An ecological model to factors associated with booster seat use: A population based study

Area of Science:

• Pediatric Safety
• Transportation Safety
• Public Health

Background:

• Belt-positioning booster seat (BPB) use is vital for preventing severe child injuries in car crashes.
• Children aged 4-7 years exhibit the lowest rates of age-appropriate car restraint use globally.
• Understanding BPB use determinants is essential for improving child passenger safety.

Purpose of the Study:

• To identify key individual, parent-child relationship, and neighborhood factors influencing belt-positioning booster seat (BPB) use.
• To analyze determinants of BPB usage in children aged 4-7 years.
• To provide insights for targeted interventions promoting child car safety.

Main Methods:

• Ecological model applied to analyze multilevel determinants of BPB use.
• Cross-sectional study involving a self-reported questionnaire completed by parents of 745 children (grades 1-2).
• Multilevel modeling used to assess individual, relational, and neighborhood-level variables.

Main Results:

• 56.6% of children reportedly used a BPB on every car trip.
• Positive determinants of BPB use included: number of children in family, parental seat belt use, parental knowledge of car safety, and authoritative parenting style.
• Child temperament and parental supervision were not significantly associated with BPB use.

Conclusions:

• Individual and parental factors significantly influence belt-positioning booster seat (BPB) use.
• Targeted interventions should focus on parental behaviors and knowledge to enhance BPB adoption.
• Neighborhood-level differences in BPB use were minimal, suggesting a stronger focus on family-level interventions.