Factors associated with car safety seats’ use

Abstract

Abstract Background Road traffic injuries are the number one cause of death in children aged 5-14 years. The evidence shows that, if correctly installed and used, child restraints can reduce infants' death by approximately 70%, and deaths among children by up to 80%. In the absence of compulsory car safety seat (CSS) legislation in Armenia, parents play the decisive role in child passenger safety. This study aimed to investigate the practice of CSS-s among Armenian parents and to find the determinants of CSS use. Methods In 2018, the study team conducted a self-administered survey among parents of children 0-6 years old living in Yerevan, the capital of Armenia. Using two stage cluster sampling, 33 kindergartens were chosen as clusters by simple random sampling and from each cluster 10 parents received a questionnaire. The study team applied a multivariable logistic regression model using the backward elimination approach to finalize the independent predictors of CSS-s use. Results Overall, 263 parents returned completed questionnaires, of which 26.2% (69) were CSS users. The CSS non-users included those who did not have a CSS (163) or had a CSS but used it sometimes, seldom or never (31). The study results showed that the factors associated with the CSS-s use among Armenian parents in the adjusted analyses were age in children (OR = 0.61, p = 0.003), attitude score (OR = 1.53, p = 0.003), knowledge score (OR = 1.45, p = 0.011) regarding CSS-s, consistent driver's side seatbelt compliance (OR = 3.4, p = 0.005), and monthly expenditures (OR = 3.35, p = 0.024). Conclusions This study was the first exploration of Armenian parents' practice of CSS-s. Our findings might serve as a starting point for further research on proper use of CSS among Armenian parents not only in Yerevan, but across all regions of the country. The revealed predictors of parental CSS-s use might be used for the development of fruitful interventions to enhance the practice of CSS-s in Armenia. Key messages This was the first-time exploration of CSS-s practice and predictors of CSS-s use in Armenia, where there is no CSS law and parents play the sole role in child passenger safety. Educational interventions for children and their parents on the importance of age and size appropriate CSS-s usage will help increase CSS-s use among Armenian parents.