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Sartin EB, Lombardi LR, Mirman JH. Systematic review of child passenger safety laws and their associations with child restraint system use, injuries and deaths. Inj Prev 2021; 27:577-581. [PMID: 34011513 DOI: 10.1136/injuryprev-2021-044196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/28/2021] [Accepted: 05/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND OBJECTIVE Many countries and all US states have legislation that mandates how children of certain ages and/or sizes should be restrained in vehicles. The objective of the current systematic review was to describe the associations between legislation and three outcomes: child restraint system use, correct child restraint system use and child passenger injuries/deaths. METHODS Included studies were published between 2004 and 2020 and evaluated associations between child passenger safety laws and the outcomes described above. Three literature searches using three search terms (child passenger safety, car seat use, booster seat use) were completed in PubMed and PsycINFO, with the last search occurring in January 2021. Studies are presented based on the outcome(s) they evaluated. The original protocol for this review is registered with PROSPERO (ID: CRD42019149682). RESULTS Eighteen studies from five different countries evaluating a variety of different types of legislation were included. Overall, positive associations between legislation and the three outcomes were reported. However, there were important nuances across studies, including negative associations between booster seat legislation and correct child restraint use. Further, there were also negative associations between various types of legislation and outcomes for populations with less formal education and lower incomes, and for racial and ethnic minorities. CONCLUSION Overall, child passenger safety legislation appears to be positively associated with child restraint system use, correct child restraint use and child passenger injuries/deaths. However, there is a need to more comprehensively characterise how different types of legislation influence child passenger safety outcomes to promote equitable effects across populations.
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Affiliation(s)
- Emma B Sartin
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Leah R Lombardi
- Center for Injury Research and Prevention, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jessica H Mirman
- Department of Clinical and Health Psychology, Centre for Applied Developmental Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, Edinburgh, UK
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Pulido J, Hoyos J, Martínez-Ruiz V, Sordo L, Fernández-Navarro P, Barrio G, Regidor E. Long-term impact of the 2008 economic crisis in Spain on road traffic collisions mortality by socioeconomic position. Health Place 2021; 71:102666. [PMID: 34507036 DOI: 10.1016/j.healthplace.2021.102666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 06/24/2021] [Accepted: 09/02/2021] [Indexed: 11/26/2022]
Abstract
We aimed to assess the effect of the 2008 crisis on road traffic collision (RTC) mortality in Spain, by socioeconomic position (SEP) and type of road use. This prospective, country-wide study covered all adults living in Spain and aged ≥30 years in November 2001. The long-term effect of the crisis was assessed by measuring the monthly percentage change (MPC) in RTC mortality between the pre-crisis (2002-2007) and crisis period (2008-2011). During the recession, RTC mortality fell more in people with low compared to high SEP, so MPCs difference between periods were of a higher magnitude in the low compared to high SEP groups, especially among men motorcyclists. RTC mortality trends were favorable following the 2008 crisis, particularly among low-SEP groups. In men motorcyclists, the upward trend of the pre-crisis period reversed course.
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Affiliation(s)
- J Pulido
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain
| | - J Hoyos
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain.
| | - V Martínez-Ruiz
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Avda. de La Investigación 11. 18016, Granada, Spain
| | - L Sordo
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain
| | - P Fernández-Navarro
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Calle Sinesio Delgado, 4. 28029, Madrid, Spain
| | - G Barrio
- CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; National School of Public Health. Carlos III Institute of Health, Calle Sinesio Delgado, 4. 28029, Madrid, Spain
| | - E Regidor
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid. Plaza Ramón y Cajal, S/n., 28040, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP). Monforte de Lemos, 3-5. 28029, Madrid, Spain; Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Calle Del Profesor Martín Lagos. 28040, Madrid, Spain
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Pulido J, Molist G, Vallejo F, Jiménez-Mejías E, Hoyos J, Regidor E, Barrio G. No effect of the Penalty Point System on road traffic accident mortality among men with a high socioeconomic status in Spain. ACCIDENT; ANALYSIS AND PREVENTION 2021; 156:106154. [PMID: 33933718 DOI: 10.1016/j.aap.2021.106154] [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: 06/20/2019] [Revised: 04/15/2021] [Accepted: 04/17/2021] [Indexed: 06/12/2023]
Abstract
The purpose of this study was to assess the effect of the Penalty Point System (PPS) on road traffic accident mortality by gender and socioeconomic status. We conducted a nationwide prospective study covering adult people living in Spain on November 2001. They were followed up until 30 Nov 2007 to determine vital status and cause of death. An interrupted time-series analysis was used to assess whether PPS (explanatory variable) had both immediate and long-term effect on the rates of road traffic accident mortality (RTAMs) separately by gender. Subjects were classified by socioeconomic status (low and high) using two indicators: educational attainment (up to lower secondary education; upper secondary education or more) and occupation (manual and non-manual workers). We performed several segmented Poisson regression models, controlling for trend, seasonality, 2004 road safety measures and fuel consumption as proxy for traffic exposure. Among men, we found a decrease on the RTAMs immediately after PPS in those with low educational level (16.2 %, IC95 %: 6.1 %-25.2 %) and manual workers (16.3 %, IC95 %: 2.8 %-27.8 %), and a non-significant increase among those with high education level and non-manual workers (6.2 % and 1.8 %). Among women, there were no significant differences in the immediate effect of PPS by socioeconomic status. We did not identify significant trend changes between pre-PPS and post-PPS periods in any socioeconomic group. In a context of downward trend of traffic mortality, the PPS implementation led to an immediate reduction on death rates only among men with a low socioeconomic status.
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Affiliation(s)
- J Pulido
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - G Molist
- Granollers General Hospital, Research and Innovation Area, Granollers, Barcelona, Spain
| | - F Vallejo
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - E Jiménez-Mejías
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Preventive Medicine and Public Health, University of Granada, Granada, Spain; Biosanitary Research Institute (Ibs Granada), Granada, Spain
| | - J Hoyos
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain.
| | - E Regidor
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Madrid, Spain
| | - G Barrio
- National School of Public Health, Institute of Health Carlos III, Madrid, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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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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Shanthosh J, Rogers K, Lung T, Brown J, Ivers R, Wilson A, Jan S. Effectiveness of child restraint legislation to reduce motor vehicle related serious injuries and fatalities: A national interrupted time series analysis. ACCIDENT; ANALYSIS AND PREVENTION 2020; 142:105553. [PMID: 32388143 DOI: 10.1016/j.aap.2020.105553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 01/29/2020] [Accepted: 04/12/2020] [Indexed: 06/11/2023]
Abstract
Children that are unrestrained while travelling in a motor vehicle are more vulnerable to serious injury and death. The greatest levels of crash protection are achieved when children use the most age or size appropriate form of restraint. In this study, we aimed to examine the effectiveness of the introduction of age-appropriate child restraint legislation on serious and fatal injury in five Australian states and territories. For this interrupted time series analysis, we used a segmented regression method to assess the association between the implementation of child-restraint legislation and motor-vehicle related serious injuries and fatalities using data obtained from transport authorities in each jurisdiction. We estimated the change in annual rates after the implementation of legislation with the number of motor-vehicle accidents resulting in fatalities or serious injuries as the outcome, and the total number of injuries (minor, serious and fatal) as an offset in the model. We identified 10882 motor-vehicle related crashes resulting in fatalities (n = 188), serious injuries (n = 1730) and minor injuries (n = 8964). In NSW and VIC, the rate ratio was statistically significant and positive, indicating an increase in the rate of serious injuries and fatalities in the period post-legislation compared to the period prior to legislation. In all other states and territories, we did not find a statistically significant effect of legislation Road safety programs incorporating interventions targeted at increasing awareness of optimal restraint practices, strengthened enforcement and measures to improve the affordability of restraints are needed to support legislation.
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Affiliation(s)
- Janani Shanthosh
- The George Institute for Global Health, University of New South Wales, Australia; The Australian Prevention Partnership Centre, Australia.
| | - Kris Rogers
- The George Institute for Global Health, University of New South Wales, Australia; Graduate School of Health, University of Technology Sydney, Australia
| | - Thomas Lung
- The George Institute for Global Health, University of New South Wales, Australia
| | - Julie Brown
- The George Institute for Global Health, University of New South Wales, Australia
| | - Rebecca Ivers
- School of Public Health and Community Medicine, University of New South Wales, Australia
| | - Andrew Wilson
- Menzies Centre for Health Policy, Faculty of Medicine and Health, University of Sydney, Australia; The Australian Prevention Partnership Centre, Australia
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Australia; The Australian Prevention Partnership Centre, Australia
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Brown J, Elkington J, Hall A, Keay L, Charlton JL, Hunter K, Koppel S, Hayen A, Bilston LE. Can child restraint product information developed using consumer testing sustain correct use 6 months after child restraint purchase? Study protocol for a cluster randomised controlled trial. Inj Prev 2018. [PMID: 29514847 DOI: 10.1136/injuryprev-2017-042571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND With long-standing and widespread high rates of errors in child restraint use, there is a need to identify effective methods to address this problem. Information supplied with products at the point of sale may be a potentially efficient delivery point for such a countermeasure. The aim of this study is to establish whether product materials developed using a consumer-driven approach reduce errors in restraint use among purchasers of new child restraint systems. METHODS A cluster randomised controlled trial (cRCT) will be conducted. Retail stores (n=22) in the greater Sydney area will be randomised into intervention sites (n=11) and control sites (n=11), stratified by geographical and socioeconomic indicators. Participants (n=836) will enter the study on purchase of a restraint. Outcome measures are errors in installation of the restraint as observed by a trained researcher during a 6-month follow-up home assessment, and adjustment checks made by the parent when the child is placed into the restraint (observed using naturalistic methods). Process evaluation measures will also be collected during the home visit. An intention-to-treat approach will be used for all analyses. Correct use and adjustment checks made by the parent will be compared between control and intervention groups using a logistic regression model. The number of installation errors between groups will be compared using Poisson regression. DISCUSSION This cRCT will determine the effectiveness of targeted, consumer-driven information on actual error rates in use of restraints. More broadly, it may provide a best practice model for developing safety product information. TRIAL REGISTRATION NUMBER ACTRN12617001252303p; Pre-results.
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Affiliation(s)
- Julie Brown
- Injury Prevention, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Jane Elkington
- Injury Prevention, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Alexandra Hall
- Injury Prevention, Neuroscience Research Australia, Randwick, New South Wales, Australia
| | - Lisa Keay
- Injury Division, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Judith L Charlton
- Accident Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Kate Hunter
- Injury Division, The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Sjaan Koppel
- Accident Research Centre, Monash University, Melbourne, Victoria, Australia
| | - Andrew Hayen
- Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Lynne E Bilston
- Injury Prevention, Neuroscience Research Australia, Randwick, New South Wales, Australia
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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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Shimony-Kanat S, Gofin R, Kienski Woloski Wruble AC, Mann L. Do parental decision-making patterns predict compliance with use of child booster seats? Int J Inj Contr Saf Promot 2017; 25:53-57. [PMID: 28498037 DOI: 10.1080/17457300.2017.1323930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Booster seat use for 4-9 year olds remains the lowest of all age groups in many countries. The objective of this study is to examine whether parents' decision-making patterns, as measured by the Melbourne Decision Making Questionnaire, relate to car booster seat use. Israeli parents of 4-7 years old children (n = 398) answered a questionnaire about car safety and decision-making habits. Ninety per cent of parents reported having a booster seat; 70.5% reported consistent booster seat use in general and on short drives during the last month (booster seat use compliance index). Greater compliance index was positively related to a vigilant decision-making pattern, passenger compliance with rear seat belts and families with fewer children. Lower booster seat use compliance index was associated with buck-passing decision-making pattern. Health professionals and policy-makers should take into account parents' habitual decision-making patterns when designing interventions for car booster seat compliance.
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Affiliation(s)
- Sarit Shimony-Kanat
- a Faculty of Medicine, School of Nursing , Hadassah Hebrew University , Jerusalem , Israel
| | - Rosa Gofin
- b Faculty of Medicine, Braun School of Public Health and Community Medicine , Hadassah & Hebrew University , Jerusalem , Israel.,c Department of Health Promotion , Social & Behavioral Health, College of Public Health , University of Nebraska Medical Center , Omaha , NE , USA
| | | | - Leon Mann
- d Research Leadership Program, CSHE and Melbourne School of Psychological Sciences , Melbourne , Australia
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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: 9] [Impact Index Per Article: 1.1] [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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Li Q, Alonge O, Hyder AA. Children and road traffic injuries: can't the world do better? Arch Dis Child 2016; 101:1063-1070. [PMID: 27543508 DOI: 10.1136/archdischild-2015-309586] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 07/19/2016] [Accepted: 07/22/2016] [Indexed: 11/03/2022]
Abstract
Road traffic injuries (RTI) impose a substantial health burden among children. Globally, 186 300 children (under 18 years) die from RTI each year. It is the fourth leading cause of death among children aged 5-9 years, third among children aged 10-14 years and first among children aged 15-17 years. At the regional level, sub-Saharan Africa accounts for 35.2% of global child deaths caused by RTI; that number is still increasing. Male children are about two times more likely to die due to RTI than female children. RTI are also related to socioeconomic inequalities; low-income and middle-income countries (LMIC) account for 95% of global child RTI deaths, and children from poor households are more likely to fall victims to RTI. Intervention strategies promoted in the five pillars of the Decade of Action for Road Safety 2011-2020 are available to prevent mortality and morbidity caused by RTI, though validation and implementation of such interventions are urgently needed in the LMIC. Through concerted efforts to cultivate strong political will, build action and advocacy capacity, increase global funding and enhance multisectoral collaboration promoted by the Sustainable Development Goals, the world is challenged to do better in saving children from RTI.
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Affiliation(s)
- Qingfeng Li
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Olakunle Alonge
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Adnan A Hyder
- Johns Hopkins International Injury Research Unit, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
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11
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Pankratz C, Warda L, Piotrowski C. Challenges in the Accurate Surveillance of Booster Seat and Bicycle Helmet Usage by Children: Lessons from the Field. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13070658. [PMID: 27399749 PMCID: PMC4962199 DOI: 10.3390/ijerph13070658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 04/19/2016] [Accepted: 04/25/2016] [Indexed: 06/06/2023]
Abstract
Motor vehicle collisions and bicycle collisions and falls are a leading cause of death by preventable injury for children. In order to design, implement and evaluate campaigns and programs aimed at improving child safety, accurate surveillance is needed. This paper examined the challenges that confront efforts to collect surveillance data relevant to child traffic safety, including observation, interview, and focus group methods. Strategies to address key challenges in order to improve the efficiency and accuracy of surveillance methods were recommended. The potential for new technology to enhance existing surveillance methods was also explored.
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Affiliation(s)
- Curt Pankratz
- Department of Sociology, University of Winnipeg, Winnipeg, MB R3B 2E9, Canada.
| | - Lynne Warda
- Injury Prevention and Child Public Health Program, Winnipeg Regional Health Authority, Winnipeg, MB R3A 1S1, Canada.
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3A 1S1, Canada.
| | - Caroline Piotrowski
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3T 2N2, Canada.
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12
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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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Hunter K, Keay L, Clapham K, Lyford M, Brown J, Bilston L, Simpson JM, Stevenson M, Ivers RQ. Buckle up safely (shoalhaven): a process and impact evaluation of a pragmatic, multifaceted preschool-based pilot program to increase correct use of age-appropriate child restraints. TRAFFIC INJURY PREVENTION 2014; 15:483-490. [PMID: 24678571 DOI: 10.1080/15389588.2013.833328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To conduct a process and impact evaluation of a multifaceted education-based pilot program targeting correct use of age-appropriate restraints in a regional setting with a high proportion of Aboriginal and Torres Strait Islander families. METHODS The program was delivered in 2010 in 3 early learning centers where 31 percent of the children were of Aboriginal and Torres Strait Islander descent. Each component of the program was assessed for message consistency and uptake. To measure program effectiveness, participating children were matched 1:1 by age, language spoken at home, and annual household income with 71 children from the control arm of a contemporaneous trial. The outcome measure in the control and program centers (a 4-category ordinal scale of restraint use) was compared using ordinal logistic regression accounting for age of the parent. RESULTS Process evaluation found that though program components were delivered with a consistency of message, uptake was affected by turnover of all staff at one center and by parents experiencing difficulty in paying for subsidized restraints at each of the centers. Impact evaluation found that children from the centers receiving the program had nearly twice the odds of being in a better restraint category than children matched from the control group (adjusted odds ratio [ORadj] = 2.06, 95% confidence interval [CI], 1.09-3.90). CONCLUSIONS This was a pragmatic study reflecting the real-life issues of implementing a program in preschools where 57 percent of families had a low income and turnover of staff was high. Despite these issues, impact evaluation showed that the integrated educational program showed promise in increasing correct use of age-appropriate restraints. The findings from this pilot study support the use of an integrated educational program that includes access to subsidized restraints to promote best practice child restraint use among communities that include a high proportion of Aboriginal and Torres Strait Islander families in New South Wales. Future trials in similar settings should consider offering more support in centers with high turnover of staff and offering alternative methods of payment when families experience financial difficulties in purchasing the subsidized restraints. If proven in larger trials, this approach could reduce death and injuries in child passengers in this vulnerable group.
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Affiliation(s)
- Kate Hunter
- a The George Institute for Global Health , Sydney , New South Wales , Australia
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14
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Brown J, Keay L, Hunter K, Bilston LE, Simpson JM, Ivers R. Increase in best practice child car restraint use for children aged 2-5 years in low socioeconomic areas after introduction of mandatory child restraint laws. Aust N Z J Public Health 2013; 37:272-7. [DOI: 10.1111/1753-6405.12070] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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15
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Keay L, Hunter K, Brown J, Simpson JM, Bilston LE, Elliott M, Stevenson M, Ivers RQ. Evaluation of an education, restraint distribution, and fitting program to promote correct use of age-appropriate child restraints for children aged 3 to 5 years: a cluster randomized trial. Am J Public Health 2012; 102:e96-102. [PMID: 23078492 DOI: 10.2105/ajph.2012.301030] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We evaluated an education, distribution, and fitting program for increasing age-appropriate and correct child restraint use. METHODS We performed a cluster randomized trial involving 28 early childhood education centers in low socioeconomic status areas in Sydney, Australia. The main outcome was optimal restraint use defined as age-appropriate restraints, installed into the vehicle correctly and used correctly. RESULTS One service withdrew after randomization, so data are presented for 689 child passengers, aged 3 to 5 years, from 27 centers. More children attending intervention centers were optimally restrained (43% vs 31%; P = .01; allowing for clustering). More 3-year-olds were using forward-facing seats rather than booster seats, more 4- to 5-year-olds were using booster seats instead of seat belts alone, and there were fewer errors in use at intervention centers. Among non-English-speaking families, more children attending intervention centers were optimally restrained (43% vs 17%; P = .002; allowing for clustering). CONCLUSIONS The program increased use of age-appropriate restraints and correct use of restraints, which translates to improved crash injury protection. Multifaceted education, seat distribution, and fitting enhanced legislation effects, and the effect size was larger in non-English-speaking families.
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Affiliation(s)
- Lisa Keay
- The George Institute for Global Health and the Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
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