Introduction
While child restraint systems are effective in protecting children from crash-related
injuries and deaths, their use in China is extremely low. This study assessed the
effectiveness of child restraint system education with and without behavioral skills
training on improved use and explored participants’ views regarding content and delivery
of an onsite intervention and online (WeChat) boosters.
Study design
A randomized trial was conducted in 6 kindergartens from May 2017 to January 2018
in Shantou and Chaozhou, China. Selected kindergartens were randomly assigned to 3
groups: (1) control, (2) child restraint system education‒only, and (3) child restraint
system education plus behavioral skills training. Analysis was conducted in May 2018.
Setting/participants
Participants were parents from the selected kindergartens.
Intervention
Both intervention groups received child restraint system education that included one-time
onsite education and biweekly online boosters for 3 months using an app to deliver
education messages.
Main outcome measures
Survey questions included parent knowledge, attitude and behaviors of child restraint
system use, and opinions related to the content and delivery of the onsite intervention
and online boosters.
Results
Child restraint system use in both intervention groups was higher than that of the
control group post-intervention (27.3% and 31.7%, respectively). Compared with the
control group, the intervention groups had a higher percentage of correct answers
to all 9 items, except Item 7 measuring the parents’ knowledge, attitude, and behaviors
of child passenger safety after the intervention. Lower parent's level of education
(OR=7.00, 95% CI=2.62, 18.70) and older child age (4 years: OR=3.92, 95% CI=1.08,
5.28; 5 years: OR=2.08, 95% CI=1.52, 5.31) were associated with lower rates of child
restraint system use. Most parents (92.3%) preferred the online over the onsite intervention
component.
Conclusions
An education intervention was effective in improving parents’ knowledge, attitude,
and practice of child restraint system use. A social media intervention booster (WeChat)
may provide a new channel to help promote child passenger safety in China.
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REFERENCES
- Incidence of road traffic injury and associated factors among patients visiting the emergency department of Tikur Anbessa Specialized Teaching Hospital, Addis Ababa, Ethiopia.Emerg Med Int. 2014; 2014439818
- Effectiveness of child safety seats vs safety belts for children aged 2 to 3 years.Arch Pediatr Adolesc Med. 2007; 161: 65-68
- Effectiveness of child safety seats vs seat belts in reducing risk for death in children in passenger vehicle crashes.Arch Pediatr Adolesc Med. 2006; 160: 617-621
- Effectiveness of belt positioning booster seats: an updated assessment.Pediatrics. 2009; 124: 1281-1286
- Effects of seating position and appropriate restraint use on the risk of injury to children in motor vehicle crashes.Pediatrics. 2005; 115: e305-e309
- Committee on Injury, Violence, and Poison Prevention. Child passenger safety.Pediatrics. 2011; 127: e1050-e1066
- Global Status Report on Road Safety 2018.World Health Organization, Geneva, Switzerland2018 (Licence: CC BY-NC-SA 3.0 IGO)
- An observational study of child safety seat use in an international safe community: Tehran, Iran.Traffic Inj Prev. 2017; 18: 88-94
- Has child restraint system use increased among parents of children in Shantou, China?.Int J Environ Res Public Health. 2016; 13: 964
- Parents’ knowledge, attitude, and use of child restraints, Shantou, China.Am J Prev Med. 2014; 46: 85-88
- Hospital-based program to increase child safety restraint use among birthing mothers in China.PLoS One. 2014; 9e105100
- Parent-based intervention to improve child restraint use among kindergarteners in China.Am J Public Health. 2018; 108: 1524-1526
- Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase use of child safety seats.Am J Prev Med. 2001; 21: 31-47
- Newborn parent based intervention to increase child safety seat use.Int J Environ Res Public Health. 2016; 13: 777
- Medical Statistics.People's Medical Publishing House, Beijing, China2014
- An exploratory study of parents’ use and knowledge of car safety seats in Beijing, China.Int J Inj Contr Saf Promot. 2010; 17: 231-238
- Parents’ experience with child safety restraint in China.BMC Public Health. 2014; 14: 318
- The influence of parental education and other socio-economic factors on child car seat use.Zdr Varst. 2017; 56: 55-64
- Children at risk: predictors of car safety seat misuse in Ontario.Accid Anal Prev. 2008; 40: 1418-1423
Article Info
Publication History
Published online: April 23, 2020
Identification
Copyright
© 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
