Just prior to the May 2005 Click It or Ticket mobilization, NHTSA's Great Lakes Region implemented a Rural Demonstration Program (RDP) to increase seat belt use in rural areas. Paid media notified rural residents that police would enforce seat belt laws. In three States (Illinois, Indiana, and Ohio), enforcement was included during this phase; however, in the remaining three States (Minnesota, Michigan, and Wisconsin), only paid media was implemented. All States intensified enforcement during CIOT. In targeted rural areas, awareness of seat belt messages increased most during the RDP, while awareness of enforcement-related messages and activities increased most during CIOT. During the RDP, States that had intensified enforcement experienced significant increases in usage in their rural targeted areas. Generally, usage did not increase unless enforcement was present. During CIOT, States that had intensified enforcement during RDP showed substantially greater overall statewide gains than States that had not intensified enforcement during RDP