Background: Motor-vehicles crashes are a leading cause of death among children. Age- and size-appropriate restraint use can prevent crash injuries and deaths among children. Strategies to increase child restraint use should be informed by reliable estimates of restraint use practices.
Objective: Compare parent/caregiver-reported and observed child restraint use estimates from the FallStyles and Estilos surveys with the National Survey of the Use of Booster Seats (NSUBS).
Methods: Estimates of child restraint use from two online, cross-sectional surveys-FallStyles, a survey of U.S. adults, and Estilos, a survey of U.S. Hispanic adults-were compared with observed data collected in NSUBS. Parents/caregivers of children aged ≤ 12 years were asked about the child's restraint use behaviors in FallStyles and Estilos, while restraint use was observed in NSUBS. Age-appropriate restraint use was defined as rear-facing child safety seat (CSS) use for children aged 0-4 years, forward-facing CSS use for children aged 2-7 years, booster seat use for children aged 5-12 years, and seat belt use for children aged 9-12 years. Age-appropriate restraint users are described by demographic characteristics and seat row, with weighted prevalence and corresponding 95% confidence intervals (CI) calculated.
Results: Overall, child restraint use as reported by parents/caregivers was 90.8% (CI: 87.5-94.1) (FallStyles) and 89.4% (CI: 85.5-93.4) for observed use (NSUBS). Among Hispanic children, reported restraint use was 82.6% (CI: 73.9-91.3) (Estilos) and 84.4% (CI: 79.0-88.6) for observed use (NSUBS, Hispanic children only). For age-appropriate restraint use, estimates ranged from 74.3% (CI: 69.7-79.0) (FallStyles) to 59.7% (CI: 55.0-64.4) (NSUBS), and for Hispanic children, from 71.5% (CI: 62.1-81.0) (Estilos) to 57.2% (CI: 51.2-63.2) (NSUBS, Hispanic children only). Conclusion and Practical Application: Overall estimates of parent/caregiver-reported and observed child restraint use were similar. However, for age-appropriate restraint use, reported use was higher than observed use for most age groups.
Keywords: Car seats; Child restraint; Hispanic; Motor vehicles.
Published by Elsevier Ltd.