Identifying interventions that promote belt-positioning booster seat use for parents with low educational attainment.
ABSTRACT Many parents with low educational attainment prematurely graduate their children to seat belt restraint rather than use belt-positioning booster seats. This study aimed to identify interventions that promoted booster seat use among this population.
This multi-site study used focus groups to elicit contributing factors to booster seat non-use, which informed subsequent intervention development. A first phase (10 focus groups, N = 117) identified parents' perceived barriers, benefits, and threats relating to belt-positioning booster seats. These findings were used to identify existing and create new interventions. A second phase (20 focus groups, n = 171) elicited parent's reactions to these interventions and provided parents with belt-positioning booster seats and education on their use. Follow-up interviews were conducted six weeks later.
Lack of education and fear of injury were the primary barriers to belt-positioning booster seat use. Parents were motivated by interventions that provided them with clear, concrete messaging relating to use. Parents favored the intervention that presented a real story detailing a child's severe injury that could have been prevented with appropriate restraint. At follow-up, parents credited this intervention with motivating booster seat use most often. Although parent's cited their child's lack of comfort and non-compliance as barriers to use, they were not as motivated by interventions that addressed these barriers.
Effective intervention programs can be created by identifying and addressing factors that contribute to a population's intention to use belt-positioning booster seats. In addition, successful programs must utilize messages that motivate the target population by addressing their perceived threats to booster seat non-use.
Journal of the American Dietetic Association 09/2011; 111(9). DOI:10.1016/j.jada.2011.06.033 · 3.92 Impact Factor
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ABSTRACT: Observed racial disparities in child safety seat use have not accounted for socioeconomic factors. We hypothesized that racial differences in age-appropriate restraint use would be modified by socioeconomic status and child passenger safety information sources. A 2-site, cross-sectional tablet-based survey of parents seeking emergency care for their 1- to 12-year-old child was conducted between October 2011 and May 2012. Parents provided self-report of child passenger safety practices, demographic characteristics, and information sources. Direct observation of restraint use was conducted in a subset of children at emergency department discharge. Age-appropriate restraint use was defined by Michigan law. Of the 744 eligible parents, 669 agreed to participate and 601 provided complete responses to key variables. White parents reported higher use of car seats for 1- to 3-year-olds and booster seats for 4- to 7-year-olds compared with nonwhite parents. Regardless of race, <30% of 8- to 12-year-old children who were ≤4 feet, 9 inches tall used a booster seat. White parents had higher adjusted odds (3.86, 95% confidence interval 2.27-6.57) of reporting age-appropriate restraint use compared with nonwhite parents, controlling for education, income, information sources, and site. There was substantial agreement (82.6%, κ = 0.74) between parent report of their child's usual restraint and the observed restraint at emergency department discharge. Efforts should be directed at eliminating racial disparities in age-appropriate child passenger restraint use for children <8 years. Booster seat use, seat belt use, and rear seating represent opportunities to improve child passenger safety practices among older children.PEDIATRICS 01/2014; 133(2). DOI:10.1542/peds.2013-1908 · 5.30 Impact Factor
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ABSTRACT: Children aged 8- to 12-years-old ("tweens") are at high risk for crash injury, and motor vehicle crashes are their leading cause of death. Data are presented from behavioral observations (N=243), surveys (N=677), and focus groups (N=26) conducted with tweens attending four urban elementary schools in Virginia. The populations assessed were predominantly Black (77.9%) and economically disadvantaged (61.9%). Focus groups revealed a number of inconsistencies in and misconceptions about safety practices. Among the 677 tweens who completed anonymous surveys, the majority (58.1%) reported wearing their seat belts "not very much at all" or "never." Many students (47.8%) reported usually sitting in the front seat or sitting in the front and back seats equally. This is despite the fact that most (92.0%) knew that the back seat was the safest place to sit. Of the 243 tweens observed in vehicles, 65.0% were unrestrained and 60.1% were seated in the front passenger seat. Findings of this study shed light on the great disparity between the national rates for child safety practices and those of children living in an economically disadvantaged urban school district. Additional intervention programs that are culturally appropriate and specifically target this age group are needed.Journal of safety research 09/2013; 46:77-82. DOI:10.1016/j.jsr.2013.04.004 · 1.34 Impact Factor