Documenting the sustainability of a mature Click It or Ticket program: the North Carolina experience

North Carolina was the first United States jurisdiction to implement a statewide program (called Click It or Ticket) coupling concentrated enforcement with massive publicity to increase seat belt use. After a successful pilot program in three very different North Carolina communities, the statewide program was launched in October 1993, and has been most active and productive as well as imitated by many other states over the past decade. This paper explores the combination of ingredients that have been employed and sustained over that period of time. These include: (a) a basic coalition of critical public-private agencies (central to the planning, execution, and publicity of the many Click It or Ticket programs); (b) critical top-down commitments (starting with the governor); (c) pervasive and innovative media events/press releases/ PSAs/ web site information; (d) vigorous and well-publicized law enforcement; (e) feedback on results with solid, updated data; (f) related statewide and local programs/activities; and last but not least (g) continuous funding.