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Virtue C, Goffe C, Shiang E, McKenzie Z, Shields W. Surveillance methods and interventions implemented in American Indian and Alaska Native communities to increase child restraint device and seat belt use in motor vehicles: a systematic review. Inj Prev 2024; 30:92-99. [PMID: 38302282 PMCID: PMC11114209 DOI: 10.1136/ip-2023-045044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 12/03/2023] [Indexed: 02/03/2024]
Abstract
BACKGROUND American Indian/Alaska Native (AI/AN) children are disproportionately affected by injuries and deaths related to motor vehicle crashes. We aimed to synthesise published evidence on surveillance methods and interventions implemented in AI/AN communities and analyse characteristics that make them successful in increasing child restraint devices and seat belt use. METHODS Studies were collected from the PubMed, Scopus, and TRID databases and the CDC Tribal Road Safety website, Community Guide, and Indian Health Service registers. Included studies collected primary data on AI/AN children (0-17) and reported morbidity/mortality outcomes related to child restraint devices or seat belt use. Studies with poor methodological quality, published before 2002, whose data were collected outside of the USA, or were non-English, were excluded. Checklists from the Joanna Briggs Institute were used to assess the risk of bias. In the synthesis of results, studies were grouped by whether a surveillance method or intervention was employed. RESULTS The final review included 9 studies covering 72 381 participants. Studies conducted surveillance methods, interventions involving law enforcement only and multipronged interventions. Multipronged approaches were most effective by using the distribution of child restraint devices combined with at least some of the following components: educational programmes, media campaigns, enactment/enforcement of child passenger restraint laws, incentive programmes and surveillance. DISCUSSION Although this review was limited by the number and quality of included studies, available resources suggest that we need multipronged, culturally tailored and sustainable interventions fostered by mutually beneficial and trusting partnerships. Continued investment in AI/AN road safety initiatives is necessary.
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Affiliation(s)
- Cierra Virtue
- Family Medicine, Boston Medical Center, Boston, Massachusetts, USA
| | - Chelsea Goffe
- Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Evelyn Shiang
- Center for Injury Research and Policy, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Zoann McKenzie
- Injury Prevention Program, Indian Health Service, Rockville, Maryland, USA
| | - Wendy Shields
- Center for Injury Research and Policy, Johns Hopkins 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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Pammer K, Freire M, Gauld C, Towney N. Keeping Safe on Australian Roads: Overview of Key Determinants of Risky Driving, Passenger Injury, and Fatalities for Indigenous Populations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052446. [PMID: 33801405 PMCID: PMC7967563 DOI: 10.3390/ijerph18052446] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 11/16/2022]
Abstract
Social and cultural barriers associated with inequitable access to driver licensing and associated road safety education, as well as socioeconomic issues that preclude ongoing vehicle maintenance and registration, result in unsafe in-car behaviours such as passenger overcrowding. This in turn is associated with improper seatbelt usage, noncompliance with child restraint mandates, and driver distraction. For example, in Australia, where seatbelt use is mandatory, Indigenous road users are three times less likely to wear seatbelts than non-Indigenous road users. This is associated with a disproportionately high fatality rate for Indigenous drivers and passengers; 21% of Indigenous motor-vehicle occupants killed on Australian roads were not wearing a seatbelt at the time of impact. In addition, inequitable access to driver licensing instruction due to financial and cultural barriers results in Indigenous learner drivers having limited access to qualified mentors and instructors. A consequent lack of road safety instruction results in a normalising of risky driving behaviours, perpetuated through successive generations of drivers. Moreover, culturally biased driver instruction manuals, which are contextualised within an English written-language learning framework, fail to accommodate the learning needs of Indigenous peoples who may encounter difficulties with English literacy. This results in difficulty understanding the fundamental road rules, which in turn makes it difficult for young drivers to develop and sustain safe in-car behaviours. This paper considers the literature regarding road safety for Indigenous road users and critically evaluates strategies and policies that have been advanced to protect Indigenous drivers. Novel solutions to increasing road safety rule compliance are proposed, particularly in relation to passenger safety, which are uniquely embedded within Indigenous ways of knowing, being, and doing. Safe driving practices have crucial health and social implications for Indigenous communities by allowing more Indigenous people to participate in work and education opportunities, access healthcare, maintain cultural commitments, and engage with families and friends, qualities which are essential for ongoing health and wellbeing.
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Affiliation(s)
- Kristen Pammer
- The School of Psychology, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia; (M.F.); (C.G.)
- Correspondence: ; Tel.: +61-1249-217-980
| | - Melissa Freire
- The School of Psychology, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia; (M.F.); (C.G.)
| | - Cassandra Gauld
- The School of Psychology, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia; (M.F.); (C.G.)
| | - Nathan Towney
- Vice-Chancellor’s Division, The University of Newcastle, Callaghan, NSW 2308, Australia;
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Use of child restraint system and patterns of child transportation in Riyadh, Saudi Arabia. PLoS One 2018; 13:e0190471. [PMID: 29293659 PMCID: PMC5749838 DOI: 10.1371/journal.pone.0190471] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/17/2017] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Child restraint system (CRS) is designed to protect children from injury during motor vehicle crash (MVC). However, there is no regulation or enforcement of CRS use in Saudi Arabia. This study estimated the prevalence of CRS use and identified patterns of child transportation in Riyadh, Saudi Arabia. METHODS In this cross-sectional study, a self-administered questionnaire was distributed across Riyadh targeting families who drove with children aged less than 5 years. The questionnaire inquired about CRS availability, patterns of child transportation if a CRS was unavailable, seat belt use by the driver and adult passengers, and the perception of CRS. RESULTS Of 385 respondents, only 36.6% reported the availability of a CRS (95% CI: 31.8-41.7%), with only half of those reported consistent use 74 (52.2%). Nearly 30% of all children aged less than 5 years were restrained during car journeys. Sitting on the lap of an adult passenger on the front seat was the most common pattern of child transportation (54.5%). Approximately 13.5% of respondents were involved in an MVC while driving with children; 63.5% of these children were unprotected by any safety system. Seat belt use by drivers was low, with only 15.3% reporting constant use. CONCLUSION The prevalence of CRS use in Riyadh is low, and safety practices are seldom used by drivers and passengers. In addition to legal enforcement of CRS use, implementation of a child transportation policy with age-appropriate height and weight specifications is imperative.
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Oh SA, Liu C, Pressley JC. Fatal Pediatric Motor Vehicle Crashes on U.S. Native American Indian Lands Compared to Adjacent Non-Indian Lands: Restraint Use and Injury by Driver, Vehicle, Roadway and Crash Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14111287. [PMID: 29068393 PMCID: PMC5707926 DOI: 10.3390/ijerph14111287] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 10/06/2017] [Accepted: 10/13/2017] [Indexed: 11/16/2022]
Abstract
There are large disparities in American Indian pediatric motor vehicle (MV) mortality with reports that several factors may contribute. The Fatality Analysis Reporting System for 2000–2014 was used to examine restraint use for occupants aged 0–19 years involved in fatal MV crashes on Indian lands (n = 1667) and non-Indian lands in adjacent states (n = 126,080). SAS GLIMMIX logistic regression with random effects was used to generate odds ratios (OR) with 95% confidence intervals (CI). Restraint use increased in both areas over the study period with restraint use on Indian lands being just over half that of non-Indian lands for drivers (36.8% vs. 67.8%, p < 0.0001) and for pediatric passengers (33.1% vs. 59.3%, p < 0.0001). Driver restraint was the strongest predictor of passenger restraint on both Indian and non-Indian lands exerting a stronger effect in ages 13–19 than in 0–12 year olds. Valid licensed driver was a significant predictor of restraint use in ages 0–12 years. Passengers in non-cars (SUVs, vans and pickup trucks) were less likely to be restrained. Restraint use improved over the study period in both areas, but disparities failed to narrow as restraint use remains lower and driver, vehicle and crash risk factors higher for MV mortality on Indian lands.
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Affiliation(s)
- Shin Ah Oh
- Department of Biostatistics, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
| | - Chang Liu
- Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
| | - Joyce C Pressley
- Department of Epidemiology, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
- Department of Health Policy and Management, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
- Center for Injury Epidemiology and Prevention, Columbia University, 722 West 168th Street, New York, NY 10032, USA.
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Hunter K, Keay L, Clapham K, Brown J, Bilston LE, Lyford M, Gilbert C, Ivers RQ. "He's the Number One Thing in My World": Application of the PRECEDE-PROCEED Model to Explore Child Car Seat Use in a Regional Community in New South Wales. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14101206. [PMID: 28994725 PMCID: PMC5664707 DOI: 10.3390/ijerph14101206] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 09/30/2017] [Accepted: 10/02/2017] [Indexed: 12/04/2022]
Abstract
We explored the factors influencing the use of age-appropriate car seats in a community with a high proportion of Aboriginal families in regional New South Wales. We conducted a survey and three focus groups with parents of children aged 3–5 years enrolled at three early learning centres on the Australian south-east coast. Survey data were triangulated with qualitative data from focus groups and analysed using the PRECEDE-PROCEED conceptual framework. Of the 133 eligible families, 97 (73%) parents completed the survey including 31% of parents who reported their children were Aboriginal. Use of age-appropriate car seats was reported by 80 (83%) of the participants, and awareness of the child car seat legislation was high (91/97, 94%). Children aged 2–3 years were less likely reported to be restrained in an age-appropriate car seat than were older children aged 4–5 years (60% versus 95%: χ2 = 19.14, p < 0.001). Focus group participants highlighted how important their child’s safety was to them, spoke of the influence grandparents had on their use of child car seats and voiced mixed views on the value of authorised child car seat fitters. Future programs should include access to affordable car seats and target community members as well as parents with clear, consistent messages highlighting the safety benefits of using age-appropriate car seats.
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Affiliation(s)
- Kate Hunter
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Lisa Keay
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Kathleen Clapham
- Australian Health Services Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia.
| | - Julie Brown
- Neuroscience Research Australia and University of New South Wales, NSW 2052, Sydney, Australia.
| | - Lynne E Bilston
- Neuroscience Research Australia and University of New South Wales, NSW 2052, Sydney, Australia.
- Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Marilyn Lyford
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Celeste Gilbert
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
| | - Rebecca Q Ivers
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2052, Australia.
- Sydney School of Public Health, The University of Sydney, Sydney, NSW 2006, Australia.
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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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Hunter K, Keay L, Clapham K, Lyford M, Brown J, Bilston L, Simpson JM, Stevenson M, Ivers RQ. Buckle up safely (shoalhaven): a process and impact evaluation of a pragmatic, multifaceted preschool-based pilot program to increase correct use of age-appropriate child restraints. TRAFFIC INJURY PREVENTION 2014; 15:483-490. [PMID: 24678571 DOI: 10.1080/15389588.2013.833328] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To conduct a process and impact evaluation of a multifaceted education-based pilot program targeting correct use of age-appropriate restraints in a regional setting with a high proportion of Aboriginal and Torres Strait Islander families. METHODS The program was delivered in 2010 in 3 early learning centers where 31 percent of the children were of Aboriginal and Torres Strait Islander descent. Each component of the program was assessed for message consistency and uptake. To measure program effectiveness, participating children were matched 1:1 by age, language spoken at home, and annual household income with 71 children from the control arm of a contemporaneous trial. The outcome measure in the control and program centers (a 4-category ordinal scale of restraint use) was compared using ordinal logistic regression accounting for age of the parent. RESULTS Process evaluation found that though program components were delivered with a consistency of message, uptake was affected by turnover of all staff at one center and by parents experiencing difficulty in paying for subsidized restraints at each of the centers. Impact evaluation found that children from the centers receiving the program had nearly twice the odds of being in a better restraint category than children matched from the control group (adjusted odds ratio [ORadj] = 2.06, 95% confidence interval [CI], 1.09-3.90). CONCLUSIONS This was a pragmatic study reflecting the real-life issues of implementing a program in preschools where 57 percent of families had a low income and turnover of staff was high. Despite these issues, impact evaluation showed that the integrated educational program showed promise in increasing correct use of age-appropriate restraints. The findings from this pilot study support the use of an integrated educational program that includes access to subsidized restraints to promote best practice child restraint use among communities that include a high proportion of Aboriginal and Torres Strait Islander families in New South Wales. Future trials in similar settings should consider offering more support in centers with high turnover of staff and offering alternative methods of payment when families experience financial difficulties in purchasing the subsidized restraints. If proven in larger trials, this approach could reduce death and injuries in child passengers in this vulnerable group.
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Affiliation(s)
- Kate Hunter
- a The George Institute for Global Health , Sydney , New South Wales , Australia
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Lapidus JA, Smith NH, Lutz T, Ebel BE. Trends and correlates of child passenger restraint use in 6 Northwest tribes: the Native Children Always Ride Safe (Native CARS) project. Am J Public Health 2012; 103:355-61. [PMID: 23237177 DOI: 10.2105/ajph.2012.300834] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared proportions of children properly restrained in vehicles in 6 Northwest American Indian tribes in 2003 and 2009, and evaluated risks for improper restraint. METHODS During spring 2009 we conducted a vehicle observation survey in Oregon, Washington, and Idaho tribal communities. We estimated the proportions of children riding properly restrained and evaluated correlates of improper restraint via log-binomial regression models for clustered data. RESULTS We observed 1853 children aged 12 years and younger in 1207 vehicles; 49% rode properly restrained. More children aged 8 years and younger rode properly restrained in 2009 than 2003 (51% vs 29%; P < .001). Older booster seat-eligible children were least likely to ride properly restrained in 2009 (25%). American Indian children were more likely to ride improperly restrained than nonnative children in the same communities. Other risk factors included riding with an unrestrained or nonparent driver, riding where child passenger restraint laws were weaker than national guidelines, and taking a short trip. CONCLUSIONS Although proper restraint has increased, it remains low. Tribe-initiated interventions to improve child passenger restraint use are under way.
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Affiliation(s)
- Jodi A Lapidus
- Northwest Tribal Epidemiology Center, Northwest Portland Area Indian Health Board, Portland, OR 97201, USA.
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Anna B. La prévention des blessures non intentionnelles chez les enfants et adolescents autochtones au Canada. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.7.394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Anna B. Preventing unintentional injuries in Indigenous children and youth in Canada. Paediatr Child Health 2012. [DOI: 10.1093/pch/17.7.393] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Desapriya E, Fujiwara T, Verma P, Babul S, Pike I. Comparison of on-reserve road versus off-reserve road motor vehicle crashes in Saskatchewan, Canada: a case control study. Asia Pac J Public Health 2010; 23:1005-20. [PMID: 20460293 DOI: 10.1177/1010539510361787] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is an overwhelmingly high incidence of severe injuries caused by motor vehicle crashes (MVCs) among Aboriginal Canadians as compared with the general population. METHODS The authors obtained MVC data for a 3-year period, 2003-2005, from Saskatchewan Government Insurance (SGI) for collisions occurring on on-reserve roads (n = 1270) together with a randomly selected sample of MVCs from off-reserve roads (n = 1270) in Saskatchewan. They compared the collision characteristics using bivariate and multiple logistic regressions. RESULTS On-reserve MVCs were more likely to include multiple collisions and result in severe injuries than the off-reserve sample. A number of factors were significantly related to the increased risk of on-reserve collisions as compared with the reference group for each variable. INTERPRETATION Factors from all 3 levels (human, environmental, and vehicle factors) are associated with on-reserve MVCs.
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Motor Vehicle Occupant Injury and Related Hospital Expenditures in Children Aged 3 Years to 8 Years Covered Versus Uncovered by Booster Seat Legislation. ACTA ACUST UNITED AC 2009; 67:S20-9. [DOI: 10.1097/ta.0b013e3181951a90] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
PURPOSE OF REVIEW There is a growing awareness of the importance of cultural competency in pediatrics. The authors review the most recent studies that examine the impact of cultural competency on general pediatric care, explore cultural beliefs and practices affecting clinical care, and describe culturally sensitive interventions designed to address racial/ethnic health disparities. RECENT FINDINGS The beneficial effects of cultural competency embrace health outcomes, quality of care, and patient satisfaction, while failure to consider language and culture can have serious adverse consequences for clinical care, including patient safety and healthcare access. A five-component model of cultural competency has been developed, and a growing literature details an array of normative cultural values, folk illnesses, parent beliefs/practices, and provider behaviors that can have a profound impact on pediatric care. Culturally sensitive interventions are being developed to lessen racial/ethnic health disparities. SUMMARY A goal for the pediatrician is to provide culturally competent healthcare by using trained medical interpreters with limited English-proficient families, being familiar with normative cultural values that affect the healthcare of commonly encountered racial/ethnic groups, and asking about folk illness beliefs and ethnomedical treatments.
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Johnston BD, Bennett E, Quan L, Gonzalez-Walker D, Crispin B, Ebel B. Factors Influencing Booster Seat Use in a Multiethnic Community: Lessons for Program Implementation. Health Promot Pract 2008; 10:411-8. [DOI: 10.1177/1524839908317743] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Based on the local incidence and severity of motor vehicle occupant injuries, the authors' community and hospital injury prevention partnership identified child passenger safety for 4-to-8-year-old children as a priority. They designed a booster seat promotion campaign using an integrated social cognition model of health behavior. A series of focus groups were held with low-income African American, Somali, and Vietnamese parents to understand determinants of booster seat use in these communities. Deficits in understanding about the purpose of booster seats were seen in all groups, and concerns about cost and self-efficacy varied in important ways. Although legislation is an important tool in motivating child passenger restraint, most families saw safety as the prime reason to use booster seats with their children. These results illustrate the use of qualitative data to adapt a theory-based intervention to the needs of specific communities.
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Affiliation(s)
| | - Elizabeth Bennett
- Guest Services, Partnerships and Advocacy at Seattle
Children's Hospital and Regional Medical Center, Seattle, Washington
| | - Linda Quan
- University of Washington in Seattle, Washington
| | | | - Beth Crispin
- Center for Children with Special Needs at Children's
Hospital and Regional Medical Center, Seattle, Washington
| | - Beth Ebel
- University of Washington in Seattle, Washington
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Letourneau RJ, Crump CE, Bowling JM, Kuklinski DM, Allen CW. Ride Safe: A Child Passenger Safety Program for American Indian/Alaska Native Children. Matern Child Health J 2008; 12 Suppl 1:55-63. [DOI: 10.1007/s10995-008-0332-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Accepted: 02/19/2008] [Indexed: 10/22/2022]
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Rangel SJ, Martin CA, Brown RL, Garcia VF, Falcone RA. Alarming trends in the improper use of motor vehicle restraints in children: implications for public policy and the development of race-based strategies for improving compliance. J Pediatr Surg 2008; 43:200-7. [PMID: 18206483 DOI: 10.1016/j.jpedsurg.2007.09.045] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2007] [Accepted: 09/02/2007] [Indexed: 11/26/2022]
Abstract
PURPOSE Little is known regarding the patterns of appropriate restraint use among minority children involved in motor vehicle collisions. The purpose of this study was to characterize patterns of restraint use among children hospitalized after motor vehicle collision and to examine the effects of race and socioeconomic status on compliance. METHODS All children admitted to our level I trauma center over a 10-year period were identified. Patterns of appropriate restraint use were compared between African American (AA) and white children. Compliance was also compared between children insured with Medicaid (as a surrogate for socioeconomic status) and those with private insurance coverage. RESULTS One thousand two hundred sixty-eight patients were included with an overall restraint use of 44.8% with only 20.3% restrained properly. Compared with white children, AAs were significantly less likely to be properly restrained (12.7% vs 22.2%, P < .001) or to be restrained by any means (28.8% vs 48.7%, P < .001). The greatest disparity between groups was observed in the use of car seats (16.0% vs 47.4%, P < .001). Medicaid patients were less likely to be restrained compared with those with commercial insurance (40.6% vs 48.3%, P = .022); however, race remained a significant predictor of noncompliance after controlling for the effect of insurance status. CONCLUSIONS These data demonstrate an alarming trend because nearly 80% of all children in our study were improperly restrained. Marked disparities in compliance were observed in the AA population even after controlling for insurance coverage. Future studies will need to further characterize the complex interplay between race and socioeconomic status with proper restraint use.
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Affiliation(s)
- Shawn J Rangel
- Division of Pediatric and Thoracic Surgery, Department of Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati Medical Center, Cincinnati, OH 45229, USA
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