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May 1, 2006

Building on parental safety concerns to motivate booster use among Latino families

Booster seats protect children from serious injury in motor vehicle crashes, yet research shows that parents are inconsistent in using booster seats to protect children 4-8 years of age. Children of Latino families are at greater risk as their parents are often ill-informed about the proper use of child-safety seats.

A community campaign highlighting the risks to child safety and the risk of a citation are likely to motivate booster seat use among Latino families, according to new research by investigators at the Harborview Injury Prevention & Research Center (HIPRC) and their colleagues. “Child Passenger Safety Behaviors in Latino Communities” is published in the May 2006 issue of the Journal of Health Care for the Poor and Underserved.

The researchers conducted one-to-one interviews with 91 mothers and fathers of booster-eligible Latino children in an urban county (King) and a rural county (Yakima) in Washington state between November 2003 and June 2004. Interviews were conducted in Spanish with parents who identified themselves as Latino and had at least one child between 4 and 8 years of age.

Of the parents interviewed, 48 parents (53 percent) reported they used a booster seat, and 43 parents (47 percent) were non-users. Most parents in both urban and rural counties reported an annual household income below $25,000, and parents who had completed high school were more likely to report booster seat use than those who had not.

Key motivators for booster users were child safety (94 percent), and concern about receiving a ticket (94 percent). Under current Washington state law, drivers receive a $101 ticket for each child passenger between 4 and 6 years of age or between 40 and 60 pounds who is not restrained in a booster seat. Among non-users, fear of receiving a ticket (79 percent) was cited more often than child safety (70 percent) as a potential motivator for using a booster seat. Of parents who were not using booster seats, 60 percent incorrectly believed their child was safe in just a seat belt.

Families in rural communities indicated that radio is the preferred method to reach Latino families, while families in urban communities said they prefer television. The preference for radio messages is an appealing target for radionovela intervention materials, delivering messages to parents while they are driving with their children. In Washington state there is currently little Spanish-language programming on free television broadcast channels, requiring a subscription service for access to Spanish language channels.

Most families thought booster seats were affordable or knew where to find inexpensive seats, however rural families were more likely to note that cost was a barrier. Coupling social marketing messages with cost-reduction strategies, such as the provision of discount coupons or low-cost seats, may help families to overcome these barriers.

“Latino parents care about their children’s safety but aren’t always aware of the most effective way to protect them in the event of a traffic crash,” says Dr. Beth Ebel, associate director of the HIPRC and lead author on the study. “Our study emphasizes behavioral factors that may be important to address in a targeted social marketing campaign. Based on these findings, we’re developing messages to be used in a community campaign.”

Materials developed for the campaign can be viewed at www.abrochatuvida.org. Targeted messages will be incorporated in radio and television novelas as well as printed brochures and posters, with the goal of increasing booster seat use among Latino parents. The researchers hope this formative research to understand behavioral factors will prove helpful in developing effective, targeted interventions to redress safety-related health disparities.

In addition to Ebel, the study was conducted by Gloria Coronado, Beti Thompson and Teri Martinez, all affiliated with the Cancer Prevention Program at the Fred Hutchinson Cancer Research Center in Seattle; Katharine Fitzgerald from Children’s Hospital and Regional Medical Center in Seattle; Dr. Frederico Vaca of the Center for Trauma and Injury Prevention Research at the University of California at Irvine; and Dr. Frederick Rivara of the HIPRC.

This research was funded by grants from the National Center for Injury Prevention and Control, the Washington Traffic Safety Commission, and the Robert Wood Johnson Foundation.