Highway Safety Behavioral Strategies

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Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide
B E H AV I O R A L T R A F F I C S A F E T Y C O O P E R AT I V E R E S E A R C H P R O G R A M
BTSCRP RESEARCH REPORT 8

Highway Safety Behavioral Strategies
for Rural and Tribal Areas
A GUIDE
Jaime Sullivan
Western Transportation Institute
Montana State University
Bozeman, MT
Jay Otto
Katie Dively
Bridget Hanson
Kari Finley
Karen Gee
Samantha Pinzl
Jamie Arpin
Center for Health and Safety Culture
Montana State University
Bozeman, MT
and
Cara Hamann
University of Iowa
Iowa City, IA
Subscriber Categories
Highways • Safety and Human Factors
Research sponsored by the Governors Highway Safety Association and National Highway Traffic Safety Administration
2023
Copyright National Academy of Sciences. All rights reserved.

BEHAVIORAL TRAFFIC SAFETY BTSCRP RESEARCH REPORT 8

COOPERATIVE RESEARCH PROGRAM
Since the widespread introduction of motor vehicles more than a Project BTS-15
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lion miles in the United States, more than 35,000 people die every year
© 2023 by the National Academy of Sciences. National Academies of
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COOPERATIVE RESEARCH PROGRAMS
CRP STAFF FOR BTSCRP RESEARCH REPORT 8

Waseem Dekelbab, Deputy Director, Cooperative Research Programs
Richard A. Retting, Senior Program Officer
Dajaih Bias-Johnson, Senior Program Assistant
Natalie Barnes, Director of Publications
Heather DiAngelis, Associate Director of Publications
Janet M. McNaughton, Senior Editor
BTSCRP PROJECT BTS-15 PANEL

Eric J. Fitzsimmons, Kansas State University, Manhattan, KS (Chair)
Andrew H. Ceifetz, WSP, Walled Lake, MI
William Haynes, Department of Safety/State Police, Center Barnstead, NH
Amy Benecke McLaren, Peoria County (IL) Highway Department, Peoria, IL
Eugene Robert Russell, Kansas State University, Manhattan, KS
Kimberly J. Vachal, North Dakota State University, Fargo, ND
Lisa N. Wundersitz, Centre for Automotive Safety Research, Adelaide, Australia
Stacy Jeleniewski, NHTSA Liaison
Bernardo B. Kleiner, TRB Liaison

FOREWORD
By Richard A. Retting
Staff Officer
BTSCRP Research Report 8: Highway Safety Behavioral Strategies for Rural and Tribal Areas:
A Guide presents results from a multidisciplinary research project that developed a toolkit of
behavioral traffic safety countermeasures for highway safety partners focused on rural road
safety (e.g., tribal authorities, local government, law enforcement, emergency responders,
engineers) to reduce the frequency and severity of motor vehicle crashes on roads in rural
areas. This publication will be of interest to state highway safety offices; state and local
departments of transportation; county departments of public works; tribal authorities; and
other stakeholders concerned with improving traffic safety in rural areas.
Although rural areas account for about 30% of total U.S. vehicle miles traveled and less than
20% of the U.S. population, half of all traffic fatalities occur in rural areas. Despite a clear need
to improve traffic safety in rural areas, numerous constraints and resource limitations
hinder safety efforts. For example, in most states, the vast majority of rural road mileage
is owned and managed by local governments. In addition, the Bureau of Indian Affairs
recognizes 573 American Indian tribes and Alaska Native Villages in the United States.
The sheer number of rural jurisdictions makes it difficult to assure that programs aimed
at improving rural transportation safety are effective in reaching all areas effectively and
equitably. Rural local government units vary considerably in the way they are organized,
their legal authority, and the financial and human resources available to them. The vast rural
highway mileage is another challenge: rural crashes are often widely dispersed, with a con-
siderable degree of randomness in crash locations. This makes it difficult to apply traditional
crash reduction strategies that focus on hot spots.
Under BTSCRP Project BTS-15, “Highway Safety Behavioral Strategies for Rural Areas,”
Montana State University developed a toolkit of behavioral traffic safety countermeasures
to assist rural highway safety partners in reducing the frequency and severity of motor
vehicle crashes on roads in rural areas. The research team (1) defined rural area roads and
conducted analysis of safety-related data; (2) conducted a literature review of traffic safety
campaigns and strategies, including rural barriers; (3) conducted interviews with selected
rural agencies to develop case studies to support the selection of noteworthy practices; and
(4) developed final deliverables. In addition to the present guide, documentation of the
overall research effort is available in BTSCRP Web-Only Document 4: Highway Safety Behav-
ioral Strategies for Rural Areas. Both publications, as well as a supplemental presentation and
video, can be accessed at nap.nationalacademies.org by searching on “BTSCRP Research
Report 8.”


CONTENTS
1 Chapter 1 Introduction
5 Chapter 2 How Behavioral Strategies Work
5 Overview
5 Logic Models
8 Chapter 3 Guidance on Process: What to Do Next

8 Guidance on Three Planning Processes
11 Benefits of Participation by Diverse Stakeholders
13 Chapter 4 Guidance on Identifying, Selecting, and

Adapting Countermeasures and Strategies
13 General Behavioral and Engineering Approaches
15 Guidance on Identifying Countermeasures and Strategies
19 Guidance on Selecting Countermeasures and Strategies
20 Guidance on Adapting Countermeasures and Strategies
23 Chapter 5 Guidance on Ways to Grow Evaluative Thinking

26 Acronyms and Abbreviations
27 References
29 Appendix A Example Logic Models
32 Appendix B Examples of Implementing Countermeasures
and Strategies in Rural Settings
35 Appendix C Summary of Countermeasures That Work
44 Appendix D Proven Engineering Safety Countermeasures
Note: Photographs, figures, and tables in this report may have been converted from color to grayscale for printing.
The electronic version of the report (posted on the web at nap.nationalacademies.org) retains the color versions.


CHAPTER 1
Introduction
Fatalities and serious injuries associated with roadway crashes are a significant public health
concern in rural and tribal settings. While about 14% of the U.S. population lives in rural areas,
almost half of roadway fatalities occur in rural settings. According to the Fatality Analysis
Reporting System in 2018, people who are American Indians and Alaska Natives experienced
roadway fatality rates on a mileage basis twice the national rate (https://www.nhtsa.gov/research
-data/fatality-analysis-reporting-system-fars).
This guide supports the Safe System Approach (https://www.transportation.gov/NRSS
/SafeSystem), which recognizes that there is no single solution to eliminate fatalities and serious
injuries on our roadways. Instead, multiple strategies are required including safer people, safer
roads, safer vehicles, safer speeds, and postcrash care. The Safe System Approach comprises six
principles and five elements:
Six Principles of the Safe System Approach:
• Deaths and serious injuries are unacceptable. A Safe System Approach prioritizes the
elimination of crashes that result in death and serious injuries.
• Humans make mistakes. People will inevitably make mistakes and decisions that can lead
or contribute to crashes, but the transportation system can be designed and operated to
accommodate certain types and levels of human mistakes and avoid death and serious injuries
when a crash occurs.
• Humans are vulnerable. Human bodies have physical limits for tolerating crash forces before
death or serious injury occurs; therefore, it is critical to design and operate a transportation
system that is human-centric and accommodates physical human vulnerabilities.
• Responsibility is shared. All stakeholders—including government at all levels, industry,
nonprofit/advocacy groups, researchers, and the general public—are vital to preventing
fatalities and serious injuries on our roadways.
• Safety is proactive. Proactive tools should be used to identify and address safety issues in the
transportation system, rather than waiting for crashes to occur and reacting afterwards.
• Redundancy is crucial. Reducing risks requires that all parts of the transportation system be
strengthened, so that if one part fails, the other parts still protect people.
Five Elements of the Safe System Approach:
• Safer people: Encourage safe, responsible behavior by people who use our roads and create
conditions that prioritize their ability to reach their destination unharmed.
• Safer roads: Design roadway environments to mitigate human mistakes and account for
injury tolerances, encourage safer behavior, and facilitate safe travel by the most vulner-
able users.

2 Highway Safety Behavioral Strategies for Rural and Tribal Areas: A Guide
• Safer vehicles: Expand the availability of vehicle systems and features that help to prevent
crashes and minimize the impact of crashes on both occupants and nonoccupants.
• Safer speeds: Promote safer speeds in all roadway environments through a combination of
thoughtful, context-appropriate roadway design; targeted education; outreach campaigns;
and enforcement.
• Postcrash care: Enhance the survivability of crashes through expedient access to emergency
medical care while creating a safe working environment for vital first responders and pre-
venting secondary crashes through robust practices for traffic incident management.
Because rural and tribal settings often do not have dedicated staff who work only on roadway
safety, opportunity often lies with those willing to take it on. This may include law enforcement,
local road owners (e.g., counties, towns, or tribal governments), public health educators, emer-
gency medical service providers, county and city elected officials, and local citizens. Each of these
roles can contribute to improving roadway safety.
Creating a coalition of interested individuals (with different roles in the community) is a way
to be more effective by sharing the work and being able to reach more people in your community.
You may want to share this guide with others and build a multidisciplinary team to engage in
the effort.
There is a growing recognition that more resources need to be made available for improving
roadway safety in rural and tribal settings. Addressing equity in roadway safety is a component of
the U.S. National Roadway Safety Strategy (https://www.transportation.gov/NRSS) (Box 1) and
may make additional funds available to rural and tribal settings. Box 2 lists sources of funding
that you may be able to use.
Box 1. Equity and Roadway Safety

“Achieving equity requires recognition that communities have been differently
impacted by circumstances, structures, and historical contexts and that those
who have been disadvantaged require a different allocation of resources and
opportunities to eventually reach an equal outcome” (Michael et al. 2021, p. 2).
Furthermore, “a Safe System can be implemented in ways that help address
structural and institutional racism by correcting for prior under-investments in
historically marginalized communities and closing gaps in safety between areas
that have been well-served and those that have been underserved” (Center for
Injury Research and Policy 2022).
The $642 billion total transportation grants funding allocated for FY22 through
FY26 by the Bipartisan Infrastructure Law (BIL) contains an unprecedented
amount of funds designated to directly benefit rural communities that have
been disadvantaged. The Equity Action Plan, released by the U.S. Department
of Transportation (DOT) in January 2022, shows the department’s commitment
to advancing equity through transportation and use of the BIL funds (U.S. DOT
2022). The Equity Action Plan has information on expanding access, providing
technology support to underserved communities, addressing uneven resource
distribution, building and activating coalitions, and improving transit deserts and
areas of the country where lack of transportation greatly affects quality of life,
and even includes a national technical assistance center to help overburdened
and underserved communities.

Box 2. Sources of Funding for Improving Roadway Safety

in Rural and Tribal Settings
Safe Streets and Roads for All (SS4A) Grant Program
https://www.transportation.gov/grants/SS4A
Transportation Funding Opportunities for Tribal Nations

https://highways.dot.gov/federal-lands/programs-tribal/funding-opportunities
Indian Health Service

https://www.ihs.gov/injuryprevention/tipcap/
Each Indian Health Service district office has specialty grants for specific project
such as car seats and observational seatbelt surveys.
Tribal Transportation Program

https://highways.dot.gov/federal-lands/programs-tribal
Rural Opportunities to Use Transportation for Economic Success

https://www.transportation.gov/rural/grants/toolkit
The Rural Opportunities to Use Transportation for Economic Success (ROUTES)

initiative has a rural grants toolkit to assist those seeking funding to address
disparities in transportation infrastructure.
Reconnecting Communities Pilot Program

https://www.transportation.gov/grants/reconnecting-communities
Indian Highway Safety Program

https://www.bia.gov/bia/ojs/dhs
Safe Kids Worldwide

https://www.safekids.org/
Safe Kids Worldwide has funding for prevention activities like car seats, bike
helmets, etc.
Local State Highway Traffic Safety Offices
Safe roads grants may be available from local state highway traffic safety offices.
Level 1 Trauma Hospitals

http://www.maptive.com/ver3/traumacenters
These hospitals must have a full-time paid injury prevention coordinator.

Hospitals must do research and funding may be available.
American Automobile Association Foundation for Traffic Safety

https://aaafoundation.org/
The American Automobile Association (AAA) foundation has state offices that
award grants for tribal and rural communities for specialty projects. For profit
companies may support local efforts to improve roadway safety:
• Insurance companies (car seats, bike helmets, etc.)

• Chick-fil-A® has supported distracted driving campaigns.
• Target® may provide gift cards for communities working on roadway safety-
related projects.
• Vehicle manufacturers (Chevrolet, Toyota, Volkswagen, etc.)
Note: These funding sources may not be available indefinitely, and new ones may become avail-
able in the future.

This guide is for anyone who wants to improve roadway safety in rural and tribal settings. It
focuses on countermeasures and strategies to promote safer decisions by road users (often called
behavioral countermeasures or strategies) as well as resources for safer roads (often engineering
or maintenance practices that improve safety) and safer speeds. The guide includes four chapters
in addition to this introduction:
• Chapter 2 is a high-level overview of how behavioral countermeasures and strategies work.
Understanding how behavioral countermeasures and strategies work will help you be more
effective in selecting, adapting, and implementing countermeasures and strategies in your
community. Countermeasures and strategies will not be effective in changing behavior
unless they are implemented well.
• Chapter 3 offers guidance on steps and resources for developing a plan to improve roadway
safety. Improving roadway safety takes time. Having a plan will help you be more effective in
the long term. It can also help you obtain funding to support your efforts.
• Chapter 4 offers guidance on resources to identify, select, and adapt countermeasures and
strategies to use in your community. There are several resources available with ideas on how
to improve roadway safety. This section will help you identify resources suitable for your
community.
• Chapter 5 identifies specific actions you can take to be more effective over time. Counter
measures and strategies to improve roadway safety have limited impact if implemented only
once. Each time you implement a strategy you can learn what worked and what did not so
that you can be more effective the next time.
More-detailed information is provided in the following appendices:
• Appendix A: Example Logic Models,
• Appendix B: Examples of Implementing Countermeasures and Strategies in Rural Settings,
• Appendix C: Summary of Countermeasures That Work, and
• Appendix D: Proven Engineering Safety Countermeasures.

CHAPTER 2
How Behavioral Strategies Work
Overview
Understanding how behavioral countermeasures and strategies work will guide you in selecting,
adapting, and implementing. To begin, it is important to distinguish three things:
• Beliefs: understanding or knowledge, such as, “It’s not safe to use a cell phone while driving”
or “Roundabouts are safer than traditional intersections”;
• Behavior: actions that lead to consequences such as risky driving (e.g., speeding, being
aggressive, distracted, or impaired) or designing a road or intersection poorly; and
• Consequences: the results of crashes, fatalities, serious injuries, trauma, loss of income, health-
care costs, insurance costs, and so forth.
Figure 1 illustrates how beliefs influence behavior, which leads to consequences. Therefore, if
you want to change the consequences (e.g., reduce fatal crashes related to impaired driving), then
you need to reduce the behavior that leads to those consequences (e.g., impaired driving, over-
serving of alcohol). Accordingly, to change a behavior, you need to grow beliefs supportive of
that behavior (e.g., “If you drive after drinking you may be arrested”; the importance of beverage
server training).
Behavioral countermeasures and strategies work by changing people’s beliefs, which then
results in changes in people’s behavior, which then reduces negative consequences. For example,
high-visibility seat belt enforcement promotes the belief among the general population that
“If I drive without using a seat belt, I may get a ticket.” Because people do not want to get a
ticket, they may be more likely to use a seat belt. When more people use a seat belt, fewer people
are likely to be killed or seriously injured in crashes.
By understanding how a behavioral countermeasure or strategy works, you can be sure that
if you need to make changes to the strategy (these changes are often called “adaptations”),
you do not lose the critical components that cause the change in beliefs. Take, for example, high-
visibility enforcement strategies. These strategies have two critical components—the enforcement
activities themselves and a media campaign to ensure awareness. If your community engaged in
high-visibility seat belt enforcement but did not promote it sufficiently, so that only a few people
were aware of it, the enforcement effort would not change beliefs among the general population
and would not have much of an impact. Chapter 4 includes more information about adapting
countermeasures and strategies.
Logic Models
A logic model is a tool for gaining understanding of how a countermeasure or strategy works
to create change. It captures what is critical for effective implementation. Table 1 shows a logic
model for high-visibility seat belt enforcement. The first column, “Inputs,” captures what is needed

Beliefs Behavior Consequences
Figure 1. Connecting beliefs, behavior, and consequences.
for implementation. In this case, officers to conduct the enforcement, people to identify and
place media messages, funding (or earned media resources) to place the media, and some time
to plan are all needed.
The next column, “Outputs,” captures what the actions are and who the audience is. In this
case, the actions include increased seat belt enforcement and a universal (meaning the campaign
seeks to reach everyone) media campaign. The audience is everyone in the county.
The final column, “Outcomes,” includes the short-term, intermediate, and long-term outcomes.
In this case, the short-term outcomes are that more people believe they will be caught if they
do not use a seat belt and that getting caught will have real consequences. The intermediate
outcome is that more people will use a seat belt. The long-term outcome is that fewer people
will be killed or seriously injured in crashes because they were not using a seat belt.
A logic model should make sense. Anyone should be able to read a logic model (from
left to right) and clearly see how each column leads to the next column. Having more officers
available to do enforcement is required for more enforcement. Having media messages to
place is required for media message placement. Engaging in visible enforcement coupled
with lots of media about the enforcement effort leads to more people believing that they will
get caught. When more people believe that they will get caught for not using a seat belt, they
are more likely to use a seat belt. When more people use a seat belt, fewer people will be killed
or seriously injured because they were not using a seat belt. The flow and logic from one column
to the next make sense.
Table 1. Example logic model for high-visibility seat belt enforcement.
Inputs: Outputs:
What are we What are we doing? Outcomes:
investing? Who are we reaching? What are our anticipated outcomes?
Resources Activities Audience Short-term Intermediate Long-term
Number of Increased seat Drivers in XX Increase in Increase in Decrease in

officers to belt County perception of seat belt use serious injuries
conduct enforcement getting caught among drivers and fatalities
enforcement in XX County from crashes
involving
Media staff to Universal Increase in unrestrained
identify and media perception of occupants in
produce campaign severe XX County
messages consequences
for getting
Cost ($) for caught
media
placement
4–6 months to
plan and
implement

How Behavioral Strategies Work 7
Logic models make you more effective:

• Logic models help stakeholders understand how a behavioral countermeasure or strategy
works.
• Logic models help stakeholders make decisions about whether they have adequate resources
to implement a behavioral countermeasure or strategy. Lack of adequate resources can result
in poor implementation and reduced (or no) outcomes (see Chapter 4).
• Logic models guide decisions about adapting countermeasures and strategies for imple-
mentation in your community (see Chapter 4).
• Logic models can inform ways that you gather information and learn so that your community
gets better each time you implement a countermeasure or strategy (see Chapter 5).
Appendix A has several more examples of logic models as well as a blank logic model template.
A logic model can help you decide whether you really want to implement the countermeasure
or strategy. It can also help you understand what will be required. It can help you explain the
countermeasure or strategy to others (e.g., the principal of a school) so that they can help or
give you permission to do it.
A training video explaining how to create a logic model is available on the National Academies
Press website (nap.nationalacademies.org) by searching for BTSCRP Research Report 8: Highway
Safety Behavioral Strategies for Rural and Tribal Areas: A Guide.

CHAPTER 3
Guidance on Process:
What to Do Next
Improving safety on your roadways is not a one-time effort; it is an ongoing process involving
four basic steps that are repeated over time. Figure 2 and Table 2 summarize the key actions and
outcomes from each step.
An analysis of crash data based on different kinds of rural communities provides potential
considerations for improving roadway safety. Following are some potential considerations based
on community type:
• Agriculture and extraction-based communities (mining- and farming-oriented counties):

– Consider countermeasures focused on low-volume roads.
– Speeding, impaired, and distracted driving may be significant causes of fatal crashes.
• Destination communities (areas with a significant amount of recreational activity, determined
by employment and seasonal housing data):
– Consider focusing on areas with many intersections.
– Speeding and impaired driving may be significant causes of fatal crashes.
• Older-age communities: Impaired driving may be a significant cause of fatal crashes.
• Remote communities:
– Speeding, impaired, and distracted driving may be significant causes of fatal crashes.
– Lower levels of seat belt use and helmets may be more common and, therefore, a
priority.
• Tribal settings and rural towns: Lower levels of seat belt use and helmets may be more
common and, therefore, a priority.
Each community is unique, and you should use your local data to confirm these insights.
Guidance on Three Planning Processes

Three planning processes have been developed specifically for rural and tribal settings:
• FHWA Local Road Safety Planning Process

https://highways.dot.gov/safety/local-rural/local-road-safety-plans)
Site includes online training and an infographic.
Steps:
1. Identify stakeholders.
2. Use safety data.
3. Choose proven solutions.
4. Implement solutions.
5. Finish line.

Guidance on Process: What to Do Next 9
Evaluate
and Assess
Learn
Implement Plan
Figure 2. Process to improve

roadway safety.
• Developing Safety Plans: A Manual for Local Rural Road Owners (Ceifetz et al. 2012)
https://safety.fhwa.dot.gov/local_rural/training/fhwasa12017/fhwasa12017.pdf
Steps:
1. Establish leadership.
2. Analyze safety data.
3. Determine emphasis areas.
4. Identify strategies.
5. Prioritize and incorporate strategies.
6. Evaluate and update the Local Road Safety Plan.
Table 2. Key actions and outcomes from process steps.
Step Key Actions Key Outcomes
Assess • Recruit a group of individuals • Task force, coalition, or group willing to

willing to improve roadway safety address roadway safety
• Gather and review data to better • Information about crashes, safety
understand the current situation outcomes, and risky driving behavior
accessible to all group members and used
• Data may include road types, to guide prioritization
crash data, road assessments,
injury reports, etc.
Plan • Prioritize problems/opportunities • Prioritized outcomes, behavior, conditions

revealed during the assessment • Countermeasures and strategies identified
• Identify, select, and possibly • Logic model for each countermeasure or
adapt countermeasures and strategy
strategies to address the priorities • Implementation plan for each
countermeasure or strategy
• Evaluation plan for each countermeasure or
strategy
Implement • Implement the countermeasures • Countermeasures and strategies are
and strategies and gather implemented in ways that lead to outcomes
important information to inform • Feasible process and/or outcome measures
evaluation and learning are collected
Evaluate • Use information gathered to make • Lessons learned

and learn improvements in subsequent • Plans for subsequent improvement
cycles

• Improving Safety on Rural Local and Tribal Roads

– Improving Safety on Rural Local and Tribal Roads—Safety Toolkit (Wemple and Colling
2014b)
https://safety.fhwa.dot.gov/local_rural/training/fhwasa14072/
Steps:
1. Compile data and resources.
2. Conduct network screening.
3. Select sites for investigation.
4. Diagnose site crash conditions and identify countermeasures.
5. Prioritize countermeasure for implementation.
6. Implement countermeasures.
7. Evaluate.
– Improving Safety on Rural Local and Tribal Roads: Site Safety Analysis—User Guide #1
(Wemple and Colling 2014c)
https://safety.fhwa.dot.gov/local_rural/training/fhwasa14073/isrltru1.pdf
Describes how to conduct a site-specific safety analysis.
– Improving Safety on Rural Local and Tribal Roads: Network Safety Analysis—User Guide #2
(Wemple and Colling 2014a)
https://safety.fhwa.dot.gov/local_rural/training/fhwasa14072/
Describes how to conduct a proactive analysis of a component of the transportation
network, such as all two-lane road segments or all stop-controlled intersections.
Additional resources to support various steps in the process are listed in Box 3.
Box 3. Additional Resources to Support the Planning Process

Tribal Crash Reporting Toolkit
https://www.tribalsafety.org/crash-reporting-toolkit
This NHTSA resource includes a crash form, database, and other resources to
help tribal settings better capture and use their crash data.
Data Visualization—Fatality Analysis Reporting System

https://cdan.dot.gov/DataVisualization/DataVisualization.htm
This NHTSA portal presents interactive visualizations that focus on several

highway safety topics of interest, including multiple dashboards with informa-
tion on fatal motor vehicle traffic crashes and fatalities based on data from
NHTSA’s Fatality Analysis Reporting System.
Screening Tool for Equity Analysis of Projects

https://hepgis.fhwa.dot.gov/fhwagis/buffertool/
This tool provides demographic information for an area around a specific road.
This information can help identify populations and potential stakeholders that
may be affected by specific roads or improvement projects.

Guidance on Process: What to Do Next 11
Benefits of Participation by Diverse Stakeholders

Engaging diverse stakeholders to improve your local roadway safety has many benefits:
• Engaging stakeholders representing different kinds of organizations (e.g., local road main-
tenance, law enforcement, public health, emergency services, health care, schools, trucking
companies) can engage more people to support education and communication with the
community.
• Diverse stakeholders can raise concerns or have insights about issues that a single stakeholder
may not know.
• Diverse stakeholders can reach many more people and other organizations who can help raise
support for countermeasures and strategies.
• Diverse stakeholders can help identify disparities and identify ways to address them.
• Diverse stakeholders can sustain efforts when leadership changes due to turnover, so efforts
do not stall or end when leaders transition, retire, or move.
A 2021 Executive Order issued by President Biden for advancing racial equity and support
for underserved communities asserts that transportation planning is to include “all segments
of the population . . . regardless of race, national origin, income, age, sex, or disability” (FHWA
and FTA, 2022). All state departments of transportation (DOTs), metropolitan planning orga-
nizations, and public transportation providers must adhere to their agency-specific Title VI
guidelines when using federal funds to plan and implement Title VI Programs.
Box 4 lists resources about recruiting, growing, and maintaining groups (often called coalitions)
that are working to improve issues such as roadway safety.
Box 4. Resources on Recruiting, Growing, and Maintaining Groups

to Improve Roadway Safety
Connecting Transportation & Health: A Guide to Communication & Collaboration
https://onlinepubs.trb.org/onlinepubs/nchrp/docs/NCHRP25-25Task105/NCHRP25
-25Task105Guidebook.pdf
This guide provides an accessible, practitioner-ready communications guide

and set of tools and resources that help the U.S. DOT, state DOTs, metropolitan
planning organizations, and local transportation professionals achieve successful
policy, planning, and project outcomes through effective collaboration with
health stakeholders. The guide is geared to a broad transportation audience,
including those who are new to transportation and health coordination efforts.
Health in All Policies: A Guide for State and Local Governments

(Rudolph et al. 2013)
https://www.apha.org/-/media/Files/PDF/factsheets/Health_inAll_Policies
_Guide_169pages.ashx
This guide fosters collaboration across sectors to promote health, including

roadway safety. Contents include background, getting started, partners
and roles, working together across sectors, structures to support health in all
policies, creating healthy public policy, talking about health in all policies,
and a case study.
(continued on next page)

Box 4. Resources on Recruiting, Growing, and Maintaining Groups

to Improve Roadway Safety (Continued)
Virtual Public Involvement Tools
https://www.fhwa.dot.gov/planning/public_involvement/vpi/resources/fact_sheets/
This web page is a compilation of eight short fact sheets that group similar
tools and offer examples of how they have been used in transportation
planning and project development.
Every Place Counts Leadership Academy

https://www.transportation.gov/leadershipacademy
This resource offers a transportation toolkit and other tools to assist community
members’ involvement in transportation decision making processes.
Guidance on Growing Traffic Safety Culture: Stories from Rural Communities

(Otto et al. 2020)
https://ruralsafetycenter.org/pdfs/RRSC_Guidance_Growing_TSC_2022.pdf
This guide provides examples gathered from rural communities as they

engaged in a process to grow traffic safety culture including recruiting and
supporting coalitions. Tips are also provided.

CHAPTER 4
Guidance on Identifying, Selecting,

and Adapting Countermeasures
and Strategies
After completing an assessment and identifying priorities, you are ready to identify potential
countermeasures and strategies to address each priority. In general, there are multiple counter
measures and strategies to choose from. However, not all of them may be suitable for your
community—perhaps one requires too much funding, or you do not have access to the focus
audience (e.g., to implement a school-based program). Therefore, after identifying potential
countermeasures and strategies, you will need to select one or more that are appropriate and
feasible to implement.
Once you have selected a countermeasure or strategy, you may need to adapt it to your local
setting. You will want to do this in a way that maintains effectiveness; otherwise, you might
implement a countermeasure or strategy and have no impact. Developing a logic model for your
countermeasure or strategy can guide selection and successful adaptation.
To begin, this chapter explores the differences between how behavioral and engineering coun-
termeasures and strategies work. Next, it provides guidance on identifying, selecting, and adapt-
ing countermeasures and strategies.
General Behavioral and Engineering Approaches

In general, behavioral countermeasures and strategies improve roadway safety by changing
people’s decisions about driving behavior. Examples include driving after drinking (impaired
driving), using a cell phone while driving (distracted driving), or using a seat belt (occupancy
protection), as well as many other behaviors. Table 3 describes four basic approaches that
behavioral countermeasures and strategies use.
In contrast, engineering countermeasures and strategies improve roadway safety by chang-
ing the physical environment in ways that change people’s behavior and reduce negative con-
sequences when people make mistakes (Table 4). Unlike behavioral countermeasures and
strategies, these countermeasures only have an impact on people’s behavior in a specific place
(where the design exists), and they do not require changing people’s beliefs to achieve changes
in behavior.
Some behavioral countermeasures and strategies change behavior that would come before and
lead to risky driving. For example, reducing underage drinking reduces impaired driving among
underage youth; that is, when fewer youth drink, fewer youth drive after drinking. Similarly,
training servers in restaurants and bars that serve alcohol about not providing too many drinks
to an individual (i.e., overserving) reduces impaired driving. Identifying and addressing such
related behavior that may contribute to risky driving is a way to expand your efforts and increase
effectiveness.
13

Table 3. Ways that behavioral countermeasures and strategies change

people’s behavior.
General
Approach How It Works Examplesa
Laws, policies, Laws, policies, and rules • Laws such as seat belt use requirements, speed limits,
rules establish clear expectations and graduated driver’s licenses
about acceptable behavior. • Workplace policies about never using a cell phone while
They also enable driving
enforcement and establish • Family rules about never driving after drinking
penalties for not complying.
Enforcement Enforcement of laws may • High-visibility enforcement campaigns such as Click-It-or-
and increase people’s belief that Ticket
adjudication they will be caught and • Teaching law enforcement officers how to detect
prosecuted if they violate the impaired drivers
law. • Teaching prosecutors how to successfully prosecute an
impaired driving case
Education Media campaigns or • Drivers’ education to teach people how to drive safely
educational experiences • Education campaigns about the dangers of distracted
change people’s driving
understanding or beliefs • Seat Belt Convincer, which allows people to experience
about certain behavior. the force of a low-speed collision to give them an
understanding of what can happen in a crash when they
do not use a seat belt
Intervention Interventions are focused • Creating an impaired driving court that includes treatment
efforts with people who have and monitoring for people arrested for impaired driving
engaged in risky behavior or • Using alcohol ignition interlocks to prevent impaired
who are about to engage in driving
a risky behavior. • Promoting bystander engagement—positive intervention
such as calling for a ride for someone who has been
drinking or asking a person not to drive after drinking or
using drugs
a These are examples and not meant to be recommendations.
Table 4. Ways that engineering countermeasures and strategies change

people’s behavior or reduce negative consequences.
General
Approach How It Works Examplesa
Roadway Roadways can be designed • Roundabouts to slow speeds and eliminate side-
design in ways that constrain the impact crashes
behavior of road users to • Pedestrian bump-outs to narrow roadways, slow
reduce crashes that result in speeds, and focus drivers on pedestrians
serious injury or fatality. • Speed bumps to slow speeds
• Reduced conflict intersections to eliminate side-impact
crashes
• Separating nonmotorized users from vehicles
Roadway Surface treatments can be • Rumble strips to reduce roadway departure or
treatment used to reduce loss of control crossing the centerline
or keep vehicles from leaving • Reflectors and wider painted edge lines to reduce the
the roadway. incidence of vehicles leaving the roadway
• High-friction surface treatments to prevent sliding and
loss of control
Managing Components that absorb • Wire rope, guard rails, and impact devices that absorb
energy energy when vehicles leave energy and keep vehicles from crossing to oncoming
the roadway can be added vehicles, rolling over embankments, or colliding with
and areas adjacent to the fixed objects
roadway can be cleared to • Clearing trees from the edge of roadways
reduce the severity of
crashes.
a These are examples and not meant to be recommendations.

Guidance on Identifying, Selecting, and Adapting Countermeasures and Strategies 15
Guidance on Identifying Countermeasures and Strategies

Reviewing countermeasures and strategies that have been used in other communities and
the evidence for their effectiveness is very helpful when decisions are being made about which
countermeasure or strategy to choose for your community. Box 5 lists various resources to help
you identify potential countermeasures and strategies, and Appendix B provides examples of
countermeasures and strategies implemented in nine rural settings. These examples may help you
as you think about selecting and implementing countermeasures and strategies in your community.
While it may seem easy, developing your own countermeasure or strategy to change behavior
is not recommended. Changing people’s behavior is complex and difficult. Over the years, many
strategies have been tried; most have been ineffective. Some have been harmful. It is far easier
and more cost-effective to select a countermeasure or strategy that has been evaluated and shown
to be effective.
Box 5. Resources for Potential Countermeasures and Strategies

Countermeasures That Work: A Highway Safety Countermeasure Guide
for State Highway Safety Offices (10th ed.) (Venkatraman et al. 2021)
https://www.nhtsa.gov/book/countermeasures/countermeasures-work
This guide provides a description of each countermeasure, the costs and time
to implement it, the evidence supporting it, and references. The guide is not
intended to be a comprehensive list of countermeasures available for use. The
topic areas addressed include alcohol- and drug-impaired driving, seat belts
and child restraints, speeding and speed management, distracted driving,
motorcycle safety, young drivers, older drivers, pedestrian safety, bicycle safety,
and drowsy driving. Appendix C of the present report includes a list of behavioral
countermeasures and strategies referenced in Countermeasures That Work
that have strong or moderate levels of evidence that they are effective.
Proven Safety Countermeasures

https://safety.fhwa.dot.gov/provencountermeasures/
This website allows users to filter engineering countermeasures and strategies

on the basis of geography, road classification, focal area (e.g., roadway
departure, intersection, pedestrian), average daily traffic, problem, and crash
type. It includes a webinar, training video, and overview flier. A guidance
document (available as a PDF) is provided for each countermeasure or strategy.
Many countermeasures are suitable for rural and tribal settings. Appendix D of
the present report lists engineering countermeasures and strategies referenced
in Proven Safety Countermeasures, all of which have evidence of effectiveness.
FHWA’s Roadway Safety Data Program Toolbox

https://safety.fhwa.dot.gov/rsdp/toolbox-home.aspx
This resource will help your organization build a new roadway safety data
program or strengthen an existing one. Options are “Manage,” “Analyze,”
“Collect,” and “Research.” The website is a database of multiple resources that
is searchable by filters, and there is a filter for “local/rural” under “focus area.”
There is no filter for “tribal.” There is also a 98-page primer to guide users.

Box 5. Resources for Potential Countermeasures and Strategies (Continued)

What Works Fact Sheet: Motor Vehicle-Related Injury Prevention (Community
Guide 2022)
https://www.thecommunityguide.org/resources/what-works-motor-vehicle
-related-injury-prevention.html
In addition to this fact sheet, the Community Guide website (https://www

.thecommunityguide.org) has a searchable database of recommendations
from the findings of the Community Preventive Services Task Force, including
28 recommendations under “Motor Vehicle Injury” (other topics include mental
health, violence, and nutrition). Most of the 28 recommendations focus on
alcohol, and there are also recommendations on seat belts, child safety seats,
and motorcycle helmets. Resources include policy and law recommendations
as well as a brochure summarizing motor vehicle safety information from the
larger Guide to Community Preventive Services.
Selected Evidence-Based Strategies for Preventing Injuries (IHS 2021)

https://www.ihs.gov/sites/injuryprevention/themes/responsive2017/display
_objects/documents/IHS_IPP_Evidence-based_Strategies.pdf
This document outlines strategies and interventions recommended by the Indian

Health Service Injury Prevention Program for working with tribal communities.
The guidance will help users identify and select the most appropriate evidence-
based or promising strategies for reducing or preventing unintentional and
intentional injuries in specific community settings, including those related to
crashes. The document identifies three core strategies to improve roadway
safety: car seat use, seat belt use, and the prevention of impaired driving. For
each strategy, it provides a few bullet points supporting the strategy and then
a table of specific interventions for implementing the strategy (along with
their level of evidence).
Evidence-Based Behavior Change Campaigns to Improve Traffic Safety Toolkit

https://aaafoundation.org/evidence-based-behavior-change-campaigns-to
-improve-traffic-safety-toolkit/
This hands-on resource from the AAA Foundation for Traffic Safety will help
practitioners develop behavior change campaigns that are evidence-based and
effective. It includes information and resources to plan, design, implement,
and evaluate behavior change campaigns.
Community-Based Toolkit for Road Safety Campaigns

https://tirf.ca/projects/community-based-toolkit-road-safety-campaigns/
This toolkit from the Traffic Injury Research Foundation will support communities
in effectively developing and delivering their own road safety campaigns.
Included are (1) a summary of research on road safety campaigns, the evidence
base, and theoretical approaches guiding the development of campaigns and
(2) a collection of fact sheets created by experts in social marketing, research,
and evaluation to support full implementation of a campaign.


Rural Intelligent Transportation System Toolkit
https://ruralsafetycenter.org/rural-intelligent-transportation-system-its-toolkit/
This toolkit from the National Center for Rural Road Safety offers a series
of 42 fact sheets (PDFs) on critical needs in rural transportation categorized
by topic for transportation practitioners. The fact sheets provide introductory
summary information to help agencies identify areas in which they can
improve efficiency and safety on roadways, public transportation systems, and
nonmotorized systems. It is designed to help rural agencies face their unique
challenges, such as extreme weather events, congestion from special events,
or seasonal recreational travel. All the content is relevant to rural settings
and could be adapted to tribal settings.
Rural Transportation Toolkit

https://www.ruralhealthinfo.org/toolkits/transportation
The Rural Health Information Hub website is a compilation of “promising”

models and resources for transportation programs in rural communities,
including resources and information on development, implementation,
evaluation, and sustainment of rural transportation programs. It primarily
focuses on transportation systems and developing or enhancing options in
rural communities. There is one subsection on road safety focused on design
and infrastructure.
A Guide to Implementing Child Passenger Safety Inspection Stations

(Ostergaard and Guzzetta 2021)
https://rosap.ntl.bts.gov/view/dot/55179/dot_55179_DS1.pdf
This guide provides recommendations for implementing child passenger safety

inspection stations. Inspection stations are an effective way to increase the
proper use of car seats, booster seats, and seat belts. This guide is intended
for all those looking to implement an inspection station in their community.
Substance Abuse and Mental Health Services Administration

https://www.samhsa.gov/
The Substance Abuse and Mental Health Services Administration website

includes several resources relevant to roadway safety:
• Drug-Free Workplace Toolkit (to reduce impaired driving),

• Preventing Marijuana Use Among Youth (to reduce impaired driving),
• Supported Education Evidence-Based Practices Kit (to promote cultural
competency of roadway safety efforts and assessments of fidelity as
strategies/countermeasures are adapted to rural or tribal settings), and
• Healthy People 2030: Injury Prevention (Objective: transportation), a national
plan supporting rural roadway safety practitioners by connecting rural
roadway safety to national health priorities as well as data and evidence-
based resources and strategies.


America’s Rural Roads: Beautiful and Deadly (GHSA 2022)
https://www.ghsa.org/resources/GHSA/Rural-Road-Safety22
This report from the Governors Highway Safety Association provides general
guidance for rural communities on ways to improve rural road safety.
Resources Related to Farm Equipment and Roadway Safety
• Lighting and Marking of Agricultural Equipment on Highways: Summary

of ASAE Standard S279.181 [Gorucu et al. (2021), https://edis.ifas.ufl.edu
/publication/AE175]. Research has shown that following lighting guidelines
for farm equipment reduces crashes. This report provides lighting guidance.
• “Raising Awareness of Farm Equipment on Public Roadways in Tennessee”
[Mehlhorn et al. (2017) https://elibrary.asabe.org/abstract.asp?AID=48579].
Tennessee created an educational program for young drivers about the laws
and guidelines pertaining to farm equipment on public roadways. This study
showed that the program did increase students’ knowledge.
• Find Me Driving (https://findmedriving.com/). Several soybean producers
sponsored this educational effort, which provides safety tips about driving
around farm equipment in the form of posters, brochures, training, and
videos. No research is available about the program’s effectiveness.
Resources Related to Amish Populations and Roadway Safety
• “Designing an Agricultural Safety Intervention Program for Ohio Amish

Youth” [Beaudreault et al. (2009) https://www.researchgate.net/publication
/240630122_Designing_an_Agricultural_Safety_Intervention_Program_for
_Ohio_Amish_Youth_CASES]. Amish youth may be exposed to risks associated
with farming. This paper reviews an approach to providing education to this
community.
• Horse and Buggy Driver’s Manual [Pennsylvania DOT (n.d.-a) https://www.dot
.state.pa.us/public/PubsForms/Publications/PUB%20632.pdf]. The Pennsylvania
DOT created this guidance for those using horse-drawn buggies.
• Safe Driving in Amish Country [Pennsylvania DOT (n.d.-b) https://www.dot
.state.pa.us/public/PubsForms/Publications/PUB%20627.pdf]. The Pennsylvania
DOT developed this fact sheet to educate the general public about driving
in areas where horse-drawn buggies may be likely.
• Amish Roadway Safety Program (https://agsafety.osu.edu/program-areas
/amish-roadway-safety-program). The Ohio State University Extension created
this series of fact sheets on a variety of topics on Amish roadway safety.
Resources Related to All-Terrain Vehicle Safety
• The All-Terrain Vehicle (ATV) Safety Institute has a variety of resources

available at https://atvsafety.org/.
• The U.S. Consumer Product Safety Commission has a public service announce-
ment on ATV safety at https://www.cpsc.gov/Safety-Education/Safety-Educa-
tion-Centers/ATV-Safety-Information-Center.
• The 4-H program for youth (often supported by Extension Agents) has an
ATV safety program: https://atv-youth.org/.

Guidance on Selecting Countermeasures and Strategies

Guidance on selecting strategies is often included in the resources listing countermeasures
and strategies as well as in the planning processes described in Chapter 3. Selecting counter-
measures and strategies that have been shown to be effective is more likely to lead to improving
roadway safety in your community than designing your own countermeasure or strategy.
As you consider a particular countermeasure or strategy, you may want to create a logic model
for it (see Chapter 2). This will help you determine whether the countermeasure or strategy
is a good fit for your setting. Factors to keep in mind when you are selecting strategies can be
categorized by general approach: laws, policies, and rules; enforcement and adjudication; educa-
tion; and intervention.
Laws, policies, and rules:
• Not all local jurisdictions may be able to enact new laws. Check with your local prosecutor
to learn more.
• Getting support from your local prosecutor and judges is important. Law enforcement officers
are less likely to enforce laws unless they know prosecutors and judges will follow up.
• Workplaces provide important opportunities to enhance roadway safety by enacting policies
about roadway safety. These could address a variety of behavior, such as seat belt use, distracted
driving, speeding, and even driving after drinking or using drugs (e.g., marijuana). Workplace
policies should be coupled with training to make them more effective. Some workplaces will
champion their role in improving roadway safety. Idaho Power’s work to promote workplace
policies on distracted driving is one example (see https://www.idahopower.com/outages-safety
/safety/driving-safety/).
• Consider approaching public workplaces as well (e.g., local government, schools) Often these
organizations are significant employers in rural and tribal settings.
• Promoting family rules can be an effective way to promote important conversations about
roadway safety in the home and establish clear expectations for all family members. Schools,
faith communities, and local parenting resources may offer information on promoting family
rules on roadway safety.
Enforcement and adjudication:
• Local enforcement resources may be limited. Consider partnering with state patrols and
even agencies in adjacent counties for special enforcement activities.
• Sometimes, local law enforcement agencies can be hesitant to enforce roadway safety laws.
Seek to elevate the voices of concerned stakeholders to support enforcement. Emphasize that
the desired outcome is not more citations but compliance and safer outcomes.
• Seek training for officers to bolster their skills. Reach out to your state’s DOT about training
opportunities for Drug Recognition Expert (DRE), Advanced Roadside Impaired Driving
Enforcement (ARIDE), Below 100, and other resources.
• Most states have Traffic Safety Resource Prosecutors who provide training on effective prosecu-
tion of impaired driving cases. The contact for each state can be found at the National Traffic
Law Center (https://ndaa.org/programs/ntlc/traffic-safety-resource-prosecutor-list/).
• Review the examples shared at the end of this chapter for more ideas.
Education:
• The most common reason education campaigns do not work is lack of dosage. Dosage
describes how much of the focus population the education reaches, how often it reaches
them, and for how long. Effective education requires significant dosage. Ask yourself: “Are
we a mile wide and an inch deep?” If so, consider how you can narrow the focus population
or obtain more resources.

• Engaging teachers can help make educational efforts more successful. Teachers know what
is developmentally appropriate for different ages and what is required to transfer knowledge.
• Often, rural and tribal settings do not have extensive budgets for campaigns. Having a diverse
coalition supporting the campaign can increase the dosage. Consider creating speaking points,
social media posts, posters, and so forth that everyone can share through their contacts.
Intervention:
• DUI courts have been shown to be effective. However, starting one requires time and com-
mitment. Reach out to your state DOT for resources on how to start a DUI court in your
community.
• Alcohol ignition interlocks have been shown to be effective for preventing alcohol-impaired
driving. However, they can be expensive and require regular maintenance. Rural and tribal
settings may need to partner with neighboring communities to implement ignition interlocks.
Reach out to your state DOT for resources on how to get started.
• Training people who work in restaurants and bars about not overserving alcohol can reduce
impaired driving. This training may also include teaching servers how to intervene and
encourage alternative transportation for individuals who have been drinking. Reach out to
local law enforcement or substance use prevention coalitions in your community or neigh-
boring communities to find someone who can provide beverage server training. You can also
get local law enforcement officers trained so that they can provide the training locally.
Guidance on Adapting Countermeasures and Strategies

Some countermeasures and strategies may need to be modified or adapted to be implemented
in your setting. You want to minimize any changes that you make, because each change could
reduce effectiveness.
Developing a logic model for the countermeasure or strategy will help you understand how
the strategy works. You can then carefully decide what changes you might need to make and
consider whether these changes may adversely affect the likelihood of achieving the desired
short-term outcomes.
Here are four reasons you may need to adapt a countermeasure or strategy:
1. You may need to change some of the content of materials to better reflect your community.
This could involve changing such things as images, words, examples, or language. However,
you want to make sure that your changes do not change the underlying meaning. For example,
an image used in a print advertisement for a local newspaper shows a scene from a city. You
recognize that most people in your community would not connect with that image, so you work
with a local graphic artist to change the image to a scene more like your community.
2. You may need to change the language (or just certain words) as well as the reading level
to better align with your focus audience. For example, a program designed for high school
students cannot be used with elementary students without significant changes. Elementary
students may not even be developmentally ready for such a program. Working with teachers
and others would be important.
3. Your community may not have the same resources as described in the countermeasure or
strategy. For example, you may not have a local television or radio station to share important
messages. You would then need to identify other ways to get messages to most people in your
community. Simply skipping this component could significantly reduce effectiveness.
4. It can be tempting to change or remove core components because people do not like them,
do not know how to implement them, or do not have the time. These kinds of changes could
significantly reduce effectiveness and should be considered very carefully. For example,

a program developed for schools may require 10 sessions; however, the school says it only has
time for one session and would prefer to do it in an assembly with all students. This kind of
change could make the program completely ineffective. In such a case, you should consider
finding another program or spend more time advocating for the school to invest in the
10 sessions.
One Technique for Adapting Countermeasures and Strategies:

Red Light, Yellow Light, Green Light
Before considering changes to a countermeasure or strategy, you could use a stoplight approach
to categorize each component or part of a countermeasure or strategy. Green-light components
are those in which changes would not meaningfully change the countermeasure or strategy and
are therefore acceptable. Yellow-light components are those in which minor changes would be
unlikely to meaningfully change the countermeasure or strategy, and changes should be care-
fully explored to ensure they do not reduce effectiveness. Red-light components are those critical
parts that cannot be changed, as changes would be likely to reduce effectiveness or are known to
do so. Your task force or coalition could consider each potential change and the component(s)
it would affect and discuss whether they considered it a green, yellow, or red-light change.
Box 6 provides resources for adapting evidence-based countermeasures and strategies.
Box 6. Resources for Adapting Evidence-Based Countermeasures

and Strategies
Rural Health Information Hub
https://www.ruralhealthinfo.org/toolkits/rural-toolkit/2/adapting-interventions
The Rural Health Information Hub provides a toolkit for choosing strategies as
well as guidance for adapting strategies to fit local needs. The toolkit provides
considerations for the types of proposed adaptations as well as components
that should not be altered.
Making Adaptations Tip Sheet (ACF n.d.)

https://www.acf.hhs.gov/sites/default/files/documents/prep-making-adaptations
-ts_0.pdf
This resource from the Administration for Children and Families, U.S. Department
of Health and Human Services, describes why and when strategies could be
adapted and provides guidance on the core components of evidence-based
strategies that must remain intact.
“Adapting Evidence–Based Behavioral Interventions for New Settings and

Target Populations” (McKleroy et al. 2006)
https://prevention.ucsf.edu/sites/prevention.ucsf.edu/files/inline-files
/CDCMapofAdaptationProcess%28MAP%292006.pdf
This paper provides practitioners with a systematic approach to identifying the

most appropriate intervention for their population and capacity, monitoring
the process, and evaluating the outcomes of the adapted intervention.

Box 6. Resources for Adapting Evidence-Based Countermeasures

and Strategies (Continued)
Community Toolbox
https://ctb.ku.edu/en/table-of-contents/analyze/choose-and-adapt-community
-interventions/cultural-adaptation/main
The Community Toolbox is a free online resource for communities working

to improve health. Chapter 19, Section 4 “Adapting Community Interventions
for Different Cultures and Communities” provides information about why and
when cultural adaptations may be necessary as well as helpful resources to
guide communities in that process.
Adapting Evidence-Based Practices for Under-Resourced Populations

(SAMHSA 2022)
https://www.samhsa.gov/resource/ebp/adapting-evidence-based-practices-under
-resourced-populations
This publication describes a variety of adaptations for evidence-based practices

for under-resourced populations and provides steps to engage in the adaptation
process. The guide also provides research supporting such adaptations.
A Story of Adapting a Pedestrian Safety Audit

A rural community wanted to conduct an audit to assess pedestrian safety and accessibility.
They needed to select a tool that both met their project goals and could be implemented with the
community’s capacity and resources.
Many of the tools they reviewed contained the same categories: sidewalk conditions, street
crossings and intersections, driver behavior, safety, and comfort. They maintained these core
components but modified the specific questions in each category to better align with a rural area.
For example, a question about whether a transit station had shelter was replaced with a ques-
tion about availability of benches or places to rest (because this community did not have transit
stations). The underlying purpose of the question—assessing the comfort of the area—was
maintained, but the question was more appropriate and meaningful for their setting.
They also added questions such as “Is there an audible pedestrian signal?” and “If there is an
audible pedestrian signal, does it give a pedestrian enough time to cross?” based on the needs of
local stakeholders concerned about people with visual impairments.

CHAPTER 5
Guidance on Ways to Grow

Evaluative Thinking
You and those working with you will invest significant time and resources in planning and
implementing countermeasures and strategies to improve roadway safety. Taking even small
evaluation steps can reveal ways that you can be more effective.
According to the American Evaluation Association, “evaluation involves assessing the strengths
and weaknesses of strategies to improve their effectiveness” (American Evaluation Association
2019). By understanding the strengths and weaknesses of a countermeasure or strategy, you can
make changes in the future to make the countermeasure or strategy more effective.
There are several reasons for evaluating countermeasures and strategies. Arguably, the most
important are to ensure systematic learning and to provide needed information in order to refine
and improve countermeasures and strategies. Other reasons for evaluation include
• Assessing effectiveness and informing good management practices by
– Comparing actual implementation with implementation plans and understanding reasons
for deviations,
– Comparing actual outcomes with intended outcomes,
– Comparing outcomes with those of previous years, and
– Establishing realistic intended outcomes for future performance.
• Fostering sustained improvements in roadway safety by
– Focusing attention on issues important to the effectiveness of the countermeasure or
strategy,
– Promoting a countermeasure or strategy by documenting and sharing its effectiveness,
– Recruiting new partners who want to join in contributing to effective countermeasures
and strategies,
– Enhancing the image of the countermeasure or strategy,
– Sustaining or increasing funding,
– Providing direction and informing training for staff and partners to implement the counter-
measure or strategy effectively in the future,
– Informing what training and technical assistance is needed to improve effectiveness,
– Informing long-range planning, and
– Justifying the investment of resources by legislators or other stakeholders by showing the
countermeasure or strategy is effective.
A good first step is to create a logic model for the countermeasure or strategy (see Chapter 2).
You can then identify things that you want to monitor and measure. Two forms of evaluation
could be particularly helpful:
• Process evaluations: Process evaluations examine the way the countermeasure or strategy
was implemented. Using the logic model, process evaluations ask questions about the outputs.
Were the activities conducted as planned and with fidelity to any available guidance? Was the
23

appropriate audience reached, and to what extent? Following are some specific examples of
process evaluation questions:
– If the countermeasure or strategy called for 5 days of enhanced visible enforcement, did
that actually happen? How much enforcement occurred each day? If there was a program
in the school, did the teacher complete all four modules?
– Did the countermeasure or strategy reach a sufficient portion of the population to make
a difference? For example, did most people in the community know about the enhanced
enforcement? Did the messages sent out actually reach people? With regard to the school
program, what percentage of students received all four modules?
• Outcome evaluations: Outcome evaluations measure the effect of the countermeasure or
strategy on creating change. In the logic model, outcome evaluations ask questions related to
the short-term, intermediate, and long-term outcomes. An outcome evaluation could assess
the degree to which the countermeasure or strategy changed beliefs. An outcome evaluation
could also assess the degree to which there was a change in behavior. Following are some
specific examples of outcome evaluation questions:
– Did people’s perception of getting caught for not using a seat belt increase?
– Did students’ knowledge change as a result of the school program?
– Did seat belt use change among the focus population?
No matter what type of evaluation you pursue, evaluation data and what was learned should be
shared with the team and used to explore ways of improving future implementation. Suggestions
for process and outcome evaluations can be categorized by general approach: laws, policies, and
rules; enforcement and adjudication; education; and intervention.
Laws, policies, and rules:
• Keep track of how many workplaces or organizations adopt policies about safe driving. Ask
how many employees the organizations have and estimate what proportion of the community
now has a safe driving policy at their place of work.
• Ask organization leadership what, if any, other activities they conduced to promote new policy
or train employees. Add a question or two to workplace surveys to ask about awareness of the
policy and driving behavior. Monitor changes in awareness and behavior over time.
• Ask families if they have family rules about safe driving practices. Work with the local school
to add a question or two to an existent survey or create a short survey to include with back-
to-school paperwork. Monitor the percentage of families with rules over time.
Enforcement and adjudication:
• Track the number of officers working on a high-visibility campaign and the number of shifts
or hours spent on high-visibility enforcement.
• Survey law enforcement officers before and after training (pre- and postdesign) to assess their
knowledge and confidence about detecting impaired drivers.
Education:
• Track the quantity and quality of specific content (whatever the topic of interest is—seat belts,
speeding, sharing the road with agricultural equipment) in driver’s education classes. Monitor
for changes over time.
• Conduct community surveys at selected locations (e.g., Post Office, Department of Motor
Vehicles, grocery store) to ask people whether they have seen the media campaign. Vary days,
times, and locations to try to get a wide cross section of community members. Do a few surveys
before the campaign starts to determine the baseline and then monitor for changes over time.
• Survey students who participate in the Seat Belt Convincer before and after the experience
to determine whether it led to any changes in attitudes or planned behavior. Do a follow-up
survey to see if changes persist.

Guidance on Ways to Grow Evaluative Thinking 25
Intervention:
• Track the number and type of cases in impaired driving court.
• Survey community members before, during, and after activities that promote bystander
engagement to assess their comfort in asking others not to drive after drinking and whether
they have asked anyone to not drive in the past month. Monitor for changes over time.
There may be skilled evaluators in your community. Evaluators often work across a variety
of subjects, and community-oriented evaluators may be eager to lend their expertise to local
efforts to improve roadway safety. You might consider reaching out to such individuals and invit-
ing them to join the coalition. The American Evaluation Association has a directory resource
(https://my.eval.org/find-an-evaluator) that may be helpful if you are looking for an evaluator
partner.
Box 7 lists additional resources for learning more about evaluation and evaluative thinking.
Box 7. Resources for Learning More About Evaluation

and Evaluative Thinking
Guidance for Evaluating Traffic Safety Culture Strategies
https://www.mdt.mt.gov/research/projects/trafficsafety-strategies.aspx
This site includes a comprehensive report, a guidance document, and a poster

providing more in-depth information about evaluating roadway safety culture
strategies.
Evaluation and Enhancement of Community Outreach Programs

https://injury.research.chop.edu/teen-driving-safety/evaluation-community
-outreach-programs-teen-driver-safety
This site offers resources from the Children’s Hospital of Philadelphia Center
for Injury Research & Prevention, in partnership with the Pennsylvania DOT,
including a guide, videos, and additional resources. The information can be
applied to total roadway safety and includes examples related to teen driver
safety.
Community Toolbox Evaluating the Initiative Toolkit

https://ctb.ku.edu/en/evaluating-initiative
The Community Toolbox is a thorough resource on community development

and covers everything from coalition development and community assessment
to program implementation and evaluation. Some of the resource material
is intended for health improvement efforts, and since health improvement
efforts often focus on human behavior, the information can be readily applied
to evaluation of behavioral countermeasures and strategies to improve roadway
safety. This evaluation toolkit is just one of many resources included in the
Community Toolbox.

Acronyms and Abbreviations
AAA American Automobile Association

ALR administrative license revocation
ALS administrative license suspension
ARIDE Advanced Roadside Impaired Driving Enforcement
ATV all-terrain vehicle
BAC blood alcohol content
BIL Bipartisan Infrastructure Law
Caltrans California Department of Transportation
CHP California Highway Patrol
CR child restraint
DOT department of transportation
DRE Drug Recognition Expert
DWI driving while intoxicated
GDL graduated driver licensing
ROUTES Rural Opportunities to Use Transportation for Economic Success
26

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McKleroy, V. S., Galbraith, J. S., Cummings, B., Jones, P., Harshbarger, C., Collins, C., Gelaude, D., Carey, J. W.,
and the ADAPT Team. (2006). Adapting Evidence–Based Behavioral Interventions for New Settings and
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Mehlhorn, S. A., Darroch, B., and Jackson, S. W. (2017). Raising Awareness of Farm Equipment on Public
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Safety, Design & Equity: A Paradigm Shift. Journal of Transport & Health, Vol. 23. https://doi.org/10.1016
/j.jth.2021.101260.
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Rudolph, L., Caplan, J., Ben-Moshe, K., and Dillon, L. (2013). Health in All Policies: A Guide for State and Local
Governments. American Public Health Association, Washington, DC, and Public Health Institute, Oakland,
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Health and Substance Use Policy Laboratory, Rockville, MD. https://www.samhsa.gov/resource/ebp
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/2022-04/Equity_Action_Plan.pdf.
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Safety Countermeasures Guide for State Highway Safety Offices, 10th ed. Report No. DOT HS 813 097.
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/fhwasa14073/isrltru1.pdf.

APPENDIX A
Example Logic Models
This appendix includes three examples of logic models and a blank logic model that can be
used as a template.
Table A-1. Logic model: Policy on workplace distracted driving.
Inputs: Outputs:
Policy template or Draft policy; champion All employees Increased Increase in managers Decrease in
example policy through understanding that and supervisors crashes, serious
organization’s process for driving distracted is holding staff injuries, and fatalities
Leadership buy-in adopting policies against company accountable for caused by distracted
policy following the policy driving
Evidence about Communication to reach all
distracted driving staff, such as Increased belief that Decrease in staff
and best practices announcement(s) and distracted driving is members driving
for policies training for all staff on the dangerous distracted (within the
addressing policy (including for bounds of the policy,
distracted driving managers/supervisors Increased such as on company
about enforcing the policy) understanding about property or when
the consequences of operating company
violating the policy vehicles)
Increased knowledge
by managers and
supervisors about how
to enforce the policy
29

Table A-2. Logic model: Move over media campaign.
Inputs: Outputs:
Understanding of Media campaign Individuals in XX Increase knowledge of Increase in motorists Decrease in deaths
audience’s current including social community the requirements of the slowing down and of and serious
knowledge of Move media, print, TV, Move Over law providing adequate injuries to law
Over law radio space for enforcement officers
Increase belief that emergency and emergency
Staff to identify and moving over is the “right responders responders caused
place messages/ thing to do” by motorists failing to
media slow down and
provide adequate
Increase understanding space on roadway
Funding for media about the consequences
placement with high and penalties of violating
dosage the Move Over law
Table A-3. Logic model: Seat belt convincer.
Inputs: Outputs:
Cost to purchase or Seat Belt Convincer Individuals at XX Understanding of Increase in seat belt Decrease in deaths
rent a Seat Belt session at XX Middle Middle School the physical impact use by middle school and serious injuries
Convincer School of not wearing a students who from crashes
seat belt in a 5- to participate in the involving unrestrained
Class period for 10-mph collision program occupants
students to engage in
Seat Belt Convincer Increase belief that
seat belts are
Staff to transition protective in
students in/out of crashes
Seat Belt Convincer
and back to
classrooms

Example Logic Models 31
Table A-4. Logic model template.
Inputs: Outputs:
What do we need to What are the core Who is our audience What are the What are the What are the long-
do this strategy? components of this for this strategy? immediate or short- medium-term term outcomes we
strategy? term outcomes we outcomes we anticipate? What is
anticipate? anticipate? our ultimate goal?
Tip: Think of Tip: Think of the
personnel, resources, critical pieces that Tip: Think of Tip: Think of changes Tip: Think of health
information. make this strategy changes in in behavior. impacts such as
work. knowledge, beliefs, reduction in serious
or skills. injury and fatalities.

APPENDIX B
Examples of Implementing
Countermeasures and Strategies
in Rural Settings
Following are examples of how communities have implemented various countermeasures
and strategies in rural settings.
Boone County, NE (Population: 5,300)

• A rural county with long straight roads used funding from its state DOT to add additional
signs (e.g., second stop signs on the left-hand side of the road) at intersections with higher
crash rates. The county also engaged in extra enforcement during local events associated with
increased levels of impaired driving.
Cameron County, PA (Population: 4,500)

• A community with limited local police departments partnered with the Pennsylvania Traffic
Safety Enforcement Resource Center and its local Pennsylvania State Police station to provide
roadway safety programs and curricula to students in grades K–12.
Hancock and Kennebec Counties, ME

(Populations: 54,800 and 122,150, Respectively)
• Many tourists come to these communities at different times in the year. Local enforcement
focuses efforts during times when there are more tourists (e.g., summer, holidays weekends)
and uses extensive social media, local media, and press releases to inform everyone about
the enhanced enforcement.
• These communities also invest in year-round communication, including the use of multiple
spokespeople, and assess campaign awareness and impact twice per year. They also leverage
sporting events and private partners (e.g., construction companies) to share media and
messages.
• Periodically, they use checkpoints for seat belts and distracted driving enforcement.
• They also use a mobile roadside testing vehicle for impaired driving, which avoids long
transport times to law enforcement offices during which blood alcohol levels may naturally
decrease.
Humboldt County, CA (Population: 136,100)

• The California Highway Patrol (CHP) frequently works with the Humboldt County Public
Works Department to identify problem areas for enforcement of speeding, impaired driving,
32

Examples of Implementing Countermeasures and Strategies in Rural Settings 33
and other safety issues. On the basis of citizen complaints, the county also works directly with
CHP to set up radar studies and other enforcement actions.
• The local task force adapted public service announcements from the state to air on local radio
stations; for instance, “Be Safe California” was adapted as “Be Safe Humboldt.”
• The county also provided localized campaigns (e.g., addressing pedestrian safety) in both
English and Spanish using outdoor, print, web, and social media outlets as well as outreach
events and innovative marketing efforts such as branded coffee cups.
• They assembled a variety of stakeholders from the Humboldt County Department of Health
and Human Services, the Humboldt County Association of Governments, CHP, the California
Department of Transportation (Caltrans), the Humboldt County Public Works, school groups,
and other partners to focus on Safe Routes to School and promote pedestrian safety around
county schools. Countermeasures and strategies included radar feedback signs and speed
humps. The county also created arrival and dismissal maps for schools, recommended walking
route maps, in-class pedestrian and bicycle safety education, walk- and bike-to-school day
activities, crossing guard training, pilot volunteer crossing guard programs, and walkability
assessments.
Keweenaw County, MI (Population: 1,100)

• Law enforcement partnered with county road trucks to conduct distracted driving enforce-
ment. Law enforcement officers (riding as passengers) in county road trucks spotted distracted
drivers for enforcement. Law enforcement created seat belt enforcement zones in which one
officer observes seat belt use and other officers pursue offenders.
• The community used dynamic message boards to communicate hazardous weather conditions
(in real time based on remote sensors) as well as high bicycle traffic during tourist seasons and
special events.
Morgan County, KY (Population: 13,270)

• Local law enforcement used checkpoints to focus on speed enforcement and seat belt use.
• They also used social media, local newspapers, and radio stations to inform residents of road
hazards and when traffic was greater.
Orange and Orleans Counties, VT

(Populations: 28,900 and 26,850, Respectively)
• These two counties partnered with neighboring states (New York and New Hampshire) through
NHTSA’s “Border to Border” initiative on seat belt enforcement.
Ravalli County, MT (Population: 43,424)

• This community created a DUI Task Force for the county that was funded by a portion of
license reinstatement fees for DUI offenders.
• The county engaged in intensive enforcement activities addressing speeding and impaired
driving, coupled with extensive media outreach.
• Local efforts also focused on enforcement of laws regarding alcohol purchased by those under
21 and beverage server training at drinking establishments coupled with education in local
schools and community media.

Crow Wing County, MN (Population: 64,775)

• Local State Patrol uses dynamic speed display signs to inform drivers when they are speeding
on rural roads. Due to limited resources, law enforcement is not able to conduct as many speed
enforcement activities as needed. However, as they move the dynamic speed display signs
around the county, they also use the devices to identify the time of day and day of week when
speeding is occurring most frequently (the signs record the speeds of all vehicles). They then
deploy their limited resources during these times. They also position officers just past the
display signs. This has resulted in more officers issuing citations instead of warnings because
the driver was just warned by the sign.

APPENDIX C
Summary of Countermeasures
That Work
The tables in this appendix list behavioral countermeasures and strategies from Counter
measures That Work (Venkatraman et al. 2021) for which there is strong or moderate evidence
that they are effective. See https://www.nhtsa.gov/book/countermeasures/countermeasures-work
for an online version of the resource.
Table C-1. Impaired driving.
Countermeasure Effectiveness Cost Use Time Approach
Deterrence: Laws
1.1 Administrative License Revocation +++++ $$$ High Medium Laws, policies, rules
or Suspension (ALR/ALS)
1.2 Open Container +++ $ High Short Laws, policies, rules
1.3 High Blood Alcohol Content (BAC) +++ $ Medium Short Laws, policies, rules
Sanctions
1.4 BAC Test Refusal Penalties +++ $ Unknown Short Laws, policies, rules
1.5 Alcohol-Impaired Driving Law Review ++ $$ Unknown Medium Laws, policies, rules
Deterrence: Enforcement
2.1 Publicized Sobriety Checkpoints +++++ $$$ Medium Short Enforcement and
adjudication
2.2 High-Visibility Saturation Patrols ++++ $$ High Short Enforcement and

adjudication
2.3 Preliminary Breath Test Devices a ++++ $$ High Short Enforcement and
adjudication
2.4 Passive Alcohol Sensorsb ++++ $$ Unknown Short Enforcement and

adjudication
2.5 Integrated Enforcement +++ $ Unknown Short Enforcement and

adjudication
Deterrence: Prosecution and Adjudication
3.1 Driving While Intoxicated (DWI) ++++ $$$ Low Medium Intervention
Courtsc
3.2 Limits on Diversion and Plea ++++ $ Medium Short Enforcement and
Agreementsd adjudication
3.3 Court Monitoringd +++ $ Low Short Intervention
3.4 Sanctions ++ Varies Varies Varies Laws, policies, rules
35

Table C-1. (Continued).
Deterrence: DWI Offender Treatment, Monitoring, and Control
4.1 Alcohol Problem Assessment and +++++ Varies High Varies Intervention
Treatment
4.2 Alcohol Ignition Interlockse +++++ $$ Medium Medium Intervention
4.3 Vehicle and License Plate Sanctionsc ++++ Varies Medium Medium Laws, policies, rules
4.4 DWI Offender Monitoringc ++++ $$$ Unknown Varies Intervention
4.5 Lower BAC Limit for Repeat ++++ $ Low Short Laws, policies, rules
Offenders
Prevention, Intervention, Communications and Outreach
5.1 Alcohol Screening and Brief +++++ $$ Medium Short Intervention

Intervention
5.2 Mass-Media Campaigns +++ $$$ High Medium Education
5.3 Responsible Beverage Service ++ $$ Medium Medium Education

Changing related
behaviors
5.4 Alternative Transportation +++ $$ Unknown Short Education

Changing related
behaviors
5.5 Designated Drivers ++ $ Medium Short Education

Changing related
behaviors
Underage Drinking and Drinking and Driving
6.1 Minimum Drinking Age 21 Laws +++++ $$$ High Low Laws, policies, rules
6.2 Zero-Tolerance Law Enforcement +++ $ Unknown Short Enforcement and

adjudication
6.3 Alcohol Vendor Compliance +++ $$ Unknown Short Enforcement and

Checksf adjudication
6.4 Other Minimum Legal Drinking +++ $$ Varies Varies Enforcement and
Age 21 Law Enforcement adjudication
6.5 Youth Programs ++ Varies High Medium Education
Drug-Impaired Driving
7.1 Enforcement of Drug-Impaired +++ $$ Unknown Short Enforcement and

Driving adjudication
7.2 Drug-Impaired-Driving Laws + Unknown Medium Short Laws, policies, rules
7.3 Education Regarding Medication + Unknown Unknown Long Education
aProven for increasing arrests.

bProven for detecting impaired drivers.
cProven for reducing recidivism.
dProven for increasing convictions.
eProven for reducing recidivism while on the vehicle.
f Proven for reducing sales to underage people.

Summary of Countermeasures That Work 37
Table C-2. Seat belt.
Seat Belt Use Laws
1.1 State Primary Enforcement +++++ $ Medium Short Laws, policies,

Seat Belt Use Laws rules
1.2 Local Primary Enforcement +++ $ Low Short Laws, policies,

Seat Belt Use Laws rules
1.3 Increased Seat Belt Use Law ++++ $ Low Short Laws, policies,
Penalties rules
Seat Belt Law Enforcement
2.1 Short Term, High-Visibility +++++ $$$ Medium† Medium Enforcement

Seat Belt Law Enforcement and
adjudication
2.2 Integrated Nighttime Seat ++++ $$$ Unknown Medium Enforcement

Belt Enforcement and
adjudication
2.3 Sustained Enforcement +++ Varies Unknown Varies Enforcement

and
adjudication
Communications and Outreach
3.1 Supporting Enforcement +++++ Varies Medium Medium Education
3.2 Strategies for Low-Belt-Use ++++ Unknown Unknown Medium Education

Groups
Child/Youth Occupant Restraint Laws
4.1 Strengthening Child/Youth +++++ $ High Short Laws, policies,

Occupant Restraint Laws rules
Child Restraint/Booster Seat Law Enforcement
5.1 Short High-Visibility Child +++++ $$$ Medium Medium Enforcement

Restraint (CR) Law Enforcement and
adjudication
6.1 Strategies for Older Children +++ Varies Unknown Medium Education
6.2 Strategies for Child Restraint +++ Varies Unknown Medium Education
and Booster Seat Use
Other Strategies
7.1 School-Based Programs +++ Varies Unknown Varies Education
7.2 Inspection Stations +++ $$ High Short Education

Intervention

Table C-3. Speed.
Laws
1.1 Speed Limits +++++ $ High Short Laws, policies,

rules
1.2 Aggressive Driving and Other + $ Low Short Laws, policies,

Laws rules
Enforcement
2.1 Automated Enforcement +++++ $$$† Medium Medium Enforcement

and
adjudication
2.2 High-Visibility Enforcement ++ $$$ Low†† Medium Enforcement

and
adjudication
2.3 Other Enforcement Methods ++ Varies Unknown Varies Enforcement

and
adjudication
Penalties and Adjudication
3.1 Penalty Types and Levels ++ Varies High Low Laws, policies,
rules
3.2 Diversion and Plea Agreement + Varies Unknown Varies Education

Restrictions, Traffic Violator Intervention
School
4.1 Communications and Outreach +++ Varies Medium Medium Education

Supporting Enforcement
Table C-4. Distracted driving.
Laws and Enforcement
1.1 Graduated Driver Licensing +++++ $ High Medium Laws, policies,

(GDL) Requirements for Beginning rules
Drivers
1.2 Cell Phone and Text Messaging ++ $ Medium Short Laws, policies,
Laws rules
1.3 High-Visibility Cell Phone/Text ++++ $$$ Low Enforcement

Messaging Enforcement Medium and
adjudication
1.4 General Distraction Laws + Varies High†† Short Laws, policies,

rules
2.1 Communications and Outreach + $$ High Medium Education

on Distracted Driving
Other Countermeasures
3.1 Employer Programs + $ Unknown Short Laws, policies,

rules

Table C-5. Motorcycle.
Motorcycle Helmets
1.1 Universal Motorcycle +++++ $ Medium Short Laws, policies,

Helmet Use Laws rules
1.2 Motorcycle Helmet Use + Varies Low to Varies Education

Promotion Programs Medium
1.3 Motorcycle Helmet Law + $ Unknown Medium Enforcement

Enforcement: Noncompliant and
Helmets adjudication
Alcohol Impairment
2.1 Alcohol-Impaired Motorcyclists: +++ Varies Unknown Varies Enforcement

Detection, Enforcement, and and
Sanctions adjudication
2.2 Alcohol-Impaired Motorcyclists: + $$ Medium Medium Education

Communications
Motorcycle Rider Licensing and Training
3.1 Motorcycle Rider Licensing + $ High Medium Laws, policies,

rules
3.2 Motorcycle Rider Training ++ $$ High Varies Education
4.1 Conspicuity and Protective + Varies High Medium Education

Clothing
4.2 Motorist Awareness of + Varies High Medium Education

Motorcyclists

Table C-6. Young drivers.
Graduated Driver Licensing
1.1 GDL +++++ $ High Medium Laws, policies,

rules
1.2 Learner’s Permit Length, +++++ $ High Medium Laws, policies,

Supervised Hours rules
1.3 Intermediate—Nighttime +++++ $ High Medium Laws, policies,

Restrictions rules
1.4 Intermediate—Passenger +++++ $ High Medium Laws, policies,

Restrictions rules
1.5 Cell Phone Restrictions ++ $ Medium Medium Laws, policies,

rules
1.6 Belt Use Requirements ++ $ Low Medium Laws, policies,

rules
1.7 Intermediate—Violation + $ High Medium Laws, policies,

Penalties rules
Driver Education
2.1 Pre-Licensure Driver Education ++ $$$ Medium Long Education
2.2 Post-Licensure Driver + $$$ Low Long Education

Education
Parents
3.1 Parent Roles in Teaching and ++ $$ Medium Short Changing

Managing Young Drivers related
behaviors
3.2 Electronic Technology for +++ $ Low Short Changing

Parental Monitoring related
behaviors
Traffic Law Enforcement
4.1 Enforcement of GDL and Zero- +++ $$ Unknown Short Enforcement

Tolerance Laws and
adjudication

Table C-7. Older drivers.
1.1 Formal Courses for Older ++ $ Low Short Education

Drivers
1.2 General Communications and + $ Unknown Short Education

Education
Licensing
2.1 License Screening and ++++ $$ High Medium Laws, policies,

Testing rules
2.2 Referring Older Drivers to ++++ $$ Low Medium Intervention

Licensing Agencies
2.3 License Restrictions ++++ $ Low Short Laws, policies,

rules
2.4 Medical Advisory Boards + Varies High Medium Intervention
2.5 License Renewal Policies: In- ++ $$$ Medium Medium Laws, policies,
Person Renewal, Vision Test rules
Traffic Law Enforcement
3.1 Law Enforcement Roles +++ Varies Medium Varies Enforcement

and
adjudication

Table C-8. Pedestrians.
Preschool-Age Children
1.1 Children’s Safety Clubs + Varies Unknown Unknown Education
1.2 Child Supervision + $ Unknown Short Intervention
School-Age Children
2.1 Elementary-Age Child +++ $ Unknown Short Education

Pedestrian Training
2.2 Safe Routes to School +++ $ High Short Education
2.3 Walking School Buses +++ $ Low Short Education
2.4 Child School Bus Training ++ $ High Short Education
Impaired Pedestrians
3.1 Communications and ++ Varies Low Medium Education

Outreach Addressing Impaired
Pedestrians
3.2 “Sweeper” Patrols of Impaired + $$ Low Medium Enforcement

Pedestrians and
adjudication
All Pedestrians
4.1 Pedestrian Safety Zones ++++ $$$ Low Medium Laws, policies,
rules
4.2 Reduce and Enforce Speed +++ $ High Varies Laws, policies,
Limits rules
4.3 Conspicuity Enhancement +++ $ Low Medium Changing

related
behaviors
4.4 Enforcement Strategies +++ $$ Low Short Enforcement

and
adjudication
4.5 Driver Training + $ Low Medium Education
4.6 Pedestrian Gap Acceptance + $$ Unknown Medium Education

Training
4.7 University Educational + $ High Medium Education

Campaign

Table C-9. Bicycle safety.
Children
1.1 Bicycle Helmet Laws for +++++ $$ Medium Short Laws, policies,
Children rules
1.2 Safe Routes to School +++ $ High Short Education
1.3 Bicycle Safety Education for ++ $ Unknown Short Education

Children
1.4 Cycling Skills Clinics, Bike + $ Unknown Short Education

Fairs, Bike Rodeos
Adults
2.1 Bicycle Helmet Laws for ++++ $ Low Short Laws, policies,
Adults rules
2.2 Bicycle Safety Education for + $$ Low Medium Education

Adult Cyclists
All Bicyclists
3.1 Active Lighting and Rider +++ $ High† Varies Changing

Conspicuity related
behaviors
3.2 Promote Bicycle Helmet Use ++ $$$ Medium Medium Education

with Education
3.3 Enforcement Strategies + $$ Unknown Varies Enforcement

and
adjudication
3.4 Motorist Passing Bicyclist + $ Medium Short Laws, policies,

Laws rules
Drivers and Bicyclists
4.1 Driver Training + $ Low Medium Education
4.2 Share the Road Awareness ++ $$ Unknown Medium Education

Programs
Table C-10. Drowsy driving.
Laws and Enforcement
1.1 GDL Requirements for +++++ $ High Medium Laws, policies,

Beginning Drivers rules
1.2 General Drowsiness Laws + Varies High†† Short Laws, policies,

rules
2.1 Communications and + $$ Unknown Medium Education

Outreach on Drowsy Driving
Other Countermeasures
3.1 Employer Programs ++ $ Unknown Short Laws, policies,

rules
Education
3.2 Education Regarding Medical + Variable Unknown Medium Education

Conditions and Medications

APPENDIX D
Proven Engineering Safety

Countermeasures
The following are engineering countermeasures and strategies referenced in Proven Safety
Countermeasures (https://safety.fhwa.dot.gov/provencountermeasures/), all of which have
evidence of effectiveness.
44

Proven Engineering Safety Countermeasures 45
Table D-1. Proven safety countermeasures with evidence of effectiveness.
Countermeasure Issue Approach
Variable speed limit signs Speeding Roadway design

Wider edge lines Roadway departure Roadway treatment
SafetyEdge™ Roadway departure Roadway treatment
Enhanced delineation for horizontal curves Roadway departure Roadway treatment
Longitudinal rumble strips and stripes Roadway departure Roadway treatment
Roadside design improvements at curves Roadway departure Roadway treatment
Managing energy
Median barriers Roadway departure Managing energy
Backplates with reflective borders Intersections Roadway treatment
Corridor access management Intersections Roadway design
Left- and right-turn lanes at two-way stop- Intersections Roadway design
controlled intersections
Reduced left-turn conflict intersections Intersections Roadway design
Roundabouts Intersections Roadway design
Systemic application of multiple low-cost Intersections Roadway treatment
countermeasures at stop-controlled intersections
Yellow change intervals Intersections Roadway treatment
Crosswalk visibility enhancements Pedestrian/bicyclist Roadway treatment
Bicycle lanes Pedestrian/bicyclist Roadway design
Rectangular rapid flashing beacons Pedestrian/bicyclist Roadway treatment
Leading pedestrian interval Pedestrian/bicyclist Roadway treatment

Medians and pedestrian refuge islands in urban Pedestrian/bicyclist Roadway design
and suburban areas
Pedestrian hybrid beacons Pedestrian/bicyclist Roadway treatment
Road diets (roadway reconfiguration) Pedestrian/bicyclist Roadway design
Walkways Pedestrian/bicyclist Roadway design
Pavement friction management Crosscutting Roadway treatment
Lighting Crosscutting Roadway treatment
Source: https://safety.fhwa.dot.gov/provencountermeasures/.




Abbreviations and acronyms used without definitions in TRB publications:

A4A Airlines for America
AAAE American Association of Airport Executives
AASHO American Association of State Highway Officials
AASHTO American Association of State Highway and Transportation Officials
ACI–NA Airports Council International–North America
ACRP Airport Cooperative Research Program
ADA Americans with Disabilities Act
APTA American Public Transportation Association
ASCE American Society of Civil Engineers
ASME American Society of Mechanical Engineers
ASTM American Society for Testing and Materials
ATA American Trucking Associations
CTAA Community Transportation Association of America
CTBSSP Commercial Truck and Bus Safety Synthesis Program
DHS Department of Homeland Security
DOE Department of Energy
EPA Environmental Protection Agency
FAA Federal Aviation Administration
FAST Fixing America’s Surface Transportation Act (2015)
FHWA Federal Highway Administration
FMCSA Federal Motor Carrier Safety Administration
FRA Federal Railroad Administration
FTA Federal Transit Administration
GHSA Governors Highway Safety Association
HMCRP Hazardous Materials Cooperative Research Program
IEEE Institute of Electrical and Electronics Engineers
ISTEA Intermodal Surface Transportation Efficiency Act of 1991
ITE Institute of Transportation Engineers
MAP-21 Moving Ahead for Progress in the 21st Century Act (2012)
NASA National Aeronautics and Space Administration
NASAO National Association of State Aviation Officials
NCFRP National Cooperative Freight Research Program
NCHRP National Cooperative Highway Research Program
NHTSA National Highway Traffic Safety Administration
NTSB National Transportation Safety Board
PHMSA Pipeline and Hazardous Materials Safety Administration
RITA Research and Innovative Technology Administration
SAE Society of Automotive Engineers
SAFETEA-LU Safe, Accountable, Flexible, Efficient Transportation Equity Act:
A Legacy for Users (2005)
TCRP Transit Cooperative Research Program
TEA-21 Transportation Equity Act for the 21st Century (1998)
TRB Transportation Research Board
TSA Transportation Security Administration
U.S. DOT United States Department of Transportation


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FIND RELATED TITLES SUGGESTED CITATION

BTSCRP RESEARCH REPORT 8

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BEHAVIORAL TRAFFIC SAFETY BTSCRP RESEARCH REPORT 8

Published research reports of the

BEHAVIORAL TRAFFIC SAFETY COOPERATIVE

Transportation Research Board

and can be ordered through the Internet by going to

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Learn more about the Transportation Research Board at www.TRB.org.

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COOPERATIVE RESEARCH PROGRAMS

CRP STAFF FOR BTSCRP RESEARCH REPORT 8

BTSCRP PROJECT BTS-15 PANEL

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8 Chapter 3 Guidance on Process: What to Do Next

13 Chapter 4 Guidance on Identifying, Selecting, and

23 Chapter 5 Guidance on Ways to Grow Evaluative Thinking

Copyright National Academy of Sciences. All rights reserved.

Copyright National Academy of Sciences. All rights reserved.

Copyright National Academy of Sciences. All rights reserved.

Box 1. Equity and Roadway Safety

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Box 2. Sources of Funding for Improving Roadway Safety

Transportation Funding Opportunities for Tribal Nations

Indian Health Service

Tribal Transportation Program

Rural Opportunities to Use Transportation for Economic Success

The Rural Opportunities to Use Transportation for Economic Success (ROUTES)

Reconnecting Communities Pilot Program

Indian Highway Safety Program

Safe Kids Worldwide

Local State Highway Traffic Safety Offices

Level 1 Trauma Hospitals

These hospitals must have a full-time paid injury prevention coordinator.

American Automobile Association Foundation for Traffic Safety

• Insurance companies (car seats, bike helmets, etc.)

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Copyright National Academy of Sciences. All rights reserved.

How Behavioral Strategies Work

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Beliefs Behavior Consequences

Figure 1. Connecting beliefs, behavior, and consequences.

Resources Activities Audience Short-term Intermediate Long-term

Number of Increased seat Drivers in XX Increase in Increase in Decrease in

Copyright National Academy of Sciences. All rights reserved.

How Behavioral Strategies Work 7

Logic models make you more effective:

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• Agriculture and extraction-based communities (mining- and farming-oriented counties):

Guidance on Three Planning Processes

• FHWA Local Road Safety Planning Process

Copyright National Academy of Sciences. All rights reserved.

Guidance on Process: What to Do Next 9

Figure 2. Process to improve

Table 2. Key actions and outcomes from process steps.

Step Key Actions Key Outcomes

Assess • Recruit a group of individuals • Task force, coalition, or group willing to

Plan • Prioritize problems/opportunities • Prioritized outcomes, behavior, conditions

Evaluate • Use information gathered to make • Lessons learned

13 Chapter 4 Guidance on Identifying, Selecting, and