Traffic Safety: Improved Reporting and Performance Measures Would
Enhance Evaluation of High-Visibility Campaigns (25-APR-08,	 
GAO-08-477).							 
                                                                 
Two primary risk behaviors related to fatal traffic crashes are  
failure to use safety belts and driving while impaired by	 
alcohol. High-visibility enforcement (HVE) campaigns that combine
enforcement of a traffic safety law with media to inform the	 
public about the campaign are effective in reducing these	 
behaviors. In 2005, the Safe, Accountable, Flexible, Efficient	 
Transportation Equity Act: A Legacy for Users authorized funding 
of an HVE program, including safety belt and impaired-driving	 
campaigns. The National Highway Traffic Safety Administration	 
(NHTSA) within the Department of Transportation (DOT) provides	 
media and coordinates with states to provide enforcement	 
activities for the campaigns. This report addresses (1) the	 
extent to which NHTSA has implemented the HVE program and (2) for
selected states, the impact of the campaigns and challenges that 
exist in conducting the campaigns. To conduct this work, GAO	 
analyzed fatality data, plans, and evaluations and interviewed	 
officials from DOT and seven selected states.			 
-------------------------Indexing Terms------------------------- 
REPORTNUM:   GAO-08-477 					        
    ACCNO:   A81889						        
  TITLE:     Traffic Safety: Improved Reporting and Performance       
Measures Would Enhance Evaluation of High-Visibility Campaigns	 
     DATE:   04/25/2008 
  SUBJECT:   Advertising					 
	     Alcohol abuse					 
	     Federal aid to states				 
	     Federal funds					 
	     Federal/state relations				 
	     High risk drivers					 
	     Highway safety					 
	     Law enforcement					 
	     Mass media 					 
	     Pedestrian safety					 
	     Performance measures				 
	     Program evaluation 				 
	     Program management 				 
	     Public roads or highways				 
	     Reporting requirements				 
	     Risk assessment					 
	     Risk factors					 
	     Risk management					 
	     Safety regulation					 
	     Safety standards					 
	     State programs					 
	     Strategic planning 				 
	     Traffic accidents					 
	     Transportation					 
	     Transportation industry				 
	     Transportation safety				 
	     Program goals or objectives			 
	     Program implementation				 
	     Safety Belt					 
	     High-Visibility Enforcement Program		 

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GAO-08-477

   

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United States Government Accountability Office: 
GAO: 

Report to the Chairman, Committee on Transportation and Infrastructure, 
House of Representatives. 

April 2008: 

Traffic Safety: 

Improved Reporting and Performance Measures Would Enhance Evaluation of 
High-Visibility Campaigns: 

GAO-08-477: 

GAO Highlights: 

Highlights of GAO-08-477, a report to the Chairman, Committee on 
Transportation and Infrastructure, House of Representatives. 

Why GAO Did This Study: 

Two primary risk behaviors related to fatal traffic crashes are failure 
to use safety belts and driving while impaired by alcohol. High-
visibility enforcement (HVE) campaigns that combine enforcement of a 
traffic safety law with media to inform the public about the campaign 
are effective in reducing these behaviors. In 2005, the Safe, 
Accountable, Flexible, Efficient Transportation Equity Act: A Legacy 
for Users authorized funding of an HVE program, including safety belt 
and impaired-driving campaigns. The National Highway Traffic Safety 
Administration (NHTSA) within the Department of Transportation (DOT) 
provides media and coordinates with states to provide enforcement 
activities for the campaigns. This report addresses (1) the extent to 
which NHTSA has implemented the HVE program and (2) for selected 
states, the impact of the campaigns and challenges that exist in 
conducting the campaigns. To conduct this work, GAO analyzed fatality 
data, plans, and evaluations and interviewed officials from DOT and 
seven selected states. 

What GAO Found: 

NHTSA has fully implemented the high-visibility enforcement program by 
(1) developing and disseminating advertising, (2) coordinating with 
states on media and enforcement activities, and (3) annually evaluating 
the effectiveness of the two HVE campaigns; however, NHTSAï¿½s 
evaluations have shortcomings that limit the agencyï¿½s ability to 
determine the effectiveness of the campaigns. Regarding advertising, 
NHTSA introduced an annual plan in 2005 that sets forth a strategy for 
the campaign advertisements, developed advertisements, and purchased 
national media time for the advertisements. To coordinate with states, 
NHTSA provides an overall strategy and guidance to assist states in 
conducting the campaigns, as well as technical assistance and 
collateral materials, such as posters and model press releases. 
Officials in selected states reported that NHTSAï¿½s coordination efforts 
provided the support and interaction needed to conduct HVE campaigns. 
Although NHTSAï¿½s annual evaluations of campaign effectiveness indicate 
that the campaigns are helping to improve safety belt use and reduce 
impaired driving, the evaluations have shortcomings that limit NHTSAï¿½s 
ability to assess the level of state and local activityï¿½a key component 
of the campaignsï¿½and the overall effectiveness of the campaigns. For 
example, the information that NHTSA has on statesï¿½ activities is 
inconsistent and incomplete because reporting of such data is generally 
voluntary for local law enforcement agencies. As a result, NHTSA has 
reported that it cannot provide meaningful analyses and comparisons of 
state activities. NHTSAï¿½s ability to measure the campaignsï¿½ overall 
effectiveness is also hindered because the performance measures used to 
evaluate the campaigns are not comprehensive. For example, while NHTSA 
measures daytime safety belt use, it does not directly measure 
nighttime safety belt use, despite recent efforts to increase safety 
belt use at night. In addition, NHTSAï¿½s evaluations do not include 
measures of the effectiveness of the campaigns at reaching all target 
audiences. NHTSA is working to develop more comprehensive performance 
measures. 

According to officials in selected states GAO visited, the campaigns 
are contributing to increased safety belt use and reduced alcohol-
involved fatalities, but these states face challenges in conducting the 
campaigns and achieving desired results. From 1997 to 2006, safety belt 
use increased in all seven of the selected states, and each state 
experienced a decrease in the alcohol fatality rate. Officials in the 
selected states said that the campaigns provide additional benefits, 
such as apprehending suspects involved in other crimes. However, 
officials in those selected states identified several challenges, such 
as increasing safety belt use and reducing impaired driving among 
resistant populations; insufficient staff to conduct the campaigns; and 
weak prosecution of impaired-driving arrests. NHTSA has initiatives 
under way to help states address some of these challenges. For example, 
NHTSA has sponsored a campaign to increase safety belt use in rural 
areas. In addition, NHTSA provides funds that can be used by states to 
purchase equipment for local law enforcement agencies, such as breath-
testing units, to encourage the agencies to participate in campaigns. 

What GAO Recommends: 

GAO recommends that the Secretary of Transportation direct NHTSA to 
establish a minimum set of reporting requirements for states to report 
HVE activities that are federally funded and include additional 
performance measures in campaign evaluations. DOT officials generally 
agreed with the findings and recommendations of the report. 

To view the full product, including the scope and methodology, click on 
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-477]. For more 
information, contact Katherine A. Siggerud at (202) 512-2834 or 
[email protected]. 

[End of section] 

Contents: 

Letter: 

Results in Brief: 

Background: 

NHTSA Has Implemented the HVE Program but Could Improve the Annual 
Evaluations of Campaign Effectiveness: 

Selected State Officials Report That HVE Campaigns Are Contributing to 
Increased Safety Belt Use and Reduced Fatalities, but Several 
Challenges Hinder Further Progress: 

Conclusions: 

Recommendations for Executive Action: 

Agency Comments: 

Appendix I: Objectives, Scope, and Methodology: 

Appendix II: HVE Campaigns in Australia, Canada, and the Netherlands: 

Appendix III: GAO Contact and Staff Acknowledgments: 

Table: 

Table 1: Funding for HVE Paid Media and Evaluations, Fiscal Years 2003-
2007: 

Figures: 

Figure 1: Total Fatalities and Total Fatalities per 100 Million Vehicle 
Miles Traveled (1985-2006): 

Figure 2: Unrestrained Vehicle Occupant Fatalities and Unrestrained 
Fatalities per 100 Million Vehicle Miles Traveled (1985-2006): 

Figure 3: Alcohol-Involved Fatalities and Alcohol-Involved Fatalities 
per 100 Million Vehicle Miles Traveled (1985-2006): 

Figure 4: HVE Campaign Activities and Timeline: 

Figure 5: Increase in Safety Belt Use for Selected States Compared with 
Overall U.S. Increase (1997-2006): 

Figure 6: Safety Belt Use Compared with Federal Goal, Selected States 
(2006): 

Figure 7: Decrease in Alcohol-Involved Fatality Rate per 100 Million 
Vehicle Miles Traveled for Selected States Compared with Average 
Decrease in the United States (1997-2006): 

Figure 8: Fatalities with a BAC of 0.08 or Greater per 100 Million 
Vehicle Miles Traveled for Selected States Compared with Federal Goal 
(2006): 

Abbreviations: 

BAC: blood alcohol content: 

CIOT: Click It Or Ticket: 

DOT: Department of Transportation: 

DUI: driving under the influence: 

FARS: Fatality Analysis Reporting System: 

FHWA: Federal Highway Administration: 

GHSA: Governors Highway Safety Association: 

HPMS: Highway Performance Monitoring System: 

HVE: high-visibility enforcement: 

NASJE: National Association of State Judicial Educators: 

NHTSA: National Highway Traffic Safety Administration: 

NTSB: National Transportation Safety Board: 

OTLUA: Drunk Driving. Over the Limit. Under Arrest: 

RBT: random breath test: 

SAFETEA-LU: The Safe, Accountable, Flexible, and Efficient 
Transportation Equity Act: A Legacy for Users: 

TEA-21: Transportation Equity Act for the 21st Century: 

VMT: vehicle miles traveled: 

[End of section] 

United States Government Accountability Office: Washington, DC 20548: 

April 25, 2008: 

The Honorable James L. Oberstar:
Chairman:
Committee on Transportation and Infrastructure: House of 
Representatives: 

Dear Mr. Chairman: 

More than 42,600 people died in traffic accidents during 2006. The 
failure to use safety belts and driving while impaired by alcohol are 
two primary risk behaviors related to these accidents. High-visibility 
enforcement (HVE) campaigns that combine intensive enforcement of a 
specific traffic safety law with extensive media communication to 
inform the public about the campaign have been found effective in the 
United States and other countries in helping reduce these behaviors. 
The Safe, Accountable, Flexible, Efficient Transportation Equity Act: A 
Legacy for Users (SAFETEA-LU), enacted in 2005, authorized funding for 
an HVE program, including two primary HVE campaigns: Click It Or Ticket 
(CIOT), to increase safety belt use, and Drunk Driving, Over the Limit, 
Under Arrest (OTLUA), to decrease the number of impaired drivers. 
[Footnote 1] SAFETEA-LU specified that the National Highway Traffic 
Safety Administration (NHTSA) within the Department of Transportation 
(DOT) should implement this program by developing and disseminating 
national advertisements for the campaigns, coordinating with states to 
conduct the campaigns, and evaluating the results of the campaigns; the 
law authorized $29 million annually for NHTSA to implement the program. 
State and local governments provide law enforcement resources for the 
campaigns--such as officers, cars, and equipment for patrols or 
checkpoints--and may supplement NHTSA's national advertisements; these 
entities may use federal traffic safety grants for such activities. 

You requested that we assess the HVE program and campaigns. 
Accordingly, this report addresses (1) the extent to which NHTSA has 
implemented the HVE program and (2) for selected states, the impact of 
the HVE campaigns and challenges that exist in conducting the 
campaigns. This report also includes additional information on the key 
components of HVE campaigns used by Australia, Canada, and the 
Netherlands (see app. II). 

To determine the extent that NHTSA has implemented the HVE program, we 
analyzed information and interviewed officials from NHTSA headquarters 
and regions; the Federal Highway Administration (FHWA); and state 
traffic safety offices, state police, local police, and police advocacy 
organizations in seven states--Arkansas, Illinois, Iowa, North 
Carolina, North Dakota, Rhode Island, and Washington. We judgmentally 
selected the states by including: states that have enacted various laws 
that may affect how states conduct enforcement campaigns; states with a 
wide range of traffic safety performance levels, such as extent of 
safety belt use and number of alcohol-involved fatalities in each 
state; states with differences in average size of law enforcement 
agencies; states that exhibited various degrees of participation by 
state and local law enforcement agencies in campaigns; and states that 
were geographically dispersed. Since we used a nongeneralizable 
sampling approach, our findings cannot be used to make inferences about 
all states that implemented the HVE program. We also interviewed 
representatives of nongovernmental organizations, including the 
American Association of State Highway and Transportation Officials, 
Governors Highway Safety Association (GHSA), International Association 
of Chiefs of Police, Mothers Against Drunk Driving, National Safety 
Council, and the National Sheriffs Association. In addition, we 
reviewed studies, reports, and laws relevant to the implementation of 
the NHTSA HVE program. To determine, for selected states, what impact 
the HVE campaigns have had and what challenges exist, we analyzed 
safety belt use and alcohol-involved fatality data and interviewed 
officials from state traffic safety offices, state police, local 
police, and police advocacy organizations in the seven selected states. 
We used data contained in NHTSA's Fatality Analysis Reporting System 
(FARS) database and vehicle miles traveled data maintained by FHWA in 
its Highway Performance Monitoring System database. We determined the 
data to be sufficiently reliable for the purposes of this report. For 
further details of our objectives, scope, and methodology, see appendix 
I. We also provide a summary of high-visibility campaigns in Australia, 
Canada, and the Netherlands, which can be found in appendix II. We 
conducted this performance audit from March 2007 to April 2008 in 
accordance with generally accepted government auditing standards. Those 
standards require that we plan and perform the audit to obtain 
sufficient, appropriate evidence to provide a reasonable basis for our 
findings and conclusions based on our audit objectives. We believe that 
the evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. 

Results in Brief: 

NHTSA has implemented the HVE program by developing and disseminating 
advertisements, coordinating with all states on advertisement and 
enforcement activities, and evaluating the effectiveness of the two HVE 
campaigns; however, NHTSA's evaluations of these campaigns have 
shortcomings that limit the extent to which NHTSA can determine the 
effectiveness of the campaigns. 

* Advertisements: To develop and disseminate advertisements, NHTSA 
introduced an annual National Communications Plan in 2005 that sets 
forth a strategy for the campaigns, including goals, dates, target 
audiences, and messages for the campaigns. Through a contactor, NHTSA 
also developed advertisements in multiple languages and media formats-
-such as broadcast television, cable television, and radio--and 
purchased national media time for the advertisements. Purchasing media 
time for these advertisements accounted for the majority of NHTSA's 
annual $29 million appropriation for the HVE program. For example, 
NHTSA allocated nearly $28 million to purchase media time for 
advertisements in fiscal year 2006. 

* Coordination: To coordinate with states on advertisement and 
enforcement activities, NHTSA provides an overall strategy and guidance 
to assist states in conducting the campaigns, as well as technical 
assistance and collateral materials--such as posters and model press 
releases--to help state officials with their advertisements. According 
to officials in our seven selected states, NHTSA's coordination efforts 
have provided the support and interaction needed to conduct HVE 
campaigns. For example, officials from one state noted that NHTSA 
assisted them in applying for traffic safety grants to conduct 
campaigns and provided tool kits that were useful in developing the 
campaigns. Officials from another state reported that NHTSA had 
improved the quality and timeliness of advertising materials, allowing 
them to devote more state resources to purchasing radio and television 
ads rather than developing the ads. NHTSA's campaign coordination 
efforts are included as part of the agency's day-to-day coordination 
efforts with the states and are not funded by the $29 million 
appropriation for the HVE program. 

* Evaluation: NHTSA evaluates the effectiveness of the campaigns 
annually, but the evaluations have shortcomings that limit NHTSA's 
ability to assess the level of state activity and the overall 
effectiveness of the campaigns. The evaluations accounted for $750,000 
of NHTSA's $29 million appropriation in fiscal years 2006 and 2007. 
NHTSA's evaluations include information on the level of enforcement 
activity by states and the results of the campaigns based on 
performance measures, such as message awareness, media activity, safety 
belt use, and fatality and injury statistics. However, the information 
that NHTSA has on states' activities is inconsistent and incomplete in 
part because states are not required to report such data, although 
NHTSA officials said that the agencies receiving federal traffic safety 
grants for campaign activities generally voluntarily report on these 
activities. As a result, NHTSA is not able to fully account for state 
and local law enforcement campaign activity--a critical component of 
HVE campaigns for which states may use federal traffic safety grants. 
NHTSA's ability to measure the campaigns' overall effectiveness is also 
hindered in part because the performance measures used to evaluate the 
campaigns are not comprehensive or consistent. For example, while NHTSA 
measures the change in daytime safety belt use, it does not directly 
measure nighttime safety belt use, despite recent efforts to increase 
the use of safety belts at night. Furthermore, measures of the 
effectiveness of NHTSA's national advertising campaign in reaching all 
target audiences were limited. For example, both the safety belt and 
impaired-driving campaign evaluations contained information about the 
effectiveness of the campaigns at reaching their primary target 
audiences but no information on the effectiveness in reaching other 
target audiences that were listed in the National Communications Plan. 
NHTSA is working to develop more comprehensive measures of the 
effectiveness of the campaigns. 

According to officials in the selected states we visited, HVE campaigns 
are contributing to increased safety belt use and reduced alcohol- 
involved fatalities, but these states face challenges such as reaching 
resistant populations, finding sufficient resources to conduct the 
campaigns, and weak prosecution of impaired-driving offenders. From 
1997 to 2006, safety belt use increased in all seven of the selected 
states, and four of those states exceeded the 2006 NHTSA goal for 
safety belt use (82 percent). HVE campaigns in the selected states are 
also contributing to reduced alcohol-involved driving fatalities. From 
1997 to 2006, each of the selected states experienced a decrease in the 
alcohol fatality rate (per 100 million vehicle miles traveled). In 
2006, five of the seven selected states met the NHTSA goal pertaining 
to alcohol-involved fatality rates. Officials said that high-visibility 
campaigns provide other benefits beyond those for which the campaigns 
are designed. For example, officials in North Carolina and Iowa said 
that stopping drivers for potential safety belt or impaired-driving 
violations also allowed them to increase overall traffic safety by 
writing citations for other traffic violations, as well as apprehend 
fugitives and recover stolen vehicles. Despite the progress made so 
far, states face several challenges in conducting the high-visibility 
campaigns and achieving desired results, including improving safety 
belt use and reducing impaired driving among resistant populations-- 
such as pickup truck drivers--and recruiting sufficient officers to 
conduct the campaigns when other law enforcement needs compete for 
resources. Officials from NHTSA and some of the selected states also 
cited weak prosecution of existing driving under the influence (DUI) 
laws as an obstacle. NHTSA has initiatives under way to help states 
address some of these challenges. For example, NHTSA has sponsored a 
campaign--Buckle Up In Your Truck--to increase safety belt use by 
pickup truck drivers. In addition, NHTSA provides funds that can be 
used by states to purchase equipment for local law enforcement 
agencies, such as breath-testing units, to encourage the agencies to 
participate in impaired-driving campaigns. 

To improve NHTSA's evaluations of the HVE campaigns, we recommend that 
the Secretary of Transportation direct NHTSA to develop a minimum core 
set of reporting requirements for states to report their federally 
funded HVE law enforcement and media activities. In addition, we 
recommend that the Secretary of Transportation direct NHTSA to include 
additional performance measures--such as a measure for nighttime safety 
belt use and additional measures of media effectiveness--in the 
agency's annual evaluations of the effectiveness of the two campaigns. 
DOT officials generally agreed with the findings and recommendations. 

Background: 

During 2006, more than 42,600 drivers, occupants, cyclists, and 
pedestrians died as a result of motor vehicle crashes. Over the 10-year 
period from 1997 through 2006, the number of motor vehicle fatalities 
per 100 million vehicle miles traveled (VMT) has decreased by 14.1 
percent, from 1.65 to 1.41. However, the number of fatalities annually 
has remained relatively constant, showing only a slight increase of 1.5 
percent, from 42,013 in 1997 to 42,642 in 2006 (see fig. 1). 

Figure 1: Total Fatalities and Total Fatalities per 100 Million Vehicle 
Miles Traveled (1985 to 2006): 

[See PDF for image] 

This figure is a combination vertical bar and line graph depicting the 
following data: 

Year: 1985; 
Total Fatalities: 43,825
Total fatalities per 100 million VMT: 2.47. 

Year: 1986; 
Total Fatalities: 46,087; 
Total fatalities per 100 million VMT: 2.51. 

Year: 1987; 
Total Fatalities: 46,390; 
Total fatalities per 100 million VMT: 2.41. 

Year: 1988; 
Total Fatalities: 47,087; 
Total fatalities per 100 million VMT: 2.32. 

Year: 1989; 
Total Fatalities: 45,582; 
Total fatalities per 100 million VMT: 2.17. 

Year: 1990; 
Total Fatalities: 44,599; 
Total fatalities per 100 million VMT: 2.08. 

Year: 1991; 
Total Fatalities: 41,508; 
Total fatalities per 100 million VMT: 1.91. 

Year: 1992; 
Total Fatalities: 39,250; 
Total fatalities per 100 million VMT: 1.75. 

Year: 1993; 
Total Fatalities: 40,150; 
Total fatalities per 100 million VMT: 1.75. 

Year: 1994; 
Total Fatalities: 40,716; 
Total fatalities per 100 million VMT: 1.73. 

Year: 1995; 
Total Fatalities: 41,817; 
Total fatalities per 100 million VMT: 1.73. 

Year: 1996; 
Total Fatalities: 42,065; 
Total fatalities per 100 million VMT: 1.69. 

Year: 1997; 
Total Fatalities: 42,013; 
Total fatalities per 100 million VMT: 1.65. 

Year: 1998; 
Total Fatalities: 41,501; 
Total fatalities per 100 million VMT: 1.58. 

Year: 1999; 
Total Fatalities: 41,717; 
Total fatalities per 100 million VMT: 1.55. 

Year: 2000; 
Total Fatalities: 41,945; 
Total fatalities per 100 million VMT: 1.53. 

Year: 2001; 
Total Fatalities: 42,196; 
Total fatalities per 100 million VMT: 1.51. 

Year: 2002; 
Total Fatalities: 43,005; 
Total fatalities per 100 million VMT: 1.51. 

Year: 2003; 
Total Fatalities: 42,884; 
Total fatalities per 100 million VMT: 1.48. 

Year: 2004; 
Total Fatalities: 42,836; 
Total fatalities per 100 million VMT: 1.45. 

Year: 2005; 
Total Fatalities: 43,510; 
Total fatalities per 100 million VMT: 1.46. 

Year: 2006; 
Total Fatalities: 42,642; 
Total fatalities per 100 million VMT: 1.41. 

Source: GAO analysis of NHTSA and FHWA data. 

[End of figure] 

Two primary behaviors related to fatal crashes are failure to use 
safety belts and driving while impaired by alcohol. Research has found 
that using lap and shoulder safety belts reduces the risk of fatal 
injury to front-seat passenger car occupants by 45 percent and light- 
truck occupants by 60 percent. Overall, unrestrained fatalities 
[Footnote 2] have decreased over the last two decades. From 1985 to 
2006, the number of unrestrained fatalities decreased from 23,236 in 
1985 to 16,053 in 2006, while the unrestrained fatality rate decreased 
by 0.78, from 1.31 to 0.53 fatalities per 100 million vehicle miles 
traveled (see fig. 2). The greatest improvements were achieved from 
1989 to 1993, a period when most states passed initial safety belt use 
laws. From 1984 to 1992, 8 states passed primary safety belt laws that 
allow law enforcement officers to stop a driver for not wearing a 
safety belt and issue a citation, and 33 states passed secondary safety 
belt laws that allow law enforcement officers to issue a citation for 
not wearing a safety belt only after the driver has been stopped for a 
separate offense. 

Figure 2: Unrestrained Vehicle Occupant Fatalities and Unrestrained 
Fatalities per 100 Million Vehicle Miles Traveled (1985 to 2006): 

[See PDF for image] 

This figure is a combination vertical bar and line graph depicting the 
following data: 

Year: 1985; 
Number of fatalities, restraint not used: 23,236; 
Unrestrained fatalities per 100 million VMT: 1.31. 

Year: 1986; 
Number of fatalities, restraint not used: 24,373; 
Unrestrained fatalities per 100 million VMT: 1.33. 

Year: 1987; 
Number of fatalities, restraint not used: 24,707; 
Unrestrained fatalities per 100 million VMT: 1.29. 

Year: 1988; 
Number of fatalities, restraint not used: 25,308; 
Unrestrained fatalities per 100 million VMT: 1.25. 

Year: 1989; 
Number of fatalities, restraint not used: 24,449; 
Unrestrained fatalities per 100 million VMT: 1.17. 

Year: 1990; 
Number of fatalities, restraint not used: 23,298; 
Unrestrained fatalities per 100 million VMT: 1.09. 

Year: 1991; 
Number of fatalities, restraint not used: 21,165; 
Unrestrained fatalities per 100 million VMT: 0.97. 

Year: 1992; 
Number of fatalities, restraint not used: 19,589; 
Unrestrained fatalities per 100 million VMT: 0.87. 

Year: 1993; 
Number of fatalities, restraint not used: 19,138; 
Unrestrained fatalities per 100 million VMT: 0.83. 

Year: 1994; 
Number of fatalities, restraint not used: 19,243; 
Unrestrained fatalities per 100 million VMT: 0.82. 

Year: 1995; 
Number of fatalities, restraint not used: 19,683; 
Unrestrained fatalities per 100 million VMT: 0.81. 

Year: 1996; 
Number of fatalities, restraint not used: 19,425; 
Unrestrained fatalities per 100 million VMT: 0.78. 

Year: 1997; 
Number of fatalities, restraint not used: 19,254; 
Unrestrained fatalities per 100 million VMT: 0.75. 

Year: 1998; 
Number of fatalities, restraint not used: 18,621; 
Unrestrained fatalities per 100 million VMT: 0.71. 

Year: 1999; 
Number of fatalities, restraint not used: 18,890; 
Unrestrained fatalities per 100 million VMT: 0.70. 

Year: 2000; 
Number of fatalities, restraint not used: 18,382; 
Unrestrained fatalities per 100 million VMT: 0.67. 

Year: 2001; 
Number of fatalities, restraint not used: 18,051; 
Unrestrained fatalities per 100 million VMT: 0.65. 

Year: 2002; 
Number of fatalities, restraint not used: 18,342; 
Unrestrained fatalities per 100 million VMT: 0.64. 

Year: 2003; 
Number of fatalities, restraint not used: 17,323; 
Unrestrained fatalities per 100 million VMT: 0.60. 

Year: 2004; 
Number of fatalities, restraint not used: 16,993; 
Unrestrained fatalities per 100 million VMT: 0.57. 

Year: 2005; 
Number of fatalities, restraint not used: 16,869; 
Unrestrained fatalities per 100 million VMT: 0.56. 

Year: 2006; 
Number of fatalities, restraint not used: 16,053; 
Unrestrained fatalities per 100 million VMT: 0.53. 

Source: GAO analysis of NHTSA and FHWA data. 

Note: Data for 1985 through 1987 data included unknown restraint use in 
fatalities ranging from 12.6 percent to 18.0 percent compared with 
unknown restraint use from 1988 through 2006 of 7.2 percent to 10.6 
percent. 

[End of figure] 

While alcohol-impaired driving showed similar improvements from 1986 to 
1994, progress has slowed, with a fluctuating number of alcohol- 
involved fatalities[Footnote 3] and generally a declining alcohol- 
involved fatality rate from 1994 to 2006 (see fig. 3). From 1985 to 
2006, the number of alcohol-involved fatalities decreased by 4,964 
people per year, and the alcohol-involved fatality rate decreased by 
0.63, from 1.13 to 0.50 fatalities per 100 million vehicle miles 
traveled. According to NHTSA, the improvements during the 1980s and 
early 1990s were influenced by the passage in 1984 of a law that 
withheld a portion of a state's federal highway funds unless the state 
established a 21-year-old minimum drinking age[Footnote 4], the efforts 
of two groups--the Presidential Commission Against Drunk Driving and 
Mothers Against Drunk Driving--to galvanize public opinion about the 
damage caused by impaired drivers, and states' efforts to strengthen 
their impaired-driving laws and increase enforcement of those laws. 
States received incentives to strengthen their laws and enforcement of 
the laws through the Transportation Equity Act for the 21st Century 
(TEA-21), which was enacted in 1998. For example, TEA-21 authorized 
incentive grants to states to enact a law to establish 0.08 blood 
alcohol content (BAC) as the legal limit for drunken driving offenses. 
The TEA-21 Restoration Act provided added incentives to encourage 
states to adopt an open container law that prohibits the possession of 
any open alcohol beverage container in a motor vehicle and enact a law 
that provides for specific penalties for individuals convicted of a 
second or subsequent drunken driving offense. For states that did not 
enact the open alcoholic beverage container and repeat drunken driving 
laws, the TEA-21 Restoration Act also included a provision to transfer 
a portion of those states' highway construction and maintenance funds 
to the state's highway safety program. 

Figure 3: Alcohol-Involved Fatalities and Alcohol-Involved Fatalities 
per 100 Million Vehicle Miles Traveled (1985 to 2006): 

[See PDF for image] 

This figure is a combination vertical bar and line graph depicting the 
following data: 

Year: 1985; 
Number of alcohol-involved fatalities: 20,086; 
Alcohol-involved fatalities per 100 million VMT: 1.13; 

Year: 1986; 
Number of alcohol-involved fatalities: 21,471; 
Alcohol-involved fatalities per 100 million VMT: 1.17. 

Year: 1987; 
Number of alcohol-involved fatalities: 20,696; 
Alcohol-involved fatalities per 100 million VMT: 1.08. 

Year: 1988; 
Number of alcohol-involved fatalities: 20,599; 
Alcohol-involved fatalities per 100 million VMT: 1.02. 

Year: 1989; 
Number of alcohol-involved fatalities: 19,531; 
Alcohol-involved fatalities per 100 million VMT: 0.93. 

Year: 1990; 
Number of alcohol-involved fatalities: 19.607; 
Alcohol-involved fatalities per 100 million VMT: 0.91. 

Year: 1991; 
Number of alcohol-involved fatalities: 17,599; 
Alcohol-involved fatalities per 100 million VMT: 0.81. 

Year: 1992; 
Number of alcohol-involved fatalities: 15,847; 
Alcohol-involved fatalities per 100 million VMT: 0.71. 

Year: 1993; 
Number of alcohol-involved fatalities: 15,547; 
Alcohol-involved fatalities per 100 million VMT: 0.68; 

Year: 1994; 
Number of alcohol-involved fatalities: 14,985; 
Alcohol-involved fatalities per 100 million VMT: 0.64. 

Year: 1995; 
Number of alcohol-involved fatalities: 15,242; 
Alcohol-involved fatalities per 100 million VMT: 0.63. 

Year: 1996; 
Number of alcohol-involved fatalities: 15,263; 
Alcohol-involved fatalities per 100 million VMT: 0.61. 

Year: 1997; 
Number of alcohol-involved fatalities: 14,421; 
Alcohol-involved fatalities per 100 million VMT: 0.57. 

Year: 1998; 
Number of alcohol-involved fatalities: 14,207; 
Alcohol-involved fatalities per 100 million VMT: 0.54. 

Year: 1999; 
Number of alcohol-involved fatalities: 14,250
Alcohol-involved fatalities per 100 million VMT: 0.53. 

Year: 2000; 
Number of alcohol-involved fatalities: 14,870; 
Alcohol-involved fatalities per 100 million VMT: 0.54; 

Year: 2001; 
Number of alcohol-involved fatalities: 14,858; 
Alcohol-involved fatalities per 100 million VMT: 0.53. 

Year: 2002; 
Number of alcohol-involved fatalities: 15,093; 
Alcohol-involved fatalities per 100 million VMT: 0.53. 

Year: 2003; 
Number of alcohol-involved fatalities: 14,678; 
Alcohol-involved fatalities per 100 million VMT: 0.51. 

Year: 2004; 
Number of alcohol-involved fatalities: 14,593; 
Alcohol-involved fatalities per 100 million VMT: 0.49. 

Year: 2005; 
Number of alcohol-involved fatalities: 15,102; 
Alcohol-involved fatalities per 100 million VMT: 0.51. 

Year: 2006; 
Number of alcohol-involved fatalities: 15,121; 
Alcohol-involved fatalities per 100 million VMT: 0.50. 

Source: GAO analysis of NHTSA and FHWA data. 

[End of figure] 

High-Visibility Enforcement (HVE) campaigns[Footnote 5] have been found 
effective in the United States and other countries in helping to reduce 
these two primary risk behaviors associated with fatal crashes. An HVE 
campaign combines intensive enforcement of a specific traffic safety 
law with extensive communication, education, and outreach informing the 
public about the enforcement activity. For example, a safety belt 
campaign could include several weeks during which television and radio 
commercials warn motorists to buckle their safety belt or risk 
receiving a ticket from increased law enforcement patrols, coupled with 
zero tolerance enforcement of safety belt laws highly visible to 
motorists through law enforcement techniques such as checkpoints and 
saturation patrols. Such a combination of activities is designed to 
increase the public's perception that people who violate the law will 
be ticketed, arrested, convicted, or punished, thereby persuading them 
to adhere to the law. HVE campaigns have been used for several decades 
in the United States and other countries to improve safety belt use and 
reduce impaired driving. Canada initiated the first safety belt HVE 
campaigns in North America in the 1980s, during which time a 1-month 
program in Ottawa, Ontario, increased belt use from 58 percent to 80 
percent. Based on the Canadian HVE campaigns, the community of Elmira, 
New York, conducted the first safety belt HVE effort in the United 
States in 1985 and raised its safety belt use rate from 49 percent to 
77 percent in 3 weeks. Impaired-driving HVE campaigns have also been 
shown to be effective at reducing alcohol-impaired driving since 1967 
in Britain and since 1980 in New Zealand. In the 1980s, law enforcement 
agencies around the United States began using sobriety checkpoints to 
deter impaired driving. For example, a yearlong checkpoint program in 
1984 in Charlottesville, Virginia, was associated with a 13 percent 
reduction in alcohol-related crashes.[Footnote 6] 

While HVE campaigns have proved effective in the United States and 
other countries, selected other countries GAO reviewed generally have 
higher safety belt use rates and lower impaired-driving fatality 
percentages than the United States. For example, while the United 
States had a 2007 safety belt use rate of 82 percent, Canada had a 2006-
2007 safety belt use rate of 93 percent, Australia has a safety belt 
use rate of around 96 percent, and the Netherlands had a 2005 safety 
belt use rate of 90 percent. An official from Canada noted that, while 
HVE campaigns in the 1980s and early 1990s had been successful in 
improving Canada's safety belt use rate, the rate has remained stagnant 
over the last 10 years and that approximately 40 percent of Canada's 
traffic fatalities still involved unbelted persons. The official 
attributed the lack of further progress to the fact that most of the 
last 10 percent of persons not wearing their safety belts are actively 
choosing not to wear the belts. Officials from Australia and the 
Netherlands noted that impaired-driving fatalities have been reduced in 
their countries because law enforcement officials are allowed to stop 
drivers at random to test the driver's breath for alcohol. However, 
this deterrent may be difficult to implement in the United States 
because other than at sobriety checkpoints (which are not allowed in 
some states), drivers cannot be stopped unless there is suspicious 
behavior or another traffic offense involved. Appendix II provides 
further details on HVE campaigns in other countries. 

The CIOT and OTLUA campaigns typically span about 7 weeks (see fig. 4). 
The CIOT campaign is conducted during May to coincide with Memorial 
Day, and the OTLUA campaign is conducted during August and September to 
cover Labor Day and again in December to cover the holiday season and 
New Year's Eve. The campaign activities conducted by NHTSA, state 
traffic safety offices, state law enforcement agencies, and local law 
enforcement agencies over the 7 weeks generally include the following: 

* Precampaign evaluation. Data such as safety belt use and public 
knowledge and attitudes about traffic enforcement programs are 
collected prior to the campaign to provide a baseline. States generally 
collect these data through safety belt use surveys, department of motor 
vehicle driver surveys, and telephone surveys. 

* Earned media. Earned media is unpaid coverage by broadcast and 
published news services, such as a press conference or press release 
provided by the state or local law enforcement officials. These media 
events are used to announce the upcoming campaign, bring news coverage 
to the ongoing enforcement effort, and update the public on the 
progress and results of the campaign. 

* Paid media. Paid media includes advertisements on television and 
radio. NHTSA purchases these advertisements nationwide, which are 
strategically placed at times and places intended to maximize exposure 
to selected audiences. For example, advertisements targeted toward 21- 
to 34-year-old men who are more likely to drive impaired might air on 
sports programs during a time when the most people in the target 
audience are likely to be watching and listening. States may augment 
the national advertising with advertisements directed at state-level 
high-risk populations such as pickup truck drivers or with taglines to 
let the audience know that their local law enforcement agencies are 
involved in the campaign. 

* Enforcement. Enforcement techniques by state and local law 
enforcement agencies may include aggressive enforcement by routine 
patrols, "saturation" patrols that increase the number of officers on 
patrol in a specific area, and stationary checkpoints along roadsides. 
States and local agencies may use traffic safety grant funds 
administered by NHTSA through their state highway safety office to 
provide the increased level of enforcement. 

* Postcampaign evaluation. Data are collected by states and local 
agencies after the campaign in the same manner as the precampaign 
evaluations and compared with precampaign data to identify changes in 
awareness of the enforcement effort, measure progress toward campaign 
goals, and measure the impact on traffic safety. 

Figure 4: HVE Campaign Activities and Timeline: 

[See PDF for image] 

This figure is an illustration of HVE Campaign Activities and Timeline, 
as follows: 

Precampain evaluation: Week 1 and 2; 
Earned Media: Week 3 through Week 7; 
Paid Media: Week 4 through Week 6; 
Enforcement: Middle of Week 4 through Week 6; 
Postcampaign evaluation: Week 7. 

Source: GAO and NHTSA. 

Note: The timeline is a general representation of campaign activities. 
The actual timing of the activities varies slightly between the CIOT 
and the OTLUA campaigns. 

[End of figure] 

Campaigns that were held prior to 2003--often referred to as Selective 
Traffic Enforcement Programs--typically relied on earned media such as 
unpaid television and radio news stories to advertise the campaigns; 
however, since 2003, Congress has funded nationwide paid advertising 
for safety belt and impaired-driving campaigns. (See table 1.) The use 
of paid media allows advertisements to be placed at optimal times with 
high-quality messages so the campaign can better reach its target 
audiences and maximize the probability that the audience will pay 
attention to the advertisements, whereas earned media placement and 
frequency are usually controlled by station managers and may not be 
placed at optimal times. NHTSA used funds authorized under TEA-21 for 
activities such as developing and producing broadcast and print 
advertisements and providing media technical assistance to the states. 
Although TEA-21, when enacted, did not authorize funding to purchase 
national advertising for the campaigns, Congress appropriated funding 
of $19 million in 2003 and $24 million in 2004 and 2005 for NHTSA to 
provide paid national advertising for both campaigns. In 2005, SAFETEA- 
LU authorized $29 million in each of fiscal years 2006 through 2009 for 
NHTSA to conduct a nationwide HVE program. The program requirements 
included developing and disseminating advertisements, coordinating with 
states, and annually evaluating the effectiveness of the program. NHTSA 
uses available funding to purchase national media time and conduct 
evaluations for the campaigns (see table 1). NHTSA also uses funding 
from other highway safety programs to develop the advertising and 
includes campaign coordination efforts as a part of the agency's 
ongoing coordination efforts with states for other highway safety 
programs.[Footnote 7] NHTSA officials report that the increase in 
funding authorized by SAFETEA-LU--$5 million above the annual funding 
level immediately prior to SAFETEA-LU--has allowed them to increase the 
visibility and frequency of advertising for the two enforcement 
campaigns during Memorial Day and Labor Day, as well as allowed them to 
provide additional national advertising for the impaired-driving 
campaign during the December holiday season. 

Table 1: Funding for HVE Paid Media and Evaluations, Fiscal Years 2003- 
2007 (Dollars in millions): 

Fiscal year: 2003; 
CIOT: $8.00; 
OTLUA: $11.00; 
Evaluation: $0; 
Available funding: $19. 

Fiscal year: 2004; 
CIOT: $10.00; 
OTLUA: $14.00; 
Evaluation: $0; 
Available funding: $24. 

Fiscal year: 2005; 
CIOT: $9.92; 
OTLUA: $13.89; 
Evaluation: $0; 
Available funding: $24. 

Fiscal year: 2006; 
CIOT: $10.00; 
OTLUA: $17.96; 
Evaluation: $0.75; 
Available funding: $29. 

Fiscal year: 2007; 
CIOT: $10.00; 
OTLUA: $18.25; 
Evaluation: $0.75; 
Available funding: $29. 

Source: GAO analysis of NHTSA data. 

[End of table] 

States have used federal traffic safety grants authorized in TEA-21 and 
SAFETEA-LU--such as State and Community Highway Safety grants, Safety 
Belt Use grants, and Alcohol-Impaired Driving Countermeasures grants-- 
to fund state and local campaign activities.[Footnote 8] States and 
local governments use grant funds for activities such as paying 
overtime for law enforcement officials to conduct sobriety checkpoints 
and saturation patrols, purchasing paid advertising, training, 
conducting safety belt surveys, and buying enforcement equipment. The 
states and local governments are also allowed to use highway safety 
funding to provide local advertising and educational campaigns in 
conjunction with the national media campaign. When included in the 
state's annual highway safety plan, a state may also conduct campaigns 
in addition to the national campaigns and provide sustained enforcement 
utilizing federal funds. States also use grant funds to purchase law 
enforcement equipment such as alcohol breath testers, radar units, and 
in-car video cameras to provide incentives for local law enforcement 
agencies to participate in the campaigns. 

NHTSA Has Implemented the HVE Program but Could Improve the Annual 
Evaluations of Campaign Effectiveness: 

NHTSA has implemented the HVE program, including two high-visibility 
traffic safety law enforcement campaigns to improve safety belt use and 
reduce impaired driving. Specifically, to meet the requirements in 
place since SAFETEA-LU, NHTSA has (1) developed and disseminated 
advertisements, (2) coordinated with states to conduct the HVE 
campaigns, and (3) evaluated the results of the campaigns. However, the 
evaluations have shortcomings that limit NHTSA's ability to assess the 
level of state activity and the overall effectiveness of the campaigns. 

NHTSA Has Developed an Advertising Plan, Created Advertising, and 
Purchased Media Time: 

To develop and disseminate advertising for the CIOT and OTLUA 
campaigns, NHTSA has developed an advertising plan and hired a 
contractor to create advertising materials for national and state use 
and purchase national media time. Since 2005, NHTSA has annually 
developed a National Communications Plan that sets forth a national HVE 
campaign advertising strategy. For example, the plan[Footnote 9] 
specifies goals, dates, target audiences, and core campaign messages 
for the campaigns. The plan also identifies how the campaign 
advertising should be developed and purchased to cost-effectively reach 
target audiences and includes links to Web sites that contain 
additional guidance and advertising materials. State traffic safety 
agencies can use these materials and develop supplemental advertising 
materials following the guidance provided in the plan. 

To create advertising materials, NHTSA contracts with a private 
advertising firm to provide technical assistance and ad production, 
including: 

* producing national ads; 

* modifying or updating national and state ads; 

* developing a national plan to purchase media; 

* reviewing states' plans to purchase media, and; 

* negotiating and purchasing air time for national ads. 

National ads are produced in several media formats and languages. Media 
formats include television, radio, magazines, newspapers, and 
alternative media. Broadcast television, cable television, and radio 
are the three most used media formats to advertise HVE campaigns, 
accounting for about 85 percent of the amount that NHTSA spends on 
campaign advertising. NHTSA has also begun to use the Internet to reach 
the target audience of young males by placing advertising messages into 
online games, social sites such as Face Book, and sports sites such as 
ESPN.com. These national ads are primarily produced in English and 
Spanish. NHTSA officials reported that they considered developing 
advertising for additional non-English-speaking populations and made 
the decision that it was not cost effective. However, they encourage 
states to develop materials for other non-English-speaking populations 
that are prevalent in the state's population. NHTSA's contractor also 
refreshes existing ads because, according to NHTSA officials, they can 
reduce costs by updating ads with new taglines or messages rather than 
creating new ads each year. For example, NHTSA darkened an existing 
television ad that had been filmed in the daytime to make it appear as 
though it were night to support an enforcement message for nighttime 
safety belt use. 

To purchase media time for the national ads, the NHTSA contractor 
prepares a plan to purchase media for NHTSA's approval and release 
before each national campaign. This plan identifies the advertising 
period, the media budget, target audience profiles, a strategy for 
purchasing the media, and the allocation of funds for different media 
formats. The allocation is based on reaching the campaign target 
audience as frequently and cost effectively as possible, the target 
audiences' use of the various media types, and the cost of placing the 
advertisements. For example, prime-time broadcast television reaches 
many young men, but because it is expensive, NHTSA may build the 
desired frequency of reaching the young men with cable television or 
radio, which is less expensive. NHTSA is increasing funds allocated for 
Hispanic media outlets, based on fatality and census data, and 
alternative media outlets as young men spend more time on the Internet. 
For example, the allocation for Hispanic media for the impaired-driving 
campaign increased from 5 percent to 12 percent from 2004 to 2007, and 
the allocation for alternative media in the safety belt campaign has 
increased from 0 percent to 5 percent from 2004 to 2007. 

Once NHTSA approves the plan to purchase media, the contractor 
negotiates with media providers--such as television or radio networks-
-to purchase media. The contractor also negotiates for value-added 
media, which is advertising time that a television or radio network may 
provide to NHTSA at no additional cost because the network supports the 
campaign message. After a campaign, the media contractor provides an 
analysis of the effectiveness of the media formats, including the 
extent to which the formats reached the target audience, the cost to 
reach the audience, and the dollar value of the value-added media. 

The National Communications Plan, the plans to purchase media, and 
other resources that NHTSA uses to advertise its campaigns include 
elements of the key practices we have previously identified through an 
expert panel[Footnote 10] as important to planning a consumer education 
campaign, motivating a target audience, and alleviating challenges in a 
campaign.[Footnote 11] The key practices include the following: 

* Define goals and objectives. NHTSA has established goals to reduce 
deaths and injuries from crashes on our nation's highways by increasing 
the number of people regularly using safety belts and decrease the 
number of impaired drivers on the road. 

* Analyze the situation. NHTSA applies research, lessons learned, and 
other knowledge such as program evaluations to develop an integrated 
year-round marketing campaign designed to modify behavior with a 
calendar of events timed to coincide with national holidays and 
celebrations, which have an increased number of traffic fatalities. 

* Identify stakeholders. NHTSA engages national, state, and local 
partners, such as coalitions, highway safety offices, and law 
enforcement agencies across the country, to be involved in the calendar 
of events. In addition, the communications plan identifies the need to 
look for marketing alliances with sports organizations and other 
corporations that already carry powerful brands important to NHTSA's 
target audiences. 

* Identify resources. Annual funding for the national campaigns is 
authorized in SAFETEA-LU through fiscal year 2009. NHTSA identifies the 
resources available for each campaign in the plan for purchasing media. 

* Research target audiences. NHTSA reviews existing research and 
surveys to help segment and target the key audiences, identifying 
preferences, beliefs, competing behaviors, and motivators. 

* Develop consistent, clear messages. The National Communications Plan 
specifies the need to maintain a strong CIOT and OTLUA brand-name 
status through consistency in presentation and broad geographical 
coverage. 

* Identify credible messengers. The credibility of the message lies in 
the combination of the message with a high level of enforcement, 
creating a general deterrence effect that increases the public 
perception that drivers are likely to receive a citation. The 
advertisements use law enforcement officers, who increase the 
credibility of the message. Additionally, the messages are produced and 
presented through media intended to appeal to the intended target 
audience, such as teens, pickup truck drivers, and rural audiences. 

* Design media mix. NHTSA identifies the target audiences and 
appropriate media for target audiences to allocate media funding. 

* Establish metrics to measure success. NHTSA's media contractor 
analyzes the results of each campaign to evaluate whether the message 
reached the intended target audience in the time period intended, and 
NHTSA reports how the campaign reached the target market. 

State Officials Report That NHTSA's Coordination Efforts Help Them 
Conduct Successful Campaigns: 

NHTSA coordinates with the states and provides resources to help states 
carry out the campaigns through several means, including the National 
Communications Plan, guidance on conducting HVE campaigns, technical 
assistance on advertisements, and collateral advertising materials. 
Officials in selected states reported that NHTSA's coordination efforts 
provided the support and interaction needed to successfully conduct HVE 
campaigns. For example, officials from one state noted that NHTSA 
assisted them in applying for federal traffic safety grants to conduct 
campaigns and provided tool kits that were useful in developing the 
campaigns. Officials from another state reported that NHTSA had 
improved the quality and timeliness of advertising materials, allowing 
them to devote more state resources to purchasing radio and television 
ads rather than developing the ads. 

The annual National Communications Plan disseminates a strategy for 
states to conduct occupant protection and impaired-driving events 
throughout the year, including the CIOT and OTLUA campaigns. 
Specifically, the National Communications Plan sets out the following: 

* a primary purpose for each event, such as "to support enforcement 
activities and to remind all partygoers of the dangers of impaired 
driving"; 

* dates for the events; 

* messages to be emphasized, such as "Drunk Driving, Over the Limit, 
Under Arrest"; 

* primary and secondary target audiences, such as men, ages 21 to 34; 
and; 

* potential themes, such as "Buzzed Driving is Drunk Driving--Designate 
a Sober Driver" 

The National Communication Plan also provides links to Web sites 
containing guidance for states in conducting campaigns, such as 
[hyperlink, http://www.TrafficSafetyMarketing.gov]. NHTSA also provides 
further guidance, such as the Uniform Guidelines for State Highway 
Safety Programs, which includes guidance for both occupant protection 
and impaired driving; and case studies of HVE campaigns, such as 
NHTSA's "Creating Impaired Driving General Deterrence--Eight Case 
Studies of Sustained, High-Visibility, Impaired-Driving 
Enforcement."[Footnote 12] 

NHTSA also furnishes technical advice and collateral materials to 
assist states with advertising for the campaigns. To provide technical 
support to states, NHTSA's contractor may, when requested by state 
officials, evaluate states' proposed media purchases and make 
suggestions for improvement. The evaluation includes reviewing states' 
proposed target demographics, budget, and purchase of advertising time 
to provide guidance on the appropriateness of the purchase. These 
evaluations are intended to help states effectively reach target 
audiences. NHTSA also provides collateral materials such as posters, 
Web banners, talking points, and model press releases. States may 
download these materials directly from NHTSA's Web site. These 
materials are designed to support the various events set out in the 
National Communications Plan. 

NHTSA's Annual Evaluations Are Limited by Inconsistent and Incomplete 
Data: 

NHTSA's annual evaluations of the HVE campaigns include information on 
the level of enforcement activity and the results of the campaigns 
based on performance measures, such as message awareness, earned media 
activity, safety belt use, and fatality and injury statistics.[Footnote 
13] For example, the CIOT evaluation[Footnote 14] includes information 
on the number of law enforcement agencies that reported enforcement 
activities and the number of safety belt citations issued by these 
agencies; this information showed that the number of citations issued 
increased from 2004 to 2005, even though the number of reporting 
agencies declined. Regarding message awareness, the OTLUA annual 
evaluation[Footnote 15] includes information from NHTSA's annual 
national telephone surveys, which found that the impaired-driving 
message was reaching the general public--especially the 18-to 34-year- 
old target audience--although the awareness did not carry over from 
campaign to campaign.[Footnote 16] The CIOT report showed that safety 
belt use rates generally increased following the 2005 campaign, and the 
OTLUA report showed that the number of alcohol-impaired drivers 
involved in fatal crashes decreased overall from 2001 to 2005. 

However, the data on HVE campaign activity--such as the number of 
agencies participating in the campaigns, hours worked by law 
enforcement officers, citations issued, DUI enforcement actions, and 
advertisements purchased by states--that states report to NHTSA are not 
complete or consistent; this situation limits NHTSA's ability to 
evaluate the overall level of state enforcement and advertising 
activity and the extent to which states use federal funding--through 
traffic safety grants--to support HVE campaigns. Because these 
campaigns--other than the media developed and purchased by NHTSA--are 
carried out by states, these data are the only way to determine whether 
the level of activity is changing from year to year and whether NHTSA 
is effectively leveraging state and local resources. According to NHTSA 
officials, states are not required to report all HVE activity, although 
in recent years states have voluntarily reported the level of activity 
for selected law enforcement agencies--generally those agencies that 
receive federal grants for HVE activities.[Footnote 17] However, such 
voluntary reporting can cause substantial variances in data from 
campaign to campaign and year to year. For the campaigns conducted from 
2003 through 2006, an average of three states did not report on 
campaign activity for each campaign, and between 22 percent to 52 
percent[Footnote 18] of the law enforcement agencies that indicated 
they would participate in the campaigns did not report on campaign 
activity. 

Of the agencies that do report, the data reported are not consistent 
among law enforcement agencies or states. For example, some agencies 
include all activities and others include only the federally funded 
portion of their activities. In addition, some states only require a 
portion of the activities to be reported by agencies and leave 
reporting on other NHTSA requested activities as optional. As a result, 
the types of activity data collected from state to state vary. For 
example, in the May 2006 CIOT campaign, while 49 states reported having 
participating agencies, only 37 states reported the hours worked and 
only 36 states reported the number of earned media TV spots. Due to 
these inconsistencies, NHTSA has reported that it is not possible to 
provide meaningful analyses and comparisons of state activities to 
conduct HVE campaigns. 

NHTSA and Governors Highway Safety Association (GHSA) officials 
stressed that law enforcement agencies are less likely to report if 
they receive little or no federal highway safety grant funding for 
enforcement activities. GHSA officials--who represent the state highway 
safety offices--suggested that simplifying reports and limiting the 
amount of data required may improve reporting. While it is important 
for NHTSA to limit reporting requirements for states, state and local 
law enforcement is a critical component of HVE campaigns that NHTSA 
currently cannot measure. A minimum set of core reporting requirements-
-such as the number of agencies reporting data, number of law 
enforcement labor hours applied to the mobilization, number of impaired-
driving arrests made during the mobilization, number of safety belt 
violation citations issued, and amount spent on television, radio, 
print, and other ads from agencies that receive federal funding for 
these activities--would minimize the reporting burden while allowing 
NHTSA to more thoroughly and consistently measure the level of state 
activity over time and provide accountability for federal funding. 

To learn more about the extent of participation by local law 
enforcement agencies, NHTSA collected information from a sample of law 
enforcement agencies that conducted campaigns independent of the 
national mobilization evaluations or that had received federal traffic 
safety grants. NHTSA sought a representative sample of law enforcement 
agencies that had at least 10 years of citation and arrest data on a 
monthly basis in order to track enforcement activities over time and 
compare enforcement activities before, during, and after the CIOT and 
OTLUA campaigns. The results of this data collection effort will be 
reported in the Evaluation of the 2006 CIOT Campaign (to be released 
later in 2008). This attempt to obtain more reliable and representative 
information has faced several obstacles, including difficulties in 
defining a representative sample of law enforcement agencies, locating 
and securing the cooperation of agencies that had 10 years of citation 
and arrest data, and finding agencies that would provide the data on a 
monthly basis. 

NHTSA's effort to evaluate the effectiveness of the HVE campaigns is 
also hindered, in part, because NHTSA's performance measures are not 
comprehensive. For example, while NHTSA measures the change in daytime 
safety belt use for the driver and right front passenger in passenger 
cars, vans, sports utility vehicles, and pickup trucks, it does not 
directly measure nighttime safety belt use, despite recent efforts to 
increase the use of safety belts at night. Specifically, NHTSA is 
working with the states of Washington, North Carolina, and West 
Virginia in pilot programs to evaluate the use of different enforcement 
strategies for increasing nighttime safety belt use. NHTSA and the 
states expect to report the results of these pilot programs by the end 
of 2008. In addition, NHTSA is preparing an enforcement guide on the 
different approaches states may use for nighttime enforcement during 
the 2008 CIOT campaign. 

The annual evaluations also include limited information on performance 
measures for the effectiveness of NHTSA's advertisements. For example, 
while the evaluations include information on the extent to which the 
advertisements are reaching the primary target audience, the 
evaluations did not measure the extent to which the advertisements 
reached special-emphasis audiences identified in the 2005 National 
Communications Plan,[Footnote 19] such as pickup truck drivers and 
Hispanics for the CIOT campaign. The impaired-driving report also did 
not evaluate the extent to which the advertisements had reached other 
targeted audiences, such as college students, men ages 35 to 59, and 
young women 21 to 25 who were also identified in the 2005 National 
Communications Plan,[Footnote 20] and did not include the media dollar 
allocation to show how NHTSA had advertised to non-English-speaking 
populations and used nontraditional media.[Footnote 21] Without this 
information, NHTSA cannot evaluate the extent to which the campaigns 
are meeting the goals set out in the National Communications Plans. 

NHTSA officials recognize the need for more comprehensive performance 
measures, and--through a contractor--the agency is developing 
additional performance measures to address these issues. The statement 
of work for the contractor specifies that the purpose of the project is 
to develop a minimum set of performance measures that could be used by 
federal, state, and local governments for traffic safety areas, 
including high-visibility enforcement campaigns. The deadline for this 
work is August 2008. However, NHTSA officials stated that the key 
requirement for developing effective performance measures is accurate 
and comprehensive data and that existing data available to states are 
not sufficient to mandate more specific performance measures. As a 
result, NHTSA plans to recommend--not require--the new performance 
measures to states. It is unlikely that all states will voluntarily 
report the same performance indicators in a consistent and 
comprehensive manner sufficient to allow national comparisons without 
specific required measures. 

Selected State Officials Report That HVE Campaigns Are Contributing to 
Increased Safety Belt Use and Reduced Fatalities, but Several 
Challenges Hinder Further Progress: 

According to officials in selected states we visited, HVE campaigns are 
contributing to increased safety belt use and reduced alcohol-involved 
fatalities. From 1997 to 2006, safety belt use increased in all seven 
of the selected states, and four of those states exceeded the 2006 
NHTSA goal for safety belt use (82 percent). In addition to increases 
in safety belt use, from 1997 to 2006, each selected state's alcohol 
fatality rate decreased, and, in 2006, five of the seven states met the 
NHTSA goal pertaining to alcohol-involved fatality rates. Despite the 
gains made so far, officials from these states reported facing several 
challenges: increasing safety belt use and reducing impaired driving 
among resistant populations; insufficient staff to conduct the 
campaigns; and weak prosecution of DUI arrests. NHTSA and the states 
are taking steps to help address these challenges. 

Officials in Selected States Report That HVE Campaigns Are Contributing 
to Increased Use of Safety Belts and Reduced Fatalities from Impaired 
Drivers: 

HVE campaigns are contributing to increased safety belt use and reduced 
alcohol-involved fatalities, according to officials in selected states 
we visited. Specifically, all of the selected states experienced 
increased safety belt use and reduced alcohol-involved fatality rates 
in the last 10 years, and state officials attributed these 
improvements, in part, to participation in HVE campaigns. 

According to NHTSA data, between 1997 and 2006, safety belt use 
increased in all of the selected states, although some states 
experienced larger increases than other states. According to NHTSA 
survey data on safety belt use, the increase in safety belt use from 
1997 to 2006 ranged from a 6.5 percentage point increase in North 
Carolina to a 29.6 percentage point increase in North Dakota. The 
overall increase in safety belt use nationwide from 1997 to 2006 was 12 
percentage points (see fig. 5). 

Figure 5: Increase in Safety Belt Use for Selected States Compared with 
Overall U.S. Increase, 1997 through 2006: 

[See PDF for image] 

This figure is a horizontal bar graph depicting the following data: 

Increase in Safety Belt Use for Selected States Compared with Overall 
U.S. Increase, 1997 through 2006: 

State: North Dakota; 
Percent increase: 29.6%. 

State: Illinois; 
Percent increase: 25.7%. 

State: Washington; 
Percent increase: 19%. 

State: Arkansas; 
Percent increase: 18.8%. 

State: Rhode Island; 
Percent increase: 15%. 

State: Iowa; 
Percent increase: 14.7%. 

State: North Carolina; 
Percent increase: 6.5%. 

State: Overall U.S.; 
Percent increase: 12%. 

Source: GAO analysis of NHTSA data. 

[End of figure] 

The range in improvements in safety belt use rates from 1997 to 2006 
can be attributed in part to the safety belt use rate each state had 
achieved by 1997. For example, in 1997, North Carolina had achieved an 
82 percent safety belt use rate, which exceeded the U.S. average safety 
belt use rate of 69 percent at that time. In contrast, North Dakota's 
safety belt use rate in 1997 was only 49 percent. 

In 2006, safety belt use in the seven selected states ranged from 69 
percent in Arkansas to 96 percent in Washington. Nationwide, safety 
belt use in 2006 ranged from a low of 64 percent in New Hampshire and 
Wyoming to Washington's 96 percent. Safety belt use in four of the 
selected states we visited--Illinois, Iowa, North Carolina, and 
Washington--exceeded the 2006 NHTSA safety belt use goal of 82 percent. 
All four of these states had a primary safety belt law in place by 
2006. Safety belt use rates for 2006 in Arkansas, Rhode Island, and 
North Dakota--states without a primary safety belt law--fell short of 
the 2006 federal goal (see fig. 6).[Footnote 22] 

Figure 6: Safety Belt Use Compared with Federal Goal, Selected States 
(2006): 

[See PDF for image] 

This figure is a horizontal bar graph depicting the following data: 

Safety Belt Use Compared with Federal Goal, Selected States (2006): 

State: Arkansas; 
Belt use (percent): 69.3%. 

State: Rhode Island; 
Belt use (percent): 74%. 

State: North Dakota; 
Belt use (percent): 79%. 

State: Illinois; 
Belt use (percent): 87.8%. 

State: North Carolina; 
Belt use (percent): 88.5%. 

State: Iowa; 
Belt use (percent): 89.6%. 

State: Washington; 
Belt use (percent): 96.3%. 

State: NHTSA goal; 
Belt use (percent): 82%. 

Source: GAO analysis of NHTSA data. 

[End of figure] 

According to officials, selected states' HVE campaigns are also 
contributing to reducing alcohol-involved fatality rates. From 1997 to 
2006, all of the selected states experienced a decrease in alcohol- 
involved fatality rates. The decrease in the alcohol-involved fatality 
rate during this period ranged from 22 percent in Rhode Island and 
North Dakota to 3 percent in Arkansas. Five of the seven selected 
states experienced declines in alcohol-involved fatality rates that 
were greater than the overall U.S. decrease of 12 percent (see fig. 7). 

Figure 7: Decrease in Alcohol-Involved Fatality Rate per 100 Million 
Vehicle Miles Traveled for Selected States Compared with Average 
Decrease in the United States (1997 to 2006): 

[See PDF for image] 

This figure is a horizontal bar graph depicting the following data: 

Decrease in Alcohol-Involved Fatality Rate per 100 Million Vehicle 
Miles Traveled: 

State: Rhode Island; 
Percent decrease: 22%. 

State: North Dakota; 
Percent decrease: 22%. 

State: Iowa; 
Percent decrease: 21%. 

State: North Carolina; 
Percent decrease: 18%. 

State: Washington; 
Percent decrease: 13%. 

State: Illinois; 
Percent decrease: 9%. 

State: Arkansas; 
Percent decrease: 3%. 

State: U.S. average; 
Percent decrease: 12%. 

Source: GAO analysis of NHTSA and FHWA data. 

[End of figure] 

In 2006, alcohol-involved fatality rates in the seven selected states 
ranged from 0.62 fatalities per 100 million vehicle miles traveled in 
Arkansas to 0.4 in Rhode Island. Nationwide, the average alcohol- 
involved fatality rate in 2006 was 0.50 fatalities per 100 million 
vehicle miles traveled. In 2006, five of the seven selected states 
experienced fatality rates that were lower than the NHTSA goal of 0.51 
fatalities per 100 million vehicle miles traveled. North Dakota and 
Arkansas experienced alcohol-involved fatality rates in 2006 that fell 
short of the NHTSA goal (see fig. 8). 

Figure 8: Fatalities with a BAC of 0.08 or Greater per 100 Million 
Vehicle Miles Traveled for Selected States Compared with Federal Goal 
(2006): 

[See PDF for image] 

This figure is a horizontal bar graph depicting the following data: 

Fatalities with a BAC of 0.08 or Greater per 100 Million Vehicle Miles 
Traveled: 

State: Arkansas; 
Fatalities per 100 million VMT: 0.62. 

State: North Dakota; 
Fatalities per 100 million VMT: 0.56. 

State: North Carolina; 
Fatalities per 100 million VMT: 0.47. 

State: Illinois; 
Fatalities per 100 million VMT: 0.46. 

State: Washington; 
Fatalities per 100 million VMT: 0.44. 

State: Iowa; 
Fatalities per 100 million VMT: 0.41. 

State: Rhode Island; 
Fatalities per 100 million VMT: 0.40. 

State: Federal Goal; 
Fatalities per 100 million VMT: 0.51. 

Source: GAO analysis of NHTSA and FHWA data. 

[End of figure] 

Officials from the selected states we visited also identified other 
benefits that result from participating in HVE campaigns. For example, 
North Carolina and Iowa officials said that, during HVE campaigns, the 
additional officers staffing checkpoints or on patrol are able to 
apprehend suspects in other crimes and write citations for traffic 
violations such as speeding; this increased level of enforcement 
activity contributes to improvements in overall traffic safety. For 
example, during a 2006 CIOT campaign in North Carolina, the state 
Department of Transportation reported that it issued over 23,000 
speeding tickets but also arrested 699 fugitives and recovered 141 
stolen vehicles. Iowa officials also said that HVE campaigns yield 
benefits in that they will often find drugs or stolen property when 
stopping vehicles, and the campaigns serve to improve relationships 
between law enforcement personnel and the community. In addition, 
another benefit is that law enforcement agencies can use the equipment 
purchased for HVE campaigns--such as patrol cars, vehicle cameras, and 
BAC testing equipment--to enhance traffic safety enforcement efforts 
throughout the year. 

Selected States Face Several Challenges in Conducting HVE Campaigns: 

Despite the gains made so far, several challenges hinder further 
progress in carrying out the HVE campaigns. The challenges cited by 
officials from the states we visited include: increasing safety belt 
use and reducing impaired driving among resistant populations; 
insufficient staff to conduct the campaigns; and weak prosecution of 
DUI arrests. Reviews of NHTSA's HVE campaigns from DOT's Office of the 
Inspector General and the National Transportation Safety Board (NTSB) 
have found similar challenges.[Footnote 23] 

Challenge in Increasing Safety Belt Use and Reducing Impaired Driving 
among Resistant Populations: 

Officials in selected states face the challenge of increasing safety 
belt use and reducing impaired driving among resistant populations, 
such as drivers in rural areas, pickup truck drivers, and hardcore 
drinking drivers. For example, statistics show that more drivers in 
rural areas resist wearing safety belts. Though recent progress has 
been made, in general, rural areas have a higher proportion of fatal 
crashes and traffic fatalities than in urban areas. In a recent NHTSA 
analysis of urban and rural fatalities, NHTSA reported that rural 
fatalities accounted for 55 percent of fatal crashes and 57 percent of 
traffic fatalities in 2006 even though only 23 percent of the U.S. 
population lived in rural areas, according to 2006 Census estimates. 
[Footnote 24] Several factors in addition to lower safety belt use 
contribute to this disparity, including higher alcohol-involved crash 
rates, higher speed, rural roads that are narrow or have sharp curves, 
and less access to emergency services in rural areas. Crashes in rural 
areas are also more likely to involve occupants who are ejected from 
vehicles because they are not wearing safety belts. According to one 
study, of the 5,959 people who died in rural crashes where a vehicle 
occupant was ejected or partially ejected from the vehicle, 92 percent 
were unbelted or were not properly restrained in a child safety seat. 
Statistics show that pickup truck drivers are also resistant to 
changing their safety belt habits. Compared with other drivers, pickup 
truck drivers are more resistant to wearing safety belts. In 2007, 
according to NHTSA, 72 percent of pickup truck drivers were belted 
compared with 84 percent of passenger car drivers. This lower safety 
belt use by pickup truck drivers and their passengers can lead to more 
vehicle occupant ejections and fatalities. 

NHTSA and the states are taking steps to increase rural safety belt use 
and have developed programs targeting pickup truck drivers. In 2006, 
for example, a NHTSA report outlined several strategies that states and 
local communities could use to improve their rural safety belt programs 
and provided examples of leading enforcement and communication programs 
in many states.[Footnote 25] Illinois, one of selected states we 
visited, targeted rural safety belt use in 2005 by participating in a 
NHTSA Great Lakes Region Rural Demonstration program. The program 
involved intensified enforcement and paid media to alert residents in 
targeted rural areas that safety belt laws would be enforced. During 
the program, Illinois aired television and radio ads in five media 
markets that include rural areas and conducted safety belt enforcement 
zones by stopping vehicles if an unbuckled occupant was observed. 
Observational surveys of safety belt use in the targeted rural areas in 
Illinois showed belt use increased from a baseline of 78.5 percent 
before the Rural Demonstration program to 81.5 percent after the 
program. Other states are also taking steps to increase safety belt use 
in rural areas. For example, Washington state developed a corridor 
program to improve traffic safety and safety belt use for one of its 
rural roads by increasing enforcement and installing signs to remind 
drivers to buckle up. Another example is in Iowa, where a rural youth 
organization expanded a program called "Farm Safety Just 4 Kids" to 
improve safety belt use among younger drivers in rural areas. 

NHTSA and the states have also taken actions to address the challenge 
of increasing belt use by drivers and occupants of pickup trucks. For 
example, in 2000, NHTSA initiated a study to identify safety belt use 
rates and important characteristics of pickup truck drivers and 
passengers, review public information campaigns intended for pickup 
truck drivers, obtain qualitative information about pickup truck 
drivers' knowledge and attitudes about safety belt use, and make 
suggestions for the development of future campaigns targeting pickup 
truck drivers. Some of the selected states, in concert with NHTSA, have 
participated in special campaigns that are designed to increase safety 
belt use in pickup trucks. Both Arkansas and North Carolina, working 
with their NHTSA regional offices, participated in safety belt 
campaigns in 2006 called "Buckle Up in Your Truck." In Arkansas, the 
campaign ran during 2 weeks in May, and the ads for the campaign aired 
in five media markets. The ads ran at times and on programs that are 
popular with young males who are more likely to be driving pickup 
trucks. An analysis of a 2005 "Buckle Up in Your Truck" campaign in 
Alabama showed a greater than 4 percent increase in safety belt use in 
pickup trucks. 

Officials in selected states also face the challenge of reducing 
impaired driving among hardcore drinking drivers. Hardcore drinking 
drivers are those who drive with a BAC of 0.15 or greater. According to 
the NTSB, hardcore drinking drivers are involved in 54 percent of 
alcohol-involved fatalities, and these drivers are likely to be repeat 
drinking drivers. NHTSA and the states have taken steps to address this 
challenge. In August 2007, NHTSA recommended increased use of ignition 
interlock devices--an in-car breath tester connected to the ignition 
that prevents the vehicle from starting if the device registers a BAC 
over a specified limit--as part of a penalty against repeat drunken 
driving offenders. In addition, NHTSA has published uniform guidelines 
for state highway safety programs that call for states to enact laws 
such as high BAC and repeat offender laws with increased sanctions for 
each offense. Many states have enacted these laws. For example, 39 
states and the District of Columbia impose higher penalties for drivers 
with BAC levels of 0.15 and above. In addition, 43 states and the 
District of Columbia have repeat offender laws to discourage multiple 
alcohol offenses. All of the seven selected states have enacted these 
laws. 

Challenge in Staffing: 

Another challenge that hinders further progress in increasing safety 
belt use and reducing impaired driving is that law enforcement agencies 
report that they do not always have a sufficient number of officers to 
conduct HVE campaigns, even though traffic safety grants can be used 
for law enforcement officers to staff checkpoints or saturation 
patrols. This shortage of officers may affect HVE activities that occur 
during normal work hours and when HVE activities are staffed by 
officers working overtime. 

The challenge of finding a sufficient number of officers to conduct HVE 
campaign work during normal work hours can occur for various reasons. 
For example, some law enforcement agencies said they do not have 
sufficient staffing levels to conduct both regular police work and 
frequent HVE campaign enforcement activities. In one city we visited, 
crime enforcement needs took priority over traffic enforcement, 
officials said. For example, until recently, Providence, Rhode Island, 
devoted most of its policing resources to reducing violent crime. 
However, with a reduction in violent crime, Providence has been able to 
increase the number of officers working on traffic safety and HVE 
campaign activities. Officials also stated that regular staffing levels 
were being depleted because many of their officers have been called up 
for duty in the armed forces. Other factors that impact police 
department staffing levels, according to one 2005 study, include 
additional homeland security duties in many jurisdictions that lead to 
an increased workload for local police, as well as a potentially 
smaller pool of qualified applicants because of previous drug use and 
lack of physical condition. In addition, some law enforcement agencies 
may have too few personnel to conduct HVE activities--staffing a full- 
scale sobriety checkpoint, for example, can require 10 or more 
officers. 

In addition to the challenge of finding sufficient staff for HVE 
activities during regular hours, officials in some of the law 
enforcement agencies we visited reported that they are also having a 
difficult time getting enough officers to sign up for overtime to work 
on HVE campaigns. For example, officials in North Dakota, Rhode Island, 
and Washington said that one of the challenges in getting a sufficient 
number of officers to work overtime is that there are often other 
opportunities for overtime work, such as working in a work-zone patrol 
car at a highway construction site or as a security guard at a mall. 
Some officers prefer these opportunities over DUI enforcement because 
DUI enforcement involves a greater amount of effort and paperwork 
compared with other duties. 

Though NHTSA continues to provide funding through traffic safety 
grants, NHTSA has taken other steps to assist state and local law 
enforcement agencies in providing adequate staff for HVE campaigns. For 
example, NHTSA provides funds that states can use to provide equipment, 
such as breath-testing units, that are used as incentives to improve 
participation. NHTSA also provides guidance on how to make better use 
of existing resources. For example, NHTSA created a set of guidelines 
on sobriety checkpoints that outlines ways that small law enforcement 
agencies with limited staff can conduct effective sobriety checkpoints 
with fewer officers. 

States are also taking steps to address the staffing challenge. For 
example, to encourage officers to participate in enforcement campaigns, 
some states have developed programs to recognize officers for their 
contributions. In 2006, the Rhode Island Office of Highway Safety 
increased recognition for HVE work by giving awards to officers who 
worked overtime in enforcement campaigns targeting drunken driving and 
drivers not wearing safety belts. In addition, Arkansas has initiated a 
recognition program for exemplary performance in DUI work. One way of 
addressing staffing limitations in states with relatively small, 
neighboring law enforcement agencies is to conduct multijurisdictional 
enforcement activities. By pooling operations, according to NHTSA 
officials, 5 to10 small agencies are able to concentrate appreciable 
resources during an HVE campaign mobilization period. For example, 
North Dakota is developing a multiagency approach to address the 
challenge of bringing together sufficient resources to staff DUI 
checkpoints. 

Weak Prosecution of DUI Arrests: 

Another challenge for implementing HVE campaigns is weak prosecution of 
DUI arrests. Based on our interviews with selected state and NHTSA 
officials and our review of reports and studies, the main factors that 
contribute to weak DUI prosecution are as follows: 

* Court systems have heavy caseloads and limited resources. Therefore, 
DUI cases may be given a lower priority compared with more violent 
crimes. According to a 2002 panel convened by the National Association 
of State Judicial Educators, this results in prolonged adjudication of 
DUI cases and increased likelihood of dismissals and acquittals. 
[Footnote 26] States often lack sufficient funds to establish special 
courts to more effectively process DUI cases and to provide the 
supervised probation and treatment that DUI offenders often require. 

* Some law enforcement officials and prosecutors lack the necessary 
knowledge and training to consistently prosecute DUI cases. In some 
cases, the DUI charge may be dismissed because an officer lacks proper 
training. For example, an arresting officer may not have taken enough 
notes on the DUI arrest to testify in sufficient detail during the 
trial. In other cases, the DUI charge may be dismissed because the 
prosecutor did not have sufficient training to effectively prosecute 
DUI cases. However, many prosecutors view themselves as often not 
sufficiently prepared for their first DUI cases. A 2002 survey of 
prosecutors found that 48 percent believed they did not have adequate 
training or preparation before they began handling DUI cases. In 
addition, prosecutors and judges have to be knowledgeable in the 
complex aspects of DUI cases, including relevant legal rulings and 
admissibility of evidence as well as more scientific and technical 
issues such as blood alcohol testing procedures. The National 
Association of State Judicial Educators (NASJE) panel cited several 
challenges that judges handling DUI cases face, including that DUI 
cases are frequently plea-bargained, which may undermine the deterrent 
value of the arrest. 

Though states have a primary role in improving prosecution, NHTSA has 
provided guidance, funded training programs, and provided grants to 
states that can be used for more effective prosecution of DUI 
offenders.[Footnote 27] In February 2007, in cooperation with the 
National District Attorneys Association, NHTSA issued guidelines for 
improving testimony, note taking, and evidence gathering procedures by 
officers. NHTSA has also developed courses designed to improve 
prosecutorial skills, including one course on prosecuting DUI cases and 
another course that examines complex cases involving alcohol-involved 
crashes and provides training on how to prosecute these cases 
effectively and respond to challenges presented by the defense. 
[Footnote 28] NHTSA has also provided funding for systems that allow 
states to share information on effective DUI prosecution. For example, 
with NHTSA funding, NASJE is developing a clearinghouse for the 
exchange of materials, techniques, and information on DUI prosecution. 

Selected states have also developed initiatives to address the 
challenge of more effectively prosecuting DUI cases. For example, 
Arkansas has developed a judicial training project initiative that 
includes training for judges and officers on DUI prosecution and 
additional training for about 400 officers on conducting field sobriety 
testing. In June 2006, Illinois used HVE 410 grant funding to conduct a 
2-day seminar for 23 judges, which included training on sentencing and 
evidentiary issues. 

Conclusions: 

HVE enforcement campaigns have been shown to be effective tools in 
raising public awareness of and encouraging compliance with safety belt 
and impaired-driving laws. NHTSA has fulfilled the requirements for 
implementing an HVE program by developing advertising, coordinating 
with states, and evaluating the effectiveness of the campaigns. 
Although state officials we spoke with reported that NHTSA's 
coordination efforts helped them implement HVE campaigns, they also 
cited several challenges to conducting campaigns and achieving desired 
results--resistant populations, insufficient staffing, and inconsistent 
DUI prosecution--that may be limiting the effectiveness of the 
campaigns. NHTSA is implementing some initiatives--such as the "Buckle 
Up In Your Truck" campaign to promote safety belt use among rural 
pickup truck drivers--to help states address these challenges. However, 
the challenges of insufficient staffing and inconsistent DUI 
prosecution are primarily state issues and largely out of NHTSA's 
control to influence under the current program. While NHTSA's 
performance measures indicate that the campaign messages are reaching 
the primary target audiences and positively affecting behaviors, 
NHTSA's assessments of campaign effectiveness do not provide a complete 
picture of the impact of HVE campaigns. For example, NHTSA lacks the 
data to consistently measure a key component of the campaigns--the 
level of state and local activities--and evaluate the use of federal 
funds used by states for campaign activities. Furthermore, the 
performance measures reported in the assessments are limited and do not 
provide information on the impact of the campaigns in areas such as 
nighttime safety belt use and advertisements for all target audiences. 
The assessments would be improved by more complete and consistent 
information on federally funded state campaign activities and a more 
comprehensive set of performance measures. 

Recommendations for Executive Action: 

To improve NHTSA's evaluations of the HVE campaigns, we recommend that 
the Secretary of Transportation direct NHTSA to take the following two 
actions: 

* Develop a minimum core set of reporting requirements for states to 
consistently report HVE law enforcement and media activities funded 
with federal dollars. These requirements should be designed to achieve 
a more consistent measure of state activity and accountability for 
federal funding without presenting an undue burden to states. 

* Develop and include additional performance measures--such as a 
measure for nighttime safety belt use and additional measures of media 
effectiveness--in the agency's annual evaluations of the effectiveness 
of the two campaigns. 

Agency Comments: 

We provided a draft of this report to DOT for its review and comment. 
DOT officials--including the Senior Associate Administrator of Traffic 
Injury Control--generally agreed with the findings and recommendations 
of the report. 

We are sending copies of this report to interested congressional 
committees and the Secretary of Transportation. We will also make 
copies available to others upon request. In addition, the report will 
be available at no cost on GAO's Web site at [hyperlink, 
http://www.gao.gov]. 

If you or your staffs have any questions about this report, please 
contact me at (202) 512-2834 or [email protected]. Contact points for 
our Offices of Congressional Relations and Public Affairs may be found 
on the last page of this report. GAO staff who made key contributions 
to this report are listed in appendix III. 

Signed by: 

Katherine A. Siggerud:
Director, Physical Infrastructure Issues: 

[End of section] 

Appendix I: Objectives, Scope, and Methodology: 

To determine the extent that the National Highway Traffic Safety 
Administration (NHTSA) has implemented the high-visibility enforcement 
program, and evaluated results, we reviewed information and interviewed 
officials from NHTSA and representatives of nongovernmental 
organizations, including the American Association of State Highway and 
Transportation Officials, Governors Highway Safety Association, 
International Association of Chiefs of Police, Mothers Against Drunk 
Driving, National Safety Council, and the National Sheriffs 
Association. In addition, we reviewed studies, reports, and laws 
relevant to the implementation and evaluation of NHTSA's and other high-
visibility enforcement programs. We also interviewed state officials to 
obtain their views on NHTSA's assistance with campaign activities in 
seven states--Arkansas, Illinois, Iowa, North Carolina, North Dakota, 
Rhode Island, and Washington. We judgmentally selected the states to 
include those with laws that may affect how states conduct enforcement 
campaigns; states with a wide range of traffic safety performance 
levels, such as safety belt use and number of alcohol-involved 
fatalities, and states with different sizes of law enforcement agencies 
and with various degrees of participation in campaigns. In selecting 
states based on differences in laws that affect campaign enforcement, 
we included states that adopted primary safety belt laws before or 
after 1997 and states that have not enacted a primary safety belt law. 
In selecting states based on levels of traffic safety performance, we 
included states that, when ranked nationally, fell into the upper, 
lower, and middle third in safety belt use, unbuckled fatalities, and 
alcohol-related fatal crash ratio.[Footnote 29] To select states based 
on size of state law enforcement agencies, we looked at the average 
number of sworn officers reported by those agencies. To select states 
based on participation by law enforcement agencies, we chose states 
that had varying reported percentages of participation in HVE 
campaigns, the extent that agencies reported campaign hours worked, and 
whether law enforcement agencies used checkpoints while conducting the 
HVE campaigns from 2003 through 2006. In selecting the states, we used 
a nongeneralizable sampling approach, and, consequently, the results 
cannot be used to make inferences about all of the states. 

We used data contained in NHTSA's Fatality Analysis Reporting System 
(FARS) database to analyze information on all traffic-related 
fatalities. Each state provides NHTSA fatality data in a standardized 
format. To be included in the database, a crash must result in the 
death of an occupant or nonmotorist within 30 days of the incident. The 
states obtain this information from such sources as police reports, 
vehicle registration files, state driver licensing files, death 
certificates, coroner or medical examiner reports, and hospital 
records. It should be noted that while fatality data are useful in 
understanding crashes, other factors in addition to those involved in 
causing the crash might have contributed to the fatality. This would 
include whether safety belt or other occupant protection measures were 
used and functioned properly. Further, in providing information on 
state fatality rate trends, we identified fatalities per million miles 
traveled. To do so, we used vehicle miles traveled data maintained by 
Federal Highway Administration in its Highway Performance Monitoring 
System (HPMS). HPMS is a national-level highway information system that 
includes data on the extent, condition, performance, use, and operating 
characteristics of the nation's highways. HPMS obtains vehicle-miles- 
traveled data from each state, and states have different methods for 
collecting certain travel information. There are certain limitations 
associated with using these data. For example, the quality of the data 
in the system relies on state data collection techniques. HPMS guidance 
is flexible, so that each state has its own approach, and some 
approaches do not require annual revisions. In addition, vehicle-miles- 
traveled data may not be comparable from state to state. We have 
previously assessed the reliability of the FARS and HPMS data by 
reviewing it for obvious errors in accuracy and completeness, reviewing 
existing information about the data, and interviewing agency officials 
knowledgeable about the data and determined that the data is 
sufficiently reliable for the purposes of this report. 

To determine the impact of the high-visibility enforcement campaigns 
and what challenges exist, we interviewed officials from state highway 
traffic safety offices, state police, and local police in the seven 
selected states. For each state we visited, we also interviewed 
officials in the applicable NHTSA regional office and, when available, 
representatives of state associations of chiefs of police and sheriffs' 
associations about the impact of the HVE campaigns and challenges they 
faced. In addition, we reviewed the state highway safety plans and 
annual reports and other relevant reports for information on HVE 
campaign activities and challenges. We also provide a summary of high- 
visibility campaigns in Australia, Canada, and the Netherlands, which 
can be found in appendix II. 

We conducted this performance audit from March 2007 to April 2008 in 
accordance with generally accepted government auditing standards. Those 
standards require that we plan and perform the audit to obtain 
sufficient, appropriate evidence to provide a reasonable basis for our 
findings and conclusions based on our audit objectives. We believe that 
the evidence obtained provides a reasonable basis for our findings and 
conclusions based on our audit objectives. 

[End of section] 

Appendix II: HVE Campaigns in Australia, Canada, and the Netherlands: 

Similar to the United States, Australia, Canada, and the Netherlands, 
among other countries, combine high-visibility enforcement (HVE) with 
advertising to improve safety belt use and reduce impaired 
driving.[Footnote 30] In fact, Canada was the first country in North 
America to demonstrate that highly publicized occupant protection 
enforcement increases compliance with occupant protection laws. The 
United States based its model for high-visibility campaigns on Canada's 
occupant protection enforcement program. 

A key difference among the U.S., Australia, and Netherlands HVE 
programs is the use of random breath testing (RBT), which allows police 
to pull over any driver at random to undergo a breath test for alcohol. 
Officials from Australia and the Netherlands noted that impaired- 
driving fatalities have been reduced in their countries because law 
enforcement officials are allowed to stop drivers at random to test the 
driver's breath for alcohol. Though other countries report that the RBT 
technique is effective in combating impaired driving, it may be 
difficult to replicate in the United States due to privacy concerns. In 
the United States, drivers must be stopped for suspicious behavior or 
another offense before being given a breathalyzer. However, states may 
be able to use equipment, such as a passive alcohol sensor embedded in 
a flashlight, to overcome potential privacy concerns. 

* Canada bases its current high-visibility enforcement campaigns on its 
national road safety plan, Road Safety Vision 2010, which commenced in 
2002. The plan has ambitious goals--a 30 percent reduction in 
fatalities and injuries based on average fatalities and serious 
injuries from 1996 to 2001--and runs through 2010. Canadian HVE 
campaigns concentrate on speed, impaired driving, and safety belts 
among other things. Despite previous success with safety belt campaigns 
in the 1980s to 1990s, Canada's safety belt use rates have remained 
stagnant at approximately 90 percent to 93 percent during the last 10 
years. Canada is currently trying to develop strategies to target the 
"last 10 percent" since approximately 40 percent of their fatalities 
involve unbuckled persons, many of whom are thrown from the vehicle. To 
target impaired drivers, Canada conducts a Reduce Impaired Driving 
Everywhere program, where police stop drivers to check for signs of 
alcohol consumption. If there is suspicion of drinking, a roadside 
screening test can be administered; if the driver fails this test, an 
evidentiary breath test is given, usually at the police station. 
Canadian law also stipulates that anyone with a blood alcohol content 
above 0.08 is criminally liable. Finally, Canada has a Web site to 
allow officers to share best practices in high-visibility campaigns. 

* Australia has primarily relied on RBT as an effective strategy for 
the country's high-visibility law enforcement campaigns against 
impaired driving. Each Australian state enacted impaired-driving laws 
between 1976 and 1992, setting a blood alcohol content of 0.05 as the 
legal limit for drunken driving offenses. Each state has also enacted 
RBT laws, beginning with the state of Victoria in 1976. It was not 
until researchers determined in the early 1980s that one in two drivers 
killed in traffic accidents had a blood alcohol content over the legal 
limit, however, that Australia began widespread implementation of RBTs. 
For example, the state of Victoria went from conducting nearly 200,000 
RBTs per year in the mid-1980s to approximately 1.2 million RBTs per 
year in the early 1990s. Since there were approximately 3 million 
licensed drivers in the state of Victoria at that time, this means more 
than one in three drivers were subject to an RBT. The proportion of 
drivers killed in Australia traffic accidents that had a blood alcohol 
content over the legal limit fell to one in five in 1992. Furthermore, 
the number of intoxicated drivers in the state of Victoria who died in 
accidents decreased from 350 per year in the 1980s to approximately 100 
in 2006. In addition, Australia implemented a campaign to educate the 
public about why police officers were conducting RBTs and ensured the 
RBTs were conducted efficiently to ensure minimal delays to drivers. 
Australia emphasized the RBTs have been successful because of the 
general deterrence theory--that is, Australian drivers are afraid of 
being pulled over and tested, and, thus, they are less likely to drink 
and drive. Finally, anyone who refuses a breathalyzer test is presumed 
to have a blood alcohol content above the legal limit. 

* The Netherlands' HVE campaigns focus on a variety of areas set by the 
Minister of Transport and employs a number of different strategies. The 
five campaigns for 2007 emphasized helmet use for motorcycles and 
mopeds, safety belt use, red light compliance, reducing impaired 
driving, and lowering driving speeds. Each campaign lasts several weeks 
and involves significant police activity using the country's 750 
traffic safety officers. Approximately 1.5 million RBTs are done per 
year in the Netherlands, and drivers are afraid of being pulled over 
and tested, based on the general deterrence theory. The Netherlands 
also has an aggressive speed enforcement program to ticket 100 percent 
of offenders on the country's motorways, through an intricate speed 
camera system. For example, a motorway will have a camera on mile 1 and 
another camera on mile 10. A citation is then issued when drivers 
exceed the speed limit between those two locations; the fine depends on 
how far over the limit the driver was traveling. In the past, the 
Netherlands has run a campaign featuring a cartoon character known as 
"Goochem the Armadillo" to encourage children ages 4 to 12 to wear 
safety belts. The campaign was intended to emphasize knowledge of 
safety belt laws, increase use of safety belts, and encourage positive 
attitudes about safety belts. The campaign was successful in raising 
safety belt use rates by back seat passengers. Safety belt use rates by 
back seat passengers increased from 40 percent in urban areas and 43 
percent in rural areas in 1998 to 73 percent for both in 2006. Further, 
although the campaign was aimed at children, a survey demonstrated that 
the campaign reached approximately 90 percent of adults, as well. In 
addition to the high-visibility campaigns, the Netherlands also 
promotes sustained activity targeting each of the campaign areas 
throughout the year. 

[End of section] 

Appendix III: 

GAO Contact and Staff Acknowledgments: 

GAO Contact: 

Katherine A. Siggerud, (202) 512-2834 or [email protected]: 

Staff Acknowledgements: 

In addition to the contact named above, other key contributors to this 
report were Sara Vermillion (Assistant Director), Elizabeth Curda, 
Sandra DePaulis, Brad Dubbs, Colin Fallon, Bert Japikse, Tom James, 
Leslie Locke, Terry Richardson, Beverly Ross, and Aron Szapiro. 

[End of section] 

Footnotes: 

[1] The OTLUA campaign was termed "You Drink & Drive, You Lose" from 
2003 to 2005. 

[2] Unrestrained fatalities are those in which the deceased was not 
wearing a shoulder belt, lap belt, lap and shoulder belt, child safety 
seat, or other restraint and were occupants (except bus passengers) of 
motor vehicles (except motorcycles, all terrain vehicles, or 
snowmobiles). 

[3] Alcohol-involved fatalities include all fatalities in a motor 
vehicle crash where one or more involved drivers, pedestrians, or pedal-
cyclists in the crash had a blood alcohol content of 0.08 g/dL or 
greater. 

[4] Pub. L. 98-363 specified that 10 percent of a state's apportioned 
funds for the National Highway System, the Surface Transportation 
Program, and interstate reconstruction and maintenance would be 
withheld if a state did not establish a 21-year-old minimum drinking 
age. 

[5] HVE campaigns are also known as Selective Traffic Enforcement 
Programs. 

[6] R.B. Voas, A.E. Rhodenizer, and C. Lynn, Evaluation of 
Charlottesville Checkpoint Operation (final report), special report 
prepared at the request of the U.S. Department of Transportation, 
National Highway Traffic Safety Administration, May 1985. 

[7] NHTSA has also continued to fund media technical assistance, the 
development of advertisements and the production of advertisements 
through Highway Safety Research and Development Section 403 funds 
(i.e., for funds appropriated to carry out 23 U.S.C. ï¿½ 403) and in 
fiscal year 2007 reported expending $3,454,458. 

[8] Information on the amount states spend on these activities is not 
available because NHTSA does not require states to report such 
information, and their grant tracking system reports on program areas 
such as occupant protection and not on components within the program 
such as HVE media. 

[9] U.S. Department of Transportation, National Highway Traffic Safety 
Administration, NHTSA National Communications Plan 2007 (Washington, 
D.C., January 2007). 

[10] The expert panel included strategic communications and social 
marketing experts. We identified these elements in NHTSA's plans and 
resources but did not evaluate each element. 

[11] GAO, Digital Television Transition: Increased Federal Planning and 
Risk Management Could Further Facilitate the DTV Transition, 
[hyperlink, http://www.gao.gov/cgi-bin/getrpt?GAO-08-43] (Washington, 
D.C.: Nov. 19, 2007). 

[12] U.S. Department of Transportation, National Highway Traffic Safety 
Administration, Creating Impaired Driving General Deterrence: Eight 
Case Studies of Sustained, High-Visibility, Impaired-Driving 
Enforcement (Washington, D.C., March 2006). 

[13] NHTSA issued its evaluation of the May 2005 CIOT Campaign in May 
2007, and the evaluation of the Impaired Driving Campaigns for 2003- 
2005 in July 2007. NHTSA plans to release evaluations of the 2006 
campaigns--the first year of the national advertising campaigns 
authorized by SAFETEA-LU--in the spring of 2008. 

[14] U.S. Department of Transportation, National Highway Traffic Safety 
Administration, Evaluation of the May 2005 Click It or Ticket 
Mobilization to Increase Seat Belt Use, Report No. DOT HS 810 778 
(Washington, D.C., May 2007). 

[15] U.S. Department of Transportation, National Highway Traffic Safety 
Administration, Evaluation of the National Impaired Driving High- 
Visibility Enforcement Campaign: 2003-2005, Report No. DOT HS 810 789 
(Washington, D.C., July 2007). 

[16] This information is based on annual telephone surveys on the 
effectiveness of impaired-driving campaigns from 2003 through 2005. 
NHTSA officials also conducted regional telephone surveys for the CIOT 
campaign in 2006 and a national telephone survey for the CIOT campaign 
in 2007; data from these surveys will be included in NHTSA's 2006 and 
2007 evaluations. NHTSA reported the 2006 evaluation should be released 
in March 2008 and the 2007 evaluation in the spring of 2009. 

[17] States that receive Alcohol-Impaired Driving Countermeasures 
Incentive Grant funds are required to report on HVE activities those 
funds support. 

[18] Percentage is based on NHTSA data collected from states, the 
District of Columbia, and Puerto Rico. 

[19] U.S. Department of Transportation, National Highway Traffic Safety 
Administration, 2005 National Communications Plan (Washington, D.C., 
November 2004). 

[20] While the 2005 Integrated National Communications Plan listed 
these other target audiences, the summary of the 2005 Impaired Driving 
Campaign shown in the appendix of the 2006 National Communications plan 
shows these additional targeted audiences were replaced with a "Newly 
Arrived Latino Immigrants" secondary target audience. 

[21] Media allocation was reported in an appendix of the 2006 National 
Communications Plan. 

[22] In general, throughout the U.S., safety belt use rates are higher 
in primary law states, but some states without a primary law have 
safety belt use rates that are higher than the nationwide average. 
Minnesota, Nevada, Ohio, Pennsylvania, Utah, Vermont, and West 
Virginias--states without a primary safety belt law according to NHTSA-
-experienced 2006 safety belt use rates that were higher than the 
nationwide average of 81 percent. 

[23] Since we used a nongeneralizable sample of seven states, these 
challenges should not be used to make inferences about challenges in 
all states that implement HVE campaigns. For similar challenges, see: 
Statement of The Honorable Calvin L. Scovel III, Inspector General, 
U.S. Department of Transportation on the Effectiveness of Federal Drunk 
Driving Programs, Senate Committee on Environment and Public Works, 
Subcommittee on Transportation Safety, Infrastructure Security, and 
Water Quality, Oversight Hearing on Effectiveness of Federal Drunk 
Driving Programs, 110th Cong., 1st sess., October 25, 2007; and 
Testimony of Mark V. Rosenker, Chairman, National Transportation Safety 
Board, Senate Committee on Environment and Public Works, Subcommittee 
on Transportation Safety, Infrastructure Security, and Water Quality, 
Oversight Hearing on Effectiveness of Federal Drunk Driving Programs, 
110th Cong., 1st sess., October 25, 2007. 

[24] NHTSA, Traffic Safety Facts: Rural/Urban Comparison, DOT HS 810- 
812 (2006). 

[25] NHTSA, Traffic Crashes Take Their Toll on America's Rural Roads: 
The Need to Establish Rural Seat Belt Programs, DOT HS 810-658 
(December 2006). 

[26] National Association of State Judicial Educators and The Century 
Council, Hardcore Drunk Driving Judicial Guide (Washington, D.C., 
2002). 

[27] States may use Alcohol-impaired Driving Countermeasures Incentive 
Grant funds to implement an outreach program to educate prosecutors and 
judges. 

[28] These courses are offered by the National Association of 
Prosecutor Coordinators and the American Prosecutors Training 
Institute. 

[29] The alcohol-related fatal crash ratio is the number of alcohol- 
related vehicle crashes with one or more fatalities divided by the 
total number of vehicle crashes with one or more fatalities. A crash 
was considered to be alcohol related if a vehicle operator, pedestrian, 
or bicyclist involved in the crash had blood alcohol content at or 
above 0.01. 

[30] GAO selected these three countries based on expert recommendation 
and the countries' performance in reducing road fatalities. 

[End of section] 

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