title: Grandparents and child passenger safety.
abstract: OBJECTIVE
  This study compares child passenger safety (CPS) practices of grandparents versus parents and determines grandparents' opinions on car safety seats (CSS), barriers to use, and ways to transport grandchildren safely.
  
  
  METHODS
  Observational surveys were conducted on a convenience sample of drivers transporting children younger than sixteen years at 25 locations by certified child passenger safety technicians observing children in motor vehicles and recorded use of child passenger restraints. The drivers were surveyed on their knowledge, attitudes, beliefs, and practices regarding CPS. Data from drivers identifying themselves as grandparents were analyzed; also, three grandparent focus groups provided opinions on CPS practices.
  
  
  RESULTS
  During the study 1758 parents transporting 2713 children and 284 grandparents transporting 391 grandchildren were included. While most drivers were restrained and used child occupant restraints, almost 25% of parents and grandparents chose the incorrect seat to transport the child, and greater than 68% had at least one harness error. Grandparents were more likely to have looser lower anchor straps or seat belts and have children younger than thirteen years in the front seat. The focus group-grandparents had a favorable attitude toward CSS. Grandparents acknowledged the need for CSS but opined that CSS were difficult to use. Physical barriers included arthritis, back pain, mobility, decreased strength, and vision problems.
  
  
  CONCLUSIONS
  Grandparents and parents were equally likely to use CSS and choose correct seats. Compared to parents, grandparents were more likely to travel with their grandchildren with CSS installed with looser harnesses or an installed CSS with looser seat belt or lower anchors. Additionally, grandparents were more likely to have a child younger than thirteen years in the front seat. The use of community resources such as permanent fitting stations could help grandparents improve a grandchild's travel safety.
authors.affiliation: Department of Pediatrics, Section of Developmental Pediatrics, Riley Hospital for Children at Indiana University Health, 705 Riley Hospital Drive Room 1601, Indianapolis, IN 46202, USA. joeoneil@iupui.edu
authors.forename: Joseph
authors.initials: J
authors.lastname: O'Neil
authors.forename: Marilyn J
authors.initials: MJ
authors.lastname: Bull
authors.forename: James E
authors.initials: JE
authors.lastname: Slaven
authors.forename: Judith L
authors.initials: JL
authors.lastname: Talty
mesh_terms: D000293:Adolescent; D000328:Adult; D001334:Automobile Driving / Q000523:psychology / Q000592:standards / Q000706:statistics & numerical data; D002648:Child; D002654:Child Care / Q000379:methods / Q000592:standards; D057207:Child Restraint Systems / Q000706:statistics & numerical data*; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D007196:Indiana; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010290:Parents; D012449:Safety / Q000592:standards / Q000706:statistics & numerical data; D012622:Seat Belts / Q000706:statistics & numerical data*