Observed child restraint misuse in a large, urban community: Results from three years of inspection events.

PROBLEM: Child restraints (CRs) are vital for optimizing child passenger safety and reducing the risk of pediatric injury and fatality in motor vehicle crashes. However, most CRs are installed improperly. METHODS: This present study was an assessment of observed instances of CR misuse. Participants were recruited through advertisements for CR inspection events in Los Angeles County, California. Child Passenger Safety Technicians collected information about each child passenger, vehicle, and aspects of CR selection and installation. RESULTS: Of 693 CRs installed upon arrival, only 3.8% were used with no instances of misuse. The most common misuses were inappropriate use of the top tether and failure to secure the seatbelt in locked mode. CONCLUSIONS: The majority of observed CRs were installed with instances of misuse. CRs in newer vehicles were less likely to be installed in front of airbags and more likely to have the seatbelt routed inappropriately compared to those in older vehicles. Older children were more likely to be prematurely restrained in the front vehicle seat. PRACTICAL APPLICATIONS: The majority of CRs are installed improperly. We identified specific instances of CR misuse that are common in a large, urban community and present recommendations to improve child passenger safety practices and education.

A School-Hospital Partnership Increases Knowledge of Pedestrian and Motor Vehicle Safety.

Pedestrian and motor vehicle-related injuries are leading causes of morbidity and mortality in children. Trauma centers have specialized resources to conduct interventions that improve the safety of whole communities. In the present study, we evaluated the effectiveness of a school-hospital partnership in increasing knowledge of pedestrian and motor vehicle safety among students and parents in a large, urban community. Staff from a Level I pediatric trauma center conducted educational interventions in an urban public school district. Elementary school students participated in a pedestrian safety program, middle school students completed a community safety program, and high school students learned about the dangers of drunk and distracted driving. Students completed pre- and post-tests. Parents in the neighboring community received child passenger safety education at two child restraint (CR) inspection events. A total of 2203 students participated at a total of nine schools. Post-test scores were significantly higher than pre-test scores for students in all three age groups and within each grade level. At CR inspection events, 67 CRs were inspected, 49 (73 %) of which were replaced with new age- and weight- appropriate CRs. The most common instance of improper CR use was loose CR fit in vehicle seat (33 %). All 120 observed instances of misuse were corrected by a certified Child Passenger Safety Technician. Educational interventions effectively increased knowledge of pedestrian and motor vehicle safety among students and parents. We have demonstrated the utility of a school-hospital partnership for furthering knowledge of safety in an urban community.

Randomized controlled trial to evaluate the effectiveness of a video game as a child pedestrian educational tool.

BACKGROUND: Injury is the number one cause of death and disability in children in the United States and an increasingly important public health problem globally. While prevention of injuries is an important goal, prevention efforts are currently fragmented, poorly funded, and rarely studied. Among school-aged children, pedestrian crashes are a major mechanism of injury. We hypothesized that we could develop a game-based educational tool that would be effective in teaching elementary school children the principles of pedestrian safety. METHODS: Between November 2011 and June 2013, second- and third-grade children in Los Angeles Unified School District were randomly assigned to play a unique interactive video game (Ace's Adventure) about pedestrian safety or to a traditional didactic session about pedestrian safety. A pretest and posttest were administered to the study participants. Afterward, study participants were observed for appropriate pedestrian behavior on a simulated street set called Street Smarts. All statistical analyses were performed using SAS version 9.2. RESULTS: A total of 348 study participants took the pretest and posttest. There were 180 who were randomized to the didactic and 168 who were randomized to the video game. The didactic group demonstrated a higher mean score increase (1.01, p < 0.0001) as compared with the video game group (0.44, p < 0.0001). However, observation of study participants revealed that participants who played the video game, as compared with the didactic group, more frequently exhibited appropriate behavior during the following: exiting a parked car (p = 0.01), signaling to a car that was backing up (p = 0.01), signaling to a stopped car (p = 0.0002), and crossing the street (p = 0.01). CONCLUSION: Students who played the educational video game about pedestrian safety performed similarly to those who attended a more traditional and labor-intensive didactic learning. Innovative educational methods, such as game playing, could significantly change our approach to injury prevention and have the potential to decrease the burden of injury among children worldwide.