Abstract
(1) Background: Children in South Africa experience significant impacts from road injury due to the high frequency of road crashes and the low uptake of road safety measures (including the use of appropriate child restraints). The current study aimed to assess the feasibility of a child restraint program and to describe factors influencing child restraint use from the perspectives of clinicians, representatives of non-government agencies, and academics in Cape Town, South Africa. (2) Methods: Qualitative interviews were conducted with 13 experts from government, academic and clinical backgrounds. Findings were analyzed using the COM-B component of the Behaviour Change Wheel and were grouped by the layers of the social-ecological model (individual, relational, community and societal). (COM-B is a framework to explain behaviour change which has three key components; capability, opportunity and motivation), (3) Results: Experts believed that there was a need for a child restraint program that should be staged and multifactorial. Participants described knowledge gaps, perceptions of risk, mixed motivations and limited enforcement of child restraint legislation as key influences of restraint use. (4) Conclusions: The results demonstrate potential areas on which to focus interventions to increase child restraint use in Cape Town, South Africa. However, this will require a coordinated and consistent response across stakeholder groups.
Highlights
In 2004, the World Health Organisation (WHO) published the ‘World report on road traffic injury prevention’ [1] followed by the ‘World report on child injury prevention’ in 2009, which appealed to governments to keep children safe through a reduction in the increasing burden caused by road traffic injuries [2]
We identified fourteen experts based in Cape Town, South Africa, comprising police, surgeons, representatives from the Department of Transport, representatives from non-government organisations (NGOs) and academics
This is the first study that reports on semi-structured interviews with stakeholders regarding their perspectives of factors influencing child restraint use in any African country
Summary
In 2004, the World Health Organisation (WHO) published the ‘World report on road traffic injury prevention’ [1] followed by the ‘World report on child injury prevention’ in 2009, which appealed to governments to keep children safe through a reduction in the increasing burden caused by road traffic injuries [2]. These two documents led to the declaration of a Decade of Action for Road Safety (2011–2020) [3] and the inclusion of a Sustainable Development Goal in 2015 to halve the number of global deaths and injuries from road traffic crashes (Target 3.6) [4]. Public Health 2020, 17, 4974; doi:10.3390/ijerph17144974 www.mdpi.com/journal/ijerph
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