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Pediatrics. 2014 Feb;133(2):262-71. doi: 10.1542/peds.2013-1908. Epub 2014 Jan 13.

Disparities in age-appropriate child passenger restraint use among children aged 1 to 12 years.

Author information

1
Department of Emergency Medicine.

Abstract

OBJECTIVE:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

child restraint systems; health behavior; socioeconomic factors; survey

PMID:
24420814
PMCID:
PMC3904276
DOI:
10.1542/peds.2013-1908
[Indexed for MEDLINE]
Free PMC Article

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