North Dakota Work Site Safety Program Manual -- Page 8

HOW TO CONDUCT A SAFETY BELT SURVEY

Surveys should be appropriate to the size and circumstances of your company. There is no "right" or "wrong" way to proceed, however, the survey should be organized carefully. The following activities are recommended:

1. Assign one person overall responsibility of the survey. Seek someone with good organizational skills and knowledge about basic statistical techniques.

2. Select locations for collecting data. (For example, the entrances and exits to the company parking areas.)

3. Decide exactly what data you will collect. (Safety belt usage by drivers? All occupants? Age? Gender? Vehicle type?)

4. Determine the best times to collect data and how many observations are needed for a credible survey. Collecting data on several dates will give a better "snapshot" of actual usage.

5. Develop a simple data collection form. Gather supplies such as clipboards, pens, signs, etc.

6. Notify police that you will be collecting data, especially if the process could affect traffic in the area. Drivers often slow down and "rubberneck" if they see activity.

7. Recruit employees to serve as data collectors and instruct them on how to collect data efficiently. Make sure they keep traffic moving and do not cause a "jam" delaying departures or arrivals.

8. Conduct a pre-survey to establish a safety belt usage baseline (pre-survey - conducted prior to extensive safety activity.)

9. Collect, tabulate and analyze data.

10. If you are unable to conduct observational surveys, you can distribute a written questionnaire. The results may not be accurate, but the activity will allow you to measure progress.

11. After conducting a baseline survey and tabulating your pre-survey to determine a baseline, establish a usage goal (85 percent) and communicate it extensively throughout the work place for several weeks. In order to evaluate program effectiveness and celebrate success, conduct a post-survey (post-survey - conducted after extensive safety activity.) Collect, tabulate and analyze data. Compare your pre- and post-survey results and document any improvements.

12. Report results extensively. Give kudos...or remedial reminders...as appropriate.

Provided courtesy of the Network of Employers for Traffic Safety (NETS.)

NHTSA ROCKY MOUNTAIN REGION
BUCKLE UP AMERICA! AWARD

HELP SAVE LIVES!
As a leader in your community, you serve an important function - helping to improve the quality of life. At the National Highway Traffic Safety Administration (NHTSA) Rocky Mountain Region, we're depending on you to ensure the safety of your most valuable asset - people. Every year, thousands of loved ones, valued co-workers and fellow citizens are needlessly hurt or killed in motor vehicle crashes. Many of these injuries and fatalities could have been prevented by safety belt use. In fact, numerous national studies prove that safety belts reduce the risk of serious injury or death by nearly 50 percent.

Not only are productive members of our community hurt or lost forever in these tragic crashes, but there is also a staggering economic cost - an estimated $230.6 billion annually. Clearly, we all pay dearly when safety belts are not used.

ENCOURAGE SAFETY BELT USE
We invite you to participate in the Buckle Up America! Award program as we strive for a national safety belt use rate of 90 percent usage by the year 2005. This prestigious program, conducted in cooperation with the State Governors' Highway Safety Representatives, is designed to encourage safety belt use and to reward those achieving 85+, 90+ and 100 percent usage rates among their members or targeted audience. Your "target group" may be your state, county, city, company, organization, school, military base, police, governmental agency or other entity comprised of 25 or more individuals.

REWARDS OF THE PROGRAM
The benefits of participation are numerous. You'll save lives, act as a role model for others and be recognized for your efforts. You'll receive a certificate for your accomplishment. Award recognition is distinguished in four levels: 85+, 90+, 95+ and 100 percent. Your achievement will be posted in the monthly NHTSA Rocky Mountain Region Buckle Up America! newsletter. These honors can be a source of pride and self accomplishment for you and your community. Many honorees may choose to arrange a local "awards ceremony" when they receive their award.

HOW DO YOU QUALIFY?
To qualify for an award, you must conduct two unannounced safety belt observational surveys at least 30 days apart. The results of each survey must show a sustained level of at least 85 percent driver safety belt use. Although it isn't necessary that the entire targeted population be surveyed, it is important that you observe a large enough sample to substantiate a valid safety belt use rate for the group, facility or jurisdiction. A self-reporting survey that asks people about their safety belt use is not acceptable.

Businesses, organizations, etc. with fewer than 25 people may participate in this program by expanding the scope of their group beyond its immediate members. For example, many small businesses and agencies are housed in the same building with several others and share the same parking facility. Each individual group alone may not have 25 people, but together they could qualify for an award based on the combined accomplishments of each office; or individual schools can combine with others in the same school district to receive recognition.

The idea is to get as many people within your reach to buckle up.

GUIDELINES
States applying for an award must provide the results of their most recent official statewide survey.

Local jurisdictions and other applicants may conduct informal surveys, but must provide a brief description of the survey method used, number and location of sites, number observed at each site, time of day of observations and dates conducted.

The same method for collecting this data should be used for each survey at each observational site. Planning should include: determining the time and location for each survey; and selecting and training two-person survey teams (ideally) to collect the data - one to observe the actual belt usage and another record this information on the observational survey form.

Survey teams should be posted where they can clearly and safely observe the driver of the vehicle. Observation sites should be selected where there is a traffic light, stop sign, or entrance/exit gate. Observers should not stop the vehicle entering or leaving the observation point to check for safety belt usage.

See sample observational survey form below. You may use the one provided or develop your own. You are not required to submit the data collection forms you used.

WHEN CAN YOU ENTER?
The Buckle Up America! Award program is ongoing. Applications may be submitted to your State Governor's Highway Safety Representative anytime throughout the year. Only one award, per achievement level, will be awarded to a group or organization within a given year. However, organizations may reapply as higher achievement levels are attained (i.e. you may qualify for an 85+ percent award in March and a 90+ percent award in September of the same year.) Your State Governor's Highway Safety Representative and NHTSA Regional Administrator will coordinate with each Buckle Up America! Award recipient on an appropriate award presentation.

SAMPLE OBSERVATIONAL SURVEY FORM

Please complete this form and attach a brief summary of the data collection procedures used.

Survey Date:
Time:
Survey Location:
Observer's Name:
Signature:

Indicate a belted or unbelted driver by checking the appropriate block (Yes/No) that corresponds to the vehicle surveyed. Only observational surveys that visually count drivers wearing safety belts will be accepted.

Please see sample survey form located in the PDF version of the Work Site Safety Manual.

OBSERVATIONAL SURVEY RESULTS

1. Enter the results of two unannounced observational surveys, which were conducted at least 30 days apart. The usage rates from each of the two surveys must be 85 percent or greater to qualify for a Buckle Up America! Award.

a. Date of survey

b. Number of drivers observed wearing safety belts

c. Divided by the total number of drivers observed in the survey

d. Equals the percent of belted drivers observed in the survey (b/c x 100)

2. Attach a brief summary of the procedures used in collecting the data. Include the number and description of the locations (e.g. residential, major intersections, shopping district, parking lot, etc.), time of day observed, number of observations and their procedures.

3. Name of Certifying Official (printed or typed):_______________
    Signature of Certifying Official:___________________________
    Title:______________________ Date:_____________________

Mail completed form to your State Governor’s Highway Safety Office (see attached list). If you have any questions, please call the Safe Communities Hotline at 1-866-332-6060 or Rocky Mountain Region National Highway Traffic Safety Administration (NHTSA) Office at (720) 963-3100. E-mail region8@nhtsa.dot.gov or call NHTSA toll-free at 1-888-327-4236.

APPLICATION FORM

Please complete this form and attach a brief summary of the data collection procedures used.

1. Level for which application is being submitted: (Circle one)
Safety belt Use Rate: 85%+  90%+   95%+  100%

2. Targeted population (e.g., military base, city or county employees, town residents, company employees, law enforcement agency, etc.):
__________________________________________________

3. Total population/number of individuals (must be at least 25) within the target population:
_________________________________________________

4. Name and location of organization jurisdiction applying for award: (Print exactly how name should appear on award.)

Name:
City:
State:
Zip Code:

5. Official who will receive the award on behalf of applicant:

Name:
Title:
Agency:
Mailing Address:
City:
State:
Zip Code:
Telephone:
Fax:

6. Contact for follow-up questions or additional information, if needed:

Name:
Title:
Agency:
Telephone:
Fax:

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