Analysis on influence of the self-confidence, motivation and authoritative advice factors on the use of child restraint / 中华流行病学杂志

Objective@#To establish the model of the self-confidence, motivation and authoritative advice factors influencing the use of child restraint and use structural equation model to test it to provide scientific basis for promoting the advocacy of use of child restraint.@*Methods@#Using multi-stage cluster random sampling method, 9 112 parents from the family with one or more private cars and 0-6 years old children in Shanghai and Shenzhen were investigated about the use of child restraint. A theoretical model of the self-confidence, motivation and authoritative advice factors influencing the use of child restraint was constructed. The theoretical model was validated and quantitatively analyzed by structural equation model.@*Results@#The overall model accords with the expected theoretical model, and the goodness of model fit was fine. The indicators had met the standard. RMSEA=0.03, CFI=0.97. The standardization coefficients of each route showed statistical significance (P<0.05). The standardization coefficients of the influence of authoritative suggestions and motives on self-confidence were 0.45 and 0.30 respectively, and the standardization coefficients of the influence of self-confidence on the use of child restraint was 0.40. The standardization coefficient of the influence of authoritative suggestions on motivation was 0.61.@*Conclusions@#In the advocacy of the use of child restraint, we should attach importance to the use of recommendations from experts and organizations with professional authority, good credibility and public welfare. We should take the status of children’s road traffic safety and the mechanism of the role of child restraint as one of the key points of propaganda.

Safety awareness and use of child safety seats among parents after the legislation in Shanghai / 中华创伤杂志(英文版)

PURPOSE@#To investigate the changes and underlying mechanisms in parents' safety awareness and the use of child safety seats after the mandatory legislation in Shanghai city, China.@*METHODS@#This study was carried out by Shanghai Key Laboratory of Environment and Children's Health using a multi-stage, simple random sampling method. Volunteers with children aged 0-12 months were recruited. Child safety seats were sent to each volunteer's family. Telephone encounters and/or on-site visits were used to collect data from parents using a phased survey on children's safety during car use.@*RESULTS@#Among all respondents, 91.2% had heard of motor vehicle accidents involving children, and 97.2% could describe the appropriate use of a safety seat to minimize the risk of child injury in a collision. Among 1078 families with newborns, awareness of child safety seats was 91.9%. There were 86% patients aware that new laws and regulations have been released regarding the use of child safety seats, and 98.5% of them plan to comply with the new laws. Moreover, 61% patients think that taxis should be routinely equipped with child safety seats.@*CONCLUSION@#The parents in Shanghai obtained a high level of awareness of children's traffic safety after the introduction of child safety seats legislation, and had a positive experience related to the use of child safety seats. Taxi may be an important area of focus for implementation of child traffic safety. Traffic safety laws and regulations with further impact should be continuously studied.

Current use of safety restraint systems and front seats in Korean children based on the 2008–2015 Korea National Health and Nutrition Examination Survey / 소아과

PURPOSE: The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children. METHODS: Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint systems and front seat use by children under six and 12 years of age, respectively. RESULTS: The percentage of respondents who said they always use safety restraint systems increased from 17.7% in 2008 to 45.0% in 2015. The rate of children who did not use the front seats at all was 47.3 % in 2008 compared to 33.4% in 2015. Multivariate logistic regression analysis showed a decrease in safety-restraint-system use as age increased (odds ratio, 0.63; 95% confidence interval [CI], 0.51–0.77). The use rate of front-passenger seat belts by the mother is significantly correlated with the safety-restraint- system use rate by children (odds ratio, 2.14; 95% CI, 1.12–4.06). CONCLUSION: Although the rate of safety-restraint-system use for children is increasing annually, it remains low. Additionally, the use rate of front passenger seats for children is high. To reduce the rates of injury and death of children from traffic accidents, it is necessary to educate on the appropriate use of safety restraint systems according to age and body size and to develop stronger regulations.

Use of child safety seats during transportation of newborns / 소아과

PURPOSE: Child safety seats (CSS) are critical for the protection of children, in case of motor vehicle accidents. Although the national legislation mandates that all newborns must be placed in an appropriately installed CSS during transportation, people often do not perceive the importance of CSS and do not use it as recommended. The purpose of this survey was to understand the use of CSS for the safe transport of newborns from hospital to home. METHODS: We interviewed parents of newborn infants, using a structured questionnaire, at the time of their discharge from Cheil General Hospital & Women’s Health Care Center, between May 2014 and July 2014. RESULTS: A total of 403 participants were interviewed. The rate of CSS use was only 14.9%. Overall, 76.4% of the families interviewed were not aware about the recommendations on CSS use for newborns when travelling in a car. The provision of education on using CSS significantly influenced their rate of use. Parents who were educated about mounting the CSS in a car used it more as compared with others (25.7% vs. 12.2%) (P=0.002). Furthermore, if parents had heard about the importance or necessity of CSS, they used it more than others did (19.5% vs. 10.6%, P=0.032). CONCLUSION: Despite the legal regulation, most parents transport their newborn infants without a CSS while traveling from hospital to their home. The rate of CSS use was influenced by parental education and their knowledge about its necessity. Education programs for parents must be reinforced to increase the CSS use.

Drivers’ Knowledge And Attitudes Towards Child Restraint System (Crs) Usage

@#Child restraint system (CRS) can protect children in the event of crash and reduce the severity of injuries. As such, it is crucial to understand the prevalence of CRS usage and knowledge attributes on CRS usage among drivers. This study aims to assessdrivers’ knowledge on CRS usage.A semi-structured questionnaire was developed and pilot tested to verify its validity and reliability. The questionnaireaddressesdrivers’ knowledge about CRS currently available in the Malaysian market, the types of restraints used and views on fitting restraints to passenger vehicles. Seventy four percentfrom 500 respondents cited that they are usingor theyhave used CRS,64% knowabout CRS and its function, and 43% areawareof ISOFIX. In short, majority of the respondents are aware of CRS use and functions. Awareness and education program should berigorously introduced to public towards the implementation of the CRS law.

TRANSPORTING CHILDREN IN CARS AND THE USE OF CHILD SAFETY RESTRAINT SYSTEMS

ABSTRACT Objective: To evaluate the transport of children in automobiles and the use of child restraints systems (CRS). Methods: This is a transversal descriptive study which included 200 vehicle drivers who carried 0-10 year old children in the city of São Luis, MA, Brazil. The drivers' passengers' and children's features were properly identified. The children's transportation using CRS were analyzed according to the Resolution 277/8 of the Brazilian National Traffic Department. Results: The transportation of children was classified as inappropriate in 70.5% of the vehicles analyzed. The most common way for children transportation was free on the back seats (47%) or on the lap of passengers/drivers (17%). The main reasons to justify the improper transportation were either not understanding the importance of CRS use (64.5%) or not having financial resources to buy the devices. The child safety seat was the most used CRS (50.8 %) among vehicles with proper child transportation system. Conclusion: The transportation of children was inappropriate in most of the vehicles analyzed, reflecting the need for creating awareness among automobile drivers, including education, supervision and improvement of policies for health improvement and prevention of accidents involving children transportation. Level of Evidence III, Cross Sectional Study.

A survey among guardians on child restraint system (crs) usage in central peninsular Malaysia

Children are much more likely than adults to get serious injuries in car crashes due to their softer bones, weaker neck muscle and fragile bodies. Child restraint system (CRS) can help in reduce injury and prevent fatality in the event of a crash. Thus the aim of this paper is to gauge the prevalence of CRS usage among guardians of children age below 11 years old. A survey to addressed guardians knowledge on CRS usage, practice and their views on fitting child restraints system to their vehicles were carried out among parents and carers who are caring children aged 11 years old and below. Seventy-four percent (74%) out of 500 respondents cited they have used CRS, however only 40% of them is currently using CRS with their children. Respondent in Kuala Lumpur and younger guardians reported twice likely to use CRS. In addition, graduate respondents are 1.5 times more likely to use CRS for their children. In conclusion, high incorrect usage rate and understanding of the CRS could promote additional injury towards the children in a car crash. Many initiatives could be introduced before the implementation of the CRS law in Malaysia such as awareness, community-based programs and CRS clinics that aim to guide guardians on the correct and effective way of installing the CRS device in their car

Analysis on influencing factors for child restraint system use in Shanghai and Shenzhen, China / 中华流行病学杂志

Objective To understand the factors related with child restraint system (CRS) use,and provide evidence for the development of appropriate intervention measures to promote the use of CRS for the protection of child passengers' safety.Methods Self-administrated questionnaire survey was conducted among 0-6 years old children' s parents who owned private cars selected through stratified cluster random sampling in Shanghai and Shenzhen to collect date about CRS use and related factors.Group discussion was conducted among some of the parents randomly selected to further understand the reasons for using or not using CRS.Results Of 7 528 parents surveyed,39.23 ％ (2 820/7 189) reported to have CRS and 17.14％(1 232/7 189) reported consistent use of CRS.Multivariate analysis indicated that young age of children,high level of education of parents,good family economic status,awareness of importance of children's safety were the positive factors for CRS use.The frequency and distance of children' car taking and the seatbelt use of drivers significantly influenced the CRS use.The main reasons for not purchasing CRS included limited car space (53.33％,2 329/4 367),low frequency of children car taking (48.55％,2 120/4 367),difficulty in installation (42.25％,1 845/4 367),high cost (38.58％,1 685/4 367),and unreliable quality (31.03％,1 355/4 367).The main reasons for not using CRS included children' s refusal (67.36％,293/435),short travel distance (53.79％,234/435),difficulty in installation or use (53.10％,231/435),limited car space (32.41％,141/435),and unnecessary (25.75％,112/435).Conclusions Parents have gaps and misunderstandings in using CRSs to protect child passengers safety.There are demands of technical guiding service in use of CRS.Integrated intervention measures should be implemented targeting at the identified barriers and needs in CRS use to promote child passenger safety,which include strengthening the propaganda and education,promoting the legislation and law enforcement,strengthening market supervision,establishing CRS related services site,exploring the rental market,etc.

Mandatory Child Restraints: A KAP Study among Parents and Nursery Instructors.

Aims: New road traffic injury (RTI) laws in Iran still neglects the importance of child restraint in automobiles. The objective of this study is to determine the Knowledge, Attitude and Practice (KAP) on the mandatory use of child restraint among parents and nursery instructors. Study Design: An observational KAP study Place and Duration of the Study: City of Tehran capital of Iran, between June 2013 and November 2013. Methodology: An observational KAP study was carried out (using a self-administered questionnaire and a Likert scale) on 403 parents, which children were less than 13 years old and nursery instructors both residing in Tehran by a stratified randomized sampling. Twelve elementary schools and six nurseries were selected randomly. Validity and reliability of questionnaires were determined using the content validity and test re-tests. Subjects were selected randomly and data was collected by trained interviewers, after obtaining consent forms from the subjects. Results: The majority (71%) of parents was female, aged 36.7±5.6 (range: 25-59). Half of the parents did not have any knowledge about child restraint laws and its implementation in the country. The knowledge among subjects about different kinds of child restraints, according to the child’s age and weight, was 22.6%. Only 28% of subjects use child restraints for their children. A significant difference was observed between subjects' use of child restraints and their region of residency. Low use of child restraints was observed among 30-40 years old age group (p=0.05). Willingness to a pay extra cost to buy a better quality of child restrain was 56%. Willingness to participate in a national child restraint educational program was of 70%. The rate of community agreement to a mandatory use of child restraint in the country was 85%. Conclusion: Knowledge and practice related to usage and kind of child restraint adjusted with child weight were low among the parents and nursery instructors. The rate of a community agreement to set a mandatory use of child restraint in the country was high.

Awareness and adoption of child restraint seats in cars in an Indian city.

Background: Protective measures for children like restraints and booster seats are seldom used in developing countries. The thriving Indian economy has resulted in booming car sales, particularly in urban areas, unfortunately the number of car crashes and accidents on roads have also increased manifold. Objective of current study was to evaluate the awareness and usage of child safety measures in cars in an Indian city. Methods: 150 parents were given a self-report questionnaire and their views, practices and attitude towards child restraint seats and booster seats were assessed. Results: Only 22% of parents used child restraints and 11% used booster seats. Among the users, 73% (infant seats) and 84% (booster seats) admitted to inadequate knowledge about installation and utilization. Conclusion: Usage and knowledge about child safety measures in cars is abysmal. Measures to improve adoption of car safety devices will have substantial and tangible benefits.

Sentimentos de pais de crianças acidentadas em automóveis sem uso de assento de segurança infantil / The feelings of parents of children victims of accidents in automobiles without child restraint systems / Sentimientos de padres de niños accidentados en automóviles sin utilizar el asiento de seguridad infantil

Os acidentes se configuram em um problema de saúde pública no Brasil. O objetivo deste estudo foi compreender a experiência de pais de crianças vítimas de acidentes automobilísticos sem a utilização de Assento de Segurança Infantil (ASI) ocorridos em Londrina, Paraná, de 2008 a 2011. Estudo exploratório de abordagem qualitativa. Os participantes foram 17 pais de crianças de zero a oito anos, atendidas pelo Sistema Integrado de Atendimento ao Trauma de Emergência (SIATE) e encaminhadas a hospitais. A análise dos dados se deu através da análise de conteúdo, resultando em duas categorias: Acidente de trânsito: quem está a salvo?; Sentimentos no momento do acidente. Concluiu-se que as pessoas não acreditam que acidentes possam acontecer consigo ou com pessoas próximas. Sentimentos de nervosismo são os observados no momento do acidente. A educação se mostra como ponto de partida para o uso do ASI, daí a importância do enfermeiro como profissional educador.

Accidents are a public health problem in Brazil. The objective of this study was to understand the experience of parents of children victims of automobile accidents without a child restraint systems (CRS) taken place in Londrina, Paraná, from 2008 to 2011. This exploratory study was performed with a qualitative approach. The participants were 17 parents of children of ages zero to eight years, seen by the Integrated Emergency Trauma Care Service and referred to hospitals. The data analysis was performed using content analysis, which revealed two categories: Traffic accidents: who is safe?; Feelings at the time of the accident. In conclusion, people do not believe that accidents may happen with them or with close ones. Feelings of nervousness are observed at the time of the accident. Education is a starting point for using the CRS, thus the importance of nurses as educators.

Los accidentes constituyen un problema de salud pública en Brasil. Se objetivó comprender la experiencia de padres de niños víctimas de accidentes automovilísticos sin utilización de Asiento de Seguridad Infantil (ASI) sucedidos en Londrina-PA, de 2008 a 2011. Estudio exploratorio de abordaje cualitativo. Participaron 17 padres de niños de 0 a 8 años, atendidos por el Sistema Integrado de Atención del Trauma de Emergencia (SIATE) y derivados a hospitales. Datos analizados por análisis de contenido, resultando dos categorías: "Accidente de tránsito, ¿quién está a salvo?"; "Sentimientos al momento del accidente". Se concluye en que las personas no creen que puedan ocurrir accidentes a sí mismos o a personas próximas. Se observan sentimientos de nerviosismo al momento del accidente. La educación se muestra como punto de partida para el uso del ASI, de allí la importancia del enfermero como educador.

La seguridad en el transporte de los niños: ¿Qué responsabilidad tenemos los pediatras? / Safe transportation of children: what is our responsability as pediatricians?

En 2009 murieron en la Argentina 564 niños de 0 a 14 años en accidentes de tránsito, cuya tasa de mortalidad es de 56/100 000 habitantes, el 858% con respecto a Suecia, el país con menor tasa. El 50% viajaban en automóviles; el 30%, en vehículos pesados; el 16,3% murieron en vuelcos, y el 4,5%, en vehículos de dos ruedas. Las lesiones graves y la muerte son más frecuentes en los bebés menores de 1 año. Las sillas de seguridad adecuadas evitan la muerte del 71% de los niños menores de 1 año y del 54% de los de 1 a 6 años. Motivar un mayor uso requiere un trabajo interdisciplinario entre el obstetra y el pediatra para asesorar a la familia. El Estado y las instituciones deben acompañar esta campaña para disminuir los accidentes mortales y sus secuelas.

During 2009, 564 children died in Argentina from 0 to 14 in traffic accidents. The mortality rate for road accidents is 56/100 000 inhabitants and is 858% when compared to Sweden, the country with the lowest rate. Fifty percent were children transported in cars, 30% in heavy duty vehicles, 16.3% died when the vehicle overturned and 4.5% died in two wheeled vehicles. Serious injuries and death are more frequent in babies less than a year old. Seventy one per cent of children under 1 year old and 54% of those between 1 and 6 years old would avoid death in an accident if transported in adequate safety seats. This requires a joint effort between obstetricians and pediatricians to inform the family about the right type of safety seat. The State and other institutions should accompany this campaign to reduce the number of fatal accidents and their consequences.

Road safety legislation in the Americas / Legislación sobre seguridad vial en las Américas

Legislating five of the main risk factors for road traffic injuries (RTIs), as much as enforcing the law, is essential in forging an integral culture of road safety. Analysis of the level of progression in law enforcement allows for an evaluation of the state of world regions. A secondary analysis of the 2009 Global status report on road safety: time for action survey was undertaken to evaluate legislation on five risk factors (speed management, drinking and driving, motorcycle helmet use, seatbelt use, and use of child restraints) in the Americas. Laws were classified depending on their level of progression: the existence of legislation, whether the legislation is adequate, a level of law enforcement > 6 (on a scale of 0-10), and whether the law is considered comprehensive. A descriptive analysis was performed. The totality of the countries has national or subnational legislation for at least one of the five risk factors. However, 63% have laws on the five risk factors studied, and none of them has comprehensive laws for all five. Seatbelt use appears to be the most extended enforced legislation, while speeding laws appear to be the least enforced. There are positive efforts that should be recognized in the region. However, the region stands in different stages of progression. Law enforcement remains the main issue to be tackled. Laws should be based on evidence about what is already known to be effective.

La legislación sobre cinco de los principales factores de riesgo de sufrir lesiones causadas por el tránsito, así como el cumplimiento de la ley, son esenciales para forjar una cultura integral de seguridad vial. El análisis del nivel de progresión en el cumplimiento de la ley permite evaluar el estado de las regiones del mundo. Se llevó a cabo un análisis secundario de la encuesta Informe sobre la situación mundial de la seguridad vial: es hora de pasar a la acción, de 2009, para evaluar la legislación sobre cinco factores de riesgo (control de la velocidad, conducir bajo la influencia del alcohol, uso del casco al conducir motocicletas, uso de cinturones de seguridad y uso de sistemas de retención para niños) en las Américas. Las leyes se clasificaron según su nivel de progresión: la existencia de legislación, si la legislación es adecuada, un nivel de cumplimiento de la ley > 6 (en una escala de 0-10) y si la ley se considera integral. Se realizó un análisis descriptivo. Todos los países tienen legislación nacional o subnacional al menos con respecto a uno de los cinco factores de riesgo; sin embargo, 63% tienen leyes sobre los cinco factores de riesgo estudiados, y ninguno de ellos tiene leyes integrales para los cinco. La legislación sobre uso de cinturones de seguridad parece ser la de mayor cumplimiento, mientras que las leyes de exceso de velocidad parecen ser las que menos se cumplen. En la región hay esfuerzos positivos que deben reconocerse; sin embargo, existen diferentes etapas de progresión. El cumplimiento de la ley sigue siendo el principal tema por abordar. Las leyes deben basarse en datos de eficacia reconocida.

Análise de metodologias de pesquisa sobre utilização de assentos de segurança infantil: lições de um projeto piloto / Analysis of research methodologies about the use of child restraint systems: lessons of a pilot project

OBJETIVO: Analisar metodologias de pesquisa sobre a utilização de assentos de segurança infantil. MÉTODOS: Quatro metodologias de pesquisa foram aplicadas, a fim de verificar o uso de assentos para transporte infantil em veículos que levavam crianças menores de quatro anos a uma creche, durante um dia letivo: inspeção sem entrevista, inspeção com entrevista, questionário auto-aplicativo e filmagem digital. As metodologias foram analisadas quanto à aceitação por parte dos sujeitos de pesquisa, capacidade de obtenção de dados e concordância de dados captados por instrumentos distintos. Aplicou-se análise de concordância (coeficiente de Kappa) para avaliar a homogeneidade dos dados obtidos pelas diversas metodologias. RESULTADOS: Foram observados 56 veículos, 75 por cento deles com filmagem. O retorno do questionário auto-aplicado ocorreu em 70 por cento. A capacidade de captação de dados foi de 99 por cento para inspeção sem entrevista, 97 por cento para inspeção com entrevista e 84 por cento para filmagem digital. A inspeção sem entrevista mostrou-se mais concordante com os dados filmados. CONCLUSÕES: O alto índice de retorno do questionário auto-aplicável pode ter sido favorecido pelas características da população estudada. A filmagem mostrou-se inadequada por questões éticas e técnicas, além de considerável índice de recusa; porém, foi útil para indicar a confiabilidade da inspeção sem entrevista em relação ao local de assento das crianças. Detectou-se falha dos instrumentos em captar o gênero dos ocupantes dos veículos. Altos índices de captação de dados atestaram a aptidão das metodologias de inspeção com e sem entrevista para explorar a utilização de assentos de segurança infantil.

OBJECTIVE: Analyze research methodologies about the utilization of child restraint systems. METHODS: In order to verify child restraint systems used in vehicles that transported children up to four years old to one day care center, during a single study day, four methods were applied: inspection without interview, inspection with interview, self-applied questionnaire and digital filming. These methods were analyzed regarding their acceptance by research subjects, their ability to retrieve data and regarding agreement of the data recovered by the different tools, according to Kappa coefficient. RESULTS: Fifty-six vehicles were observed - 75 percent of them by filming. The rate of return of the self-applied questionnaire was 70 percent. The ability to recover data was 99 percent for inspection without interview, 97 percent for inspection with interview and 84 percent for digital filming. Inspection without interview had the better agreement towards digital filming for data retrieving. CONCLUSIONS: The high index of self-applied questionnaire return may be related to characteristics of the studied population. Filming was not suitable due to ethical and technical reasons and considering the high refusal rate, but it was useful to show agreement with inspection without interview of infant retaining device placement. The tools failed to identify the gender of the passengers. The high index of the data recover indicates the ability of the inspection methodologies to explore the use of child restraint system.