Adult seat belt use: does the presence of children in the household make a difference?
OBJECTIVE
To obtain prevalence estimates of seat belt use among adults with and without at least one child in the household and to examine whether having at least one child in the household is associated with adult seat belt use.


METHODS
The Second Injury Control and Risk Survey (ICARIS-2) was a nationwide cross-sectional, list-assisted random-digit-dialing telephone survey of individuals who were at least 18 years old and who spoke either English or Spanish. ICARIS-2 was carried out from 2001 to 2003; a similar study, ICARIS-1, had been conducted in 1994. National estimates were calculated for the prevalence of adult seat belt use and stratified according to the presence or absence of children in the household. Prevalence estimates for the two ICARIS surveys were compared using t-tests. Multivariable logistic regression was used to explore the association between having at least one child in the household and self-reported adult seat belt use.


RESULTS
Based on the 9,684 completed household interviews in ICARIS-2, an estimated 15.9% (13 million) of drivers with children in their households did not always wear their seat belt when driving, and 17.5% (15 million) of adult passengers with children in their households did not always wear their seat belt while riding. The prevalence of drivers and passengers who did not always wear their seat belt decreased between ICARIS-1 and ICARIS-2. Both driver and passenger seat belt use were associated with the respondent's age, sex, ethnicity, level of education, current marital status, and self-reported alcohol-impaired driving or riding with an alcohol-impaired driver. Drivers with children in the household, living in the Northeast, North Central, and Southern census regions of the country were significantly more likely than those in the West to report wearing their seat belt less than always.


CONCLUSIONS
While seat belt use rates are increasing, many more lives could be saved by more complete restraint use. Effective strategies for increasing seat belt use rates and decreasing the number of both fatal and nonfatal motor vehicle injuries include primary enforcement laws, enhanced enforcement of seat belt use laws, and child safety-seat distribution combined with education programs.
Boyd
Rebecca
R
Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, Atlanta, Georgia 30341, USA.
Kresnow
Marcie-Jo
MJ
Dellinger
Ann M
AM
D000056:Accident Prevention / Q000379:methods; D000063:Accidents, Traffic / Q000517:prevention & control / Q000706:statistics & numerical data*; D000328:Adult; D000367:Age Factors; D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D006801:Humans; D007223:Infant; D015370:Infant Equipment / Q000706:statistics & numerical data; D008297:Male; D010287:Parent-Child Relations; D012307:Risk Factors; D012309:Risk-Taking; D012622:Seat Belts / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D012737:Sex Factors; D011795:Surveys and Questionnaires