title: Use and misuse of automobile child restraint devices.
abstract: OBJECTIVE
  To determine demographic, social, and behavioral characteristics that are associated with correct child restraint device (CRD) use.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Fast-food restaurant parking lots in southeastern Michigan.
  
  
  METHODS
  Children younger than age 4 years and their drivers.
  
  
  METHODS
  Consecutive sample.
  
  
  METHODS
  None.
  
  
  RESULTS
  Seven hundred seventeen child passengers were observed for 11 dimensions of CRD use and 661 of their drivers were interviewed. Three hundred ninety-four (55%) of the children were in CRDs, but 248 (63%) of those children were incorrectly restrained. A 43-point misuse index was constructed based on scores assigned for different types of misuse. Seven variables (ie, age of child, race of parent, driver as a parent, days driving, number of occupants, perceived comfort of CRDs, and belief that the social norm supports CRD use) were highly predictive of CRD use. In contrast, only three factors (ie, age of child, education of the driver, and knowledge of the CRD law) were minimally predictive of correct use.
  
  
  CONCLUSIONS
  Since correct use of CRDs represents such a complex behavior, the best strategy to address the widespread problem of CRD use may be through the design of less complicated CRDs.
authors.affiliation: Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill 27599.
authors.forename: L H
authors.initials: LH
authors.lastname: Margolis
authors.forename: A C
authors.initials: AC
authors.lastname: Wagenaar
authors.forename: L J
authors.initials: LJ
authors.lastname: Molnar
mesh_terms: D000367:Age Factors; D001336:Automobiles; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008824:Michigan; D044469:Racial Groups; D012622:Seat Belts / Q000706:statistics & numerical data; D012959:Socioeconomic Factors