title: Seat belt repositioning and use of vehicle seat cushions is increased among older drivers aged 75 years and older with morbidities.
abstract: OBJECTIVE
  Good seat belt fit and positioning is important for crash protection. Older drivers experience problems in achieving good seat belt fit and often reposition seat belts and/or use seat cushions. Comfort influences these behaviours. This work examines the impact of functional morbidities on belt positioning and accessory use and whether comfort mediates this relationship METHODS: Mediation analysis was used to examine the relationship between morbidities affecting physical function, comfort, belt repositions and seat cushion use among 380 drivers aged 75 years and older.
  
  
  RESULTS
  Musculoskeletal morbidities increase the likelihood of seat belt repositioning (OR 1.37, 95% CI 1.12-1.67) and comfort partially mediates this relationship (P = 0.03). Morbidities of any type also increase the likelihood of seat cushion use (OR 1.15 95% CI 1.04-1.27), but comfort plays no role in this relationship (P = 0.87).
  
  
  CONCLUSIONS
  Greater awareness among older drivers is needed, to ensure behavioural modifications do not impair their crash protection.
authors.affiliation: NeuRA Injury Prevention Research Centre, Neuroscience Research Australia; and School of Medical Science, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Brown
authors.affiliation: Injury Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney; and Sydney School of Science and Health, University of Western Sydney, Sydney, New South Wales, Australia.
authors.forename: Kristy
authors.initials: K
authors.lastname: Coxon
authors.affiliation: NeuRA Injury Prevention Research Centre, Neuroscience Research Australia; and School of Medical Science, University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Cameron
authors.initials: C
authors.lastname: Fong
authors.affiliation: Kolling Institute of Medical Research, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Clarke
authors.affiliation: The George Institute for Global Health, Sydney, New South Wales, Australia.
authors.forename: Kris
authors.initials: K
authors.lastname: Rogers
authors.affiliation: Injury Division, The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Keay
mesh_terms: D000063:Accidents, Traffic / Q000517:prevention & control*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D001334:Automobile Driving; D001336:Automobiles; D001364:Awareness; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016015:Logistic Models; D008297:Male; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D009517:New South Wales / Q000453:epidemiology; D016017:Odds Ratio; D011187:Posture; D018570:Risk Assessment; D012307:Risk Factors; D012622:Seat Belts
keywords: injury control; morbidity; motor vehicle; safety; seat belt