Background and Aim: Despite evidence supporting the protective effect of seatbelts, compliance in bus travel is understudied, particularly in Iran. The purpose of this study was to determine the predictors of seatbelt use in passengers of intercity buses.
Materials & Methods: A cross-sectional study was conducted with 448 passengers recruited from intercity bus terminals in Tehran using a multistage sampling method. Data were collected through a validated 57-item questionnaire. Logistic regression analyses were applied to examine predictors of seatbelt non-use across three models incorporating behavioral, demographic, and background variables. SPSS 16 software was used to analyze the data.
Results: Only 24% of passengers consistently used seatbelts. In the final logistic regression model, significant predictors of seatbelt non-use included perceived barriers (OR = 1.08, 95% CI: 1.02–1.15, p = 0.003), Low & supervision (OR = 1.13, 95% CI: 1.00–1.28, p = 0.04), health locus of control (OR = 1.18, 95% CI: 0.99–1.40, p = 0.05) and poor law adherence (OR = 2.60, 95% CI: 1.67–4.06, p < 0.001). Conversely, subjective norms (OR = 0.75, 95% CI: 0.65–0.87, p < 0.001) and environmental factors (OR = 0.82, 95% CI: 0.69–0.97, p = 0.02) were associated with higher seatbelt use. The model showed acceptable goodness-of-fit (Hosmer–Lemeshow p = 0.08) and good discrimination (AUC = 0.78; 95% CI: 0.74–0.87).
Conclusion: Seatbelt use among intercity bus passengers in Iran is low and externally motivated. Interventions should enhance awareness, address ergonomic and accessibility barriers, and ensure seatbelt functionality.