The impact of worksite-based safety belt programs: a review of the literature.

PURPOSE: The purpose of this paper is to provide a literature review of the research that examines the effectiveness of worksite intervention programs designed to increase the use of safety belts by employees. SEARCH METHODS: The literature search, which identified 14 research studies on worksite safety belt programs conducted between 1968 and 1994, originated as part of a larger review on the health impact of worksite health promotion programs that was conducted by the Centers for Disease Control and Prevention (CDC). In addition, the authors conducted an additional search in an effort to validate the CDC search, but found no additional research articles. SUMMARY OF IMPORTANT FINDINGS: The literature specific to the effectiveness of safety belt programs is limited to only 14 studies. The safety belt intervention most commonly evaluated used behavioral modification principles involving incentives. These and other interventions demonstrated effective increases in seat belt utilization that, upon withdrawal of the intervention, achieved a recidivism rate above baseline levels. However, the vast majority of studies failed to incorporate control groups into their research design, which caused significant threats to internal validity. Thus, a summary of findings is only suggestive at best. MAJOR CONCLUSIONS: Based on the literature, there appears to be an insufficient number of quality research studies from which to derive a clear view of the impact of worksite safety belt programs. While the evidence is suggestive of a positive impact on safety belt use, there is a clear need for new, well-designed research initiatives on the effectiveness of theory-based safety belt intervention programs.

Hazard surveillance and injury control: a university-based pedestrian-safety project.

Hazards to pedestrians at 15 campus crosswalk sites were identified, using a data collection protocol the authors developed so that two-person teams of trained observers could record the volume of vehicular and pedestrian traffic at the sites. Findings from the study revealed the nature of certain pedestrian hazards on campus, with specific intersections found to be more dangerous for pedestrians than others. The data collected were analyzed to create practical and effective hazard-control and safety programs for student groups.

Clinical measurement of head and shoulder posture variables.

A reliable method that is practical for clinical use for measuring head posture in standing has not been demonstrated in the literature. The purposes of this study were: 1) to produce a reliable method for measuring sagittal plane head and shoulder posture that is practical for clinical use and 2) to perform a pilot study to compare means between a nonpatient sample and a sample of people who have a history of recurring cervical pain. A method of measuring sagittal plane postural alignment of the head and shoulder in relationship to the lateral malleolus was developed using a carpenter's tri-square with a line level attached to the horizontal arm and a goniometer with a line level attached to the horizontal arm. Horizontal measures were taken with the tri-square from a vertical reference point to the tragus of the ear, to the shoulder axis, and to the lateral malleolus. Angular measures were taken with the goniometer of C7-tragus with the horizontal and tragus-corner of the eye with the horizontal. A reliability study was performed by two therapists with 15 non-patient subjects. Intraclass correlation coefficients measuring interrater reliability for horizontal and angular measures were as follows: 1) tragus to lateral malleolus: R = .87; 2) shoulder to lateral malleolus: R = .91;3) tragus to shoulder: R = .7;4) angle tragus-eye-horizon: R = .68; and 5) angle C7-tragus-horizon: R = .34. In the pilot study, 41 nonpatient subjects (11 males and 30 females, 20-45 years) and 10 patient subjects with cervical pain (one male and nine females, 23-43 years) were measured. Means calculated for horizontal distances (in cm) were: 1) tragus to lateral malleolus (nonpatients: 8.14; patients: 6.65);2) shoulder to lateral malleolus (nonpatients: 5.47; patients: 5.98); and 3) tragus to shoulder (nonpatients: 2.78; patients: .56). Means calculated for angular measures were: 1) tragus-eye-horizon (nonpatients: 18.78 degrees; patients: 21.57 degrees) and 2) C7-tragus-horizon (nonpatients: 49.34 degrees; patients: 49.43 degrees). No statistically significant differences were found between the two samples in this pilot study using an independent two-sample t test. This study demonstrates a reliable and practical method for taking postural measurements in the clinic and describes a pilot study for comparing a patient and a nonpatient sample.

The Midfield High School Safety Belt Incentive Program.

Motor vehicle accidents constitute the leading cause of death among children and youth ages 15-24. The Year 2000 Health Objectives for the Nation call for reduction in fatalities in this population through increasing occupant restraint measures. This article provides an overview of how one school district developed a school and community safety belt incentive program to increase safety belt use among high school students. The intervention program followed a seven-step process, involving community leaders, school officials, students, and local law enforcement personnel in its design, implementation, and evaluation. Local merchants and the Alabama Dept. of Health donated program incentives. Measurement of safety belt use among the target population revealed increased use throughout the program.

A secondary analysis of the School Health Education Evaluation data base.

This secondary analysis examined variables directly related to teacher training not fully examined in the School Health Education Evaluation (SHEE). The problem was to determine the effect of School Health Curriculum Project (SHCP) teacher training and curriculum implementation variables on overall student health knowledge, attitude, and self-reported practice scores in SHCP grades four-six. The major variables of interest had no statistically significant interactive effects on student scores in the knowledge, attitude, and practice domains. The teacher implementation variable had significant (p less than or equal to .05) main effects on student scores within attitude and practice domains in addition to statistically significant effects on related subscores within categorical item areas. Design flaws, which represent serious threats to internal and external validity of the primary analysis, may have effected results associated with this project.

Kinematics, ground reaction force, and muscle balance produced by backward running.

This study was conducted at the University of Kentucky Biodynamics Laboratory in Lexington, KY and was partially supported by a grant from the Kentucky Chapter of the American Physical Therapy Association. Backward running (BR) is employed for conditioning and for rehabilitation in sports, orthopaedics, and neurology. Our purposes were to compare kinematics and training effects of BR to forward running (FR). Ten runners (6 males, 4 females, ages 20-34 years) were assigned to a backward running (BRG) or control (FRG) group. Subject isokinetic muscular torque production (IMTP) and biomechanics during FR and BR at 3.58 m/sec were studied at the beginning and after 8 weeks of training. Stance time was significantly shorter during BR. The peak vertical component of the ground reaction force (Fz) and Fz impulse were significantly less during BR. After training, knee extensor IMTP of the BRG increased significantly at 75 and 120 degrees /sec. We concluded that BR produced lower Fz stress than FR and improved knee extensor torque at low speeds. Backward running may be clinically useful for reducing stress to injured joints and for increasing knee extensor strength. J Orthop Sports Phys Ther 1989;11(2):56-63.