Abstract
BackgroundLittle is known about the barriers to use of child car seats in Australian Aboriginal communities, or the acceptability of programs to increase appropriate car seat use. This formative evaluation sought to consult and partner with Aboriginal Community Controlled Health Services (ACCHS) to develop and evaluate the feasibility and acceptability of a program intended to improve optimal use of child car seats.MethodsFocus groups were conducted with parents and carers of Aboriginal children to identify the barriers and facilitating factors for child car seat use, and staff of two ACCHS were interviewed to inform program development. Following the implementation of the resulting multi-faceted program, consisting of staff training, education, hands-on demonstrations and a subsidised car seat distribution scheme, interviews were conducted to assess process issues and acceptability with 13 staff members.ResultsParents and carers in the focus groups reported a lack of awareness of child car seat use, confusion about the right car seats for different aged children but agreed about the importance of safety and community responsibility to keep children safe in cars. Interviews with service staff informed an approach to deliver relevant information. Information and resources were delivered to families, while the car seat distribution scheme supplied 33 families with child car seats. Following the conclusion of the program, staff reported that the program was relevant to their role. They also valued the car seat distribution scheme. Staff training in selection and installation of car seats increased confidence in staff knowledge.ConclusionsWe developed a program to promote child car seat use in ACCHS, which focused on developing capacity, made use of existing infrastructure and developed resources for use in this setting. The program shows promise as a means to promote child car seat use in Aboriginal communities; however, the impact on child car seat use will need to be evaluated in a larger scale prospective trial.
Highlights
Little is known about the barriers to use of child car seats in Australian Aboriginal communities, or the acceptability of programs to increase appropriate car seat use
Amongst those who were aware, there was confusion about the appropriate car seat for age and when to progress children to the car seat. These findings reinforced the need for the program to increase awareness and include education about child car seat use
Having an external advisor present was reported to help resolve and clarify these issues—this indicates the benefits of supporting program staff during the early stages of program implementation to feel confident and well informed. Staff at both services recommended having a person dedicated to the program implementation and that this would enhance the program fidelity. This pragmatic study has shown that a child car seat program delivered through Aboriginal Community Controlled Health Services (ACCHS), informed by community consultation consisting of access to information, hands-on demonstrations, subsidised car seats and car seat checks performed by appropriately trained staff was feasible and accepted by the local staff of the ACCHS in Western and South-Western Sydney
Summary
Little is known about the barriers to use of child car seats in Australian Aboriginal communities, or the acceptability of programs to increase appropriate car seat use. Aboriginal and Torres Strait Islander people comprise 3% of the Australian population, and a significant proportion live in major cities (33%; 233,100 people) [4]. The suburbs of greater Sydney are home to the highest population of Aboriginal people of any Australian city (10%; 54,746 people) [5]. Fatalities and injuries are disproportionately higher in the Aboriginal and Torres Strait Islander population, where child passengers aged 0–4 years suffer 4 times more fatalities and 2.2 times more serious injuries than non-Indigenous Australians [6]
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