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Navneet Singh1, Julie Chambers2, James Hamill3
1Medical Student, University of Auckland, Auckland.
Insights
New Zealand child restraint use improved for 5-9 year olds after 2013 legislation, but declined for younger children. Parental knowledge of recommendations inversely correlated with compliance, suggesting a need for legislative review.
Area of Science:
- Pediatric Safety
- Public Health Policy
- Transportation Safety
Background:
- Child restraint practices in New Zealand have historically not met best practice recommendations.
- Child restraint legislation in New Zealand was amended in 2013.
Purpose of the Study:
- To assess current child restraint practices among children admitted to hospital.
- To evaluate changes in child restraint use following the 2013 legislative amendment.
Main Methods:
- Interviews were conducted with parents of 300 pediatric inpatients (aged 0-13 years).
- Data collected included usual child restraint use, restraint use during the hospital trip, and parental knowledge of laws and recommendations.
- Responses were compared to a 2013 pre-amendment survey.
Main Results:
- Child restraint use was high for children under 5 (97%).
- A significant increase in child restraint use was observed for 5-9 year olds post-amendment (OR 2.49).
- Child restraint use declined in children under 6, and parental knowledge inversely correlated with compliance.
Conclusions:
- Extending child restraint legislation to children older than seven years should be considered.
- Further research is needed to understand barriers to child restraint use and the impact of extended laws.
Aim:
Child restraint practices among New Zealand children have fallen short of best practice recommendations. In 2013, New Zealand child restraint legislation was amended. The aim of the present study was to determine the child restraint practices of a cohort of children admitted to hospital and how practices have changed since the amendment in child restraint legislation.
Methods:
We conducted interviews with the parents of 300 paediatric inpatients aged 0-13 years. Data were recorded on their child's usual child restraint use, the restraint used during their trip to hospital, and parental knowledge of child restraint law and best practice recommendations. We compared their responses with those of our survey published in 2013, which was performed before the amendment in child restraint legislation.
Results:
The median age of the 300 children was three years: 181 (60%) were aged 0-4 years, 65 (22%) 5-9 years and 54 (18%) 10-13 years. One hundred and thirty-six (45%) were girls. Of children <5 years of age, 97% always used a child restraint. Of children 5-9 years of age, 60% always used a child restraint, 12% sometimes and 28% never. A significantly greater proportion of 5-9 year-old children used a child restraint at least some of the time in the present study compared to the 2013 study (47/65 versus 27/53, OR 2.49 [95%CI 1.09-5.81]). Child restraint use declined in children <6 years of age. On their journey to hospital, five children used no restraint, four of whom were held in the arms of a caregiver. Parental knowledge of child restraint recommendations correlated inversely with their compliance with the recommendations (OR 0.33 [95%CI 0.11-0.91]).
Conclusions:
Consideration should be given to extending child restraint legislation to children older than seven years of age. Further studies could explore the barriers parents face to the use of child restraints and the potential effect of extending child restraint laws to older children.