title: Opportunities, threats and barriers to enacting mandatory child car restraint laws in Iran.
abstract: Approximately one-third of Iranian children's deaths are caused by injuries. Of these, 36% result from road traffic injuries (RTIs). Both RTIs and fatalities could be reduced by using child car restraints (CCRs). Despite their demonstrated effectiveness, CCRs are not mandatory in Iran. This study was conducted to assess opportunities and barriers in enacting mandatory CCR laws in that country. Using mixed method research, a phenomenological approach was used to explore the experiences and perspectives of road safety stakeholders in regard to opportunities and threats in enacting mandatory CCR laws in Iran. The themes derived from group discussions were used to first develop a structured questionnaire, which was later distributed to and completed by study participants. The study analysis was conducted using scores and rankings from the responses to these questions. Twenty-eight stakeholders participated in the study. Most were male, aged 36.7 ± 5.6 (range 25-59). In terms of identifying the organization that should establish mandatory CCR laws, the Traffic Police Department achieved the highest score of 90 (range 0-100). The participants also thought that the Traffic Police department is responsible to monitor compliance and conduct follow-up investigations (score = 100). In regard to existing barriers in enacting CCR laws, the lack of positive Publicity by mass media and the lack of related laws received scores of 85 and 70, respectively. Enabling factors and opportunities included 'positive regards or attitude of families towards their child's health,' 'officials' commitment to support such laws' and 'having adequate resources to raise community awareness of the importance of CCR use. These received scores of 83, 69 and 68, respectively. The results suggest that cooperation and collaboration among stakeholders including the Traffic Police, families and local communities are needed to maximize the likelihood of mandating CCR laws.
authors.affiliation: a Safety Promotion and Injury Prevention Research Center, School of Public Health , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Soori
authors.affiliation: b Safety Promotion and Injury Prevention Research Center , Shahid Beheshti University of Medical Science , Tehran , Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Ainy
authors.affiliation: c Department of Psychiatry , Charles R. Drew University of Medicine and Science of California , Los Angeles , CA , USA.
authors.forename: Shahrzad
authors.initials: S
authors.lastname: Bazargan-Hejazi
mesh_terms: D000056:Accident Prevention / Q000331:legislation & jurisprudence*; D000063:Accidents, Traffic / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D001334:Automobile Driving / Q000331:legislation & jurisprudence*; D002648:Child; D057207:Child Restraint Systems; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D007223:Infant; D007492:Iran; D008297:Male; D037141:Mandatory Programs / Q000331:legislation & jurisprudence*; D020380:Needs Assessment; D012449:Safety; D012622:Seat Belts / Q000331:legislation & jurisprudence; D011795:Surveys and Questionnaires
keywords: barriers to enacting laws; child car restraints; enabling; road safety stakeholders; road traffic injury; threatening