This demonstration project examined the effects of strategies to increase seat belt use among drivers in a rural county in NC. Information about rural drivers was obtained through written surveys administered before and after the program at driver license stations and high schools in the test and comparison sites and a rural site with high belt use. A coalition of schools, emergency medical personnel, the health department and law enforcement agencies implemented an eight month program. Interventions included seat belt reminders and incentives for lowbelt- use target groups such as pickup truck drivers. During the program, overall belt use in the test site rose from 33% to a high of 58%, then remained above 50%;​ belt use for drivers of pickup trucks went from about 22% to a program high of 45%. Usage rates in the comparison site were stable in the low 30% range throughout the program. Increases in belt use, observed among all categories of drivers, were attributed to intervention strategies designed specifically for rural populations with little or no increase in enforcement.