Learn From Others—Challenges and Lessons Learned

There are numerous challenges to getting 4- to 8-year-old children placed in booster seats, in addition to the many situational factors that affect their use. Consider the following:

• The lack of information among parents and other caregivers about (1) the correct progression of restraint use for children, (2) how booster seats work, and (3) the safety benefits of booster seats.

• The desire of young children to be grown up and not to have to sit in any type of child restraint.

• The inconsistency of State laws pertaining to protecting older children and booster seat use. Without consistent laws, or laws that provide for mandatory booster seat use for the older child, parents and other caregivers will continue to question the need for and benefits of booster seats.

• Finally, even though many new passenger vehicles include lap and shoulder belts for front- and rear-seat occupants, millions of older vehicles do not have rear-seat shoulder safety belts.

Staying aware of these challenges will help you set realistic goals and objectives as you design your program to promote booster seats. Use the following insights gleaned from the qualitative research conducted under the demonstration projects to guide your efforts.

Back to Top

Insights From the Qualitative Research

The following information is taken from the research and findings of the demonstration projects. It provides insights into many factors and issues to consider during program and message development. Although these insights represent comments from small groups of individuals, the majority are consistent with other NHTSA research findings.

Misinformation among parents

• Thought that child safety seats were safer than booster seats

• Had an inaccurate understanding of weight and age guidelines for safety belt use

• Had inconsistent information about booster seat use

• Thought that a lap belt was safe and adequate

Factors that prevented parents from using booster seats

• Cost of booster seats

• Lack of lap-shoulder belts in rear seats of pre-1990 cars

• Lack of availability in local stores

• Not compatible with current motor vehicle

• Children's objection to being placed in a "baby seat"

• Children not able to understand the idea of "correct use" of safety belts

• Difficulty grasping the dynamics of a crash

• Lack of understanding of the need to buckle up each time

• Difficulty finding information about booster seat use

Factors that might encourage booster seat use

• State law requiring use

• Cooperation from children (kids viewing booster seats as "big kid seats")

Positive messages about using booster seats

• Booster seats are safer.

• Your child will be able to see out the window.

• Your child will feel more comfortable with improved belt fit.

Suggestions for promoting booster seats

• Use a credible source to provide information about booster seats.

• Physicians'/doctors' offices are viewed as the best source of information.

• Harness/vests are a safe alternative for use in older vehicles.

• Information about booster seat use must be written in many languages to accommodate adults who do not speak English as their first language.

• Childcare centers serving low- to middle-income families can be effective venues for distributing seats and information.

Obstacles to address when developing programs and activities

• Cultural and language barriers

• Economic barriers (vehicles with lap-only safety belts, lack of funds to purchase booster seats)

• Educational barriers (difficulty understanding the dynamics of a crash)

• High staff turnover in retail organizations (difficulty maintaining workers who are knowledgeable about booster seats)

Back to Top

Factors Influencing Involvement of Potential Community Advocacy Groups and Individuals

Positive

• Physicians visited personally by the grant administrator were more likely to be interested in sharing booster seat information with their patients.

• The fact that law enforcement professionals have their own traffic safety training programs makes them receptive to information on CPS and open to expanding their efforts on CPS promotion.

• Childcare providers and educators are highly likely to use brochures and other print information on child passenger safety.

Negative

• Many healthcare professionals do not maintain memberships with professional associations; therefore, use of these organizations may be ineffective as vehicles for distribution of information to these audiences.

• Time constraints experienced by healthcare professionals, along with attitudinal resistance (physicians dismissing health-related information from nonphysicians, negativity about office solicitors), may reduce receptivity to information about booster seats.

Back to Top

Key Findings and Lessons Learned

Significant findings and lessons learned are noted in the areas of program development, communications and education, the benefits of permanent inspection/fitting stations, and working with underserved and non-English-speaking populations. As with the qualitative research findings, this information provides helpful guidance for program development.

Program Development

• Booster seat promotion should be done in the context of an overall comprehensive child passenger safety program.

• Target audiences who already see public safety and/or child advocacy as their responsibility are more likely to adopt child booster seat advocacy.

• Organizations that work with low-income families are not always able to follow through on education about and the use of child safety seats and booster seats. Their effectiveness is often influenced by whether their client contact is routine or emergency.

• In some instances, outreach to physicians and other healthcare professionals requires contact by a person whom they perceive as "credentialed." As a result, obtaining support from this group can place additional time requirements on the "credentialed/credible" individual. However, once educated, physicians and other healthcare professionals can become an increasingly important source of child passenger information for families of young children.

• Integrating child passenger safety into existing health-related services is an effective way to ensure the ongoing delivery of child passenger safety information. Public health nurses are an excellent resource for providing this type of information.

• In rural communities, it is especially important to find a well-respected community member to promote your message. In addition, it is difficult to conduct observational studies with young children in rural communities because they are often bused to Head Start or kindergarten programs.

• Holding contests, e.g., designing posters at schools, depends on the principal's interest (usually low). The contests held were labor-intensive to organize and promote.

Communications and Education

• Nonuse of restraints is still an issue. Many children continue to ride unrestrained in the front and back seat. A number of children also wear backpacks when seated and are unable to properly wear safety belts. The issue of not wearing a backpack while riding in vehicles may have to be addressed in educational materials.

• It doesn't suffice to simply make booster seats available. The use of booster seats must be marketed to parents and children.

• Crash epidemiology should be incorporated into curricula for healthcare professionals, e.g., nursing, physical therapy, chiropractic, medical. Some of these groups do not understand crash dynamics and how restraints work to prevent injury.

Inspection/Fitting Stations

• Establishing a permanent child safety seat clinic or inspection/fitting station is an important component of any ongoing effort to promote child passenger safety. One approach is to get a community organization to be the sponsor of the station and other organizations, such as car dealerships and fire stations, to host the ongoing safety inspections.

Back to Top