Shahrekord University of Medical Sciences Epidemiology and Health System Journal 2980-7891 12 1 2025 06 07 Examining the Determinants of Seatbelt Use Among Rural Drivers: An Application of the Theory of Planned Behavior 14 19 10.34172/ehsj.26265 EN Homayoun Sadeghi-Bazargani https://orcid.org/0000-0002-0396-8709 Fatemeh Malekpour https://orcid.org/0000-0002-0313-0164 Yousef Mohammadian https://orcid.org/0000-0002-5545-3619 Tohid Jafari-Koshki https://orcid.org/0000-0002-6928-1387 Forouzan Rezapur-Shahkolai https://orcid.org/0000-0001-5049-1109 Mehdi Khansari https://orcid.org/0009-0007-9093-1237 Alireza Malekpour https://orcid.org/0009-0001-2427-997X Masoumeh Maleki Marzroud https://orcid.org/0009-0004-4150-881X Journal Article 10.34172/ehsj.26265 2024 09 10 2025 03 03 Background and aims: Wearing a seat belt significantly reduces the severity and fatality of road traffic injuries. This study aimed to predict seatbelt-wearing behavior among rural drivers using the Theory of Planned Behavior (TPB) and to identify its influencing factors. Methods: This study was conducted among 450 rural drivers in the Hashtrood district of Iran using a random sampling method in 2023. Data were collected through a structured questionnaire containing questions on demographic characteristics, general traffic-related behaviors, and seatbelt use behavior based on the TPB constructs. Regression analysis was conducted using SPSS software (version 16) to predict TPB constructs. Results: The findings indicated that 59.1 % of drivers strictly adhered to the traffic rules. However, only 21.4% of drivers used the front, and 19% used seatbelts in the rear seat on rural roads. Based on regression analysis of TPB constructs, subjective norms, attitude, and perceived behavioral control considerably predicted behavioral intention to use a seat belt (P<0.05, R2=0.422, adjusted R2=0.417). Furthermore, the constructs of behavioral intention and perceived behavioral control were found to be significant predictors of actual seatbelt use behavior (P<0.01, R2=0.283, adjusted R2=0.280). Adherence to traffic rules, parental behavior, exposure to seatbelt use training by parents and friends, and being fined for not wearing a seat belt significantly impacted the seatbelt use behavior (P<0.05). Conclusion: The results of this study demonstrated that TPB predicted seatbelt use behavior among rural drivers. Educational preventive programs grounded in TPB principles could improve seatbelt use behavior among rural societies.