Changes in Pediatricians' Child Passenger Safety Counseling With Initiation of a Booster Seat Program

Booster seats reduce injury in motor vehicle crashes, yet they are used less frequently than car seats and seat belts. Primary care providers are well positioned to educate and encourage families to use booster seats. We aimed to assess how a booster seat distribution program affected the documentation of restraint usage and anticipatory guidance at well-child visits at a pediatric primary care practice. We performed a retrospective chart review of patients aged 4 to 12 years from June to December in 2019 and 2020, representing before and after a booster seat program. The most frequently documented restraints in 2019 and 2020 were seat belts (51% vs 30%), booster seats (25% vs 27%), and not documented/unclear (17% vs 25%) (P < .001). The program significantly increased referrals for booster seats (P < .001). Despite significant differences in the proportion of children in each restraint category, overall booster seat use was similar between years.

Ride-Share Use and Child Passenger Safety Behaviors: An Online Survey of Parents

OBJECTIVE

Ride-share services are increasingly used for transportation, but little is known about ride-share use and passenger safety behaviors among parents of children for whom child restraint systems (CRS) are recommended. Our objectives were to characterize ride-share use with children and examine passenger restraint use in ride-share.

METHODS

A cross-sectional survey, distributed to the TurkPrime Parent Panel using Amazon Mechanical Turk (MTurk), was designed to assess ride-share and passenger safety behaviors. After screening, adult parents of minor children were invited to complete the full survey about transportation behaviors. Descriptive and chi-square statistics were calculated. Logistic regression was conducted to test for characteristics associated with suboptimal restraint use in ride-share.

RESULTS

Of 655 screened parents, 162 had no minor children, 43 had incomplete responses or failed an attention check question. Of 450 parents with minor children, 309 (68.7%) used ride-share in the past year and 73.1% of parents who use ride-share did so with their child(ren). Ride-share use with children was most common on vacation. Among parents of children age ≤8 years, 49% reported always using their child's CRS when traveling in ride-share. Suboptimal restraint use in rideshare was associated with child age (3-8 years compared with <3 years), larger family size, and attitudes and behaviors that tolerate suboptimal CRS use.

CONCLUSIONS

This study identifies an opportunity to promote use of CRS in ride-share services. Child passenger safety messaging, education, policy, enforcement of legislation, and CRS design will need to be adapted as ride-share services become more widely adopted.

Family readiness for evidence-based injury prevention and car seat safety in Jordan

Primary prevention involves developing positive health behaviours designed to avert adverse health outcomes, whereas evidence-based primary prevention adopts practices that reduce illness and injury. This study's objective was to determine whether families in Jordan would adopt car safety measures after participating in an evidence-based injury prevention programme. Parents of children attending a regional government hospital in Jordan took part in an evidence-based educational class on child car restraints and car safety, six months later follow-up phone calls were made to see if the parents implemented the knowledge obtained in the class. Fifty families participated in the injury prevention class. The results showed that the evidence-based class on child restraint systems led to the adoption of the three interventions by the parents. At the time of the class 45% of parents allowed their infants to sit in the front seat, in the lap of an adult, this was reduced to 12%, being a 33% reduction. In addition, for children aged 6-12 using a seat belt in the back seat, the parents reported that their children using a seat belt increased from 13% to 70%. Finally, parents who participated were more likely to use a child car seat.

Vital Sign Monitoring in Car Seats Based on Electrocardiography, Ballistocardiography and Seismocardiography: A Review

This paper focuses on a thorough summary of vital function measuring methods in vehicles. The focus of this paper is to summarize and compare already existing methods integrated into car seats with the implementation of inter alia capacitive electrocardiogram (cECG), mechanical motion analysis Ballistocardiography (BCG) and Seismocardiography (SCG). In addition, a comprehensive overview of other methods of vital sign monitoring, such as camera-based systems or steering wheel sensors, is also presented in this article. Furthermore, this work contains a very thorough background study on advanced signal processing methods and their potential application for the purpose of vital sign monitoring in cars, which is prone to various disturbances and artifacts occurrence that have to be eliminated.

Parent's knowledge, attitude, and practice about children car seats at Unaizah city, KSA

Background:

Motor vehicle collision (MVC) is a major cause of death in children worldwide. Using children car seats will stabilize them during accidents and decrease the morbidity and mortality from MVC dramatically. There is no study in Saudi Arabia about car seat use and relationship between using it and children morbidity and mortality following a car accident.

Objectives:

To assess knowledge, attitude, and practice of children car seats among parents at Unaizah city, KSA, to assess the level of awareness regarding the children car safety system, to determine the parent level of education, socioeconomic status, and other factors affecting their behavior regarding car seats, to determine the prevalence of car seat use among parents in Unaizah city, and to assess the effectiveness of car seat policies on parents’ behavior.

Design:

Cross-sectional study.

Settings:

Public and private pediatric clinics at Unaizah city in Qassim region.

Materials and Methods:

The study was conducted from May to June 2018, among parents with child ≤7 years old. Anyone who could not complete the questionnaire for any reason was excluded from our study. SPSS version 20 has been used to analyze all data.

Main Outcome Measures:

To assess knowledge, attitude, and practice of children car seats among parents at Unaizah city, KSA.

Sample Size:

350.

Results:

There were 350 participants who were included in this study of which females were dominant 77.1%. The age range of parents was 25–35 years old. Most of them complied with the seatbelt policy (56.7%). Among these numbers, 130 participants use a seatbelt for security reason while others were to protect from irregularities. More parents do not put baby seat in the car (57.3%) while 57 participants use child seat every time the child rides in the car.

Conclusion:

The overall knowledge, attitude, and practices toward children car safety seat in this study was relatively low. This signifies the need of parents to step up their awareness to safe guard their children while on the road.

Limitations:

Small sample size and limited to pediatrics clinics visitors.

Teaching installation and use of child passenger safety restraints

Correctly installed child passenger safety restraints may reduce the risk of child injury and death during accidents. The present study evaluated behavioral skills training and self-monitoring to teach correct installation and use of a child passenger safety restraint in the rear-facing position. Extension probes were conducted with untrained installations and harnessing positions. Training was successful in teaching participants all installation methods and harnessing positions.

"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

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.

Looking Back on Rear-Facing Car Seats: Surveying US Parents in 2011 and 2013

OBJECTIVE

We sought to determine the age at which US parents first turned their child's car seat to face forward and information sources used to make that decision at the time of the release of the 2011 guidelines for child passenger safety and 30 months later.

METHODS

We administered 2 separate cross-sectional Web-based surveys of nationally representative panels of US parents in May 2011 and November 2013. Survey participation rate was 54% in both years. Parents of children ≤4 years old responded to questions about transitioning from rear-facing to forward-facing car seats (n = 495 in 2011; n = 521 in 2013).

RESULTS

In 2011, 33% of parents of 1- to 4-year-old children who had been turned to face forward (n = 409) turned at or before 12 months and 16% turned at 2 years or older. In 2013, 24% of parents of 1- to 4-year-old children who had been turned to face forward (n = 413) turned at or before 12 months and 23% turned at 2 years or older. Car seat packaging and clinicians were the most common information sources. Demographic characteristics associated with turning to face forward at or before 12 months of age in 2011 (parent age, education, household income, rural residence) were not significantly associated with transitioning at or before 12 months in 2013.

CONCLUSIONS

Delaying the transition to a forward-facing car seat still represents an opportunity to improve passenger safety in the United States. As common sources of information, clinicians may be influential in a parent's decision to turn their child's car seat to face forward.

Saudi women's beliefs on the use of car infant restraints: a qualitative study

OBJECTIVE

The focus of this study was to identify the salient beliefs of pregnant women in Saudi Arabia that may influence their intentions to use infant restraints for their children. These beliefs were later used to inform a subsequent quantitative study.

METHODS

This qualitative study employed Ajzen's theory of planned behavior to elicit the salient behavioral, normative, and control beliefs of Saudi pregnant women regarding the use of infant restraints for their future children. Twenty-five pregnant women participated in 2 focus groups conducted in June 2013 at Dallah Hospital in Riyadh.

RESULTS

Lack of health education and law enforcement; cultural pressure and traditions; counsel from family, specifically from husbands and mothers; desire to stay close to the child; family size; and car size were key factors in deciding whether or not to use car seats; the high cost of car seats was not.

CONCLUSIONS

Aside from providing awareness to future mothers and the general public, health interventions should target the specific beliefs identified in this study. Because participants identified husbands as significant referents, further studies are needed to examine the husbands' attitudes and beliefs.

An Inpatient Child Passenger Safety program

Background. Our institution implemented an Inpatient Child Passenger Safety (CPS) program for hospitalized children to improve knowledge and compliance with the Massachusetts CPS law, requiring children less than 8 years old or 57 inches tall to be secured in a car seat when in a motor vehicle. Methods. After the Inpatient CPS Program was piloted on 3 units in 2009, the program was expanded to all inpatient units in 2010. A computerized nursing assessment tool identifies children in need of a CPS consult for education and/or car seat. Results. With the expanded Inpatient CPS Program, 3650 children have been assessed, 598 consults initiated, and 325 families have received CPS education. Car seats were distributed to 419 children; specialty car seats were loaned to 134 families. Conclusions. With a multidisciplinary approach, we implemented an Inpatient CPS Program for hospitalized children providing CPS education and car seats to families in need.

Protecting children: a survey of caregivers' knowledge of Georgia's child restraint laws

Introduction

The leading cause of injury and death among children in the United States is motor vehicle crashes. Even though restraint laws are in place and public awareness campaigns and educational interventions have increased, many children are still improperly restrained or not restrained at all. When correctly used, child restraints significantly reduce risk of injury or death.

Methods

The purpose of the study was to elicit caregiver baseline knowledge of car seat installation and regulation before receiving car seat education from certified technicians at Inspection Station events. Inspection Station is a program whereby staff assists parents in correctly positioning car seats in participants’ vehicles. Over an 8-week period, Safe Kids Cobb County Car Seat Technicians distributed a 16-item survey, with 10 knowledge-based questions and six demographic questions to Inspection Station participants. Descriptive statistics and t-tests were conducted to assess relationships between participant age, ethnicity, and gender with overall knowledge scores. Regression analysis was run to determine the association between participant education level and total child restraint knowledge.

Results

One hundred sixty-nine surveys were completed. Participant knowledge of vehicular child restraint ranged from 0% to 90% on all items. Only 29.6% of caregivers understood the proper tightness of the harness system. Less than half of the caregivers (43.8%) were aware of the Georgia law requiring children aged 6 years and younger to be in some type of child restraint. Only 43.2% of caregivers surveyed knew that children need to ride in a rear-facing child restraint until 1 year of age and 20 pounds. No significant correlations between participant knowledge and age were found. Statistically significant associations were found between total knowledge scores and education level, ethnicity, and gender.

Discussion

The results from this study describe baseline knowledge among a sample of participants at Inspection Station activities held in Cobb County, Georgia. These results can help inform tailoring of future programming so that the impact of enhanced health education/prevention messages for intended populations can be maximized and health child injury risk related to improper restraints can be minimized.