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Stolworthy C, Hu J, Merritt N. Pediatric cervical spine fracture case report: Best practice to delay transition to rear-facing restraint. Trauma Case Rep 2021; 34:100500. [PMID: 34195341 PMCID: PMC8220592 DOI: 10.1016/j.tcr.2021.100500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 11/19/2022] Open
Abstract
Pediatric physicians and motor vehicle safety experts have been advocating for change in child passenger restraint practices for decades. As professional recommendations evolve to support extended rear-facing restraint, actual practices remain disparate. We report a case of pediatric cervical spine fracture due to motor vehicle collision, an uncommon, yet predictable, pattern of injury for which prevention education is undoubtedly preferable to managing the consequences of premature forward-facing in vulnerable pediatric patients. Currently, 9 kg is a minimum legal standard for forward-facing child restraint system use in Ontario, rather than a recommended transition time. We advise that parents should be counselled on the benefits of rear-facing as long as possible and discuss realistic transition times using their child restraint system manual as a reference, with the goal of approaching, but not exceeding, the maximum weight, height and fit requirements for optimal safety.
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Affiliation(s)
| | - Jonathan Hu
- Schulich School of Medicine, Western University, London, Ontario, Canada
| | - Neil Merritt
- Department of Paediatric Surgery, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
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2
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Kendi S, Howard MB, Mohamed MA, Eaddy S, Chamberlain JM. So much nuance: A qualitative analysis of parental perspectives on child passenger safety. TRAFFIC INJURY PREVENTION 2021; 22:224-229. [PMID: 33661063 DOI: 10.1080/15389588.2021.1877276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore barriers and facilitators to optimal child restraint system (CRS) use for diverse parents of newborn infants and to obtain input from parents on the use of technology-assisted remote car seat checks as tools for promoting optimal CRS use. METHODS Parents were recruited using purposive sampling. Interviews were conducted with English- or Spanish-speaking parents with a full term newborn and regular access to a car. Interviews were conducted by phone, and recorded and transcribed verbatim. Interviews were conducted until thematic saturation was reached. Data were organized for analysis using Atlas.ti, and codes grouped by theme using constant comparison. RESULTS 30 parents were enrolled. Barriers and facilitators to optimal CRS use were classified into three themes, as were thoughts on the pros and cons regarding remote car seat checks. Themes on barriers and facilitators included motor vehicle and CRS features (such as age and size of the motor vehicle and presence of the Lower Anchors and Tethers for Children LATCH system), resources (availability, accessibility, and accuracy of resources), and parental factors (parental emotions and characteristics). Themes related to pros and cons of remote car seat checks included the ability (and challenge) of remote car seat checks to identify and correct errors, the potential use of remote car seat checks in certain situations (such as CRS transitions and periods of growth), and convenience of remote car seat checks (including increased availability and ease of access). Subthemes with further detail were arranged within each theme identified. CONCLUSION From a parent perspective, there are several identified barriers and facilitators of optimal CRS use. Although car seat checks were identified as a resource, in-person accessibility was an issue, and there were mixed opinions on technology-assisted remote car seat checks. These results provide a foundation for additional study on targeted interventions, including remote interventions for which there is an increased need due to the COVID-19 pandemic.
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Affiliation(s)
- Sadiqa Kendi
- Children's National Hospital, Washington, DC
- The George Washington University School of Medicine and Health Sciences, Washington, DC
- Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts
| | - Mary Beth Howard
- Children's National Hospital, Washington, DC
- The George Washington University School of Medicine and Health Sciences, Washington, DC
| | - Mohamed A Mohamed
- The George Washington University School of Medicine and Health Sciences, Washington, DC
- The George Washington University Hospital, Washington, DC
| | - Samuel Eaddy
- Children's National Hospital, Washington, DC
- Nova Southeastern University Dr. Kiran C Patel College of Osteopathic Medicine, Fort Lauderdale, Florida
| | - James M Chamberlain
- Children's National Hospital, Washington, DC
- The George Washington University School of Medicine and Health Sciences, Washington, DC
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3
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Krepis P, Papasotiriou M, Tsolia MN, Soldatou A. Child Car Safety: A Parental Survey at a Tertiary Care Emergency Treatment Center in Greece. Pediatr Emerg Care 2021; 37:29-33. [PMID: 29489606 DOI: 10.1097/pec.0000000000001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to assess parental behavior in terms of child restraint systems (CRS) use under emergency conditions while driving to the hospital's outpatient settings as well as their routine child car safety (CCS) practices. METHODS A cross-sectional survey of parents/caregivers transporting children 13 years or younger was conducted at the Emergency Treatment Center of a pediatric tertiary care center in Athens, Greece. Participants completed a questionnaire inquiring about the possession of CRS, and type and use of appropriate CRS while driving to the Emergency Treatment Center and under routine conditions. In addition, presence and type of parental education with regard to CCS and the use of seat belts among drivers were assessed. RESULTS Of 444 participants, 51.4% children were carried restrained, although 48.6% were fastened in an improper seat for their age, in contrast with 23.7% who travel unrestrained on a daily basis. Forward-facing restraint seats were most popular, with 53.9% total use even in children younger than 2 years or older than 4 years, whereas booster seats (9.4%) and rear-facing restraint seats (18.2%) were inappropriately disfavored. Children younger than 4 years, male drivers, and drivers who had received information on CCS had higher odds of using CRS. The proportion of those had never been provided any CCS education was 38.5%. CONCLUSIONS Child restraint systems use was inappropriately low under routine conditions and declined even further under emergency circumstances. Most children younger than 2 years and older than 4 years traveled inappropriately restrained in a forward-facing restraint seat. Parents should be more intensively educated on child car safety seat and the proper CRS use.
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Affiliation(s)
- Panagiotis Krepis
- From the Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | | | - Maria N Tsolia
- From the Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Alexandra Soldatou
- From the Second Department of Pediatrics, "P. & A. Kyriakou" Children's Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Wymore C, Denning G, Hoogerwerf P, Wetjen K, Jennissen C. Parental attitudes and family helmet use for all-terrain vehicles and bicycles. Inj Epidemiol 2020; 7:23. [PMID: 32532340 PMCID: PMC7291627 DOI: 10.1186/s40621-020-00253-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Background Helmets prevent head trauma in both all-terrain vehicle (ATV) and bicycle crashes. This pilot study’s objective was to compare family helmet use and participant attitudes regarding helmets for ATVs versus bicycles. Methods A convenience sampling of adults attending a 2017 university-sponsored health fair who had at least one child < 18 years living at home were surveyed. Demographics, frequency of helmet use, and information about factors influencing helmet use were collected. Descriptive (frequencies) and bivariate (Fisher’s exact test) analyses were performed. Qualitative themes of written responses were also examined. Results Subjects (N = 98) were 26–57 years old (mean 40 years). Three-quarters (76%) were female. The percentage always wearing a helmet riding bicycles was 63% (subjects), 58% (spouses/partners), and 51% (children), compared to 11, 14 and 37% on ATVs, respectively. Moreover, the percentage never wearing a helmet while on an ATV was 68% for subjects, 71% for spouses, and 47% for children. Despite helmet use differences between bicycles and ATVs, the importance of children wearing a helmet on these vehicles was rated highly and equally important, 9.28 and 9.58 on a 1–10 scale, respectively. Higher proportions of subjects’ oldest children wore a bike helmet 100% of the time if at least one parent always wore a helmet (81%), compared to children whose parents both wore helmets < 100% of the time or didn’t ride (21%) (p < 0.0001). The proportion of children wearing ATV and bicycle helmets less than 100% of the time was significantly higher if parents reported barriers to effectively enforcing helmet use than if they did not (p = 0.04 and p = 0.004, respectively). Many reported a “strict no helmet, no bike/ATV riding rule” as being most effective in getting their children to always wear a helmet. Conclusions This study is the first to explore family helmet use while riding bicycles vs ATVs. Although parent’s belief in the importance of helmet use was high for both, helmet use was greater when riding bicycles. Further research is needed to better understand the social and environmental influences that shape parental helmet attitudes and practices in order to improve safety interventions for increasing pediatric helmet use.
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Affiliation(s)
- Cole Wymore
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, USA
| | - Gerene Denning
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, USA
| | - Pamela Hoogerwerf
- Injury Prevention and Community Outreach Program, University of Iowa Stead Family Children's Hospital, University of Iowa, Iowa City, USA
| | - Kristel Wetjen
- Pediatric Trauma Program, University of Iowa Stead Family Children's Hospital, University of Iowa, Iowa City, USA
| | - Charles Jennissen
- Department of Emergency Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, USA. .,Department of Pediatrics, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, USA.
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Ghiasvand H, Roshanfekr P, Ali D, Ardakani HM, Stephens AN, Armoon B. Determinants of road traffic injuries in Iranian children; results from a National Representative Demographic- Health Survey 2010. BMC Pediatr 2020; 20:231. [PMID: 32429865 PMCID: PMC7236294 DOI: 10.1186/s12887-020-02127-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 05/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Road Traffic Injuries (RTIs) are a leading cause of disabilities and mortalities in Iran. The occurrence of RTIs among children is increasing. This study aims are to assess RTIs among Iranian children and to determine the main socio-economics determinants. Methods The National Institute of Health Research (NIHR) in collaboration with the Iran Ministry of Health (MoH) conducted a nationwide survey: The Multiple Indicator Demographic and Health Survey 2010 (IrMIDHS 2010). The Survey was undertaken by Medical Universities in Iran. Based on multistage clustered randomized sampling, 30,960 households were included in the survey. We performed a multivariate logistic regression to determine the main socio-economic factors associated with RTIs among children. Results Approximately 0.9% of the children received RTIs in 2010. Main socio-economics contributors to RTIs involving Iranian children included household size (Adjusted OR: 1.06 (CI 95% 1.01, 1.14), sex (Adjusted ORfemale: 0.38 (CI 95% 0.29, 0.50), living with both parents (Adjusted OR: 0.55 (CI 95% 0.13, 0.95), being in the 2nd (Adjusted OR: 0.81 (CI 95%: 0.60, 0.90) or 4th income quartile (Adjusted OR: 0.13 (CI 95%: 0.02, 0.92) rather than the 1st income quartile, being aged five to nine (Adjusted OR: 1.39 (CI 95%: 1.10, 2.10), or aged 15 to 18 (Adjusted OR: 2.94 (CI 95%: 2.07, 4.97), and residency in a non- owned or non-tenancy house (Adjusted OR: 0.42 (CI 95%: 0.23 0.74). Conclusions Children need safe places for playing and doing their daily activities. Policy and regulation development aimed at protecting children from road traffic injuries needs to take into consideration the socio-economic factors associated with risk of road traffic injury among children.
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Affiliation(s)
- Hesam Ghiasvand
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran.,Health Economics Group, Medical School, Saint Luke's Campus, University of Exeter, Exeter, UK
| | - Payam Roshanfekr
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation, Tehran, Iran
| | - Delaram Ali
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation, Tehran, Iran
| | | | - Amanda N Stephens
- Monash University Accident Research Centre, Monash University, Clayton, Australia
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran. .,School of Nursing and Midwifery, Saveh University of Medical Sciences, Tehran-Saveh freeway, Kaveh Industrial Estate company, Saveh, 3914334911, Iran.
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Childhood road traffic injuries in Canada - a provincial comparison of transport injury rates over time. BMC Public Health 2018; 18:1348. [PMID: 30522470 PMCID: PMC6282394 DOI: 10.1186/s12889-018-6269-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/27/2018] [Indexed: 11/15/2022] Open
Abstract
Background In Canada, road traffic injuries are the leading cause of death among children and youth ≤19. Across the country, there is variability in road traffic injury prevention policies and legislation. Our objective was to compare pediatric road traffic related injury hospitalization and death rates across Canadian provinces. Methods Population-based hospitalization and death rates per 100,000 were analyzed using data from the Discharge Abstract Database and provincial coroner’s reports. Road traffic related injuries sustained by children and youth ≤19 years were analyzed by province and cause between 2006 and 2012. Results The overall transport-related injury morbidity rate for children in Canada was 70.91 per 100,000 population between 2006 and 2012. The Canadian population-based injury hospitalization rates from all transport-related causes significantly decreased from 85.51 to 58.77 per 100,000 (− 4.42; p < 0.01; − 5.42; − 3.41) during the study period. Saskatchewan had the highest overall transport related morbidity rate (135.69 per 100,000), and Ontario had the lowest (47.12 per 100,000). Similar trends were observed for mortality rates in Canada. Conclusions Transport-related injuries among children and youth have significantly decreased in Canada from 2006 to 2012; however the rates vary by province and cause. Electronic supplementary material The online version of this article (10.1186/s12889-018-6269-9) contains supplementary material, which is available to authorized users.
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Lei H, Gao R, Yang J, Li L. Parent-Based Intervention to Improve Child Restraint Use Among Kindergarteners in China. Am J Public Health 2018; 108:1524-1526. [PMID: 30252521 PMCID: PMC6187795 DOI: 10.2105/ajph.2018.304650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of parent-based child restraint system (CRS) education and hands-on CRS installation training. METHODS We conducted a randomized trial with cluster sampling from May 2016 to January 2017 in 6 selected kindergarten classes in Shantou and Chaozhou, China. Parents were randomly assigned to receive 1 of the 3 study conditions: CRS education only, CRS education plus hands-on CRS installation training, or control (child electricity safety). RESULTS Three months after the intervention, significantly higher CRS use was reported in the CRS education plus hands-on CRS installation training group than was reported in the control group (41.2% vs 18.5%; P = .011). However, no significant difference in CRS use was found between the CRS education only and the control groups (26.7% vs 18.5%; P = .33). The ratings on child passenger safety awareness increased significantly in both intervention groups but remained unchanged in the control group after the intervention. CONCLUSIONS The CRS education plus hands-on CRS installation training increased the use of child restraints, but the CRS education only condition did not. Both intervention methods helped to improve child passenger safety awareness.
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Affiliation(s)
- Huiqian Lei
- Huiqian Lei, Ran Gao, and Liping Li are with the Injury Prevention Research Center, Shantou University Medical College, Shantou, China. Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Ran Gao
- Huiqian Lei, Ran Gao, and Liping Li are with the Injury Prevention Research Center, Shantou University Medical College, Shantou, China. Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Jingzhen Yang
- Huiqian Lei, Ran Gao, and Liping Li are with the Injury Prevention Research Center, Shantou University Medical College, Shantou, China. Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
| | - Liping Li
- Huiqian Lei, Ran Gao, and Liping Li are with the Injury Prevention Research Center, Shantou University Medical College, Shantou, China. Jingzhen Yang is with the Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH
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8
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Asbridge M, Ogilvie R, Wilson M, Hayden J. The impact of booster seat use on child injury and mortality: Systematic review and meta-analysis of observational studies of booster seat effectiveness. ACCIDENT; ANALYSIS AND PREVENTION 2018; 119:50-57. [PMID: 29990613 DOI: 10.1016/j.aap.2018.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 06/19/2018] [Accepted: 07/01/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To determine through systematic review and meta-analysis of observational studies if booster seats, compared to seatbelts alone, reduce injury and mortality from motor vehicle collisions among child passengers four to eight years of age. METHODS A comprehensive search of several data sources (including Medline, Embase, and PsycINFO) was conducted from inception to December 2016, to retrieve relevant publications in any language and from any geographic region. Data extraction was completed by two independent reviewers, capturing: study details, population characteristics, exposure (booster seat compared to seat belt use), outcomes (injury and fatality), and all associations reported between the exposure and outcomes. Risk of bias assessment was completed by two reviewers using the QUIPS tool. Meta-analysis of sufficiently similar studies was conducted using random effects models. RESULTS Eleven observational studies were included in qualitative syntheses. The systematic review and meta-analysis found no association between booster seat use, compared to seatbelts, and reduced injury (4 studies, OR 1.03; 95% CI 0.53-1.99) or fatality (2 studies, OR 0.91; 95% CI 0.73-1.13). CONCLUSIONS Evidence on booster seat effectiveness to protect against injury and mortality in real-world conditions is limited. This review identified the need for high quality studies assessing the effects of different models of booster seats on children of varying ages and weights.
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Affiliation(s)
- Mark Asbridge
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Rachel Ogilvie
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Maria Wilson
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Jill Hayden
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
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9
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Bruce BS, Mundle K, Cramm CF, Williams DP. Promoting booster seat use for young children: A school-based intervention pilot study. Paediatr Child Health 2018; 22:89-91. [PMID: 29479188 DOI: 10.1093/pch/pxx025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose Misuse and/or lack of booster seat use are often associated with high rates of injury and death among school-aged children. This pilot study examined the efficacy and the potential effectiveness of a booster seat intervention in the classroom. Methods Two elementary schools participated (randomly assigned as one intervention school and one control school). At the intervention school, a certified car seat specialist and a police officer held an interactive booster seat session. The height and age for each child were recorded. Children received a certificate indicating whether they met the requirements for booster seat use and a postcard with car seat restraint specifications. Children in the control school received a brochure on car seat safety. Pre- and post-intervention self-reports were collected and booster seat use was observed. Results Observational findings showed a decline in booster seat use at the control school and an increase in use at the intervention school. Self-reports of booster seat use indicated a decline at both schools; however, cell sizes were too small to permit statistical analyses. Conclusion Anecdotally researchers found the sessions were easy to conduct and were well received by the children and could be easily integrated into programming in schools. Classroom sessions may have the potential to positively influence booster seat use among 6- to 8-year-olds.
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Affiliation(s)
- Beth S Bruce
- Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia
| | - Kim Mundle
- IWK Health Centre, Child Safety Link, Halifax, Nova Scotia
| | - Camille F Cramm
- Faculty of Health Professions, Dalhousie University, Halifax, Nova Scotia
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Abstract
Education is ubiquitous with clinical care. However, not all education supports behavioral change. Education is a broad term that encompasses the process of obtaining general knowledge, personal awareness, and skills training. Although not sufficient, education is a necessary component for behavior change. This article outlines the role of education in behavior change and offers practical suggestions for how clinicians can provide education to their patients to help them change behavior.
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Affiliation(s)
| | - Craig A Johnston
- Department of Health and Human Performance, University of Houston, Houston, Texas
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11
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Caregivers’ Use of Child Passenger Safety Resources and Quality of Future Child Restraint System Installations. SAFETY 2017. [DOI: 10.3390/safety3040024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hunter K, Keay L, Clapham K, Brown J, Bilston LE, Lyford M, Gilbert C, Ivers RQ. "He's the Number One Thing in My World": Application of the PRECEDE-PROCEED Model to Explore Child Car Seat Use in a Regional Community in New South Wales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101206. [PMID: 28994725 PMCID: PMC5664707 DOI: 10.3390/ijerph14101206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 09/30/2017] [Accepted: 10/02/2017] [Indexed: 12/04/2022]
Abstract
We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at three early learning centres on the Australian south-east coast. Survey data were triangulated with qualitative data from focus groups and analysed using the PRECEDE-PROCEED conceptual framework. Of the 133 eligible families, 97 (73%) parents completed the survey including 31% of parents who reported their children were Aboriginal. Use of age-appropriate car seats was reported by 80 (83%) of the participants, and awareness of the child car seat legislation was high (91/97, 94%). Children aged 2–3 years were less likely reported to be restrained in an age-appropriate car seat than were older children aged 4–5 years (60% versus 95%: χ2 = 19.14, p < 0.001). Focus group participants highlighted how important their child’s safety was to them, spoke of the influence grandparents had on their use of child car seats and voiced mixed views on the value of authorised child car seat fitters. Future programs should include access to affordable car seats and target community members as well as parents with clear, consistent messages highlighting the safety benefits of using age-appropriate car seats.
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Affiliation(s)
- Kate Hunter
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Julie Brown
- Neuroscience Research Australia and University of New South Wales, NSW 2052, Sydney, Australia.
| | - Lynne E Bilston
- Neuroscience Research Australia and University of New South Wales, NSW 2052, Sydney, Australia.
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Marilyn Lyford
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Celeste Gilbert
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Rebecca Q Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
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13
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Ndu KI, Ekwochi U, Osuorah DC, Ifediora OC, Amadi FO, Asinobi IN, Okenwa OW, Orjioke JC, Ogbuka FN, Ulasi TO. Parental practice of child car safety in Enugu, Southeast Nigeria. PEDIATRIC HEALTH MEDICINE AND THERAPEUTICS 2016; 7:141-148. [PMID: 29388575 PMCID: PMC5683289 DOI: 10.2147/phmt.s115842] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Child safety restraints and seat belts are regarded as the most successful safety and cost-effective protective devices available to vehicle occupants, which have saved millions of lives. This cross-sectional descriptive study evaluated the practice and use of child car restraints (CCRs) among 458 purposively selected respondents resident in two local government areas in Enugu State, Nigeria. Self-administered questionnaires were sent to parents of children attending private schools who owned a car. Chi-square and multivariate analyses were used to assess the determinants of the use of car restraints in children among respondents. In all, 56% and 45% of adults and children, respectively, used car restraints regularly. The awareness of child safety laws and actual use of age-appropriate CCRs among respondents was negatively and weakly correlated (r=−0.121, P=0.310). Only respondent’s use of seat belt during driving (P=0.001) and having being cautioned for non-use of CCRs (P=0.005) maintained significance as determinants of the use of CCRs in cars on multivariate analysis. The most frequent reasons given for the non-use of CCRs included the child being uncomfortable, 64 (31%); restraints not being important, 53 (26%), and restraints being too expensive, 32 (15%). Similarly, for irregular users, exceptions for non-use included the child being asleep (29%), inadequate number of CCRs (22%), and the child being sick (18%). There is a need for a strategy change to enforce the use of CCRs in Nigeria.
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Affiliation(s)
- K I Ndu
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - U Ekwochi
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - D C Osuorah
- Child Survival Unit, Medical Research Council UK, The Gambia Unit, Fajara, Gambia
| | - O C Ifediora
- Griffiths University Medical School, Gold Coast, QLD, Australia
| | - F O Amadi
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - I N Asinobi
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - O W Okenwa
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - J C Orjioke
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - F N Ogbuka
- Department of Paediatrics, Enugu State University of Science and Technology, Enugu State, Engu, Nigeria
| | - T O Ulasi
- Department of Paediatrics, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria
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Rok Simon M, Korošec A, Bilban M. The influence of parental education and other socio-economic factors on child car seat use. Zdr Varst 2016; 56:55-64. [PMID: 28289464 PMCID: PMC5329786 DOI: 10.1515/sjph-2017-0008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 07/07/2016] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION The behaviour of parents in ensuring car passenger safety for their children is associated with socio-economic (SE) status of the family; however, the influence of parental education has rarely been researched and the findings are contradictory. The aim of the study was to clarify whether parental education influences the use of a child car seat during short rides. METHODS A cross-sectional survey was carried out in outpatient clinics for children's healthcare across Slovenia. 904 parents of 3-year-old children participated in the study; the response rate was 95.9%. A self-administered questionnaire was used. A binary multiple logistic regression was applied to assess the association between parental unsafe behaviour as dependent variable, and education and other SE factors as independent variables. RESULTS 14.6% of parents did not use a child car seat during short rides. Families where mother had low or college education had higher odds of the non-use of a child car seat than families where mother had a university education. Single-parent families and those who lived in areas with low or medium SE status also had higher odds of the non-use of a child car seat. CONCLUSIONS Low educational attainment influences parents' behaviour regarding the non-use of a child car seat. Low parental education is not the only risk factor since some highly educated parents also have high odds of unsafe behaviour. All parents should therefore be included in individually tailored safety counselling programmes. SE inequalities could be further reduced with provision of free child car seats for eligible families.
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Affiliation(s)
- Mateja Rok Simon
- National Institute of Public Health, Centre for Health Research and Development, Trubarjeva 2, 1000 Ljubljana, Slovenia
| | - Aleš Korošec
- National Institute of Public Health, Centre for Health Research and Development, Trubarjeva 2, 1000 Ljubljana, Slovenia
| | - Marjan Bilban
- Institute of Occupational Safety, Chengdujska c. 25, 1260 Ljubljana-Polje, Slovenia
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Golonka RP, Dobbs BM, Rowe BH, Voaklander D. Prevalence and predictors of booster seat use in Alberta, Canada. Canadian Journal of Public Health 2016; 107:e155-e160. [PMID: 27526212 DOI: 10.17269/cjph.107.5254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Revised: 01/20/2016] [Accepted: 01/30/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the prevalence of booster seat misuse in a Canadian province and identify determinants of non-use. METHODS A cross-sectional study using parking lot interviews and in-vehicle restraint inspections by trained staff was conducted at 67 randomly selected childcare centres across Alberta. Only booster-eligible children were included in this analysis. Odds ratios (OR) and 95% confidence intervals (CI) are reported using unadjusted and adjusted logistic regression. RESULTS Overall, 23% of children were not in a booster seat, and in 31.8% of cases there was evidence of at least one misuse. Non-use increased significantly by age, from 22.2% for children 2 years of age to 47.8% for children 7 years of age (p = 0.02). Children who were at significantly increased risk of booster seat non-use were those in vehicles with drivers who could not recall the booster seat to seatbelt transition point (OR: 4.54; 95% CI: 2.05-10.06) or drivers who were under the age of 30 (OR: 3.54; 95% CI: 1.45-8.62). A front row seating position was also associated with significantly higher risk of nonuse (OR: 18.00; 95% CI: 2.78-116.56). Children in vehicles with grandparent drivers exhibited significantly decreased risk of booster seat non-use (OR: 0.21; 95% CI: 0.05-0.85). CONCLUSION Messaging should continue to stress that the front seat is not a safe place for any child under the age of 9 as well as remind drivers of the booster seat to seatbelt transition point, with additional emphasis placed on appealing to parents under the age of 30. Future research should focus on the most effective means of communicating booster seat information to this group. Enacting mandatory booster seat legislation would be an important step to increase both awareness and proper use of booster seats in Alberta.
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Affiliation(s)
- Richard P Golonka
- School of Public Health, University of Alberta, 4075 Research Transition Facility, Edmonton, AB, T6C 2R3, Canada
| | - Bonnie M Dobbs
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Brian H Rowe
- School of Public Health, University of Alberta, 4075 Research Transition Facility, Edmonton, AB, T6C 2R3, Canada.,Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada
| | - Don Voaklander
- School of Public Health, University of Alberta, 4075 Research Transition Facility, Edmonton, AB, T6C 2R3, Canada.
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Bachman SL, Salzman GA, Burke RV, Arbogast H, Ruiz P, Upperman JS. Observed child restraint misuse in a large, urban community: Results from three years of inspection events. JOURNAL OF SAFETY RESEARCH 2016; 56:17-22. [PMID: 26875160 DOI: 10.1016/j.jsr.2015.11.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 09/22/2015] [Accepted: 11/18/2015] [Indexed: 06/05/2023]
Abstract
PROBLEM Child restraints (CRs) are vital for optimizing child passenger safety and reducing the risk of pediatric injury and fatality in motor vehicle crashes. However, most CRs are installed improperly. METHODS This present study was an assessment of observed instances of CR misuse. Participants were recruited through advertisements for CR inspection events in Los Angeles County, California. Child Passenger Safety Technicians collected information about each child passenger, vehicle, and aspects of CR selection and installation. RESULTS Of 693 CRs installed upon arrival, only 3.8% were used with no instances of misuse. The most common misuses were inappropriate use of the top tether and failure to secure the seatbelt in locked mode. CONCLUSIONS The majority of observed CRs were installed with instances of misuse. CRs in newer vehicles were less likely to be installed in front of airbags and more likely to have the seatbelt routed inappropriately compared to those in older vehicles. Older children were more likely to be prematurely restrained in the front vehicle seat. PRACTICAL APPLICATIONS The majority of CRs are installed improperly. We identified specific instances of CR misuse that are common in a large, urban community and present recommendations to improve child passenger safety practices and education.
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Affiliation(s)
- Shelby L Bachman
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Garrett A Salzman
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Rita V Burke
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Helen Arbogast
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Pearl Ruiz
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Jeffrey S Upperman
- Division of Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, CA, USA; Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Sheldon SH. Sleep Education in Schools: Where Do We Stand? J Clin Sleep Med 2015; 11:595-6. [PMID: 25979099 DOI: 10.5664/jcsm.4762] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 04/30/2015] [Indexed: 11/13/2022]
Affiliation(s)
- Stephen H Sheldon
- Sleep Medicine Center, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL
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Yanchar NL, Young JB, Langille DB. Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: phase II. ACCIDENT; ANALYSIS AND PREVENTION 2015; 74:150-156. [PMID: 25463955 DOI: 10.1016/j.aap.2014.09.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 08/25/2014] [Accepted: 09/29/2014] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To examine changes to knowledge and practice of childhood motor vehicle restraint (CMVR) use in Nova Scotia after the implementation of stricter car seat and new booster seat (BS) legislation in 2007. METHODS A random telephone survey of households (at least one child <12 years) was performed in 2004 and 2010. Logistic regression determined variables independently associated with correct knowledge and/or practice of CMVR use. RESULTS Families were surveyed in the pre- (N=426 families, 728 children) and post- (N=453 families, 723 children) legislative periods. Reported appropriate use of forward-facing car seats (FFCSs) and BSs increased significantly (74-92% and 58-95%, respectively). After adjusting for covariates, the post-law period remained a significant predictor of increased knowledge of when to graduate to a BS or a seat belt alone (SB) (OR:1.4(95% CI:1.0-2.0) and 1.9(1.4-2.7), respectively), which was significantly associated with correct use. The strongest independent predictor of the correct use of FFCSs and BSs was the post-law period (OR:14(3.0-68) and 43(17-114), respectively). With regards to rear-facing car seats (RFCSs), new legislation and associated social marketing on graduating from a rear-facing car seat was not associated with increases in correct practice. CONCLUSIONS Legislation, combined with social marketing at the time of introduction, is an effective means to educate parents on when to graduate from a FFCS and the importance of BSs while also influencing parents to use them, though not for RFCS graduation. The known protective effect of BSs dictates the need for all regions in Canada to adopt comprehensive BS legislation.
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Affiliation(s)
- Natalie L Yanchar
- Division of Pediatric General Surgery and IWK Trauma Care Program, IWK Health Centre, Halifax, Nova Scotia, Canada.
| | - Julian B Young
- Provincial Coordinator, Injury Prevention and Control, Nova Scotia Department of Health and Wellness, Halifax, Nova Scotia, Canada.
| | - Donald B Langille
- Faculty of Medicine, Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.
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