Has Child Restraint System Use Increased among Parents of Children in Shantou, China?
OBJECTIVE
to examine parents' use of child restraint systems (CRS), and determine if parents' knowledge of, attitude toward, and use behavior of child restraint systems have improved following enactment of child restraint use laws in other cities.


METHODS
Observations and a cross-sectional survey of drivers transporting children 17 years and under were conducted at the gate of the schools and parking lots of hospitals in Shantou. Observers recorded the seating location of child passengers, the type of restraint, and appropriate use of CRS and safety belts based on the observation. Knowledge of and attitudes towards use of CRS were reported by the driver following observation.


RESULTS
Approximately 6.6% of passengers aged 0-12 were in CRS; rate of forward-facing CRS in children aged 3-5 (9.9%) was higher than rear-facing CRS for children aged 0-2 (1.1%) and booster seat use among children aged 6-12 (0.1%). Children younger than four years old (OR = 3.395, 95% CI = 2.125-5.424), drivers having a college or higher lever education (OR = 2.908, 95% CI = 1.878-4.500) and drivers wearing seatbelt (OR = 3.194, 95% CI = 1.605-6.356) had greater odds of CRS use. Over half (56.6%) of parents might or would use CRS if they could rent CRSs with fees.


CONCLUSIONS
The rate of CRS is still low in Shantou. Comprehensive public education programs supported by legislation might be an effective way to improve child passenger safety. Renting CRSs to parents could be a new approach to encourage use.
Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China. yufangyixuelhq@sina.com.
Huiqian
H
Lei
Center for Injury Research and Policy, The Ohio State University, Columbus, OH 43205, USA. Ginger.Yang@nationwidechildrens.org.
Jingzhen
J
Yang
Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China. xxliu2014@126.com.
Xiangxiang
X
Liu
The First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China. xjchen@stu.edu.cn.
Xiaojun
X
Chen
Injury Prevention Research Center, Medical College of Shantou University, 22 Xin Ling Road, Shantou 515041, China. lpli@stu.edu.cn.
Liping
L
Li
attitude; child restraint system (CRS); knowledge; parents
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