Pediatricians' knowledge, perceptions, and behaviors regarding car booster seats

Pediatricians are a recognized primary resource and advocate for injury prevention. The purpose of this study was to examine pediatricians' knowledge, perceptions, and behaviors regarding car booster seats and their willingness to use resources for parent education. Investigators implemented an anonymous, mailed survey to a national random sample of 1,041 US office-based pediatricians with 464 respondents: 53% female, 63% Caucasian, 52% parents of children under 12 years, and 87% board-certified. Fifty-two percent have counseled at least half of their families about booster seats. Sixty-nine percent rely on American Academy of Pediatrics (AAP) resources for counseling, and 87% agreed that counseling parents improves child outcomes in a motor vehicle crash. Fifty-seven percent said there were no barriers to booster seat counseling; 39% did not counsel parents about booster seats unless it is the reason for the office visit. Forty-seven percent lacked the time to counsel, and 81% were confident they were counseling according to AAP guidelines. Twelve percent were unsure of their state's booster seat laws. Significant relationships were found between responses to knowledge questions and suburban location, gender, race, length of time in pediatric practice. Many pediatricians are not counseling their patients' parents on booster seats but believe counseling is important; many are confident in their counseling but do not rely on AAP-recognized counseling resources. Education about state booster seat laws and AAP guidelines may be useful in increasing the cues to action pediatricians convey to parents regarding booster seat use.