February 18, 2003
Car booster seat usage rises after community campaign
Few children aged 4- to 8-years old ride in booster seats despite evidence that these children are not adequately protected by adult seat belts and that booster seats are effective in reducing children?s risk of injury. What can be done to persuade parents to buy and use booster seats for their children?
A multi-faceted community-education campaign can significantly increase the use of booster seats, according to a new study by researchers at the Harborview Injury Prevention and Research Center and Children?s Hospital and Regional Medical Center. ?Use of Child Booster Seats in Motor Vehicles Following a Community Campaign? is published in the Feb. 19, 2003 issue of the Journal of the American Medical Association.
The study compared four communities in the greater Seattle area, where a booster-seat campaign was begun in January 2000, with comparison communities in Portland, Ore., and Spokane, Wash., which served as control sites. Follow-up observations were conducted 15 months later, beginning in March 2001.
The researchers developed the King County Booster Seat Coalition to set priorities for the campaign and spearhead outreach efforts with child-care and health-care providers, schools and parents, explains Dr. Beth Ebel, a UW assistant professor of pediatrics and primary author for the study.
The educational campaign in the Seattle area brought together parents, public-health professionals, child-care providers, community-outreach workers, educators and law-enforcement professionals. The coalition created public service announcements for TV, radio and print media, targeting community newspapers and parenting magazines. Educational materials were provided in multiple languages. Coalition members coordinated classes and health fair events for families, and disseminated materials and discount coupons.
The investigators observed 5,656 children traveling in cars during baseline and follow-up periods, and 3,609 children were eligible to be riding in booster seats, based on their ages and weights. Observations were conducted at child-care centers and after-school programs, with 85 percent of drivers agreeing to take part in the survey.
Booster seat usage in the Seattle area nearly doubled during this period, with usage rising from 13.3 percent to 26.1 percent. This compares to an increase from 17.3 percent to 20.2 percent in Portland and Spokane, the control sites.
Booster seat usage was greatest for children aged 4-6 years old (26 percent) and relatively rare for children 7-8 years old (9 percent). Booster seat use was significantly more common when the driver wore a seatbelt.
Washington was the first state to pass a booster seat law. Fifteen states and the District of Columbia currently have states requiring booster seat use, and federal legislation, passed on Nov. 18, 2002, directs the National Highway Traffic Safety Administration to improve federal standards of vehicle-restraint systems for children.
?The booster seat campaign shares elements with other successful community-based injury strategies,? Ebel says. ?Parent focus groups guided campaign messages, and the campaign impact was carefully evaluated. This program might serve as a useful model for other communities working on injury-prevention strategies.?
Dr. Frederick Rivara, a UW professor of pediatrics and adjunct professor of epidemiology, was principal investigator for the study. In addition to Rivara and Ebel, the study was conducted by Dr. Thomas Koepsell, a UW professor of epidemiology, and Elizabeth Bennett, M.P.H., health education manager for Children?s Hospital and Regional Medical Center.
