Too Small for a Seatbelt: Predictors of Booster Seat Use by Child Passengers

Ebel, Beth E.; Koepsell, Thomas D.; Bennett, Elizabeth; Rivara, Frederick P.

doi:10.1542/peds.111.4.e323

Cited by 82 publications

(85 citation statements)

References 11 publications

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“…However, as already observed, rates of booster seat use are generally low Decina, Knoebel, 1997;Ebel, Koepsell, Bennett, Rivara, 2003;Ramsey, Simpson, Rivara, 2000;Taft, Mickalide, Taft, 1999). In order to design effective programs to promote use of booster seats it is imperative to understand the barriers to booster seat use as well as the factors that promote use.…”

Section: Introductionmentioning

confidence: 58%

“…Utilizing parental interview methods, a handful of studies has begun to investigate the factors that influence use of booster seats (Ebel et al, 2003; NHTSA, 2004;Ramsey et. al., 2000;Vaca et.…”

Section: Introductionmentioning

confidence: 99%

“…The study also found that knowledge of when to use a booster seat is poor, with less than one-half of parents knowing that children weighing 40 to 60 pounds should be placed in a booster seat and less than two-thirds having a correct understanding of the child safety restraint laws in their state. Thus, there appears to be significant misunderstanding surrounding the use of booster seats.Utilizing parental interview methods, a handful of studies has begun to investigate the factors that influence use of booster seats (Ebel et al, 2003; NHTSA, 2004;Ramsey et. al., 2000;Vaca et.…”

mentioning

confidence: 99%

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Factors influencing the use of booster seats: A state-wide survey of parents

Bingham

Eby

Hockanson

et al. 2006

Accident Analysis & Prevention

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This study gathered telephone interview data on attitudes, knowledge and motivations regarding booster seat use from a representative stratified random sample of parents with children between the ages of 4 and 8 years living in the State of Michigan. Interviews were completed between December 1 and December 15, 2004, with parents of children in 350 households. Due to demographic differences between this sample and the National Household Travel Survey (NHTS), weights were calculated using NHTS data, and both unweighted and weighted analyses were conducted. No differences were found between the conclusions drawn from the weighted and unweighted analyses; therefore, unweighted results were reported. Analyses examined the sample, overall, part-time booster seat users, and booster seat non-users. Numerous differences were identified based on parental sex, and booster seat use. Results indicated that the lack of legislation mandating booster seat use was a key variable determining level of use and the motivation to use booster seats. Nearly 70% of part-time users said that they used booster seats because they believed it was the law. Similarly, 60% of part-time and non-booster seat users said that they would be more likely to use booster seats if use were mandated by law, with non-users being more than three times as likely as part-time users to agree that a law would increase their booster seat use. Finally, over 90% of part-time and non-booster seat users said it would be easier for them to use booster seats if a law required it, and non-users were almost three times more likely than part-time users to agree that a law would make use easier. The need for booster seat laws, issues of social equity, and implications for intervention were discussed. Key WordBooster seat use, restraint use, safety belt use, telephone survey, representative, occupant protection SI* (MODERN METRIC) CONVERSION FACTORS APPROXIMATE CONVERSIONS TO SI UNITS Introduction BackgroundIt is widely recognized in the fields of injury prevention and transportation safety that motor vehicle crash (crash) is the leading cause of morbidity and mortality among children ages 4 to 8 years (Subrmanian, 2005). Although motor-vehicle-related injuries have declined in recent years (National Highway Traffic Safety Administration [NHTSA], 2003a), child restraint non-use is common in this age group, and contributes significantly to the risk of crash-related injury. Booster seats are important and effective tools in the effort to protect young children from injury in crashes, decreasing the risk of injury in a crash by as much as 59% (Durbin, Elliot, Winston, 2003;Nance et. al., 2004).In spite of their effectiveness (Durbin, Kallan, Winston, 2001), children who have outgrown child safety seats (i.e., infant or toddler seats) but are still too small to be fully protected by a safety belt designed for an adult (adult safety belt, i.e., lap and shoulder), are often either not placed in booster seats, placed inappropriately in a safety belt, or not restrained...

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Section: Introductionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Factors influencing the use of booster seats: A state-wide survey of parents

Bingham

Eby

Hockanson

et al. 2006

Accident Analysis & Prevention

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“…This is the explanation given by 56% of parents in one study (9) and 45% of respondents in another (8). A focus group study found that additional barriers included cost, difficulty and child acceptance.…”

Section: Barriers To Booster Seat Usementioning

confidence: 99%

“…The most recent Canadian national data are from 1997, when only 4.5% of children five to nine years old were using booster seats, whereas 78.9% of children in the same age group were using seat belts (7). Observational studies in Seattle in 1999 and 2000 showed that only 10% to 16% of children who should have been using booster seats did so regularly (8,9). There is some evidence that booster seat use increased for four-and five-yearolds in the United States between 1999 and 2002 (10).…”

Section: Booster Seat Use Ratesmentioning

confidence: 99%

Removing barriers to booster seat use in Canada

Howard

Snowdon

Macarthur³

2004

Paediatrics &Amp; Child Health

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Effects of a Booster Seat Education and Distribution Program in Child Care Centers on Child Restraint Use Among Children Aged 4 to 8 Years

Thoreson¹,

Myers²,

Goss³

et al. 2009

Arch Pediatr Adolesc Med

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To compare child care center-based booster seat education and distribution with no intervention when implemented immediately after booster seat legislation. Design: Cluster randomized controlled trial. Setting: Thirty-nine urban child care centers. Participants: Eight hundred fifty-four parents and 1010 children aged 4 to 8 years in vehicles leaving centers. Intervention: We trained 168 staff members at 20 centers to give parents and children messages promoting booster seats and supplied lesson plans, children's activities, and free booster seats. Main Outcome Measures: Observed booster seat use, "good practice" restraint use, and legal restraint use. Results: Parents at intervention centers were more likely to report receiving restraint information from the center (adjusted odds ratio [AOR], 4.06; 95% confidence interval [CI], 2.48-6.67), speaking with staff about booster seats (AOR, 3.95; 95% CI, 2.26-6.88), and using fit to decide when to move children into seat belts (AOR, 3.39; 95% CI, 1.91-5.99). Groups did not differ in proportions using booster seats (44% vs 43%; AOR, 1.03; 95% CI, 0.62-1.73), good practice (42% vs 41%; AOR, 1.11; 95% CI, 0.70-1.74), or legal restraints (65% vs 65%; AOR, 0.79; 95% CI, 0.48-1.31). Results were similar for children aged 4 to 5 and 6 to 8 years. All outcomes were significantly less likely among children riding in pickup trucks or with Hispanic or black drivers. Conclusions: The intervention increased parents' receipt of information from center staff and knowledge about booster seats but not booster seat use. Research is needed to identify methods and messages that will empower center providers to promote booster seats effectively and reach high-risk populations.

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Too Small for a Seatbelt: Predictors of Booster Seat Use by Child Passengers

Abstract: Many parents still incorrectly believe that children are safe in a seatbelt and have outgrown the need for a car seat. These results demonstrate the need for public education campaigns to educate parents about booster seat use.

Cited by 82 publications

References 11 publications

Factors influencing the use of booster seats: A state-wide survey of parents

Factors influencing the use of booster seats: A state-wide survey of parents

Removing barriers to booster seat use in Canada

Effects of a Booster Seat Education and Distribution Program in Child Care Centers on Child Restraint Use Among Children Aged 4 to 8 Years

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