title: Free child passenger restraints for patients in an urban pediatric medical home: effects on caregiver behavior.
abstract: BACKGROUND
  Motor vehicle crashes are a leading cause of death in children despite the availability of effective child passenger restraints that reduce morbidity and mortality. Inappropriate restraint is more common in minority and low-income populations. Removing barriers by distributing child passenger restraint systems (CPRS) and providing education has been 1 approach to improve child safety. The objective of this study was to evaluate the efficacy of providing no-cost CPRS in combination with targeted education to improve restraint use for low-income, minority, and urban children in a medical home.
  
  
  METHODS
  This prospective, non-randomized, community-based cohort study used a certified car seat technician to provide CPRS and training to the caregivers of 101 children when those caregivers reported not owning the appropriate type of restraint system during the index clinic visit.
  
  
  RESULTS
  In the first 3 months of follow-up, caregivers were 2.4 times more likely to report appropriate use of CPRS: relative risk 2.4 (95% confidence interval [CI] 1.7 to 3.5). Reported improvement declined slightly between months 4 and 9.
  
  
  CONCLUSIONS
  Appropriate restraint significantly improved, yet rates remained suboptimal. Multifactoral approaches are needed to understand why the set of patients studied and other at-risk populations may not use child restraints properly even when given access and information.
authors.affiliation: Injury Research Center, Medical College of Wisconsin, Downtown Health Center Pediatric Clinic, Milwaukee, WI 53233, USA. sbrixey@mcw.edu
authors.forename: Suzanne
authors.initials: S
authors.lastname: Brixey
authors.forename: Clare E
authors.initials: CE
authors.lastname: Guse
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ngui
mesh_terms: D001336:Automobiles; D017028:Caregivers / Q000523:psychology*; D002648:Child; D057207:Child Restraint Systems / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016012:Poisson Distribution; D011204:Poverty Areas; D011446:Prospective Studies; D014505:Urban Population; D014922:Wisconsin