refused.....................………………3
Q.1 How often do you drive a motor vehicle? Almost every day, a few days
a week, a few days a month, a few days a year, or do you never drive?
Almost every day.................1
Few days a week................….......2
Few days a month................3
Few days a year...…….................4
Never.........................……..5 SKIP TO Q9
Other (SPECIFY) ........................6
(VOL) Don't know...........7
(VOL) Refused.....................….8
NHTSA1010
Q.2 Is the vehicle you drive most often a car, van, motorcycle, sport utility vehicle, pickup truck, or other type of truck? (NOTE: IF RESPONDENT DRIVES MORE THAN ONE VEHICLE OFTEN, ASK:) "What kind of vehicle did you LAST drive?"
Car............................…….1
Van or minivan.........................2
Motorcycle........................3 SKIP TO Q9
Pickup truck...................….….4
Sport Utility Vehicle.........5
Other.............................……...10
Other truck (SPECIFY)....11
(VOL) Don't know......…........12
(VOL) Refused...............13
Q.3 For the next series of questions, please answer only for the
(car/truck/van) you said you usually drive. Do the seat belts in the
front seat of the (car/truck/van) go across your shoulder only, across
your lap only, or across both your shoulder and lap?
INTERVIEWER INSTRUCTION: SEATBELT QUESTIONS REFER TO DRIVER SIDE BELTS.
Across shoulder......................1
Across lap...................….............2 SKIP TO Q5
Across both....................…....3
Vehicle has no belts.....................4 SKIP TO Q9
(VOL) Don't know...............5 SKIP TO Q6
(VOL) Refused...........................6 SKIP TO Q6
Q.4 When driving this (car/truck/van), how often do you wear your shoulder belt... (READ LIST)
ALL OF THE TIME..................1
MOST OF THE TIME......................2
SOME OF THE TIME..............3
RARELY OR................……............4
NEVER..........................………5
(VOL) Don't know................…......6
(VOL) Refused......................…………7
IF Q3=1 SKIP TO Q6
Q.5 When driving this (car/truck/van), how often do you wear your lap belt...(READ LIST)
ALL OF THE TIME..................1
MOST OF THE TIME.....................2
SOME OF THE TIME..............3
RARELY OR.................……..........4
NEVER..........................………5
(VOL) Don't know................…….6
(VOL) Refused......................…………7
Q.6 When was the last time you did NOT wear your seat belt when driving?
Within the past day..........………...........1
Within the past week....................………….2
Within the past month.............…………3
Within the past year.....................…………..4
A year or more ago/I always wear it..….5
(VOL) Don't know.......................…………6
(VOL) Refused......................…………7
Q.7 In the past 30 days, has your use of seat belts when driving (vehicle driven most often) increased, decreased, or stayed the same?
Increased........................1
Decreased..............................2 SKIP TO Q9
Stayed the same.............3 SKIP TO Q9
New driver............................4 SKIP TO Q9
(VOL) Don't know......5 SKIP TO Q9
(VOL) Refused...................6 SKIP TO Q9
Q.8 What caused your use of seat belts to increase?
(DO NOT READ LIST ‑ MULTIPLE RECORD)
Increased awareness of safety....….1
Seat belt law.......................……………...2
Don't want to get a ticket.......…….3
Was in a crash.......................……………4
New car with automatic belt......….5
Influence/pressure from others....……......6
More long distance driving.......…………...7
Remember more/more in the habit……..8
The weather……………………..9
The holidays……………….……..10
Driving faster…………………..11
Other (SPECIFY____)...…………..27
(VOL) Don't know..............………….....28
(VOL) Refused..................……...29
Q.9 Does Virginia have a law requiring seat belt use by adults?
Yes.......................………….1
No..............................………….2 SKIP TO Q12
(VOL) Don't know........….3 SKIP TO Q12
(VOL) Refused.................……4 SKIP TO Q12
IF Q1=5 AND Q9=1, SKIP TO Q11
If Q2 = 3 AND Q9 = 1, SKIP TO Q11
Q.10 Assume that you do not use your seat belt AT ALL while driving over the next six months. How likely do you think you will be to receive a ticket for not wearing a seat belt? READ
Very likely........................1
Somewhat likely...........................2
Somewhat unlikely...........3
Very unlikely..................…..........4
(VOL) Don't know.........5
(VOL) Refused...........................6
Q.11 According to your state law, can police stop a vehicle if they observe a seat belt violation or do they have to observe some other offense first in order to stop the vehicle?
Can stop just for seat belt violation..........1
Must observe another offense first……….......2
(VOL) Don't know..................………...3
(VOL) Refused..................………………….4
Q.12 In your opinion, SHOULD police be allowed to stop a vehicle if they observe a seat belt violation when no other traffic laws are being broken?
Should be allowed to stop…...1
Should not...……………………...2
(VOL) Don't know………....3
(VOL) Refused......……………..4
Q.13 Please tell me whether you strongly agree, somewhat agree, somewhat disagree or strongly disagree with the following statements?
ROTATE
a) Seat belts are just as likely to harm you as help you.
b) If I was in an accident, I would want to have my seat belt on.
c) Police in my community generally will not bother to write tickets for seat belt violations.
d) It is important for police to enforce the seat belt laws.
e) Putting on a seat belt makes me worry more about being in an accident.
Police in my community are writing more seat belt tickets now than they were a few months ago.
Q.14 Yes or No--in the past 30 days, have you seen or heard of any special effort by police to ticket drivers in your community for seat belt violations?
Yes...............……...1
No....................……….2 SKIP TO Q24
(Vol) Don’t know...3 SKIP TO Q24
(Vol) Refused.........…..4 SKIP TO Q24
Q.15 Where did you see or hear about that special effort?
[DO NOT READ--MULTIPLE RESPONSE]
TV.............................……1
Radio.............................……2
Friend/Relative..................3 SKIP TO Q24
Newspaper…………….4 SKIP TO Q24
Personal observation/on the road….5 SKIP TO Q24
Billboard/signs……………..7 SKIP TO Q24
Educational Program…….……..8 SKIP TO Q24
I’m a police officer/judge……..9 SKIP TO Q24
Direct contact by police officer…10 SKIP TO Q24
Other (specify_____)……… 17 SKIP TO Q24
Don’t know.......................18 SKIP TO Q24
Refused.............................…….19 SKIP TO Q24
Q.16 Was the (TV/radio) message a commercial (or advertisement), was it part of a news program, or was it something else? MULTIPLE RECORD
Commercial/Advertisement/
Public Service Announcement....………....1
News story/news program.....................………….2
Something else (specify): _________..……..3
Don’t know..................................………………..4
Refused...............................…………………5
Q17 Yes or No – in the past 30 days, have you seen or heard of anything about the police setting up seat belt checkpoints where they will stop motor vehicles to check whether drivers and passengers are wearing seat belts?
Yes.........................1
No...............……………..2
Don’t know............3
Refused..........…………...4
By checkpoint, we mean a systematic effort by police to stop vehicles for the purpose of checking for compliance with existing seat belt laws.
Q18 Let me just confirm, is this the type of checkpoint that you have seen or heard about in the past 30 days?
Yes.........................1
No...............……………..2
Don’t know............3
Refused..........…………...4
Q19 Where did you see or hear about the police checkpoints for seat belts?
[DO NOT READ--MULTIPLE RESPONSE]
TV.............................……1
Radio.............................…2
Friend/Relative..................3 SKIP to Q21 Newspaper………………4 SKIP to Q21
Other…………………….5 SKIP to Q21
Don’t know……………...6 SKIP to Q21
Refused…………………..7 SKIP to Q21
Q20 Was the (tv/radio) message a commercial (or advertisement), was it part of a news program, or was it something else?
MULTIPLE RECORD
Commercial / Advertisement/ Public
Service Announcement……………….1
News story / news program…………………...2
Something else (specify)……………………...3
Don’t Know…………………………………..4
Refused………………………………………..5
Q21 In the past 30 days, did you personally see any checkpoints where police were stopping motor vehicles to see if drivers and passengers were wearing seat belts?
Yes.........................1
No...............……………..2
Don’t know............3
Refused..........…………...4
Again, by checkpoint we mean a systematic effort by police to stop vehicles for the purpose of checking for compliance with existing seat belt laws.
Q.22. Let me just confirm, is this the type of checkpoint that you personally saw in the past 30 days?
Yes.........................1
No...............………2 SKIP to Q24
Don’t know............3 SKIP to Q24
Refused..........…….4 SKIP to Q24
Q.23. Were you personally stopped by police at a seat belt checkpoint in the past 30 days?
Yes.........................1
No...............……………..2
Don’t know............3
Refused..........…………...4
Q24 In the past 30 days, have you seen or heard of any special effort by police to ticket drivers in your community if children in their vehicles are not wearing seat belts or are not in car seats or booster seats?
Yes.........................1
No...............……………..2
Don’t know............3
Refused..........…………...4
Q25 Now, I would like to ask you a few questions about educational or other types of activities?
In the past 30 days, have you seen or heard any messages that encourage people to wear their seat belts. This could be public service announcements on TV, messages on the radio, signs on the road, news stories, or something else.
Yes.........................1
No...............………….2 SKIP TO NQ28B
Don’t know............3 SKIP TO NQ28B
Refused..........……….4 SKIP TO NQ28B
Q.26 Where did you see or hear these messages?
[DO NOT READ--MULTIPLE RESPONSE]
TV…………………..1
Radio…………………2
Friend/Relative……….3 SKIP TO Q28
Newspaper…………….4 SKIP TO Q28
Personal observation/on the road….5 SKIP TO Q28
Billboard/signs……………..7 SKIP TO Q28
Educational Program…….……..8 SKIP TO Q28
I’m a police officer/judge……..9 SKIP TO Q28
Direct contact by police officer…10 SKIP TO Q28
Other (specify_____)……… 17 SKIP TO Q28
Don’t know.......................18 SKIP TO Q28
Refused.............................…….19 SKIP TO Q28
Q 27 Was the (TV/radio) message a commercial (or advertisement), was it part of a news program, or was it something else? MULTIPLE RECORD
Commercial/Advertisement/
Public Service Announcement.…........1
News story/news program...............……….......2
Something else (specify): _________.....3
Don’t know...................................…………….4
Refused...............................…………….5
Q.28 Would you say that the number of these messages you have seen or heard in the past 30 days is more than usual, fewer than usual, or about the same as usual?
More than usual......................1
Fewer than usual..........…………..2
About the same.......................3
Don’t know.................…………...4
Refused...........................…....5
Q.29 Are there any advertisements or activities that you have seen or heard in the past 30 days that encouraged adults to make sure that children use car seats or seat belts?
Yes.........................1
No..........…………….....2 SKIP TO Q31
Don’t know............3 SKIP TO Q31
Refused.........…………..4 SKIP TO Q31
Q30 What did you see or hear?
-----------------------------
______________________________________________________
Q31 Thinking about everything you have heard, how important do you think it is for Virginia to enforce seat belt laws for ADULTS more strictly . . . . very important, fairly important, just somewhat important, or not that important?
Very important..................……..1
Fairly important..........………………2
Just somewhat important............3
Not that important.........…………….4
Don’t know.......................……..5
Refused...............…………………....6
Q32 Do you recall hearing or seeing the following slogans in the past 30 days? READ LIST AND MULTIPLE RECORD YESES
ROTATE PUNCHES 1-70
1. Friends don't let friends drive drunk (PUNCH "1") (All)
2. Click it or ticket (PUNCH "2") (All)
3. Buckle Up America (PUNCH "3") (All)
4. Children In Back (PUNCH "4") (All)
5. You Drink and Drive. You Lose. (PUNCH "5") (All)
6. Didn't see it coming? No one ever does (PUNCH "6") (All)
7. Get the keys (PUNCH "7") (All)
13. Click it or ticket [+stlst+] (PUNCH "13") (All)
14. Buckle Up [+stlst+] (PUNCH "14") (All)
36. Four Steps for Kids (PUNCH “36”) (All)
37. BUCKLE UP IN YOUR TRUCK (NM/LA)
41. You wouldn't treat a crash test dummy like a child (National only)
42. If they're under FOUR FEET, NINE INCHES, they need a booster seat (National only)
71. (VOL) None of these
72. (VOL) Don't know
73. (VOL) Refused
ASK ALL
Now, I need to ask you some basic information about you and your household.
Q.33 What is your age?
__________ AGE REFUSED=99
Q.34 Including yourself, how many persons, age 16 or older, are living in your household at least half of the time or consider it their primary residence?
____________ REFUSED=99
Q35 How many children age 15 or younger are living in your household
at least half of the time or consider it their primary residence?
____________ NONE=0 REFUSED=99
Q.36 Do you consider yourself to be Hispanic or Latino?
Yes....................……....1
No..........................………2
(VOL) Not sure..........3
(VOL) Refused................4
Q.37 Which of the following racial categories describes you? You may select more than one. [READ LIST--MULTIPLE RECORD]
American Indian or Alaskan Native............1
Asian...................…………………..........................2
Black or African American.............…….....3
Native Hawaiian or other Pacific Islander……........4
White.....................................……………..5
Other(VOL)..................................……………6
___________________________________________
(VOL) Refused.................................…….9
Q.38 What is the highest grade or year of school you completed?
8th grade or less....……….....9
9th grade.....................………..…..10
10th grade.............……….....11
11th grade....................………..….12
12th grade/GED...........……..13
Some college..................………....14
College graduate or higher….15
(VOL) Refused...………..............16
Q.39 Do you have more than one telephone number in your household?
Yes............………….1
No..........……………2 SKIP TO Q41
Don’t know....……...3 SKIP TO Q41
(VOL) Refused....…..4 SKIP TO Q41
Q.40 Not including cells phones, and phones used primarily for fax or computer lines,
how many different telephone numbers do you have in your household?
___________ 10 OR MORE=10 DON'T KNOW=11 REFUSED=12
Q.41 FROM OBSERVATION, ENTER SEX OF RESPONDENT
Male..............1
Female..................2
That completes the survey.
Thank you very much for your time and cooperation.
| File Type | application/msword |
| Author | Kevin B. Sharp |
| Last Modified By | john.siegler |
| File Modified | 2007-03-05 |
| File Created | 2007-02-22 |