Reviews of evidence regarding interventions to increase use of child safety seats
Related Experiment Video
Updated: Jul 17, 2026
A Test Bed to Examine Helmet Fit and Retention and Biomechanical Measures of Head and Neck Injury in Simulated Impact
Published on: September 21, 2017
S Zaza1, D A Sleet, R S Thompson
1Division of Prevention Research and Analytic Methods, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA. szaza@cdc.gov
Insights
Child safety seat laws and distribution plus education programs are effective in preventing child traffic fatalities. These strategies, along with community campaigns and incentives, significantly reduce injury and death risks for young children in vehicles.
Area of Science:
- Public Health
- Injury Prevention
- Traffic Safety
Background:
- Motor vehicle crashes caused nearly 600 deaths in children under 4 in 1998.
- A significant percentage of young children (29%) were not secured in appropriate restraints.
- Properly used child safety seats reduce hospitalizations by 69% and deaths by up to 70%.
Purpose of the Study:
- To systematically review the effectiveness of interventions aimed at increasing child safety seat usage.
- To identify evidence-based strategies for reducing child passenger injuries and fatalities.
Main Methods:
- A systematic review of scientific evidence was conducted.
- Five interventions to increase child safety seat use were evaluated.
- Over 3500 citations were screened, with 72 meeting inclusion criteria for the reviews.
Main Results:
- Strong evidence supports the effectiveness of child safety seat laws and distribution plus education programs.
- Community-wide campaigns, enhanced enforcement, and incentive programs also showed sufficient evidence of effectiveness.
- Education-only programs demonstrated insufficient evidence of effectiveness.
Conclusions:
- Four of the five reviewed interventions have evidence of effectiveness.
- This scientific evidence can support resource allocation and commitment for implementing effective strategies.
- Implementing evidence-based interventions is crucial for improving child passenger safety.
Background:
In 1998, nearly 600 child occupants of motor vehicles aged younger than 4 years died in motor vehicle crashes. Yet approximately 29% of children aged 4 years and younger do not ride in appropriate child safety seat restraints, which, when correctly installed and used, reduce the need for hospitalization in this age group by 69% and the risk of death by approximately 70% for infants and by 47% to 54% for toddlers (aged 1 to 4 years).
Methods:
The systematic review development team reviewed the scientific evidence of effectiveness for five interventions to increase child safety seat use. For each intervention, changes in the use of child safety seats or injury rates were the outcome measures evaluated to determine the success of the intervention. Database searching was concluded in March 1998. More than 3500 citations were screened; of these citations, 72 met the inclusion criteria for the reviews.
Results:
The systematic review process identified strong evidence of effectiveness for child safety seat laws and distribution plus education programs. In addition, community-wide information plus enhanced enforcement campaigns and incentive plus education programs had sufficient evidence of effectiveness. Insufficient evidence was identified for education-only programs aimed at parents, young children, healthcare professionals, or law enforcement personnel.
Conclusions:
Evidence is available about the effectiveness of four of the five interventions we reviewed. This scientific evidence, along with the accompanying recommendations of the Task Force elsewhere in this supplement, can be a powerful tool for securing the resources and commitment required to implement these strategies.
