REAR SEATBELT USE IN URBAN SOUTHEAST ASIA: RESULTS FROM MULTI-ROUND CROSS-SECTIONAL STUDIES

Background Road traffic injury remains a leading cause of morbidity and mortality in Southeast Asia. Rear seatbelt use, a key behavioral risk factor, is understudied. We aim to estimate the prevalence and predictors of rear seatbelt use in Bandung, Indonesia and Bangkok, Thailand. Methods Roadside observational studies were conducted across Bandung and Bangkok to provide a representative picture of behavioral risk factor prevalence in each city. Trained observers collected data from stationary vehicles at intersections during the daytime throughout the week. We computed descriptive statistics and conducted multivariable logistic analyses by city. Results Eight rounds of observations were conducted between July 2015 to April 2019. 39,479 and 7,207 rear-seat passengers were observed in Bandung and Bangkok, respectively. Across all rounds, 4.2% of rear seatbelt passengers used seatbelts in Bandung, compared to 8.4% in Bangkok. In both cities, males and adults, as compared to females and adolescents (aged 12–17 years), had higher odds of rear seatbelt use, as did passengers with a belted driver. Additionally, passengers in a light truck (compared to sedan) had higher odds of rear seatbelt use in Bandung, while a belted front passenger was associated with rear seatbelt use in Bangkok. Conclusions Rear seatbelt use was low in Bangkok and even lower in Bandung. Gender, age, and the behavior of other occupants were key predictors of rear seatbelt use. Learning Outcomes Findings highlight the need for rear seatbelt laws in Bandung and improved enforcement of existing rear seatbelt laws in Bangkok.