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 12th 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 9th 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 12th 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 12th 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 12th 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 9th 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 12th 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 12th 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 12th 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 9th 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 12th 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 12th 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
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: ________________________________________
Did the crash report mention whether the drivers were wearing their seat belts? (Check one.)
Yes
No
I am not sure
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
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
Did the crash result in one or more deaths? (Check one.)
Yes
No
I am not sure
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
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
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
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
How much do you agree with the following statement: “Seat belts save lives”? (Check one.)
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
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
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
Highway driving
Long trip
Children or spouse in the car
Not applicable: I never wear my seat belt
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
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
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
The red-light phase of a traffic signal means “Stop.” (Check one.)
False
True
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
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
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
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
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
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
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
In what State do you live? ____________________________________
How would you describe the area where you live? (Check one.)
Urban/City
Suburban
Rural
What is your sex? (Check one.)
Male
Female
Your Age: _________
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
What is your ethnicity?
Hispanic or Latino
Not Hispanic or Latino
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.)
What type of vehicle do you usually drive? (Check one.)
Car
Pick-Up Truck
SUV or Crossover
Van/Mini-Van
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
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
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
Have you ever been in a car crash as a driver?
Yes
No
Have you ever been in a car crash as a passenger?
Yes
No
Have you ever received a ticket or a warning for not wearing a seat belt?
Yes
No
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
Which of the following best describes your use of seat belts?
Full-Time User
Part-Time User
Non-User
NHTSA Form No. 1601
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Larry Decina |
| File Modified | 0000-00-00 |
| File Created | 2023-08-27 |