Study Identifies Need for New Approaches for Child Passenger Safety

Researchers Urge Targeted Safety Messages, Lower-Cost Child Safety Seats and Booster Seats for At-Risk Families

PHILADELPHIA, Dec. 5 -- A study released this week from researchers at The Children's Hospital of Philadelphia found that parents with a high school education or less are among the least likely to use appropriate child restraints, suggesting that current public education campaigns aimed at increasing car seat use may need to be better tailored to these families at highest risk for crash injury.

The study, published in the journal Traffic Injury Prevention, used information collected from parents involved in crashes reported to State Farm Insurance Companies(R) through the ongoing Partners for Child Passenger Safety (PCPS) research initiative. Using this data from real-life crashes, researchers identified specific socioeconomic factors associated with inappropriate restraint use for children under age nine. More than any other demographic factor, a parent's level of education has the biggest impact on whether or not they use age- and size-appropriate child restraints to protect their children in a crash. Children whose parents have a high school education or less put their children at highest risk of serious injury or death in a crash, because these children are 27 percent more likely to be inappropriately restrained compared with those whose parents have attended some college.

"What this research shows us is that broad educational campaigns to improve child passenger safety are no longer sufficient. Many parents who want to do the best for their children still do not understand the importance of booster seats in protecting their children," said Flaura Winston, M.D., Ph.D., who led the study and is Principal Investigator of PCPS. "In order to protect all children riding in cars, we need to develop more effective educational campaigns that provide a compelling and clear safety message which resonates with families who stand to benefit the most."

For the purpose of this study, the authors define inappropriate restraint as using a forward-facing seat for a child less than one year and 20 pounds, or using a seat belt rather than a car seat or booster seat for children younger than nine. Independent of educational level, the researchers found that African Americans, children with parents older than 35, and families with an income of $20,000 or less were also more likely to use inappropriate child restraints. Individually, each of these risk factors increases a child's likelihood of being inappropriately restrained by about 25 percent.

Children in the four- to eight-year-old age group had the highest likelihood of being improperly restrained, with 65 percent riding in an adult seat belt instead of in the appropriate car seat or booster seat.

Motor vehicle crashes are the leading cause of death and acquired disability among all U.S. children older than one year. Previous studies have shown that using age- and size-appropriate child restraints reduces a child's risk of injury in a crash to less than one percent. For all children under age nine, riding in an adult seat belt alone puts them at twice the risk of injury in a crash, compared with using the right car seat or booster seat for their age and size. In particular, these children are much more likely to suffer serious abdominal and spinal injuries, known as "seat belt syndrome," which are caused by an improper fit of the belt.

Data for this study were gathered from interviews with 3,818 parent- drivers who were in crashes involving 5,146 restrained children age nine and younger, between the years 2000 and 2004. These interviews were conducted as part of the ongoing research partnership of The Children's Hospital of Philadelphia and State Farm, Partners for Child Passenger Safety, that is the world's largest ongoing surveillance system of children involved in real-world crashes. The crashes occurred in 15 states in the Eastern, Midwestern, and Western United States.

"Studies like this one, that involve parents in the research, help us understand how to develop culturally relevant, effective educational campaigns based on the needs of specific groups of parents," said Dr. Winston, a pediatrician and biomechanical engineer at The Children's Hospital of Philadelphia.

The researchers identified strategies for improved educational efforts, including the need for separate educational tactics for parents who don't restrain their children at all, and for those who are incorrectly using seat belts. "Educational efforts need to take into account the parents' attitudes toward health, cultural and language factors, and children's resistance," said Dr. Winston. "Legislation and law enforcement can also play a role in convincing parents of the necessity of child restraints; and once a law is passed, educational campaigns should refer to the new law." Finally, because poverty is an important factor, the authors recommend increased availability of low-cost child restraints and booster seats for low-income families.

Children's Hospital researchers are currently working with the National Highway Traffic Safety Administration to better understand the challenges faced by African American and Hispanic parents with a high school education or less, and are testing interventions with parents to develop safety campaigns that are proven to reach the audiences who need the information most.

Parents seeking straightforward and accurate information about how to choose and install car safety seats or booster seats can visit http://www.chop.edu/carseat to find educational videos and information in both English and Spanish, or they can locate a certified child passenger safety technician in their community who will teach them how to install the seat properly.

About The Children's Hospital of Philadelphia-State Farm Alliance and Partners for Child Passenger Safety (PCPS)

Partners for Child Passenger Safety (PCPS) is a research initiative of The Children's Hospital of Philadelphia and State Farm(R). As of February 2005, PCPS has created a database containing information on more than 377,000 crashes involving more than 557,000 children from birth through age 15 years. It is the world's largest study of children in motor vehicle crashes.

About The Children's Hospital of Philadelphia

The Children's Hospital of Philadelphia was founded in 1855 as the nation's first pediatric hospital. Through its long-standing commitment to providing exceptional patient care, training new generations of pediatric healthcare professionals and pioneering major research initiatives, Children's Hospital has fostered many discoveries that have benefited children worldwide. Its pediatric research program is among the largest in the country, ranking third in National Institutes of Health funding. In addition, its unique family-centered care and public service programs have brought the 430-bed hospital recognition as a leading advocate for children and adolescents. For more information, visit http://www.chop.edu/.

About State Farm

State Farm(R) insures more cars than any other insurer in North America and is the leading U.S. home insurer. State Farm's 17,000 agents and 68,000 employees serve over 74 million auto, fire, life and health policies in the United States and Canada, and more than 1.8 million bank accounts. State Farm Mutual Automobile Insurance Company is the parent of the State Farm family of companies. State Farm is ranked No. 22 on the Fortune 500 list of largest companies. For more information, please visit statefarm.com(R) or in Canada statefarm.ca(TM).