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Journal of Community Health

, Volume 36, Issue 1, pp 166–173 | Cite as

Pediatricians’ Knowledge, Perceptions, and Behaviors Regarding Car Booster Seats

  • Faith Yingling
  • Heather A. Stombaugh
  • James Jeffrey
  • Frankie B. LaPorte
  • Michael F. Oswanski
Original Paper

Abstract

Pediatricians are a recognized primary resource and advocate for injury prevention. The purpose of this study was to examine pediatricians’ knowledge, perceptions, and behaviors regarding car booster seats and their willingness to use resources for parent education. Investigators implemented an anonymous, mailed survey to a national random sample of 1,041 US office-based pediatricians with 464 respondents: 53% female, 63% Caucasian, 52% parents of children under 12 years, and 87% board-certified. Fifty-two percent have counseled at least half of their families about booster seats. Sixty-nine percent rely on American Academy of Pediatrics (AAP) resources for counseling, and 87% agreed that counseling parents improves child outcomes in a motor vehicle crash. Fifty-seven percent said there were no barriers to booster seat counseling; 39% did not counsel parents about booster seats unless it is the reason for the office visit. Forty-seven percent lacked the time to counsel, and 81% were confident they were counseling according to AAP guidelines. Twelve percent were unsure of their state’s booster seat laws. Significant relationships were found between responses to knowledge questions and suburban location, gender, race, length of time in pediatric practice. Many pediatricians are not counseling their patients’ parents on booster seats but believe counseling is important; many are confident in their counseling but do not rely on AAP-recognized counseling resources. Education about state booster seat laws and AAP guidelines may be useful in increasing the cues to action pediatricians convey to parents regarding booster seat use.

Keywords

Child Passenger Counseling Equipment Restraint 

Notes

Acknowledgments

This research was generously supported by a Physician’s Trauma Prevention Research Grant ($10,000) from the American Trauma Society in 2007. The authors also wish to thank James H. Price, PhD, MPH of the University of Toledo for his proofreading, editing, and general support in the development of this manuscript.

References

  1. 1.
    Centers for Disease Control and Prevention. (2010). Web-based Injury Statistics Query and Reporting System (WISQARS). National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. www.cdc.gov/ncipc/wisqars. Accessed June 7, 2010.
  2. 2.
    Durbin, D. R., Chen, I., Smith, R., Elliott, M. R., & Winston, F. K. (2005). Effects of seating position and appropriate restraint use on the risk of injury to children in motor vehicle crashes. Pediatrics, 115(3), e305–e309.CrossRefPubMedGoogle Scholar
  3. 3.
    American Academy of Pediatrics. (2010). Belt-positioning booster seats: East to use, affordable and safe. http://stokes.chop.edu/programs/injury/files/Educational_Ills/FYF_boosters.pdf. Accessed June 7, 2010.
  4. 4.
    Committee on Injury and Poison Prevention, & American Academy of Pediatrics. (2002). Selecting and using the most appropriate car safety seats for growing children: Guidelines for counseling parents. Pediatrics, 109(3), 550–553.CrossRefGoogle Scholar
  5. 5.
    Durbin, D. R., Elliott, M. R., & Winston, F. K. (2003). Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes. The Journal of the American Medical Association, 289(21), 2835–2840.CrossRefGoogle Scholar
  6. 6.
    National Center for Statistics and Analysis, & National Highway Traffic Safety Administration. (2009). Traffic safety facts: Booster seat use in 2008. Washington, DC: National Highway Traffic Safety Administration. DOT HS 811 121.Google Scholar
  7. 7.
    Winston, F. K., Chen, I. G., Elliott, M. R., Arbogast, K. B., & Durbin, D. R. (2004). Recent trends in child restraint practices in the United States. Pediatrics, 113(5), e458–e464.CrossRefPubMedGoogle Scholar
  8. 8.
    Simpson, E. M., Moll, E. K., Kassam-Adams, N., Miller, G. J., & Winston, F. K. (2002). Barriers to booster seat use and strategies to increase their use. Pediatrics, 110(4), 729–736.CrossRefPubMedGoogle Scholar
  9. 9.
    Ramsey, A., Simpson, E., & Rivara, F. P. (2000). Booster seat use and reasons for nonuse. Pediatrics, 106(2), E20.CrossRefPubMedGoogle Scholar
  10. 10.
    Pierce, S. E., Mundt, M. P., Peterson, N. M., & Katcher, M. L. (2005). Improving awareness and use of booster seats in Head Start families. Wisconsin Medical Journal, 104(1), 46–51.PubMedGoogle Scholar
  11. 11.
    Ebel, B. E., & Grossman, D. C. (2003). Crash proof kids? An overview of current motor vehicle child occupant safety strategies. Current Problems in Pediatric and Adolescent Health Care, 33(2), 38–55.CrossRefPubMedGoogle Scholar
  12. 12.
    Ebel, B. E., Koepsell, T. D., Bennett, E. E., & Rivara, F. P. (2003). Too small for a seatbelt: Predictors of booster seat use by child passengers. Pediatrics, 111(4 Pt 1), e323–e327.CrossRefPubMedGoogle Scholar
  13. 13.
    Gunn, V. L., Phillippi, R. M., & Cooper, W. O. (2007). Improvement in booster seat use in Tennessee. Pediatrics, 119, e131–e136.CrossRefPubMedGoogle Scholar
  14. 14.
    DiGuiseppi, C., & Roberts, I. G. (2000). Individual-level injury prevention strategies in the clinical setting. Future Child, 10(1), 53–82.CrossRefPubMedGoogle Scholar
  15. 15.
    Simon, T. D., Phibbs, S., Dickinson, L. M., et al. (2006). Less anticipatory guidance is associated with more subsequent injury visits among infants. Ambulatory Pediatrics, 6(6), 318–325.CrossRefPubMedGoogle Scholar
  16. 16.
    Gardner, H. G. (2007). Office-based counseling for unintentional injury prevention. Pediatrics, 119(1), 202–206.CrossRefPubMedGoogle Scholar
  17. 17.
    Agran, P. F., & Hoffman, B. (2008). Child passenger safety: Direction, selection, location, installation. Pediatric Annals, 37(9), 614–621.CrossRefPubMedGoogle Scholar
  18. 18.
    American Academy of Pediatrics, & Committee on Practice and Ambulatory Medicine and Bright Futures Steering Committee. (2000). Policy statement: Recommendations for preventive pediatric health care. Pediatrics, 105(3), 645–646.CrossRefGoogle Scholar
  19. 19.
    Barkin, S., Fink, A., & Gelberg, L. (1999). Predicting clinician injury prevention counseling for young children. Archives of Pediatrics and Adolescent Medicine, 153(12), 1226–1231.PubMedGoogle Scholar
  20. 20.
    Bull, M. J., & Sheese, J. (2000). Update for the pediatrician on child passenger safety: Five principles for safer travel. Pediatrics, 106(5), 1113–1116.CrossRefPubMedGoogle Scholar
  21. 21.
    Prochaska, J. O. (2008). Decision making in the transtheoretical model of behavior change. Medical Decision Making, 28(6), 845–849.CrossRefPubMedGoogle Scholar
  22. 22.
    Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice Hall.Google Scholar
  23. 23.
    Asch, D. A., Jedrziewski, M. K., & Christakis, N. A. (1997). Response rates to mail surveys published in medical journals. Journal of Clinical Epidemiology, 50(10), 1129–1136.CrossRefPubMedGoogle Scholar
  24. 24.
    Everett, S. A., Price, J. H., Bedell, A. W., & Telljohann, S. K. (1997). The effect of a monetary incentive in increasing the return rate of a survey to family physicians. Evaluation & the Health Professions, 20(2), 207–214.CrossRefGoogle Scholar
  25. 25.
    Halpern, S. D., Ubel, P. A., Berlin, J. A., & Asch, D. A. (2002). Randomized trial of 5 dollars versus 10 dollars monetary incentives, envelope size, and candy to increase physician response rates to mailed questionnaires. Medical Care, 40(9), 834–839.CrossRefPubMedGoogle Scholar
  26. 26.
    Kasprzyk, D., Montano, D. E., St Lawrence, J. S., & Phillips, W. R. (2001). The effects of variations in mode of delivery and monetary incentive on physicians’ responses to a mailed survey assessing STD practice patterns. Evaluation & the Health Professions, 24(1), 3–17.CrossRefGoogle Scholar
  27. 27.
    Kellerman, S. E., & Herold, J. (2001). Physician response to surveys. A review of the literature. American Journal of Preventive Medicine, 20(1), 61–67.CrossRefPubMedGoogle Scholar
  28. 28.
    Maheux, B., Legault, C., & Lambert, J. (1989). Increasing response rates in physicians’ mail surveys: An experimental study. American Journal of Public Health, 79(5), 638–639.CrossRefPubMedGoogle Scholar
  29. 29.
    VanGeest, J. B., Wynia, M. K., Cummins, D. S., & Wilson, I. B. (2001). Effects of different monetary incentives on the return rate of a national mail survey of physicians. Medical Care, 39(2), 197–201.CrossRefPubMedGoogle Scholar
  30. 30.
    Winston, F. K., Kallan, M. J., Elliott, M. R., Xie, D., & Durbin, D. R. (2007). Effect of booster seat laws on appropriate restraint use by children 4 to 7 years old involved in crashes. Archives of Pediatrics and Adolescent Medicine, 161(3), 270–275.CrossRefPubMedGoogle Scholar
  31. 31.
    Insurance Institute for Highway Safety. (2010). Child restraint/belt use laws. www.iihs.org/laws/restraintoverview.aspx. Updated July 2009. Accessed June 7, 2010.
  32. 32.
    Reisinger, K. S., & Bires, J. A. (1980). Anticipatory guidance in pediatric practice. Pediatrics, 66(6), 889–892.PubMedGoogle Scholar
  33. 33.
    American Academy of Pediatrics. (2009). Children’s health topics: Car safety seats and transportation safety. www.aap.org/healthtopics/carseatsafety.cfm. Accessed July 24, 2009.
  34. 34.
    Waksman, R. D., & Pirito, R. M. (2005). The pediatrician and traffic safety. Jornal de Pediatria, 81(5 Suppl), S181–S188.CrossRefPubMedGoogle Scholar
  35. 35.
    Hauer, E. (2007). A case for evidence-based road-safety delivery. In: Improving traffic safety culture in the United States: The journey forward. Washington, DC: AAA Foundation for Traffic Safety.Google Scholar
  36. 36.
    Bingham, C. R., Eby, D. W., Hockanson, H. M., & Greenspan, A. I. (2006). Factors influencing the use of booster seats: A state-wide survey of parents. Accident; Analysis and Prevention, 38(5), 1028–1037.CrossRefPubMedGoogle Scholar
  37. 37.
    Partners for Child Passenger Safety. (2005). CPS issue report: Safe seating for children. Philadelphia, PA: The Children’s Hospital of Philadelphia.Google Scholar
  38. 38.
    Will, K. E., & Geller, E. C. (2004). Increasing the safety of children’s vehicle travel: From effective risk communication to behavior change. Journal of Safety Research, 35(3), 263–274.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Faith Yingling
    • 1
  • Heather A. Stombaugh
    • 2
  • James Jeffrey
    • 3
  • Frankie B. LaPorte
    • 4
  • Michael F. Oswanski
    • 2
  1. 1.Wellness ConnectionBowling Green State UniversityBowling GreenUSA
  2. 2.Trauma ServicesToledo Children’s HospitalToledoUSA
  3. 3.Department of Health & Rehabilitative ServicesUniversity of ToledoToledoUSA
  4. 4.Health Education and Research CorporationProMedica Health SystemToledoUSA

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