Caregivers’ Use of Child Passenger Safety Resources and Quality of Future Child Restraint System Installations

Jessica H Mirman,Mark R Zonfrillo,Kristy B Arbogast,Dennis R Durbin,Sara J Seifert,Kristi Metzger

doi:10.3390/safety3040024

Abstract

Objectives: Child Restraint System (CRS) misuse is common. We characterized caregivers’ use of child passenger safety informational and instructional resources and determined whether there were differences in the quality of CRS installations associated with prior exposure to specific resources as evaluated in a standardized CRS installation environment. Methods: Caregivers completed self-report surveys and installed a forward-facing CRS in a controlled environment. Installations were evaluated for security (tightness) and accuracy (no errors) by a child passenger safety technician (CPST). Results: CRS manuals were the most common way caregivers learned to install a CRS. Primary care providers (PCP)s were the most frequently endorsed source of CRS safety information. There was no strong pattern of associations between prior exposure to resources and installation quality (security or accuracy), although some evidence supports protective effects of learning from CPSTs; 13% (19 out of 151) installations were secure and 57% (86 out of 151) installations were accurate. Conclusions: A focus on developing effective and lasting behavioral interventions is needed.

Highlights

Riding in an age-appropriate and properly installed Child Restraint System (CRS) can reduce the risk of death among 2 to 6 year-olds by 28% compared to riding in a seatbelt [1]
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We focused on CRS installation and not on CRS choice, or on how to harness a child into a CRS; we did not examine use of the top tether

Summary

Introduction

Riding in an age-appropriate and properly installed Child Restraint System (CRS) can reduce the risk of death among 2 to 6 year-olds by 28% compared to riding in a seatbelt [1]. Most of whom are parents, are in a prime position to ensure that child occupants are properly restrained, but despite significant and important gains in the overall use of CRS, misuse remains prevalent at approximately 70% [2,3]. Evidence-based prevention strategies to promote obtaining a CRS, using the CRS correctly (i.e., reduce errors in CRS attachment to the vehicle or of the child in the harness), and using the CRS appropriately (i.e., correct seat type for size and age of the child) are needed.

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Discussion

Conclusion