What can public health campaigns teach us about traffic safety?
Earlier this year, the National Highway Traffic Safety Administration (NHTSA) released data that showed that traffic-related fatalities increased significantly despite fewer drivers being on the roads during the COVID-19 pandemic. From January–September 2021, there was a 12% jump in deaths on U.S. roadways as compared to the same 9-month period in 2020. The social and behavioral shifts caused by the pandemic—combined with fewer cars on the road—presented opportunities for speeding and reckless driving.
A recent study by the National Safety Council shows that even as traffic volumes have returned to pre-pandemic levels, traffic-related injuries and deaths continue to rise. In low-income communities, the burden of increased traffic-related injuries is amplified by systemic factors like street design that favors vehicles over pedestrians and bicyclists, fewer available crosswalks, poorly maintained vehicles, and substance misuse.
The U.S. Department of Transportation recently released the National Roadway Safety Strategy (NRSS), a plan that outlines equitable approaches and tactics for making people, roads, vehicles, and speeds safer and improving post-crash care. As DOT Secretary Pete Buttigieg noted, “The status quo is unacceptable, and it is preventable.” Among the approaches for Safer People, the NRSS includes “updating Departmental safety messaging so that it is unified across the entire Department and reflects the Safe System Approach principle of human fragility.” This provides a prime opportunity to address and strive for more parity in roadway safety—and to leverage proven public health behavior change practices to effectively communicate with drivers, pedestrians, and travelers.
At the state and local level, where most traffic and street safety campaigns happen, there is growing openness to applying public health strategies to traffic safety campaigns. As Mark Ezzell, Director of the North Carolina Governor’s Highway Safety Program and a public health professional who has led substance use disorder prevention and tobacco control campaigns, told us: “Highway Safety professionals have been slow to adopt public health practices and messaging. However, the tide is changing, and the field is more open than ever to applying the lessons of previous public health campaigns to traffic safety messaging.”
From ICF’s decades of experience leading successful health behavior change campaigns in tobacco cessation, vaccination uptake, preventative screenings, and infectious disease prevention, we agree that many of the same lessons can be applied to traffic safety communications. We can use these evidence-based practices to motivate drivers and pedestrians to adopt behaviors that improve their safety and protect the well-being of others:
Prioritize formative research
While demographic segmenting may be a part of defining audiences using qualitative and quantitative approaches, successful public health approaches define audiences geographically, linguistically, culturally, and experientially to understand how decisions happen, how calculations around personal risk are made, and why behaviors occur. This approach creates messaging that feels authentic to your audiences, motivates change in ways that are relevant to their lives, and advances equity. For example, to ensure that messaging and materials on the COVID-19 vaccine for Morehouse School of Medicine were culturally relevant to our target audience, we conducted more than 70 in-depth interviews and 25 focus groups with African American, Hispanic/Latino, Alaska Native, American Indian, Filipino American, Native Hawaiian, and Haitian American communities; Spanish-speaking migrant workers; and African Americans with mild to moderate intellectual disabilities.
Test concepts for accuracy, preference, and impact
Once you’ve developed messaging strategies, it is crucial to learn from your audiences through quantitative and qualitative testing. This will help to identify what messages are most likely to motivate change (which is not always the same messages the audiences “like” or “prefer”), and any unintended consequences of the message. Testing should also consider language, culture, systemic inequities, and calls to action to ensure they resonate and are attainable to the audience. Ultimately, the goal is to create messages that speak to audiences on both an intellectual and emotional level: they understand and agree with the logic in the message and the call to action, and they have emotionally-based reasons (fear, happiness, desire to protect or care for loved ones, hope for the future) for adopting a healthy behavior as well.
Promote messenger over message
Just as important as getting the right nuance for a message, is who delivers the message—particularly among ethnic minority and multicultural groups. When it comes to traffic safety messaging, a governmental- or law enforcement-sponsored message is credible for some audiences, but for others those voices may be seen as untrustworthy or even antagonistic. Through the processes of understanding the total context of audiences, you’ll learn who will be most listened to and believed. From this information, you can then work with credible individuals and organizations to deliver messages in authentic, resonant ways that are audience focused. This is particularly important when considering equity approaches among those disproportionately impacted by traffic accidents.
Employ a multi-layered outreach approach that meets audiences where they live, work, and play
Like public health campaigns, traffic safety campaigns must approach media buys with a social context lens. Digital and social media allow for a social/behavioral framework to be at the center of your media buying strategy because audiences can be prioritized and reached utilizing profiles based on their online activity. But even more traditional media—out-of-home, place-based, broadcast, radio, and print—can be informed by this understanding of audience. You can also engage partner organizations to deliver offline communication that is critical in reaching multicultural communities.
Track, measure, and refine processes to maximize impact
Finally, public health and safety campaigns typically include rigorous evaluation to understand not only reach and engagement, but also actual or self-reported behavior change. For example, ICF worked with CDC to develop, test, promote, and evaluate the Rx Awareness campaign to increase awareness that prescription opioids can be addictive and dangerous and lower prescription opioid misuse. The campaign received 112 million impressions. Most importantly, 27% of people who saw a campaign video intended to avoid using prescription opioids because of exposure to the campaign.
The road forward
It has never been more important to deliver impactful traffic and roadway safety campaigns to motivate behavior change that can ultimately save lives and prevent life-altering injuries. Behavior-change communication approaches used in public health address the context in which audiences calculate risk and make decisions, deliver messages that speak to audiences on both intellectual and emotional levels, and use credible voices to deliver these messages.
Applying lessons learned from successful public health communications campaigns can serve as a starting point for the federal government—as well as state and local authorities—to innovate and deliver messages that speak to audiences on multiple levels and result in safer behaviors. Considering the immediacy of the issue and the lives at stake, it is time to use this evidence-based approach to innovate traffic and roadway safety communications.
