Abstract
PURPOSE: Despite having the highest risk per miles driven for motor vehicle crash involvement, only 57% of US high school students reported always using a seat belt when riding in a car with another driver in 2019. METHODS: Data from the national Youth Risk Behavior Surveys conducted biennially from 1991 to 2019 were used to assess trends in seat belt use. Modified Poisson regression with robust variance estimates and linear splines was used to examine seat belt use trend changes overall and by gender, race/ethnicity, and grade. RESULTS: From 1991 to 2015, seat belt use was about 3.3% higher each survey cycle compared with the previous survey cycle, adjusting for gender, race/ethnicity, and age. After 2015, seat belt use was about 1.8% lower each survey cycle than the previous survey cycle, adjusting for the same covariates. DISCUSSION: New and effective strategies should be considered for promoting consistent seat belt use among US high school students.