Rural–urban differences in health care provider child passenger safety anticipatory guidance provision

Abstract

Many children do not travel safely in vehicles, with rural children often traveling less safely than urban children. Motor vehicle crashes were the leading cause of death of children aged from 1 to 14 years in the United States in 2011. Lack of education or inadequate parental education during well-child visits regarding proper child restraint within vehicles by health care providers (HCPs) in rural areas could be resulting in increased misuse of child restraints and lack of restraint use in rural areas. This study sought to determine rural–urban differences in frequency and accuracy of anticipatory guidance related to child passenger safety (CPS) provided by HCPs, in addition to rural–urban differences in HCP confidence in providing this counseling. HCPs from rural and urban areas in several upper Midwest states were surveyed about frequency and confidence of advice provided to parents related to CPS and their knowledge level on this subject. Urban HCPs were significantly more likely than rural HCPs to consistently provide advice to parents related to CPS across all age groups for children aged 12 years or younger. Differences were found between rural and urban HCPs regarding confidence in their ability to address parents׳ questions/concerns, and knowledge related to specific CPS issues. Significant differences exist in the frequency of CPS anticipatory guidance provision and confidence in accurate provision of CPS anticipatory guidance by rural and urban HCPs to parents. Significant differences also exist between rural and urban HCPs in relation to CPS knowledge. Differences may be due to increased levels of training for urban HCPs. This research is important as it adds to the compendium of knowledge related to CPS counseling patterns focused on reducing motor vehicle-related injuries and fatalities in children.