Form 1601 Experiment Form

OMB Control No. 2127-NEW

Expiration Date: XX/XX/XX

Under the Paperwork Reduction Act, a Federal agency may not conduct or sponsor, and a person is not required to respond to a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a current valid OMB Control number. The OMB Control Number for this information collection is 2127-XXXX (expiration date: XX/XX/XXXX). The average amount of time to complete the study is 20 minutes. All responses to this collection of information are voluntary. The purpose of this research study is to examine public attitudes toward motor vehicle safety and relationships between attitudes, behaviors, and demographics. The information collected will be summarized in a report to support future countermeasure development. If you have comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden send them to Information Collection Clearance Officer, National Highway Traffic Safety Administration, 1200 New Jersey Ave, S.E., Washington, DC, 20590.

Instructions:

Thank you for participating in this study. You will first read a newspaper article that describes a recent motor vehicle crash. Then, you will answer some questions about what you read, your attitudes about motor vehicle safety, and provide some demographic information (e.g., age, race/ethnicity, education, etc.).

Please read the crash report thoroughly, taking as much time as you need to understand its contents. Once you read the crash report and click “Begin” to start the study, you will not be able to go back and read the crash report again. However, you will be able to return to previously answered questions if the need arises.

It is also important that you know:

• Your responses will remain anonymous. No one besides the researcher will see your answers and your responses will never be associated with your name.

• Study reports will present all findings as a whole, so individual responses cannot be identified.

• You might be uncomfortable answering some of these questions.

• Your participation in this study is voluntary. You may skip any questions that you do not want to answer or stop answering at any point.

• This study has been reviewed by an institutional review board, which is a committee that has reviewed this research study to help ensure that your rights and welfare as a research participant are protected and that the research study is carried out in an ethical manner.

Scenario 1

Car with Trouble Stopping at Intersection Leads to Crash with Pick-Up Truck

A two-vehicle crash that occurred at West 12^th Street and Woodlawn Avenue literally turned one driver’s world upside down.

According to local police, the crash involved a car driven by Mary Smith, age 27, of the 1800 block of West 9^th Street, and a pick-up truck, owned and operated by Larry Jones, age 45, of the 800 block of Harrison Avenue. Officer Johnson reported that the car was traveling southbound on Woodlawn Avenue and ran the stop sign at the two-way stop at West 12^th Street. Smith told the officer that her brakes appeared to fail and she could not stop her car.

Jones’ pick-up truck was traveling east on West 12^th and, as it passed through the intersection, Smith’s car slammed into the driver’s side. The pick-up truck then hit the curb, causing it to flip over and roll several times, eventually landing on its roof.

Police reported that both drivers were wearing their seat belts and neither driver was injured.

Scenario 2

Car with Trouble Stopping at Intersection Claims Life of Local Resident

A two-vehicle crash that occurred at West 12^th Street and Woodlawn Avenue claimed the life of a local resident after the pick-up truck he was driving flipped and rolled several times.

According to local police, the crash involved a car driven by Mary Smith, age 27, of the 1800 block of West 9^th Street, and a pick-up truck, owned and operated by Larry Jones, age 45, of the 800 block of Harrison Avenue. Officer Johnson reported that the car was traveling southbound on Woodlawn Avenue and ran the stop sign at the two-way stop at West 12^th Street. Smith told the officer that her brakes appeared to fail and she could not stop her car.

Jones’ pick-up truck was traveling east on West 12^th and, as it passed through the intersection, Smith’s car slammed into the driver’s side. The pick-up truck then hit the curb, causing it to flip over and roll several times, eventually landing on its roof.

The driver of the pick-up truck, who was not wearing a seat belt, was pronounced dead at the scene. The driver of the car was wearing a seat belt and was treated by emergency responders and released.

Scenario 3

Car with Trouble Stopping at Intersection Claims Life of Local Resident

A two-vehicle crash that occurred at West 12^th Street and Woodlawn Avenue claimed the life of a local resident after the pick-up truck he was driving flipped and rolled several times.

According to local police, the crash involved a car driven by Mary Smith, age 27, of the 1800 block of West 9^th Street, and a pick-up truck, owned and operated by Larry Jones, age 45, of the 800 block of Harrison Avenue. Officer Johnson reported that the car was traveling southbound on Woodlawn Avenue and ran the stop sign at the two-way stop at West 12^th Street. Smith told the officer that her brakes appeared to fail and she could not stop her car.

Jones’ pick-up truck was traveling east on West 12^th and, as it passed through the intersection, Smith’s car slammed into the driver’s side. The pick-up truck then hit the curb, causing it to flip over and roll several times, eventually landing on its roof.

The driver of the pick-up truck was pronounced dead at the scene. The driver of the car was treated by emergency responders and released.

Begin

1. The crash could have been avoided if… (Check one.)

 The car driver could have stopped at the Stop sign.

 The truck driver had not been texting.

 The road had been dry.

 Other: ________________________________________

2. Did the crash report mention whether the drivers were wearing their seat belts? (Check one.)

 Yes

 No

 I am not sure

3. Was the driver of the car wearing a seat belt? (Check one.)

 Yes

 No

 I am not sure

 Not applicable: The crash report did not mention seat belt use

4. Was the driver of the pick-up truck wearing a seat belt? (Check one.)

 Yes

 No

 I am not sure

 Not applicable: The crash report did not mention seat belt use

5. Did the crash result in one or more deaths? (Check one.)

 Yes

 No

 I am not sure

6. If someone died in the crash, who was it? (Check one.)

 The driver of the car

 The driver of the pick-up truck

 Both drivers

 I am not sure

 The crash report did not mention whether anyone died

 Not applicable: Neither driver died

7. If the crash involved a death, the use of a seat belt would have saved the driver’s life. (Check one.)

• Strongly disagree

• Somewhat disagree

• Neither disagree nor agree

• Somewhat agree

• Strongly agree

• Not applicable: The crash did not involve a death

8. If the car driver survived the crash, what was the likelihood that wearing a seat belt saved her life? (Check one.)

• Very unlikely

• Unlikely

• Neutral

• Likely

• Very likely

• Not applicable: The car driver did not survive the crash

9. If the pick-up truck driver survived the crash, what was the likelihood that wearing a seat belt saved his life? (Check one.)

• Very unlikely

• Unlikely

• Neutral

• Likely

• Very likely

• Not applicable: The pick-up truck driver did not survive the crash

10. How much do you agree with the following statement: “Seat belts save lives”? (Check one.)

• Strongly disagree

• Somewhat disagree

• Neither disagree nor agree

• Somewhat agree

• Strongly agree

11. When is the last time that you did not wear a seat belt when driving? (Check one.)

 Today

 Within the past week

 Within the past month

 Within the past 12 months

 A year or more ago

 Not applicable: I have worn a seat belt every time I have driven

12. As a driver, if you do not wear a seat belt all the time, what are your main reason(s) for not wearing a seat belt? (Check up to 3 reasons.)

 Only going a short distance

 Seat belt is uncomfortable

 Forgot to put seat belt on

 In a rush

 Driving on low-speed roads

 Driving in light traffic

 Probability of crash is low

 Do not like being told what to do

 Do not want clothes wrinkled.

• Seat belts sometimes cause injuries

 People I am with are not wearing a seat belt

 Other reasons ___________________________

• Not applicable: I always wear my seat belt when driving

13. As a driver, what are the main reason(s) for when you do wear a seat belt? (Check up to 3 reasons.)

 It’s the law

 Do not want a ticket

 Other passengers are wearing seat belt

 Others want me to wear the seat belt

 Avoid serious injury

 Vehicle has bell, buzzer, or light as a reminder

 Inclement weather

 Nighttime

 Highway driving

 Long trip

 Children or spouse in the car

 Required for work

• Not applicable: I never wear my seat belt

14. As a passenger in a car, when is the last time that you did not wear a seat belt? (Check one.)

 Today

 Within the past week

 Within the past month

 Within the past 12 months

 A year or more ago

 Not applicable: I always wear my seat belt when riding as a passenger

15. As a passenger in a car, if you do not wear a seat belt all the time, what are your main reason(s) for not wearing a seat belt? (Check up to 3 reasons.)

 Only going a short distance

 Seat belt is uncomfortable

 Forgot to put seat belt on

 In a rush

 Driving on low-speed roads

 Driving in light traffic

 Probability of crash is low

 Do not like being told what to do

 Do not want clothes wrinkled

• Seat belts sometimes cause injuries

 People I am with are not wearing a seat belt

 When I am riding in the back seat

 Other reasons ___________________________

• Not applicable: I always wear my seat belt when riding as a passenger

16. As a passenger in a car, what are the main reasons for when you do wear a seat belt? (Check up to 3 reasons.)

 It’s the law

 Do not want a ticket

 Other passengers are wearing seat belts

 Others want me to wear the seat belt

 Avoid serious injury

 Vehicle has bell, buzzer, or light as a reminder

 Inclement weather

 Nighttime

 Highway driving

 Long trip

 Children or spouse in the car

 Required for work

• Not applicable: I never wear a seat belt

17. The red-light phase of a traffic signal means “Stop.” (Check one.)

• False

• True

18. States should have a law that requires people to wear a seat belt when driving. (Check one.)

• Strongly Disagree

• Somewhat Disagree

• Neither Disagree nor Agree

• Somewhat Agree

• Strongly Agree

19. Police should enforce a seat belt law that requires people to wear a seat belt when driving. (Check one.)

• Strongly Disagree

• Somewhat Disagree

• Neither Disagree nor Agree

• Somewhat Agree

• Strongly Agree

20. I intend to wear my seat belt in the future when I drive. (Check one.)

• Strongly disagree

• Somewhat disagree

• Neither disagree nor agree

• Somewhat agree

• Strongly agree

21. I intend to wear my seat belt in the future when I travel as a passenger. (Check one.)

• Strongly disagree

• Somewhat disagree

• Neither disagree nor agree

• Somewhat agree

• Strongly agree

22. To what extent do you agree or disagree with the following statement: When it is your time to die, you will die, so it does not matter whether you wear your seat belt. (Check one.)

• Strongly disagree

• Somewhat disagree

• Neither disagree nor agree

• Somewhat agree

• Strongly agree

23. If I were in a crash, I would want to have my seat belt on. (Check one.)

• Strongly Disagree

• Somewhat Disagree

• Neither Disagree nor Agree

• Somewhat Agree

• Strongly Agree

24. Where do you get your news? (Check all that apply.)

• Newspaper (either paper or digitally)

• Online Articles

• TV News

• Radio

• Social Media

• Friends/Family

• Other ________________________

• I do not access news anywhere

25. In what State do you live? ____________________________________

26. How would you describe the area where you live? (Check one.)

• Urban/City

• Suburban

• Rural

27. What is your sex? (Check one.)

• Male

• Female

28. Your Age: _________

29. What is your race? (One or more categories may be selected).

• American Indian or Alaska Native

• Asian

• Black or African American

• Native Hawaiian or Other Pacific Islander

• White

30. What is your ethnicity?

• Hispanic or Latino

• Not Hispanic or Latino

31. What is the highest level of school you have completed? (Check one.)

• Less than high school

• High school graduate or GED equivalent

• Some college

• Trade school (e.g., mechanics, plumbing, cosmetology, etc.)

• Associate’s Degree

• Bachelor’s Degree

• Graduate Degree (e.g., Master’s, Ph.D.)

32. What type of vehicle do you usually drive? (Check one.)

• Car

• Pick-Up Truck

• SUV or Crossover

• Van/Mini-Van

33. Before the COVID-19 pandemic, how often did you drive? (Check one.)

• Daily

• Few times a week

• Once a week

• Once a month

• Few times a year

34. Before the COVID-19 pandemic, how often did you drive at night? (Check one.)

• Daily

• Few times a week

• Once a week

• Once a month

• Few times a year

• Not applicable: I do not drive at night

35. Before the COVID-19 pandemic, how often did you drive on highways or other roads with speeds of 55 mph or faster? (Check one.)

• Daily

• Few times a week

• Once a week

• Once a month

• Few times a year

• Not applicable: I do not drive on highways

36. Have you ever been in a car crash as a driver?

• Yes

• No

37. Have you ever been in a car crash as a passenger?

• Yes

• No

38. Have you ever received a ticket or a warning for not wearing a seat belt?

• Yes

• No

39. What is your total annual household income before taxes?

• Less than $24,999

• $25,000 - $49,999

• $50,000 - $74,999

• $75,000 - $99,999

• $100,000 or greater

• I prefer not to say

40. Which of the following best describes your use of seat belts?

• Full-Time User

• Part-Time User

• Non-User

NHTSA Form No. 1601