Using fear and efficacy to increase booster-seat use: A field test of a high-threat message

During the last decade, the motor vehicle fatality rate for 5- to 8-year-old children has failed to decline while rates for other age groups have significantly improved. This research piloted a 6-minute video that uses a novel threat-appeal approach (without gore) to deliver preventive messages about the importance of booster-seat and rear-seat use to parents. Its high-threat content motivates by evoking a sense of vulnerability to motor vehicle hazards and its high-efficacy content provides caregivers with the knowledge to protect one's family from motor vehicle risks. When designed and targeted appropriately, threat-appeal tactics are known to motivate maximum behavioral change; however, the literature indicates that similar methods have not yet been employed in child passenger safety programming. Thus, the video's threat appeal approach represents a unique and innovative methodology in child occupant protection, as most programs are primarily informational in nature. The video-intervention program was piloted at two after-school care centers (N = 226 caregivers) via an interrupted time series design with two control sites for comparison. The study's results indicate that, compared to baseline and control assessments, the treatment groups' child passenger safety knowledge, risk-reduction attitudes, perceptions of fear and efficacy, and behavioral intentions related to booster-seat and back-seat use increased significantly from pre-test to post-test. Further, trend analyses confirmed that there were significant increases in observed overall restraint use and booster-seat use following exposure to the intervention video compared to both baseline and to control sites. Due to ceiling effects, there was no observed change in back-seat use.