title: Discrepancies between knowledge and practice of childhood motor vehicle occupant safety in Nova Scotia--a population-based study.
abstract: OBJECTIVE
  To determine discrepancies between knowledge and practice of childhood motor vehicle restraints (CMVRs) and vehicle seating position amongst parents within the province of Nova Scotia.
  
  
  METHODS
  Random telephone survey.
  
  
  METHODS
  The Canadian province of Nova Scotia.
  
  
  METHODS
  Four hundred and twenty-six households with at least one child under the age of 12 years, totaling 723 children.
  
  
  METHODS
  The proportion of parents whose children who should be in a specific stage of CMVR and sitting in the rear seat of the vehicle, and who demonstrate correct knowledge of that restraint system and seating position, yet do not use that restraint system/seating position for their child (demonstrate practice discrepant from their knowledge).
  
  
  RESULTS
  Awareness of what restraint system to use is good (>80%). However, knowledge of when it is safe to graduate to the next stage is low (30-55%), most marked for when to use a seatbelt alone. Awareness of the importance of sitting in the rear seat of a vehicle was universal. Discrepancies between knowledge and practice were most marked with booster seats and rear-seating of older children. Factors influencing incorrect practice (prematurely graduated to a higher-level restraint system than what is appropriate for age and weight) included lower household income, caregiver education level, and knowledge of when to graduate from forward-facing car seats and booster seats. Incorrect practice was also more commonly observed amongst children of weight and/or age approaching (but not yet reaching) recommended graduation parameters of the appropriate CMVR.
  
  
  CONCLUSIONS
  Discrepancies between knowledge and practice are evident through all stages of CMVRs, but most marked with booster seats. The roles of lower socioeconomic status and gaps in CMVR legislation, in influencing discrepant practice, must be acknowledged and suggest the need for targeted education concurrent with development of comprehensive all-stages CMVR policies.
authors.affiliation: Division of Pediatric General Surgery, IWK Health Centre, 5850 University Avenue, Halifax, NS, Canada B3 J 3G9. natalie.yanchar@iwk.nshealth.ca
authors.forename: Natalie L
authors.initials: NL
authors.lastname: Yanchar
authors.forename: Susan A
authors.initials: SA
authors.lastname: Kirkland
authors.forename: John C
authors.initials: JC
authors.lastname: LeBlanc
authors.forename: Donald B
authors.initials: DB
authors.lastname: Langille
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D000367:Age Factors; D001835:Body Weight; D002648:Child; D057207:Child Restraint Systems / Q000592:standards / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003625:Data Collection; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007407:Interviews as Topic; D009674:Nova Scotia; D010290:Parents / Q000193:education*; D012449:Safety / Q000592:standards; D012622:Seat Belts / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000517:prevention & control*