Challenging Dogma - Fall 2009

Thursday, December 16, 2010

Analysis of Click It or Ticket and The Comprehensive Approach to A New, More Effective Campaign- Heather Valerio

Every hospital in every city in the United States has seen the effects of neglecting to use an automobile’s built in safety belts. Safety belt use is and has been an issue in the United States for quite some time. The use of safety belts significantly reduces the chance of serious injury or death when in an accident, yet some people continue to disregard them and not utilize them when driving or riding in a car. According to the National Institute for Highway Safety Research and Communications, roughly forty thousand people died from car accidents each year in 2009 (13). Their data states that this is the number one cause of death for individuals under the age of 35 and accounts for a disproportionately high number of deaths in the 16-19 year old age group. The NIHSRC goes on to report that the use of safety belts in this age group is only around 41% in drivers of all reported accidents and only 29% of passengers. Passengers are more likely than drivers to refrain from using safety belts, and the highest percentage of those who choose to refrain are 14-20 years old in both passengers and drivers. This data is striking, and indicates a need for intervention.
In the 1980s American health officials noticed the need for intervention and developed the “Click It or Ticket” campaign (13). Although public officials see the success in this program, when it is closely looked at and critiqued, the flaws become quite evident. Because of its flaws, Click It or Ticket does not reach an optimal number of people and therefore does not achieve its full potential as a public health campaign. The Click It or Ticket campaign has seen success in only those who respond to threats from law enforcement and those who care about their current health outcomes. This indicates a strong need for a campaign that focuses on teenagers, as motor vehicle accidents are the number one cause of death for this age group, and are more prone to psychological reactance (4). The Click It or Ticket campaign is focused on the legality of wearing a safety belt, when in reality it should be framed as a public health issue (13). This campaign also focuses only on safety belts, when there are a lot of other contributing factors to motor vehicle injuries and deaths. The need for a comprehensive, group prevention program that takes psychological and social theories into account is evident and should be made a state and nationwide priority.
Most Click It or Ticket commercials are mainly focused on the law enforcement consequences of refraining to wear a seatbelt (13). These television announcements show images of police pulling over and ticketing those who are not wearing a seatbelt. The announcements state that there is no way to avoid a ticket, and that if a person is not wearing a seatbelt, they will most definitely be caught (13). The remaining small minority of commercials focus on the health benefits of wearing a seatbelt stating that if you are not wearing a safety belt and get into an accident, you will most definitely die, and on the other hand if you are wearing a safety belt and get into an accident you will most certainly live (13). Everyone knows that this is not the case. These television commercials rely on scare tactics, whether it be from law enforcement or death (13). This flawed campaign strategy does reach a small amount of people, but fails to reach the population that needs an intervention most: teenagers (13).
Failure to adapt to age group that is most prone to neglect safety belts
Teenagers, more than any other age group, are more likely to disregard the Click It or Ticket campaign. This is due to the fact that this campaign relies heavily on the effects of law enforcement and makes it seem like the police are taking away freedom when making it necessary to wear a safety belt when riding in cars. Reactance theory states that when one perceives their freedom to be in danger, he or she will act out in the opposite way, in order to preserve their liberty (2). Teenagers are prone to reactance theory, other wise known as psychological reactance (4). This is important to consider because it has been found that an increase in psychological reactance increases one’s risky decision making, especially in adolescence (7). This means that teenagers or adolescents will do whatever they can in order to maintain their freedom and that this threat to freedom will cause these adolescents to act out in a risky behavior. If someone of authority tells adolescents to do something, they are most likely going to do the exact opposite in order to take a stand for their freedom (7). It is of vital importance to take into account when building a public health campaign. One should not build a campaign meant to target an entire population that uses a do this or else strategy (6).
Neglect to take other aspects of dangerous driving into account, in order to prevent automobile crashes.
Drivers in the sixteen to nineteen year old age group are more likely to be “distracted drivers,” (10). Distracted drivers are those who engage in other activities along with driving such as talking on a cell phone, texting, or letting car conversation effect your focus on the road (10). This data indicates that this group, more than ever, needs an intervention that successfully tackles safe driving and usage of seatbelts. The Click It or Ticket campaign focuses only on seatbelt use and not on preventing those things that cause accidents in the first place (13). This campaign should be broadened in order to incorporate a prevention plan for distracted driving. Data has shown that, distracted driving is the number one cause of fatal or injury causing motor vehicle accidents (10). More and more state officials are hoping to cut down on the amount of distracted drivers by passing laws that ban talking on a cell phones and texting while driving . According to the Governor’s Highway Safety Association (GHSA), talking on a hand held cell phone use is banned in eight states (California, Connecticut, Delaware, New Jersey, New York, Oregon, and Washington), (11). This means that citizens in these states cannot hold a phone up to their face and drive, but use of a bluetooth device is acceptable, though these too are arguably distracting. In addition to talking, The GHSA reports that thirty states ban text messaging and driving (11). Some states enforce this law to all ages and others just target teenagers (11). While these laws have the good intention of reducing distracted driving, they still create a psychological reactance type of response. Those laws that target teenagers only seem unfair to them, and they will be more prone to act out, and therefore to text, talk, and not wear a safety belt.
Failure of the Health Belief Model
The Click It or Ticket safety belt campaign is built and based on the health belief model. The health belief model is a balancing act between the perceived benefits and the perceived severity of a certain behavior (9). According to this model, whatever side has more weight reigns supreme and the actions that follow that side will be taken (9). This is an individually based model that assumes that people act rationally and always take both views into account when making a health decision (9). This model has some positive attributes, as it calls to attention the need for education and prevention before a positive health behavior can be initiated. The health belief model is also good for predicting one time decisions such as whether or not to get immunized. The health belief model, however, is not a good predictor of habitual behaviors such as putting on a safety harness upon entering an automobile. Because safety belt use is a habitual behavior, an intervention or public health campaign that targets this topic should not be based around the health belief model.
Because the health belief model is individually based it should not be used with the intention of changing behaviors of a population. This is a major mistake in the Click It or Ticket campaign. The makers of this campaign believe that people will change their behavior based on solely facts (13). They believe that after seeing their ads, viewers will weigh the costs (death or monetary loss) and benefits (life), and that all viewers will see the overwhelming benefit in life and choose to wear their seatbelt (13). In this model, the person must take into account his or her perceived susceptibility, perceived severity, perceived barriers, and perceived benefits in order to make a health changing decision. Teenagers are not likely to sit down and weigh out options of susceptibility, severity, barriers, and benefits (9). Teenagers are also not likely to be motivated by health outcomes, as they are prone to a false perception of invincibility (3). Adolescent males are notoriously egocentric and have a false perception of invincibility (5). This fact contributes to both lack of following guidelines for safe driving and failure to wear a safety belt. These particular teens believe that they will not fall victim to a crash—so why bother looking uncool in a seatbelt, or following traffic laws (5). The makers of this campaign believe that the legality of “buckling up,” through phrases such as “the cops are cracking down,” is enough to persuade anyone to wear use a safety harness (13). Along with health outcomes, legal issues are non-motivators to many adolescents (3). Adolescent’s false perception of invincibility translates to legality; they believe that if they break the law, they have a lesser chance of being caught than someone else (3).
The Click It or Ticket campaign utilizes both mass media and highway signs to get their message to the masses (13). The flaw in this, however, is that the programming they choose to show their commercials in programs that are not watched by any target population. Unless shown during a major sporting event, their advertisements are sporadically placed in adult programming, making them nearly unseen by adolescents. The Click It or Ticket highway signs are small and go relatively unnoticed by passers by (13). When looked at the signs only read “Click It or Ticket,” and are accompanied with a picture of a stick figure or the representing state with their respective dollar fines (13). Few people can identify with a stick figure, and most wish not to be reminded of potential fines they can incur on the road. These bland signs and random commercials do not create a sense of familiarity and instead they get overlooked or disregarded. This campaign fails to recognize the need for different media outputs for different age groups and target audiences.
The Click It or Ticket campaign does not take adolescent’s psychological factors or reactions, such as perceived threat to freedom or flawed sense of invincibility, into account (13). This neglects to reach the demographic that needs an intervention most (13). The campaign’s sole use of the health belief model makes it look like an outdated program with an intense need for rethinking their approach. While the Click It or Ticket campaign has good intentions, it is not utilizing the right behavior change theories or techniques to promote the safest driving possible. As shown, the campaign only focuses on one aspect of safe driving instead of encompassing everything that goes into the responsibility of operating a motor vehicle (13). The campaign also has a series of flaws that surface when considering it was designed in order to change the behavior and effect the overall morbidity and mortality rates of the general population. As indicated, the campaign also fails to account for the many age groups of driving. Many changes must be implemented to this campaign in order for it to be most effective.
Proposal of New Campaign Plan
As seen, there is a great need for a new way to address both safe driving and safety belt use. The following proposed program is fictional, but provides a more concise and new approach to this issue. This program will include all aspects of safe driving: safety belt use, cell phone use, and everything that goes along with distracted driving. The new campaign will use group based intervention models, as it is trying to change the behavior of a population (1, 8). Because there really is no clear cut campaign for teens to utilize safety belts, this proposed campaign will focus mainly on the adolescent age group. This safe driving and safety belt promotional campaign will be called “Let’s Get It On”. This campaign will utilize a few psychological strategies of health behavior change, instead of focusing on just one like Click It or Ticket.
Utilization of Alternative, Group-Based Behavior Change Models: Advertising Theory and Marketing Theory
Campaigns such as Click It or Ticket should be broadened from the individually based health belief model to a group-based model. The Let’s Get It On safety belt campaign aimed at teens will use advertising theory to adequately deliver its message of safety belt use. Campaigns that utilize advertising theory should adopt the techniques of advertisement executives when creating their commercial (15). Television advertisements for the Let’s Get It On campaign will deliver a promise and back it up with images (15). Let’s Get It On will deliver the promise that being safe can be part of the fun. The campaign will back up this message with laughing teens getting into an automobile and buckling their seatbelts in a rhythmic fashion. The commercial will go on for thirty seconds showing different teens getting into cars and bucking their seatbelts in this same rhythm, signifying that they are part of this “rhythm of life.” The commercial will then end with the key phrase of the campaign, “Let’s Get It On.” Some of these commercials will include images of teens turning off, closing their cell phones, or handing them to passengers, thereby adding to this rhythm. This advertisement is predicted to be better received than the traditional Click It or Ticket campaign because it does not establish a sense of psychological reactance in the viewer. The phrase “Let’s Get It On” will be well received in the adolescent community because it is nonthreatening and fun.
Throwing health statistics or legal fines at viewers is unnecessary, as this campaign takes psychological reactance into account. These advertisements will also be loosely based around marketing theory (14). Campaign directors will first identify what our target audience, adolescents, identifies as core values (14). Upon research, campaigners should utilize the values of friends, fun, feeling as part of the group, freedom, and humor. Friends are an important element in the adolescent world, therefore the advertisements will show teenagers getting into the car with other teenagers, not authorities figures. This will work to reduce the amount of psychological reactance felt by the target audience, as no one in these advertisements is blatantly telling them what to do. Most adolescents would much rather be having fun or going out than going to school, therefore these commercials will show teenagers getting together to head somewhere social—the mall, a football game, or someone else’s house. The advertisements will utilize the core value of acceptance and feeling as part of the group through the creation of a rhythmic flow throughout the commercial. This shows that the teens are a part of something bigger than just buckling up every time they get into a car; as indicated, it shows them that they are part of this rhythm of life. As explained through the theory of psychological reactance, adolescents feel the need to express their freedom in any way possible. This core value of freedom will be respected in this campaign. As stated, advertisements will only show teenagers getting into the car with people they wish to be with, and going somewhere they wish to go. The last core value this campaign will use, humor, will be in the campaign name itself: “Let’s Get It On.”
Utilization of Modeling
This campaign will work with the idea of modeling, and getting people to emulate what they see. When adolescents see people they look up to doing something, they are more likely to do it (8). In order to effectively use modeling, the campaign will first contact the major television networks and ask them to feature more safe driving snippets in shows. Ideal shows would be ones that teenagers watch such as Glee or How I Met Your Mother. Writers of these shows can subtly include scenes where a character gets in a car, puts on a safety belt, and refrains from cell phone use. Teen Mom, a show on MTV, should also receive this message as they are constantly showing these teenage mothers driving their children around and talking on cell phones, and sometimes neglecting to use safety belts on themselves. Implementing this strategy will instill a modeling effect in watchers and they will therefore be more likely to use more precautionary measures when behind the wheel. This tactic can even start in shows that preteens and children watch. This will create a habitual effect so that when these children are old enough to drive, they know they have to do so safely.
Liking, Familiarity, Social Learning Theory and Celebrity endorsements
Modeling can also come in another form: celebrity endorsements. While taking the easy road out and using a celebrity endorsement is seen as cheesy or like a reach, they will be effective in this instance (8). It has been shown that celebrity endorsements have the ability to sway young people’s behavior in whatever way people want them to act (1). In the Let’s Get It On campaign, some advertisements will use celebrities to get their message across. Ideally, this will cover the majority of the print messages. Attractive celebrities will be pictured with just the line “Let’s Get It On” under them, and with a message in smaller print that reads “[name of the celebrity] gets it on every time he/she is in a car.” These celebrity endorsements can be broadened to fit the visual campaigns. Famous musicians that are popular in the adolescent community will be asked for permission of their songs and possibly their time to use in the television advertisements. Ideally, these popular songs will be used in the commercial and the buckling of the safety belts will follow the beats of these famous songs and the artist will make a cameo appearance. If a commercial were to go on the air today, makers of the Let’s Get It On campaign would find it in their best interest to sign today’s popular artists such as Cee Lo Green and use his song “Forget You.” This will instill a liking and familiarity effect in the target audience and they will be more likely to respond positively to the messages that are being presented.
The Click It or Ticket campaign needs a major facelift if they want to effectively reach all age groups of drivers and change their behavior. The campaign also neglects to take into account the need to stop behavior that gets drivers into accidents in the first place. There is an obvious need for a more comprehensive plan that takes all areas of safe driving into account, that targets the population that needs it most, and that does not use scare tactics to get them across. The Let’s Get It On campaign does all that. This campaign makes it look like when you are wearing a safety belt, you are part of the crowd. This campaign also takes into account the core values of its target population and effectively delivers its message. Let’s Get It On subtly hints at putting away your cell phones or giving them to your passengers to man for the ride. This campaign is well thought out and if instated, will be received positively. So next time you get in a car, disregard threats from the National Highway Traffic Safety Administration and think like Marvin Gaye… get it on.

Journal Articles:
1. Austin, E. W., Pinkleton, B. E., Van de Vord, R., & Epstein, E. (2008). Celebrity endorsements and their potential to motivate young viewers Mass Communication and Society
2. Brehm, S. S., & Weinraub, M. (1977). Physical barriers and psychological reactance: 2-yr-olds' responses to threats to freedom. Journal of Personality and Social Psychology, 35(11), 830-836. doi:10.1037/0022-3514.35.11.830
3. Crook, M. W. (2005). Tool development to measure the adolescent perception of invincibilityProQuest Information & Learning). Dissertation Abstracts International: Section B: The Sciences and Engineering, 65(9-) Retrieved from (2005-99006-187)
4. Drivers aged 16 or 17 years involved in fatal crashes -- united states, 2004-2008. (2010). MMWR: Morbidity & Mortality Weekly Report, 59(41), 1329-1334. Retrieved from
5. Drucker, A. D. (2000). Egocentrism and invincibility in adolescent male automobile drivers: An applied perspectiveProQuest Information & Learning). Dissertation Abstracts International: Section B: The Sciences and Engineering, 61(1-) Retrieved from (2000-95014-017)
6. Frank, S. J., Jackson-Walker, S., Marks, M., Van Egeren, L. A., Loop, K., & Olson, K. (1998). From the laboratory to the hospital, adults to adolescents, and disorders to personality: The case of psychological reactance. Journal of Clinical Psychology, 54(3), 361-381. doi:10.1002/(SICI)1097-4679(199804)54:3<361::AID-JCLP6>3.0.CO;2-S
7. Miller, C. H., & Quick, B. L. (2010). Sensation seeking and psychological reactance as health risk predictors for an emerging adult population. Health Communication, 25(3), 266-275. doi:10.1080/10410231003698945
8. Nangle, D. W., Erdley, C. A., Adrian, M., & Fales, J. (2010). A conceptual basis in social learning theory. In P. J. Norton (Ed.), Practitioner's guide to empirically based measures of social skills. (pp. 37-48). New York, NY US: Springer Publishing Co. doi:10.1007/978-1-4419-0609-0_3
9. Rosenstock, Irwin M, Hochbaum, Godfrey M. (1961). Some principles of research design in public health American Journal of Public Health Nation's Health, 51(2), 266-277.
10. Wilson, F. A., & Stimpson, J. P. (2010). Trends in fatalities from distracted driving in the united states, 1999 to 2008. American Journal of Public Health, 100(11), 2213-2219. Retrieved from

11. Governors highway safety association: State laws and funding. (2010). Retrieved 12/5, 2010, from
12. National highway traffic safety administration: Click it or ticket. (2010). Retrieved 12/5, 2010, from
13. National institute for highway safety research and communications. (2009). Retrieved 12/5, 2010, from
14. Lovelock, Christopher & Wirtz, Jochen. (2004). Services Marketing: People, Technology, Strategy. Upper Saddle River, NJ. (8)
15. Percy, L. (1980). In Percy L., Rossiter J. R. (Eds.), Advertising strategy: A communication theory approach (1st ed.). New York: Praeger Publishers.

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