title: Seat belt misuse among children transported in belt-positioning booster seats.
abstract: OBJECTIVE
  Observe and report seat belt use among children transported in belt-positioning booster seats.
  
  
  METHODS
  We conducted a cross-sectional, observational survey of children transported in motor vehicles between 2006 and 2007. While drivers completed a survey reporting the child's age, weight and gender, and the driver's age, gender, race, income, education, and relationship to the child; a child passenger safety technician recorded vehicle seating location, restraint type, and use of the car safety seat harness or seat belt as appropriate for the child.
  
  
  METHODS
  Twenty-five fast food restaurants and discount department stores throughout Indiana.
  
  
  METHODS
  A convenience sample of drivers transporting children younger than 16 years.
  
  
  METHODS
  Seat belt use among children transported in belt-positioning booster seats.
  
  
  METHODS
  Seat belt misuse.
  
  
  RESULTS
  Overall, 1446 drivers participated, 2287 children were observed with 564 children in belt-positioning booster seats. At least one seat belt misuse was observed for 64.8% of the children transported. Common misuses were the shoulder belt being placed over the booster seat armrest (35.8%); shoulder belt not at mid-shoulder position (28.5%), seat belt was too loose (24.5%), and the shoulder belt was either behind the child's back (9.1%) or under their arm (10.0%).
  
  
  CONCLUSIONS
  There is a high frequency of seat belt misuses among children transported in booster seats. Advice to parents on appropriate car seat selection, and encouragement to parents to supervise seat belt use may decrease misuse.
authors.affiliation: Riley Hospital for Children, Indiana University School of Medicine, 702 Barnhill Drive, Suite 1601, Indianapolis, IN 46202, USA. joeoneil@iupui.edu
authors.forename: Joseph
authors.initials: J
authors.lastname: O'Neil
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Daniels
authors.forename: Judith L
authors.initials: JL
authors.lastname: Talty
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Bull
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001334:Automobile Driving; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004868:Equipment Failure; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D015370:Infant Equipment; D008297:Male; D008875:Middle Aged; D012622:Seat Belts / Q000706:statistics & numerical data*; D055815:Young Adult