these laws has significantly increased the rate of restraint use (Graham, 1993). In both cases, public education efforts have accompanied and spurred enactment of this legislation, transmitted knowledge about the provisions and penalties of laws to promote compliance, and generated public support for law enforcement programs.

Self-protection. Another key development has been increased attention to the ways in which potential victims can reduce their own vulnerability or exposure to injury. Research on promoting helmet use by cyclists and safety belt use by motorists and passengers is a natural extension of medical research on the logic of immunization or prophylaxis. When extended to assaultive injuries, self-protection takes the form of bulletproof vests for police officers and other forms of personal security aiming to reduce exposure or vulnerability (NRC, 1993). Avoiding intoxication is another way that potential victims can protect themselves (Room et al., 1995). Increased scientific attention to the opportunities for precautionary behavior reflects an enriched appreciation of the ways in which changing the behavior of potential victims can reduce the risk of injury. It should be acknowledged, however, that one of the potential pitfalls of efforts to promote self-protection is the tendency to blame victims for failing to take precautions if injury does occur. This concern highlights the interaction of attitudes toward prevention and personal responsibility in an overall injury prevention strategy.

High-risk groups. Another area requiring systematic research is in understanding and developing strategies for reaching high-risk groups. Although many interventions are appropriately aimed at the general population, research is needed on prevention interventions aimed specifically at groups with above-average risk. However, proper targeting is a first step. For example, most infants and young children traveling in passenger vehicles are in child safety seats. Yet there is an important but relatively neglected subgroup (an estimated 35 percent of children ages 4 and under) that travels without such restraints and has twice the risk of death and injury as those who use safety seats (SAFE KIDS, 1998). Research on protecting children who travel without restraints may be more useful than cataloging all the forms of misuse. Additionally, research has shown the promise of reducing injuries through home visitation for high-risk first-time mothers (Kitzman et al., 1997; Olds et al., 1997).

Research demonstrates that at-risk populations do not necessarily have to be addressed directly in order to change their behavior. For example, there has been some success with peer intervention training in high schools as a means of getting students to intervene in the drinking and driving of their associates (McKnight and McPherson, 1986). Others who have some influence over at-risk individuals—for example, sellers and servers of alcohol—can be targeted, and server intervention programs have shown some success in reducing excessive alcohol consumption (McKnight and Streff, 1994).

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