Form 1325 Seat Belt Survey

OMB Control No. 2127-XXXX

Expiration Date XX/XX/XXXX

Appendix C

Seat Belt Survey

Form 1325

Community Survey on Driving Safety and Law Enforcement

We would like to know your opinions and experiences about driving safety and law enforcement in Norman, Oklahoma. Your participation will help improve services and safety in our community. Participation is voluntary and you can skip any question you like, but we encourage you to answer as many questions as possible.

1. Do you feel that law enforcement in Norman are spending too much time, too little time, or about the right amount of time on traffic enforcement?

 Too much time  Too little time  About the right amount of time

2. In your opinion, is low seat belt use a problem in Norman?

 Yes If yes, how big a problem?  A big problem  A moderate problem  A small problem

 No

3. In Norman, how likely is it that drivers who DON’T wear seat belts will receive a ticket?

 Very likely  Somewhat likely  Not very likely  Don’t know

4. How much do you agree with the following statement: Police in Norman are writing more seat belt tickets than they were a few months ago?

 Strongly Agree  Somewhat Agree  Somewhat Disagree  Strongly Disagree  Don’t know

5. In the past 30 days, have you seen or heard of any special efforts by police in Norman to issue tickets to drivers who are not wearing seat belts?

If yes, where did you see or hear about it? (Check all that apply)

 Newspaper  Radio  TV  Billboards  Brochure  Social media

 Community Meeting  Family/friend  Other (please list): ______________

 Yes

 No

6. How often do you think police should ticket for seat belt violations? On a scale of 1 to 5, where 1 means police should hardly ever give tickets and 5 means police should give tickets at every opportunity when it comes to enforcing seat belt laws.

 1 (Police should hardly ever give tickets)

 2

 3

 4

 5 (Police should give tickets at every opportunity)

7. How much do you agree or disagree with the statement “Police in Norman should do more to encourage seat belt use”?

 Agree strongly Agree  Neither agree not disagree  Disagree  Disagree strongly

8. How often do you wear a seat belt?

 All of the time  Most of the time  Some of the time  Rarely  Never

9. When was the last time you did NOT wear a seat belt? (Check only one)

 Within the past day

 Within the past week

 Within the past month

 Within the past year

 I always wear a seat belt

If yes, what kinds of contacts have you had with the police? (Check all that apply)

 Reported a crime

 Stopped for a traffic violation

 Car crash

 Casual conversation with a police officer

 Asked an officer for information or advice

 Working with police to solve specific problems

 Was involved in a community activity/meeting/event that involved the police

 Other (please list): _______________________________________

10. In the past 6 months, have you been in contact with the local police in Norman for any reason?

 Yes

 No

11. In the past 6 months, has police officer presence in Norman:

 Increased  Decreased  Stayed the same  I never see police in my community

12. In the past 6 months, what activities have you seen police conducting in Norman?

(Check all that apply)

 Talking with residents in the community

 Talking with business owners in the community

 Attending community meetings

 Enforcing traffic laws

 Getting involved with kids through recreational or school activities

 Other (please list): ____________________________________________

 I have not seen any police activities in my community

Have you attended any of these meetings?

 Yes  No

13. In the past 6 months, have you heard about any meetings in Norman to talk about seat belts?

 Yes

 No

14. How much work are police doing with the residents of Norman to increase seat belt use?

 A lot  Some  Very Little  Nothing at all  Don’t know

15. Your sex:  Male  Female

16. Your age:  Under 18  18-20  21-34  35-49  50-64  65 or older

17. What is your home zip code? ______________

18. Do you consider yourself Hispanic or Latino?  Yes  No

19. Your race: (Check all that apply)

 White  Black or African American  American Indian or Alaska Native

 Asian  Native Hawaiian or other Pacific Islander  Other

20. What level of school have you completed?

 Less than high school  High school graduate  Some college  College graduate

21. What type of vehicle do you usually drive?

 Car  Pickup truck  SUV  Van/Minivan  Motorcycle  Other  I rarely or never drive

22. If you have any other thoughts about police enforcement of seat belt use in Norman, please provide them below:

Thank you for completing this survey! Please drop it in the box before you leave.

Note: This collection of information is voluntary and will be used for statistical purposes only so that we may develop and evaluate programs designed to reduce the number of traffic-related injuries and deaths. The public reporting burden is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Your participation is anonymous, and we will not collect any personal information that would allow anyone to identify you. Please note that a federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB control number. The OMB control number for this collection is # XXXX-XXXX.

NHTSA Form #1325