Assessing community child passenger safety efforts in three Northwest Tribes

Abstract

Objective: To identify strengths and weaknesses in community based child passenger safety programs by developing a scoring instrument and conducting observations of child restraint use in three Native American communities. Setting: The three communities are autonomous Tribal reservations in the Pacific Northwest. Their per capita incomes and rates of unemployment are comparable. Methods: In each community, 100 children under 5 years old were observed for car seat use. A six item community assessment tool (100 points maximum) awarded points for such items as the type (primary or secondary) and enforcement of child restraint laws; availability of car seats from distribution programs; extent of educational programs; and access to data on vehicle injuries. Results: For children from birth to 4 years, the car seat use rate ranged from 12%-21%. Rates for infants (71%-80%) far exceeded rates for 1-4 year old children (5%-14%). Community scores ranged from 0 to 31.5 points. There was no correlation between scores and observed car seat use. One reason was the total lack of enforcement of restraint laws. Conclusions: A community assessment tool can highlight weaknesses in child passenger efforts. Linking such a tool with an objective measure of impact can be applied to other injury problems, such as fire safety or domestic violence. The very process of creating and implementing a community assessment can enhance agency collaboration and publicize evidence based "best practices" for injury prevention. Further study is needed to address methodologic issues and to examine crash and medical data in relation to community child passenger safety scores.

Utilização de assentos de segurança por crianças matriculadas em creches

“…The mandatory use of CSRS is an important legal factor but it is not enough for compliance. 6,7,11,18,19,24 Given low rates of CSRS use associated to slightly low rates of seat belt use by the drivers and the recent implementation of specific CSRS legislation, CSRS use is a challenge to preventive medicine in Brazil, requiring action focusing on raising awareness of safety transportation rules for children. Further studies are needed for developing strategies to promote CSRS use as a way to prevent injuries and deaths in children passengers of vehicles.…”

Restraint Use Among Northwest American Indian Children Traveling in Motor Vehicles

“…Car seat use among infants (71%-80%) exceeded use among children aged 1 to 4 years (5%-14%). 10 Restraint use among children age 5 and older was not evaluated, and no detailed information about the proper use of seats was provided.…”

Fatal Pediatric Motor Vehicle Crashes on U.S. Native American Indian Lands Compared to Adjacent Non-Indian Lands: Restraint Use and Injury by Driver, Vehicle, Roadway and Crash Characteristics

“…This occurred as MV mortality rates fell in all race and ethnic groups, but with smaller improvements for American Indian/Alaskan Natives that produced an actual widening of MV occupant disparities [ 3 ]. Appropriate restraining of children in motor vehicles is effective in lowering child MV crash mortality [ 4 , 5 , 6 ], but American Indian pediatric passengers are reported to be less likely to be properly restrained [ 3 , 7 , 8 , 9 , 10 ], thus potentially increasing the risk of mortality. Several risk factors for increased risk of injury and mortality among American Indians have been identified [ 11 , 12 , 13 , 14 , 15 ], although there are also reports of racial misclassification for American Indians [ 16 , 17 , 18 ].…”