title: Child safety restraint use among children attending day care centers.
abstract: OBJECTIVE
  To estimate the prevalence of child safety restraint use and factors associated.
  
  
  METHODS
  Observational cross-sectional study using a stratified sampling conducted in the city of Maringá, Southern Brazil, between March and May 2007. Each day care center was visited at one day only. The outcome was use of child safety restraints by children under four. Vehicles (N=301) driving children under four were approached and information was collected using semi-structured questionnaires. Variables regarding child and adult seat distribution, use of safety restraints by occupants and driver's gender were analyzed. Data analyses included Fisher's exact test, Mantel-Haenszel chi-square test, and logistic regression.
  
  
  RESULTS
  Of the drivers approached, 51.8% were using seat belts (60.4% among women, 44.9% among men). Among children, 36.1% were using child safety seats, 45.4% were unrestrained during traveling, 16.0% were seated on an adult lap, and 2.7% were using seat belts. The logistic regression showed the following factors affecting child safety restraint use: child age under 15 months (OR = 3.76); seat belt use by the driver (OR = 2.45); and children from socio-occupational condition with higher income and education (OR = 1.37).
  
  
  CONCLUSIONS
  Child safety restraint use was associated to child age, seat belt use by the driver, and socio-occupational condition of day care centers. The finding of low rates of child safety restraint use poses a challenge to preventive medicine in Brazil, requiring attention and action to promote its widespread use.
authors.affiliation: Departamento de Medicina, Universidade Estadual de Maringá, Maringá, PR, Brasil. sergiolopes.uem@gmail.com
authors.forename: Sergio Ricardo Lopes de
authors.initials: SR
authors.lastname: Oliveira
authors.forename: Maria Dalva de Barros
authors.initials: MD
authors.lastname: Carvalho
authors.forename: Rosângela Getirana
authors.initials: RG
authors.lastname: Santana
authors.forename: Gabriela C S
authors.initials: GC
authors.lastname: Camargo
authors.forename: Ludmila
authors.initials: L
authors.lastname: Lüders
authors.forename: Simone
authors.initials: S
authors.lastname: Franzin
mesh_terms: D000328:Adult; D001334:Automobile Driving / Q000592:standards*; D001938:Brazil; D002648:Child; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D057207:Child Restraint Systems / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017149:Private Sector; D017150:Public Sector; D012149:Restraint, Physical / Q000706:statistics & numerical data; D012449:Safety; D012622:Seat Belts / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors