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Goel R, Tiwari G, Varghese M, Bhalla K, Agrawal G, Saini G, Jha A, John D, Saran A, White H, Mohan D. Effectiveness of road safety interventions: An evidence and gap map. CAMPBELL SYSTEMATIC REVIEWS 2024; 20:e1367. [PMID: 38188231 PMCID: PMC10765170 DOI: 10.1002/cl2.1367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
Background Road Traffic injuries (RTI) are among the top ten leading causes of death in the world resulting in 1.35 million deaths every year, about 93% of which occur in low- and middle-income countries (LMICs). Despite several global resolutions to reduce traffic injuries, they have continued to grow in many countries. Many high-income countries have successfully reduced RTI by using a public health approach and implementing evidence-based interventions. As many LMICs develop their highway infrastructure, adopting a similar scientific approach towards road safety is crucial. The evidence also needs to be evaluated to assess external validity because measures that have worked in high-income countries may not translate equally well to other contexts. An evidence gap map for RTI is the first step towards understanding what evidence is available, from where, and the key gaps in knowledge. Objectives The objective of this evidence gap map (EGM) is to identify existing evidence from all effectiveness studies and systematic reviews related to road safety interventions. In addition, the EGM identifies gaps in evidence where new primary studies and systematic reviews could add value. This will help direct future research and discussions based on systematic evidence towards the approaches and interventions which are most effective in the road safety sector. This could enable the generation of evidence for informing policy at global, regional or national levels. Search Methods The EGM includes systematic reviews and impact evaluations assessing the effect of interventions for RTI reported in academic databases, organization websites, and grey literature sources. The studies were searched up to December 2019. Selection Criteria The interventions were divided into five broad categories: (a) human factors (e.g., enforcement or road user education), (b) road design, infrastructure and traffic control, (c) legal and institutional framework, (d) post-crash pre-hospital care, and (e) vehicle factors (except car design for occupant protection) and protective devices. Included studies reported two primary outcomes: fatal crashes and non-fatal injury crashes; and four intermediate outcomes: change in use of seat belts, change in use of helmets, change in speed, and change in alcohol/drug use. Studies were excluded if they did not report injury or fatality as one of the outcomes. Data Collection and Analysis The EGM is presented in the form of a matrix with two primary dimensions: interventions (rows) and outcomes (columns). Additional dimensions are country income groups, region, quality level for systematic reviews, type of study design used (e.g., case-control), type of road user studied (e.g., pedestrian, cyclists), age groups, and road type. The EGM is available online where the matrix of interventions and outcomes can be filtered by one or more dimensions. The webpage includes a bibliography of the selected studies and titles and abstracts available for preview. Quality appraisal for systematic reviews was conducted using a critical appraisal tool for systematic reviews, AMSTAR 2. Main Results The EGM identified 1859 studies of which 322 were systematic reviews, 7 were protocol studies and 1530 were impact evaluations. Some studies included more than one intervention, outcome, study method, or study region. The studies were distributed among intervention categories as: human factors (n = 771), road design, infrastructure and traffic control (n = 661), legal and institutional framework (n = 424), post-crash pre-hospital care (n = 118) and vehicle factors and protective devices (n = 111). Fatal crashes as outcomes were reported in 1414 records and non-fatal injury crashes in 1252 records. Among the four intermediate outcomes, speed was most commonly reported (n = 298) followed by alcohol (n = 206), use of seatbelts (n = 167), and use of helmets (n = 66). Ninety-six percent of the studies were reported from high-income countries (HIC), 4.5% from upper-middle-income countries, and only 1.4% from lower-middle and low-income countries. There were 25 systematic reviews of high quality, 4 of moderate quality, and 293 of low quality. Authors' Conclusions The EGM shows that the distribution of available road safety evidence is skewed across the world. A vast majority of the literature is from HICs. In contrast, only a small fraction of the literature reports on the many LMICs that are fast expanding their road infrastructure, experiencing rapid changes in traffic patterns, and witnessing growth in road injuries. This bias in literature explains why many interventions that are of high importance in the context of LMICs remain poorly studied. Besides, many interventions that have been tested only in HICs may not work equally effectively in LMICs. Another important finding was that a large majority of systematic reviews are of low quality. The scarcity of evidence on many important interventions and lack of good quality evidence-synthesis have significant implications for future road safety research and practice in LMICs. The EGM presented here will help identify priority areas for researchers, while directing practitioners and policy makers towards proven interventions.
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Affiliation(s)
- Rahul Goel
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Geetam Tiwari
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Kavi Bhalla
- Department of Public Health SciencesUniversity of ChicagoChicagoIllinoisUSA
| | - Girish Agrawal
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | | | - Abhaya Jha
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
| | - Denny John
- Faculty of Life and Allied Health SciencesM S Ramaiah University of Applied Sciences, BangaloreKarnatakaIndia
| | | | | | - Dinesh Mohan
- Transportation Research and Injury Prevention CentreIndian Institute of Technology DelhiNew DelhiIndia
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Wan L, Wen D, Wan X, Ren Y, Jia C, Yang X, He M. Frequency of child restraint system use and parental knowledge of such systems in western China. Public Health Nurs 2023; 40:655-661. [PMID: 37114457 DOI: 10.1111/phn.13203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 03/20/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023]
Abstract
OBJECTIVES This study investigated the frequency of child restraint system (CRS) use in cars and assessed parental knowledge and attitudes toward such restraint systems in western China. STUDY DESIGN Cross-sectional survey. METHODS This cross-sectional survey was conducted between December 2021 and January 2022. Hospitals and kindergartens were convenience sampling selected, and parents with cars were asked whether they owned and used CRS. Parents' knowledge and attitudes toward such systems were also determined. Factors associated with CRS were explored using binary logistic regression. RESULTS A total of 4764 questionnaires were distributed to parents with children 0-6 years old. Among the 4455 responses received, 50.8% of the respondents owned CRS, and most of which were front-facing child seats (42.0%). Less than half (44.4%) reported using a CRS sometimes, but only 19.6% used it all the time. The possession and use of a CRS varied significantly with the parental education level, age of the child, place of residence, number of children, family income, travel frequency, and travel distance. Logistic regression analysis showed that the frequency of car travel with a child and monthly family income significantly affected CRS use. Most parents (85.2%) perceived that adult seat belt in cars are effective at protecting their children in the event of a crash. The most frequent reason for not using a CRS was the tendency for children to travel in the car less often. CONCLUSIONS Although approximately half of the respondents owned a CRS, most of them used it rarely, if at all. Educating parents about safe ways for children to ride in a car and use of safety belts may promote CRS use.
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Affiliation(s)
- Li Wan
- Department of Nursing, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Dan Wen
- Intensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Xingli Wan
- Department of Nursing, West China Second Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yinghong Ren
- Department of Nursing, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Chao Jia
- Intensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Xiuru Yang
- Intensive Care Unit, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
| | - Mei He
- Hospital office, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, Sichuan Province, China
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Liu J, Huo Y. Predictors of parents' use of child restraint systems: Evidence from China. TRAFFIC INJURY PREVENTION 2023; 24:632-637. [PMID: 37486268 DOI: 10.1080/15389588.2023.2236261] [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: 02/28/2023] [Revised: 07/10/2023] [Accepted: 07/10/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE Child restraint systems (CRS) can significantly lower the chance of child harm and death. Despite the benefit of CRS, their use in developing countries is low. Therefore, examining the factors that affect parents' use of CRS is essential. METHODS In this study, the associations of demographic characteristics and the exogenous constructs in the health belief model (HBM) and the theory of planned behavior (TPB) with parents' CRS use were investigated with structural equation modeling. RESULTS Demographic factors alone explained 23.1% of the variance in CRS use. The model's explanatory power increased greatly when exogenous constructs were incorporated from the HBM and TPB. Having a college degree, knowledge about CRS, perceived susceptibility, self-efficacy, and attitude significantly impacted parents' use of CRS. CONCLUSIONS The use of CRS in China is still low. Much effort should be done to increase the use of CRS in China, including education, and publicity.
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Affiliation(s)
- Jianrong Liu
- School of Civil Engineering and Transportation, South China University of Technology, Guangzhou, China
| | - Yueying Huo
- Transportation Institute, Inner Mongolia University, Hohhot, China
- School of Mathematical Science, Inner Mongolia University, Hohhot, China
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Harzand-Jadidi S, Sadeghi-Bazargani H, Ponnet K, Jamali-Dolatabad M, Minuzzo B, Kamrani A, Abbasalizad-Farhangi M, Bakhtari Aghdam F, Jahangiry L. Parents' knowledge and socio-demographic determinants toward child's restraint system use. BMC Pediatr 2023; 23:315. [PMID: 37349678 PMCID: PMC10288661 DOI: 10.1186/s12887-023-04136-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 06/16/2023] [Indexed: 06/24/2023] Open
Abstract
BACKGROUND Lack of protection or improper protection, is one of the most important reasons of child passenger's death and injury in traffic crashes. Based on what we see on the roads, Iranian children are unrestrained inside the car. The aim of this study was to investigate children restrained system (CRS) use rate, its socio-demographic determinants and parents' knowledge toward CRS use among Iranian parents. METHODS Using multi-stage cluster sampling and direct in filed method of observation, the behavior of 700 children in cars was observed in the current cross-sectional study. Socio-demographic determinants and parents' knowledge, toward using the CRS were evaluated using questionnaires. The study was performed from July to August 2019 in Tabriz city, northwestern Iran. RESULTS The rate of child safety seat (CSS) use was 15.1% CI 95%:(12.5%,18.0%), and the rate of booster use was 0.6%; CI 95%:(4.3%,8.0%). The majority of parents [e.g. 64.3%; CI 95%: (60.7%,67.9%)], had low knowledge about the use of CRS. The most important reasons for not using CRS was lack of laws and policies [e.g. 59.7%; CI 95%:(12.5%,18.0%)], lack of knowledge [e.g.59.6%; CI 95%:(57.9%, 63.3%)] and the high cost of CRS [e.g. 57.6%; CI 95%:(53.81%,61.2%)]. The most important predictors of not using CRS were the child's age, parental knowledge, and the socioeconomic status of the household (p < 0.05). CONCLUSIONS Most children did not have CRS. The parents with higher education and those with higher socioeconomic status had higher rate of CRS use. Based on the low rate of CRS use and poor parental knowledge about it, education of parents toward boosters use and benefits of using CRS, enforcing mandatory laws and ploicies for CRS use in Iran, and allocation of government subsidies to low-income families for purchasing CRS are suggeted as essential strategies to increase CRS use.
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Affiliation(s)
- Sepideh Harzand-Jadidi
- Road Traffic Injury Research Center& Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Homayoun Sadeghi-Bazargani
- Road Traffic Injury Research Center& Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Koen Ponnet
- Faculty of Social Sciences, Imec-Mict-Ghent University, Ghent, Belgium
| | - Milad Jamali-Dolatabad
- Road Traffic Injury Research Center& Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Amirreaza Kamrani
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Fatemeh Bakhtari Aghdam
- Road Traffic Injury Research Center& Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran.
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Leila Jahangiry
- Department of Health Education & Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
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Cazacu-Stratu A, Varga NK, Cociu S, Dulf D, Peek-Asa C. Child safety restraint patterns in Moldova. TRAFFIC INJURY PREVENTION 2022; 23:483-487. [PMID: 35947496 DOI: 10.1080/15389588.2022.2106476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/08/2022] [Accepted: 07/22/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The Republic of Moldova has one of the European region's highest road traffic injury rates and also has an increase in motorization and exposure of children as vehicle passengers. This study describes child restraint use, and parents' knowledge and attitudes toward child restraint based on observations in Chisinau, the country's capital and largest city. The study aims to describe the use of child restraints and to compare data with existing standards of good practice. METHODS An observational study on child safety restraint use was conducted in 2018. Observational sites included 22 early education institutions, where drivers (n = 611) and child passengers (n = 710) were observed. Observations were conducted as motor vehicles parked or pulled to a stop near the early education institutions and included a driver survey on knowledge and attitudes toward restraint legislation and child safety behavior. RESULTS Of the 710 child passengers observed, 462 (65.1%) were appropriately restrained, 145 (20.4%) were seated in restraints inappropriate for the child and 103 (14.5%) of children were unrestrained. Younger children (0-3 year-old) were 7 times more likely to be properly restrained compared with children with ages between 4 and 6 (OR 1.92, 95% CI 1.15 to 3.22). Two-thirds out of 609 observed drivers with full study data, N = 431 (70,8%), knew about the mandatory legislation on using child safety restraints in the Republic of Moldova. The drivers using child safety restraints responded that they used them because of their safety features, and the major reason for nonuse was high price/affordability. CONCLUSION This study, the first to document child safety restraint use among children, indicates that much progress has been made, in that the majority of children are restrained and most drivers of children are aware of safety policies. However, progress can be made to increase knowledge and motivation to safely transport children, and to ensure safety seats are affordable and available. These data will be an important foundation on which to advocate for increased safety activities, child restraint policies, educational approaches in Moldova and to monitor progress over time.
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Affiliation(s)
- Angela Cazacu-Stratu
- Department of Preventive Medicine, Nicolae Testemitanu" State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Nane-Katharina Varga
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Svetlana Cociu
- Department of Preventive Medicine, Nicolae Testemitanu" State University of Medicine and Pharmacy, Chisinau, Republic of Moldova
| | - Diana Dulf
- Department of Public Health, Faculty of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Corinne Peek-Asa
- Department of Epidemiology, School of Public Health, University of California, San Diego
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Ye J, Bao Y, Zheng J, Liang J, Hu L, Tan L, Tan L. Epidemiology of unintentional injury in children admitted to ICU in China mainland: a multi-center cross-sectional study. Transl Pediatr 2022; 11:340-348. [PMID: 35378960 PMCID: PMC8976685 DOI: 10.21037/tp-21-387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/24/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND To investigate the epidemiology of unintentional injury in children admitted to Intensive Care Unit (ICU) in China mainland. METHODS A total of 39 hospitals in 19 provinces contributed to the 1-day point prevalence study of serious unintentional injury in children aged 0-16 years admitted to ICU. RESULTS A total of 1,017 patients from the 39 participating ICUs on the study day were included. Among them, 56 pediatric patients were identified to be suffered from unintentional injury from 18 participating ICUs, accounting for 5.5% (56/1,017) of all the ICU patients. The percentage of boys was more than twice the percentage of girls. Most patients had an age of less than 6 years old (n=42, 75%). The leading cause of unintentional injury was fall (n=17, 30.4%). The patterns of unintentional injury in children were age-related. There were no urban-rural differences in our cohort. The injury happened on 12:00-18:00 PM in 27 cases (48.2%), and 28 patients (50%) had injuries happened at working day. 35 patients (62.5%) received primary treatment at local hospitals. Thirty-five patients (62.5%) needed resuscitation in the emergency department, 15 patients (26.8%) still needed resuscitation in ICU. These 56 children suffered from a total of 106 lesions corresponding to 1.89 lesions per patient. Respiratory failure was most commonly seen (n=18, 32.1%). There was no death in our cohort during the study. After effective treatment during their ICU stay, 45 (80.4%) patients showed improvement, with Glasgow Coma Scale (GCS), Pediatric Trauma Score (PTS) and Pediatric Risk of Mortality III (PRISM III) score significantly better than those before treatment (P<0.05). CONCLUSIONS Higher injury rates among children under 6 years old of age illustrate the need for preventive measures, especially programs and public policies targeting this high-risk group.
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Affiliation(s)
- Jing Ye
- Department of Surgical ICU, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Yiyao Bao
- Department of Surgical ICU, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Jicui Zheng
- Department of Neurosurgery, The Children's Hospital, Fudan University School of Medicine, Shanghai, China
| | - Jianfeng Liang
- Department of Medical Statistics, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Lei Hu
- Department of Surgical ICU, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
| | - Linhua Tan
- Department of Surgical ICU, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China
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Chen T, Bachani AM, Li Q. Child restraint use in motor vehicles in Shanghai, China: a multiround cross-sectional observational study. BMJ Open 2021; 11:e050896. [PMID: 34845069 PMCID: PMC8634021 DOI: 10.1136/bmjopen-2021-050896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES While appropriate child restraint use in motor vehicles can reduce the risk of injuries or deaths, few previous studies have assessed child restraint practice in China. We aim to describe the prevalence of child restraint use and investigate risk factors affecting child restraint practice in Shanghai, China. DESIGN AND SETTING A cross-sectional observational study was conducted near children's hospitals, kindergartens, entertainment places and shopping malls in Shanghai, China. PARTICIPANTS Eight rounds of data were collected between October 2015 and April 2019 with a total sample size of 12 061 children. PRIMARY OUTCOME MEASURES At each site, trained field workers observed and recorded child restraint use in all passing motor vehicles with at least one child passenger. RESULTS The overall child safety restraint use rate was 6.42%. Child restraint use rate rose over time, from 5.12% in round 1% to 8.55% in round 8 (p<0.001). Results from the adjusted logistic regression model showed that children occupants with the following risk factors had a higher likelihood of child restraint use: children younger than 5 years compared with those aged 5-12 years (OR 2.12; 95% CI 1.78 to 2.53; p<0.001), sitting in rear seat compared with those in front seat (OR 31.80; 95% CI 4.45 to 227.14; p=0.001), children occupants observed near entertainment places (OR 2.34; 95% CI 1.67 to 3.28; p<0.001) or near shopping malls (OR 1.86; 95% CI 1.36 to 2.55; p<0.001) compared with those near children's hospitals and transportation in the morning compared with afternoon (OR 1.30; 95% CI 1.04 to 1.62; p=0.021). CONCLUSIONS The overall child safety restraint use rate was low in Shanghai. Our findings may shed light on monitoring child restraint practice and have implications for intervention programmes for children occupants with the identified risk factors, which may help to promote child restraint use in motor vehicles and prevent road traffic injuries or deaths.
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Affiliation(s)
- Ting Chen
- Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Abdul M Bachani
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Qingfeng Li
- Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA
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Cai W, Lei L, Zhou H, Wang Y, Peng J, Jin Y, Deng X. Child restraint system use and its associated factors in Shenzhen. ACCIDENT; ANALYSIS AND PREVENTION 2021; 160:106321. [PMID: 34339910 DOI: 10.1016/j.aap.2021.106321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 06/15/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
Child restraint system (CRS) is effective to protect child passenger safety in a motor vehicle crash. However, research on CRS is limited and the use rate of CRS is not high in China. We carried out a cross-sectional study to examine the use of CRS and its associated factors in Shenzhen. Via the method of cluster random sampling, parents who had at least one child aged 0 to 6 and owned a car from nine community health service centers and eight kindergartens were invited to complete the self-administered questionnaire during April and May 2014, including their knowledge of, attitude toward, and use behavior of CRS and socio-demographics. Multivariable logistic regression was used to explore the factors associated with CRS use. A total of 3768 parents participated in the survey, with a mean age of 33.94. Parents' knowledge and attitude regarding CRS were fair, with the mean score of 3.07 and 3.33 out of 6, respectively, and only 22.8% of them used CRS for their child passengers. Children aged below 3 years, drivers owing expensive cars and wearing seatbelts, and parents with higher knowledge and attitude scores had greater likelihoods to use CRS. Moreover, trip frequency and distance were also significantly associated with CRS use. The findings indicate that the use rate of CRS is low in Shenzhen and parents have fair levels of knowledge and attitude regarding CRS use. Comprehensive public education programs and legislative interventions are urgently required to increase the use of CRS and ensure child passenger safety in Shenzhen.
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Affiliation(s)
- Weicong Cai
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; The George Institute for Global Health, University of New South Wales, NSW 2042, Australia.
| | - Lin Lei
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Haibin Zhou
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Yirong Wang
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Ji Peng
- Department of Chronic and Non-Communicable Disease Control and Prevention, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China.
| | - Ye Jin
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
| | - Xiao Deng
- National Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
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Yan S, Yang J, Fu J, Ding K, Ye W, Chen X, Fan G, Li L. Assessing an App-Based Child Restraint System Use Intervention in China: An RCT. Am J Prev Med 2020; 59:e141-e147. [PMID: 32334955 DOI: 10.1016/j.amepre.2020.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 02/05/2020] [Accepted: 02/06/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION While child restraint systems are effective in protecting children from crash-related injuries and deaths, their use in China is extremely low. This study assessed the effectiveness of child restraint system education with and without behavioral skills training on improved use and explored participants' views regarding content and delivery of an onsite intervention and online (WeChat) boosters. STUDY DESIGN A randomized trial was conducted in 6 kindergartens from May 2017 to January 2018 in Shantou and Chaozhou, China. Selected kindergartens were randomly assigned to 3 groups: (1) control, (2) child restraint system education‒only, and (3) child restraint system education plus behavioral skills training. Analysis was conducted in May 2018. SETTING/PARTICIPANTS Participants were parents from the selected kindergartens. INTERVENTION Both intervention groups received child restraint system education that included one-time onsite education and biweekly online boosters for 3 months using an app to deliver education messages. MAIN OUTCOME MEASURES Survey questions included parent knowledge, attitude and behaviors of child restraint system use, and opinions related to the content and delivery of the onsite intervention and online boosters. RESULTS Child restraint system use in both intervention groups was higher than that of the control group post-intervention (27.3% and 31.7%, respectively). Compared with the control group, the intervention groups had a higher percentage of correct answers to all 9 items, except Item 7 measuring the parents' knowledge, attitude, and behaviors of child passenger safety after the intervention. Lower parent's level of education (OR=7.00, 95% CI=2.62, 18.70) and older child age (4 years: OR=3.92, 95% CI=1.08, 5.28; 5 years: OR=2.08, 95% CI=1.52, 5.31) were associated with lower rates of child restraint system use. Most parents (92.3%) preferred the online over the onsite intervention component. CONCLUSIONS An education intervention was effective in improving parents' knowledge, attitude, and practice of child restraint system use. A social media intervention booster (WeChat) may provide a new channel to help promote child passenger safety in China.
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Affiliation(s)
- Shuzhen Yan
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Jingzhen Yang
- Center for Injury Research and Policy, Research Institute at Nationwide Children's Hospital, Columbus, Ohio
| | - Jingmei Fu
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Kele Ding
- Department of Health Sciences, Kent State University, Kent, Ohio
| | - Wanbao Ye
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Xiaodong Chen
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Guanhua Fan
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China.
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Yan S, Ding K, Yang J, Ye W, Li L. Prevalence of child passenger restraint use in Shantou, China from 2012 to 2017. BMC Public Health 2020; 20:807. [PMID: 32471397 PMCID: PMC7257449 DOI: 10.1186/s12889-020-08859-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/06/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Child passenger safety is an important public health problem in China. This study aimed to examine the prevalence of child passenger restraint use while riding in a car in the city of Shantou in China from 2012 to 2017. METHODS Three large-scale cross-sectional observational studies were conducted in 2012, 2015 and 2017, respectively. The observation sites included randomly selected hospitals, kindergartens, and primary and secondary schools. The outcome measures included the changes in percentages of seating position (e.g., front vs. rear), whether sitting on lap, and use of child restraint systems (CRS) or seat belts by year and by age group. Descriptive statistics, Chi-square tests and logistic regression were used to address the study aims. RESULTS A total of 9858 commuting children aged 17 and younger were observed in passenger cars in Shantou, China during the study. The proportion of children aged 0-5 sitting on adult's lap decreased from 26.6% in 2012 to 24.6% in 2017, while the proportion of CRS use among the children sitting in the rear row increased among children aged 0-5 (from 0.7% in 2012 to 14.2% in 2017) and children aged 6-11 (from 0.7% in 2012 to 2.4% in 2017). Comparing children aged 0-11 in 2012, children in the same ages were less likely to sit in the front row in 2015 (OR = 0.42, 95%CI = 0.37, 0.48) and in 2017 (OR = 0.27, 95%CI = 0.23, 0.31). Children aged 0-11 were more likely to sit in the rear row with CRS use in 2015 (OR = 8.50, 95%CI = 5.44, 13.28) and in 2017 (OR = 10.95, 95%CI = 7.02, 17.08) comparing with children in the same ages in 2012. As for children aged 12-17, they were more likely to use seat belt in 2017 (OR = 1.40, 95%CI = 1.06, 1.85) compared with those children in 2012. CONCLUSIONS While child passenger safety behaviors improved from 2012 to 2017 in Shantou, China, more efforts are needed to protect child passengers from injuries.
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Affiliation(s)
- Shuzhen Yan
- Injury Prevention Research Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Kele Ding
- Department of Health Sciences, Kent State University, Kent, OH, USA
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA
| | - Wanbao Ye
- Injury Prevention Research Center, Shantou University Medical College, Shantou, Guangdong Province, China
| | - Liping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou, Guangdong Province, China.
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Affordability and Availability of Child Restraints in an Under-Served Population in South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061979. [PMID: 32192206 PMCID: PMC7143186 DOI: 10.3390/ijerph17061979] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/14/2020] [Accepted: 03/14/2020] [Indexed: 12/13/2022]
Abstract
Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.
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Goal-Framing and Temporal-Framing: Effects on the Acceptance of Childhood Simple Obesity Prevention Messages among Preschool Children's Caregivers in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030770. [PMID: 31991873 PMCID: PMC7037522 DOI: 10.3390/ijerph17030770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/19/2020] [Accepted: 01/22/2020] [Indexed: 11/17/2022]
Abstract
A range of intervention models are available for childhood obesity prevention; however, few studies have examined the effectiveness of intervention messages. This study developed childhood simple obesity prevention messages on the basis of goal-framing and temporal-framing effects to improve message acceptance among the caregivers of preschool children and explored associated factors. A cross-sectional study was conducted among 592 caregivers of preschool children in urban kindergartens in China during March to April 2019. The framing messages were developed based on prospect theory and construal level theory. The majority (48.4%) of caregivers found the gain-framed, present-oriented message most salient for acceptance. We found that gender, education background, theme, and the use of negative words have impacts on goal-framing effects; and previous participation in a health related intervention, career category, and the theme have impacts on temporal-framing effects (p < 0.001). Goal-framing effects and temporal-framing effects can influence each other (p < 0.001). The findings suggest that the gain-framed, present-oriented message could be considered a strategy to improve the acceptance of information by caregivers. When framing a message, subtle differences like using negative words might affect the exertion of framing effects.
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Niu L, Gao YM, Tian Y, Pan SM. Safety awareness and use of child safety seats among parents after the legislation in Shanghai. Chin J Traumatol 2019; 22:85-87. [PMID: 30975507 PMCID: PMC6487456 DOI: 10.1016/j.cjtee.2018.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/07/2018] [Accepted: 10/10/2018] [Indexed: 02/04/2023] Open
Abstract
PURPOSE To investigate the changes and underlying mechanisms in parents' safety awareness and the use of child safety seats after the mandatory legislation in Shanghai city, China. METHODS This study was carried out by Shanghai Key Laboratory of Environment and Children's Health using a multi-stage, simple random sampling method. Volunteers with children aged 0-12 months were recruited. Child safety seats were sent to each volunteer's family. Telephone encounters and/or on-site visits were used to collect data from parents using a phased survey on children's safety during car use. RESULTS Among all respondents, 91.2% had heard of motor vehicle accidents involving children, and 97.2% could describe the appropriate use of a safety seat to minimize the risk of child injury in a collision. Among 1078 families with newborns, awareness of child safety seats was 91.9%. There were 86% patients aware that new laws and regulations have been released regarding the use of child safety seats, and 98.5% of them plan to comply with the new laws. Moreover, 61% patients think that taxis should be routinely equipped with child safety seats. CONCLUSION The parents in Shanghai obtained a high level of awareness of children's traffic safety after the introduction of child safety seats legislation, and had a positive experience related to the use of child safety seats. Taxi may be an important area of focus for implementation of child traffic safety. Traffic safety laws and regulations with further impact should be continuously studied.
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Affiliation(s)
- Lei Niu
- Department of Emergency Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China
| | - Yan-Min Gao
- Shanghai University of Medicine and Health Sciences, Shanghai, 201318, China
| | - Ying Tian
- Shanghai Key Laboratory of Environment and Children's Health, Shanghai 200092, China
| | - Shu-Ming Pan
- Department of Emergency Medicine, Xinhua Hospital, Shanghai Jiaotong University, Shanghai 200092, China,Corresponding author.
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Dulf D, Peek-Asa C, Jurchiș F, Bărăgan EA. Safety seat and seat belt use among child motor vehicle occupants, Cluj-Napoca, Romania. Inj Prev 2019; 26:18-23. [PMID: 30674541 DOI: 10.1136/injuryprev-2018-042989] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 12/07/2018] [Accepted: 12/16/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Use of seat belts and car seats for children are among the most effective interventions to reduce injury severity when a crash occurs. The use should be enforced in order to have an increase in wearing these restraints. Romania has the lowest rate of using seatbelts in the backseat, 16%. The purpose of the study is to describe the use of child safety restraints and compare it with existing standards of good practice. METHODS An observational study on child safety restraint was conducted in Cluj-Napoca, Romania, between 2013 and 2014. Observational sites included 38 schools and kindergartens and three commercial areas, where drivers (n=768) and child passengers (n=892) were observed. Observations were conducted as vehicles parked or pulled to a stop and were followed by driver surveys on knowledge and attitudes towards restraint legislation and child safety behaviour as car occupants. RESULTS The proportion of observed child motor vehicle occupants wearing some type of restraint was 67.4% (n=601). The majority of children (82.6%) were in the back seat, and 14.2% of infants were in a rear-facing child seat. The proportion of restrained children declined with age, with children 5 years old or younger being almost five times more likely to be properly restrained (OR 4.87, 95% CI 2.93 to 8.07) when compared with older children. CONCLUSIONS Although minimum legal requirements of child motor vehicle occupant safety were in place in Romania at the time of the study, the rates of using children restraints was low compared with other middle-income and high-income countries.
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Affiliation(s)
- Diana Dulf
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Corinne Peek-Asa
- Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA
| | - Florin Jurchiș
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania.,Faculty of Economics and Business Administration, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Erika-Andrada Bărăgan
- Department of Public Health, College of Political, Administrative and Communication Sciences, Babes-Bolyai University, Cluj-Napoca, Romania
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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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Liu S, Zhou H, Ma J, Wang C, Chen Z, Chen S, Yang Y, Liu X, Peng J, Duan L, Deng X. Knowledge, attitudes, and behaviors related to child safety restraint in citizens of Shenzhen Municipality, China, and the associations between these factors. TRAFFIC INJURY PREVENTION 2018; 19:42-48. [PMID: 28534715 DOI: 10.1080/15389588.2017.1329534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Accepted: 05/08/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE A child safety restraint (CSR) is an effective measure to reduce the risk of child injury from traffic collisions. This study aims to explore knowledge, attitudes, and behaviors regarding CSRs in a Chinese population. METHODS A cross-sectional survey regarding CSR use was conducted from April to May 2014 in Shenzhen municipality. Respondents were parents who had at least one child 0 to 6 years of age and owned a car. These parents provided a self-report of demographic characteristics as well as information about their knowledge, attitudes, and behaviors toward CSR use. RESULTS Most respondents had a fair level of knowledge about CSRs, with higher mean knowledge scores demonstrated among the respondents who were male, had an advanced degree, had a higher income, owned an expensive car, had an older child, drove frequently with children, and routinely drove greater distances with children. In addition, most respondents had a more positive attitude toward CSR use, with a higher mean attitude score among those who had an advanced degree, owned an expensive car, drove frequently with children, and routinely drove greater distances with children. However, some myths regarding CSR use also existed (e.g., parents can effectively protect their children in a car collision by holding them, they are not required to purchase the CSR for child safety if there is no mandatory provision by law, among others). Among 3,768 respondents who had at least one child and a car, 27.8% (1,047) had a CSR and 22.9% (864) used the CSR. A logistic regression model showed the likelihood of CSR ownership to be higher if respondents drove frequently or greater distances and was dependent on both the education level of the respondents and the age of the children. The frequency of CSR use increased as the age of children decreased (P = .0274). Respondents who owned a CSR and those who frequently used CSRs had higher mean knowledge and mean attitude scores. CONCLUSIONS This observational study found that although the majority of respondents had fair levels of knowledge and positive attitudes, they had lower rates of CSR ownership and use. Therefore, efforts at developing opportunities to expand public awareness of CSR use should be made to improve child passenger safety practices and eliminate child injury caused by traffic collisions.
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Affiliation(s)
- Shengyuan Liu
- a Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Haibin Zhou
- b Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Jianping Ma
- a Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Changyi Wang
- a Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Zhongwei Chen
- a Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Sihan Chen
- a Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Nanshan Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Yingzhou Yang
- b Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Xiaoli Liu
- b Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Ji Peng
- b Department of Chronic Non-communicable Disease Control and Prevention , Shenzhen Center for Chronic Disease Control , Shenzhen, Guangdong , China
| | - Leilei Duan
- c National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
| | - Xiao Deng
- c National Center for Chronic Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention , Beijing , China
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Yang JZ, Li LP, Wu HQ, McGehee D, Peek-Asa C. A comparative analysis of child passenger restraint use in China and the United States. World J Pediatr 2017; 13:593-598. [PMID: 28752389 DOI: 10.1007/s12519-017-0057-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/31/2016] [Indexed: 02/05/2023]
Abstract
BACKGROUND Few published studies have examined child passenger safety practices across countries. This study compared the prevalence and associated factors of child passenger restraint use among children, aged 0 to 17 in the state of Iowa in the United States, and the city of Shantou in China. METHODS Child restraint use observations were conducted in Iowa and in Shantou in 2012, respectively, among child passengers. Observations in Iowa were conducted at randomly selected gas stations, while in Shantou observations were completed at randomly selected schools or medical clinics. Research observers approached the driver, observed restraint use, and collected brief survey data. RESULTS A total of 3049 children from Iowa and 3333 children aged 0 to 17 years from Shantou were observed. For children aged 0 to 3 years, only 0.1% were compliantly restrained in Shantou as compared to 95.9% in Iowa. The proportion of children who were compliantly restrained in Shantou increased with age, but generally decreased with age in Iowa. In Shantou, 36.0% of children aged 0 to 3 were sitting in the front seat as compared to only 1.7% of children of the same age in Iowa. Driver seat belt use was significantly associated with child restraint in both Iowa and Shantou; the association was stronger in Iowa than Shantou for all age groups. CONCLUSIONS A significantly higher prevalence of children who were not appropriately restrained was observed in Shantou than in Iowa. Our findings support the need of mandatory child safety restraint use legislation in China.
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Affiliation(s)
- Jing-Zhen Yang
- The Research Institute at Nationwide Children's Hospital, Center for Injury Research and Policy, Columbus, OH, USA
- Department of Pediatrics, College of Medicine, the Ohio State University, Columbus, OH, USA
| | - Li-Ping Li
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Hong-Qian Wu
- Department of Biostatistics, University of Iowa, Iowa City, Iowa, USA
- Injury Prevention Research Center and Department of Occupational and Environmental Health, University of Iowa, 145 N. Riverside Drive S160 CPHB, Iowa City, Iowa, USA
| | - Daniel McGehee
- Injury Prevention Research Center and Department of Occupational and Environmental Health, University of Iowa, 145 N. Riverside Drive S160 CPHB, Iowa City, Iowa, USA
- Human Factors and Vehicle Safety Research Division, University of Iowa Public Policy Center, Iowa City, Iowa, USA
| | - Corinne Peek-Asa
- Injury Prevention Research Center and Department of Occupational and Environmental Health, University of Iowa, 145 N. Riverside Drive S160 CPHB, Iowa City, Iowa, USA.
- Department of Occupational and Environmental Health, University of Iowa, Iowa City, Iowa, USA.
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Shimony Kanat S, Gofin R. An ecological model to factors associated with booster seat use: A population based study. ACCIDENT; ANALYSIS AND PREVENTION 2017; 108:245-250. [PMID: 28918223 DOI: 10.1016/j.aap.2017.09.007] [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: 02/19/2017] [Revised: 06/28/2017] [Accepted: 09/05/2017] [Indexed: 06/07/2023]
Abstract
Belt-positioning booster seat use (BPB) is an effective technology to prevent severe child injury in cases of car crash. However, in many countries, age-appropriate car restraint use for children aged 4-7 years old remains the lowest among all age groups. The aim of this study was to identify the main determinants of BPB use through a comprehensive approach. An ecological model was used to analyze individual, parent-child relationships, and neighborhood characteristics. Parents of children enrolled in the first and second grades completed a self-reported questionnaire (n=745). The data were subjected to multilevel modeling. The first level examined individual and parent-child relationship variables; in addition the second level tested between neighborhood variance. According to parental self- reports, 56.6% of their children had used a BPB on each car trip during the previous month. The results indicated that the determinants positively related to BPB use were individual and parental; namely, the number of children in the family, the parents' car seat belt use, parental knowledge of children's car safety principles, and a highly authoritative parenting style. Children's temperaments and parental supervision were not associated with BPB use. At the neighborhood level, a small difference was found between neighborhoods for BPB users compared to non-users.
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Affiliation(s)
- Sarit Shimony Kanat
- Henrietta Szold School of Nursing, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
| | - Rosa Gofin
- Department of Health Promotion, Social & Behavioral Health, College of Public Health, University of Nebraska Medical Center, NE, USA; Braun School of Public Health and Community Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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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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İnce T, Yalçın S, Yurdakök K. Parents' Attitudes and Adherence to Unintentional Injury Prevention Measures in Ankara, Turkey. Balkan Med J 2017; 34:335-342. [PMID: 28443574 PMCID: PMC5615966 DOI: 10.4274/balkanmedj.2016.1776] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background: Childhood unintentional injuries are perceived as a leading public health issue since they are one of the preventable causes of paediatric mortality and morbidity. Whether and how parental factors are related to childhood injury has been researched insufficiently. Aims: To investigate parents’ attitudes to preventive measures of unintentional childhood injury, and the parental adherence to these measures. Study Design: Cross-sectional, descriptive study. Methods: The data were collected from the parents of children younger than ten years of age admitted to university hospital outpatient clinics for any reason and who agreed to be involved in the study. The first part of the questionnaire included sociodemographic profiles of participating children. Serious injuries were considered to be any injury that requires hospital admission. The second part of the questionnaire was prepared to evaluate parents’ adherence to injury prevention rules. A total score calculation about the adherence of the parents to the injury prevention rules was worked out the addition of the scores of each answer given in each age group. Answers for each item given by the parents were scored as wrong (0), sometimes (1) or correct (2). The score for each item was added and the result normalized to 100 points. Only complete questionnaires were used for analysis. Results: A total of 1126 children and parent pairs agreed to participate in the survey. It was found that 13.8% of the participating children had experienced at least one serious injury. Although three-quarters of the parents had received information about injury prevention, the overall injury prevention scores were found to be low. As children’s age increased, the total injury prevention scores of parents decreased significantly. Injury prevention scores were shown to increase significantly with high education and maternal occupation. However, scores were shown to decrease significantly with increased child age and family size. Conclusion: Our study shows that parental adherence to the child safety measures aimed at decreasing the unintentional injury risk of children is not satisfactory in Turkey. In particular, parents of 5-9-year-old children, big families (more than five people), parents with less than 8 years of education and non-working mothers should be the main target groups for intervention strategies according to our study results.
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Affiliation(s)
- Tolga İnce
- Department of Pediatrics, Social Pediatrics Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Songül Yalçın
- Department of Pediatrics, Social Pediatrics Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - Kadriye Yurdakök
- Department of Pediatrics, Social Pediatrics Unit, Hacettepe University School of Medicine, Ankara, Turkey
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Moradi M, Khanjani N, Nabipour AR. An observational study of child safety seat use in an international safe community: Tehran, Iran. TRAFFIC INJURY PREVENTION 2017; 18:88-94. [PMID: 27258595 DOI: 10.1080/15389588.2016.1177638] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 05/01/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE Despite strong evidence of the effectiveness of child safety seats in reducing injuries, the use of these devices in some communities is still rare. The purpose of this study was to determine the prevalence of child safety seat use and the factors influencing its use in the safe community of Tehran. METHODS This roadside observational study was conducted in 2015 and 2,178 personal cars with a child under 12 years aboard were observed on Tehran's streets in regard to use of child safety seats. Other variables such as the gender of the driver, driver's age group, type of street, region of municipality, time of day, and day of the week were also collected. RESULTS Prevalence of child safety seat use was 4.3% and was significantly higher among women drivers, on freeways, and in municipal regions 1, 4, and 7. CONCLUSIONS The prevalence of child safety seat use in Tehran as a most populous member of the international safe community was very low and most children commuted in insecure situations in the vehicle. Therefore, it is proposed that plans should be made to increase the use of child safety seats in international safe communities.
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Affiliation(s)
- Marziyeh Moradi
- a Department of Biostatistics and Epidemiology , Faculty of Public Health, Kerman University of Medical Sciences , Kerman , Iran
| | - Narges Khanjani
- b Environmental Engineering Research Center, School of Public Health, Kerman University of Medical Sciences , Kerman , Iran
- c Monash Centre for Occupational & Environmental Health, School of Public Health and Preventive Medicine, Monash University , Melbourne , Australia
| | - Amir Reza Nabipour
- d Neuroscience Research Center, Kerman University of Medical Sciences , Kerman , Iran
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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: 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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Lei H, Yang J, Liu X, Chen X, Li L. Has Child Restraint System Use Increased among Parents of Children in Shantou, China? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13100964. [PMID: 27690070 PMCID: PMC5086703 DOI: 10.3390/ijerph13100964] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/22/2016] [Accepted: 09/26/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE to examine parents' use of child restraint systems (CRS), and determine if parents' knowledge of, attitude toward, and use behavior of child restraint systems have improved following enactment of child restraint use laws in other cities. DESIGN Observations and a cross-sectional survey of drivers transporting children 17 years and under were conducted at the gate of the schools and parking lots of hospitals in Shantou. Observers recorded the seating location of child passengers, the type of restraint, and appropriate use of CRS and safety belts based on the observation. Knowledge of and attitudes towards use of CRS were reported by the driver following observation. RESULTS Approximately 6.6% of passengers aged 0-12 were in CRS; rate of forward-facing CRS in children aged 3-5 (9.9%) was higher than rear-facing CRS for children aged 0-2 (1.1%) and booster seat use among children aged 6-12 (0.1%). Children younger than four years old (OR = 3.395, 95% CI = 2.125-5.424), drivers having a college or higher lever education (OR = 2.908, 95% CI = 1.878-4.500) and drivers wearing seatbelt (OR = 3.194, 95% CI = 1.605-6.356) had greater odds of CRS use. Over half (56.6%) of parents might or would use CRS if they could rent CRSs with fees. CONCLUSIONS The rate of CRS is still low in Shantou. Comprehensive public education programs supported by legislation might be an effective way to improve child passenger safety. Renting CRSs to parents could be a new approach to encourage use.
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Affiliation(s)
- Huiqian Lei
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China.
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Ohio State University, Columbus, OH 43205, USA.
| | - Xiangxiang Liu
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China.
| | - Xiaojun Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China.
| | - Liping Li
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China.
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Liu X, Yang J, Cheng F, Li L. Newborn Parent Based Intervention to Increase Child Safety Seat Use. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13080777. [PMID: 27490562 PMCID: PMC4997463 DOI: 10.3390/ijerph13080777] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/14/2016] [Accepted: 07/14/2016] [Indexed: 11/16/2022]
Abstract
This paper intends to assess the effect of a maternity department intervention on improvement of knowledge and use of child safety seats (CSS) among newborn parents. An intervention study included three groups (one education plus free CSS intervention group, one education only group, and one control group). The participants were parents of newborns in the maternity department of two hospitals. Both of the intervention groups received a folded pamphlet of child passenger safety, a height chart and standardized safety education during their hospital stay after giving birth. The education plus free CSS intervention group received an additional free CSS and professional installation training at hospital discharge. The control group received a pamphlet with educational information about nutrition and food safety. Three months after enrollment, a telephone follow-up was conducted among participants in the three groups. Data on child passenger safety knowledge, risky driving behaviors, and use of CSS were evaluated before and after the intervention. A total of 132 newborn parents were enrolled in the study; of those, 52 (39.4%) were assigned into the education plus free CSS intervention group, 44 (33.3%) were in the education intervention only group, and 36 (27.3%) were in the control group. No significant differences existed in demographics among the three groups. There was a significant difference in newborn parents' child passenger safety knowledge and behaviors in the three groups before and after the intervention. In addition, the CSS use increased significantly in the education plus free CSS group after the intervention compared to parents in the education only or control groups. Education on safety, combined with a free CSS and professional installation training, were effective at increasing newborn parents' knowledge and use of CSS. Future studies with larger sample sizes and longer follow-up are needed to determine a long-term effect of the intervention.
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Affiliation(s)
- Xiangxiang Liu
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China.
| | - Jingzhen Yang
- Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University, 700 Children's Drive, Columbus, OH 43205, USA.
| | - Fuyuan Cheng
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China.
| | - Liping Li
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China.
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Liu X, Yang J, Chen X, Li L. Knowledge, Attitudes and Behaviors on Child Passenger Safety among Expectant Mothers and Parents of Newborns: A Qualitative and Quantitative Approach. PLoS One 2016; 11:e0146121. [PMID: 26735974 PMCID: PMC4703300 DOI: 10.1371/journal.pone.0146121] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/13/2015] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To investigate the knowledge, attitudes, and intended behaviors about use of child safety seats among parents of newborns and explore expectant mothers' views and decisions regarding child safety seats use. METHODS A cross-sectional survey and semi-structured interview were conducted in the maternity departments of two hospitals in China. Parents of newborns were recruited after delivery and surveyed on their knowledge, attitudes and behaviors regarding child safety seats use. Pregnant women were also interviewed to learn about their views and decisions regarding child safety seats use. Both quantitative and qualitative methods were used to analyze the data collected. RESULTS Of a total of 242 parents of newborns recruited in the quantitative survey, 202 (83.5%) parents had heard of child safety seats and 149 (61.6%) parents reported they would use child safety seats for their babies. Parents' knowledge, car ownership, occupation, and income were significantly associated with their decision regarding use of child safety seats. Three themes were identified from the qualitative interview of 30 pregnant women: (1) the pregnant women perceived child passenger safety as important; (2) the car ownership and price and quality of child safety seats were major influencing factors of their decisions on use of child safety seats; and (3) lack of awareness and lack of laws requiring use were perceived to contribute to low use of child safety seats in China. CONCLUSION Lack of knowledge and awareness on child passenger safety were found to be two most important factors associated with low use of child safety seats. Effective interventions are urgently needed to improve parents' knowledge before laws are enacted and implemented.
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Affiliation(s)
- Xiangxiang Liu
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou, 515041, China
| | - Jingzhen Yang
- Injury Prevention Research and Police Center, The University of Iowa, Iowa City, Iowa, Columbus, Ohio, 43205, United States of America
| | - Xiaojun Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, 515041, China
| | - Liping Li
- Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou, 515041, China
- * E-mail:
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Li L, Scherpbier R, Wu J, Zhu X, Zhang W, Zhang L, Gao X, Luo J, Hu G. Legislation coverage for child injury prevention in China. Bull World Health Organ 2015; 93:169-75. [PMID: 25838612 PMCID: PMC4371490 DOI: 10.2471/blt.14.139998] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 10/25/2014] [Accepted: 01/04/2015] [Indexed: 11/27/2022] Open
Abstract
Objective To examine the extent to which effective interventions to prevent unintentional child injury are reflected in the laws and regulations of China. Methods We focused on the six common causes of fatal child injuries – drowning, road traffic injury, falls, poisoning, burns and suffocation. We investigated 27 interventions recommended by the United Nations Children’s Fund, the World Health Organization or the European Child Safety Alliance. We searched China National Knowledge Infrastructure and Lawyee for Chinese legislations using keywords and synonyms for the 27 interventions. We reviewed the identified legislations for statements specifying the responsible implementation department. Findings Seven national laws, nine regulations of the State Council and 46 departmental regulations were found to relate to at least one of the interventions. Although seven of the 27 internationally recommended interventions were covered by Chinese laws, 10 were not covered by any current Chinese law or regulation. None of the interventions against drowning and falls that we investigated was covered by national laws. The implementation responsibilities for effective interventions were either not specified or were assigned to multiple governmental departments in 11 or 20 legislative documents, respectively. Conclusion In Chinese laws and regulations, interventions proven to prevent major causes of unintentional child injuries are underrepresented and the associated implementation responsibilities are often poorly defined. China should include all such interventions in laws and regulations, and assign implementation responsibility for each to a single department of the national government.
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Affiliation(s)
- Li Li
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, China
| | - Robert Scherpbier
- Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children's Fund, Beijing, China
| | - Jing Wu
- Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Xu Zhu
- Section of Health and Nutrition and Water, Environment and Sanitation, United Nations Children's Fund, Beijing, China
| | - Wei Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, China
| | - Lin Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, China
| | - Xin Gao
- Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Jiesi Luo
- Chinese Center for Disease Control and Prevention (China CDC), Beijing, China
| | - Guoqing Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Central South University, 110 Xiangya Road, Changsha, 410078, China
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Heydari ST, Sarikhani Y, Lankarani KB, Shirazi MK. Burden of transportation injuries among children and adolescents of Fars province: analysis of Iran's 20-year trends. Epidemiol Health 2014; 36:e2014032. [PMID: 25420953 PMCID: PMC4300829 DOI: 10.4178/epih/e2014032] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Accepted: 11/23/2014] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES: Transportation injuries are among the top ten causes of burden of disease in all age groups worldwide. The burden of transportation injuries among children and adolescents in Iran is higher than the world average and that of other developing countries. The aims of this study were to investigate the burden of transportation injuries in children and adolescents in the province of Fars in Iran from 2009 to 2013, and to report the burden of these kinds of injuries in children and adolescents in Iran from 1990 to 2010. METHODS: The number of deaths due to transportation injuries and the location of fatal injuries in the province of Fars in Iran from 2009 to 2013 were analyzed using data from the Fars Forensic Medicine Organization. The 20-year trend in the burden of transportation injuries in Iran was analyzed using data from the Institute for Health Metrics and Evaluation. RESULTS: Similarly to the long-term trend in Iran, the burden of transportation injuries among the male population of Fars province was generally higher than in females. Most fatal accident injuries occurred on roads (males: n=4151, 61.51%; females: n=1182, 65.95%) and in urban areas (males: n=1994, 29.54%; females: n=473, 26.40%). CONCLUSIONS: Considering that children and adolescents are high risk groups for transportation injuries, adopting an effective comprehensive multi-sectoral approach, including enacting and enforcing appropriate laws and regulations, developing general knowledge, and facilitating the availability of Personal protective equipment, could be helpful for reducing the burden of these injuries.
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Affiliation(s)
- Seyed Taghi Heydari
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran ; Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yaser Sarikhani
- Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
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Chen X, Yang J, Peek-Asa C, Li L. Parents' experience with child safety restraint in China. BMC Public Health 2014; 14:318. [PMID: 24708776 PMCID: PMC4234189 DOI: 10.1186/1471-2458-14-318] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Accepted: 04/03/2014] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Child safety restraints are effective measures in protecting children from an injury while traveling in a car. However, the rate of child restraint use is extremely low in Chinese cities. Parent drivers could play an important role in promoting child safety restraint use, but not all of them take active responsibility. METHODS This study used a qualitative approach and included 14 in-depth interviews among parents with a child, under the age of 6, living in Shantou City (7 child safety restraint users and 7 non-users). Purposive sampling was used to recruit eligible parent drivers who participated in a previous observation study. Interview data were collected from March to April 2013. The audio taped and transcribed data were coded and analyzed to identify key themes. RESULTS Four key themes on child safety restraint emerged from the in-depth interviews with parents. These included 1) Having a child safety restraint installed in the rear seat with an adult sitting next to the restrained child is ideal, and child safety restraint is seen as an alternative when adult accompaniment is not available; 2) Having effective parental education strategies could help make a difference in child safety restraint use; 3) Inadequate promotion and parents' poor safety awareness contribute to the low rate of child safety restraint in China; 4) Mandatory legislation on child safety restraint use could be an effective approach. CONCLUSION Inadequate promotion and low awareness of safe traveling by parents were closely linked to low child safety seat usage under the circumstance of no mandatory legislation. Future intervention efforts need to focus on increasing parents' safe travel awareness combined with CSS product promotion before the laws are enacted.
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Affiliation(s)
- Xiaojun Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Jingzhen Yang
- The University of Iowa Injury Prevention Research Center, Iowa, USA
- Department of Social and Behavioral Sciences, Kent State University, Kent, USA
| | - Corinne Peek-Asa
- The University of Iowa Injury Prevention Research Center, Iowa, USA
- Department of Occupational and Environmental Health, University of Iowa, Iowa, USA
| | - Liping Li
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
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Chen X, Yang J, Peek-Asa C, Chen K, Liu X, Li L. Hospital-based program to increase child safety restraint use among birthing mothers in China. PLoS One 2014; 9:e105100. [PMID: 25133502 PMCID: PMC4136798 DOI: 10.1371/journal.pone.0105100] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/19/2014] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE To evaluate a hospital-based educational program to increase child safety restraint knowledge and use among birthing mothers. METHODS A prospective experimental and control study was performed in the Obstetrics department of hospitals. A total of 216 new birthing mothers from two hospitals (114 from intervention hospital and 102 from comparison hospital) were recruited and enrolled in the study. Intervention mothers received a height chart, an 8-minute video and a folded pamphlet regarding child safety restraint use during their hospital stay after giving birth. Evaluation data on the child safety seat (CSS) awareness, attitudes, and use were collected among both groups before and after the intervention. An additional phone interview was conducted among the intervention mothers two months after discharge. RESULTS No significant differences existed between groups when comparing demographics. Over 90% of the intervention mothers found the educational intervention to be helpful to some extent. A significantly higher percentage of mothers in the intervention than the comparison group reported that CSS are necessary and are the safest seating practice. Nearly 20% of the intervention mothers actually purchased CSS for their babies after the intervention. While in both the intervention and comparison group, over 80% of mothers identified the ages of two through five as needing CSS, fewer than 50% of both groups identified infants as needing CSS, even after the intervention. CONCLUSION The results indicated that child safety restraint education implemented in hospitals helps increase birthing mothers' overall knowledge and use of CSS. Further efforts are needed to address specific age-related needs to promote car seats use among infants.
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Affiliation(s)
- Xiaojun Chen
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Jingzhen Yang
- Injury Prevention Research Center, The University of Iowa, Iowa City, Iowa, United States of America
| | - Corinne Peek-Asa
- Injury Prevention Research Center, The University of Iowa, Iowa City, Iowa, United States of America
| | - Kangwen Chen
- The Women and Children Hospital of Shantou, Shantou, China
| | - Xiangxiang Liu
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
| | - Liping Li
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China
- Injury Prevention Research Center, Shantou University Medical College, Shantou, China
- * E-mail:
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