Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and predictors of booster seat use in Alberta, Canada

  • Invited Commentary
  • Published:
Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

OBJECTIVE: To determine the prevalence of booster seat misuse in a Canadian province and identify determinants of non-use.

METHODS: A cross-sectional study using parking lot interviews and in-vehicle restraint inspections by trained staff was conducted at 67 randomly selected childcare centres across Alberta. Only booster-eligible children were included in this analysis. Odds ratios (OR) and 95% confidence intervals (CI) are reported using unadjusted and adjusted logistic regression.

RESULTS: Overall, 23% of children were not in a booster seat, and in 31.8% of cases there was evidence of at least one misuse. Non-use increased significantly by age, from 22.2% for children 2 years of age to 47.8% for children 7 years of age (p = 0.02). Children who were at significantly increased risk of booster seat non-use were those in vehicles with drivers who could not recall the booster seat to seatbelt transition point (OR: 4.54; 95% CI: 2.05–10.06) or drivers who were under the age of 30 (OR: 3.54; 95% CI: 1.45–8.62). A front row seating position was also associated with significantly higher risk of non-use (OR: 18.00; 95% CI: 2.78–11 6.56). Children in vehicles with grandparent drivers exhibited significantly decreased risk of booster seat non-use (OR: 0.21; 95% CI: 0.05–0.85).

CONCLUSION: Messaging should continue to stress that the front seat is not a safe place for any child under the age of 9 as well as remind drivers of the booster seat to seatbelt transition point, with additional emphasis placed on appealing to parents under the age of 30. Future research should focus on the most effective means of communicating booster seat information to this group. Enacting mandatory booster seat legislation would be an important step to increase both awareness and proper use of booster seats in Alberta.

Résumé

OBJECTIF: Déterminer la prévalence du mésusage des sièges d’appoint dans une province canadienne et repérer les déterminants de leur non-utilisation.

MÉTHODE: Dans 67 centres de la petite enfance sélectionnés au hasard en Alberta, nous avons mené une étude transversale comportant des entretiens dans les parcs de stationnement et des inspections des ensembles de retenue dans les véhicules par du personnel formé. Seuls les enfants ayant besoin d’un siège d’appoint ont été inclus dans l’analyse. Les rapports de cotes (RC) et les intervalles de confiance de 95 % (IC) obtenus par régression logistique ajustée et non ajustée sont indiqués.

RÉSULTATS: Globalement, 23 % des enfants n’étaient pas dans un siège d’appoint, et dans 31,8% des cas, il y avait des signes d’au moins un mésusage du siège. La non-utilisation augmentait de façon significative avec l’âge, passant de 22,2 % pour les enfants de 2 ans à 47,8 % pour les enfants de 7 ans (p = 0,02). Les enfants qui étaient significativement plus à risque de non-utilisation d’un siège d’appoint étaient ceux dans les véhicules dont le conducteur ne se souvenait pas du point de passage du siège d’appoint à la ceinture de sécurité (RC: 4,54; IC de 95 %: 2,05–10,06) ou dont le conducteur avait moins de 30 ans (RC: 3,54; IC de 95 %: 1,45–8,62). La place de l’enfant sur le siège avant était aussi associée à un risque sensiblement plus élevé de non-utilisation (RC: 18,00; IC de 95 %: 2,78–11 6,56). Les enfants dans les véhicules conduits par un grand-parent présentaient un risque sensiblement moins élevé de non-utilisation du siège d’appoint (RC: 0,21; IC de 95 %: 0,05–0,85).

CONCLUSION: Dans les messages, il faut continuer à souligner que le siège avant n’est pas un endroit sûr pour les enfants de moins de 9 ans, rappeler aux conducteurs quel est le point de passage du siège d’appoint à la ceinture de sécurité, et s’adresser en particulier aux parents de moins de 30 ans. Les études futures devraient porter sur les moyens le plus efficaces de communiquer l’information sur les sièges d’appoint à ce groupe. L’adoption de mesures législatives obligatoires sur les sièges d’appoint serait un pas important pour accroître la sensibilisation et l’utilisation correcte des sièges d’appoint en Alberta.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Keep Kids Safe: Car Time Stages 1, 2, 3 and 4. Available at: https://www.canada.ca/en/services/transport/road/child-car-seat-safety/installing-using-child-car-seat-booster-seat-seat-belt.html (Accessed July 18, 2016).

  2. Alberta Traffic Safety Act: Vehicle Equipment Regulation, 82(1)(a)(2009).

  3. Durbin DR, Elliott MR, Winston FK. Belt-positioning booster seats and reduction in risk of injury among children in vehicle crashes. JAMA 2003; 289(21):2835–40. PMID: 12783914. doi: 10.1001/jama.289.21.2835.

    Article  Google Scholar 

  4. Elliott MR, Kalian MJ, Durbin DR, Winston FK. Effectiveness of child safety seats vs seat belts in reducing risk for death in children in passenger vehicle crashes. Arch Pediatr Adolesc Med 2006;160(6):617–21. PMID: 16754824. doi: 10.1001/archpedi.160.6.617.

    Article  Google Scholar 

  5. Ma X, Griffin R, McGwin G, Allison DB, Heymsfield SB, He W, et al. Effectiveness of booster seats compared with no restraint or seat belt alone for crash injury prevention. Acad Emerg Med 2013;20(9):880–87. PMID: 24050794. doi: 10.1111/acem.12204.

    Article  Google Scholar 

  6. Charyk Stewart T, McClafferty K, Shkrum M, Comeau JL, Gilliland J, Fraser DD. A comparison of injuries, crashes, and outcomes for pediatric rear occupants in traffic motor vehicle collisions. J Trauma Acute Care Surg 2013;74(2):628–33. PMID: 23354261. doi: 10.1097/TA.0b013e31827d606c.

    Article  Google Scholar 

  7. Snowdon A, Rothman L, Slater M, Kolga C, Hussein A, Boase P, et al. A comparison of booster seat use in Canadian provinces with and without legislation. Inj Prev 2009;15(4):230–33. PMID: 19651994. doi: 10.1136/ip.2008.020537.

    Article  CAS  Google Scholar 

  8. O’Neil J, Daniels DM, Talty JL, Bull MJ. Seat belt misuse among children transported in belt-positioning booster seats. Accid Anal Prev 2009;41(3):425–29. doi: 10.1016/j.aap.2009.01.003.

    Article  Google Scholar 

  9. Macy ML, Reed MP, Freed GL. Driver report of improper seat belt position among 4- to 9-year-old children. Acad Pediatr 2011;11(6):487–92. PMID: 21963869. doi: 10.1016/j.acap.2011.08.009.

    Article  Google Scholar 

  10. Snowdon A, Rothman L, Slater M, Kolga C, Hussein A, Boase P, et al. Methodology of estimating restraint use in children: Roadside observation or parking lot interview survey. Accid Anal Prev 2010;42(6):1545–48. PMID: 20728601. doi: 10.1016/j.aap.2010.02.020.

    Article  Google Scholar 

  11. Eichelberger AH, Chouinard AO, Jermakian JS. Effects of booster seat laws on injury risk among children in crashes. Traffic Inj Prev 2012;13(6):631–39. PMID: 23137094. doi: 10.1080/15389588.2012.660663.

    Article  Google Scholar 

  12. Mannix R, Fleegler E, Meehan WP III, Schutzman SA, Hennelly K, Nigrovic L, et al. Booster seat laws and fatalities in children 4 to 7 years of age. Pediatrics 2012;130(6):996–1002. PMID: 23129070. doi: 10.1542/peds.2012-1058.

    Article  Google Scholar 

  13. Road Safety and Motor Vehicle Regulation Directorate. Results of Transport Canada’s Rural and Urban Surveys of Seat Belt Use in Canada 2009–2010. Ottawa, ON: Transport Canada, 2011.

    Google Scholar 

  14. Canadian Council of Motor Transport Administrators. Canada’s Road Safety Strategy 2015. Ottawa, ON, 2011. Available at: http://ccmta.ca/crss-2015/_files/road_safety_strategy_2015.pdf (Accessed July 18, 2016).

    Google Scholar 

  15. Simniceanu A, Richmond SA, Snowdon A, Hussein A, Boase P, Howard A. Child restraint use in Canadian provinces with and without legislation in 2010. Traffic Inj Prev 2014;15(7):734–39. PMID: 24279898. doi: 10.1080/15389588.2013.867483.

    Article  Google Scholar 

  16. Alberta Municipal Affairs. 2006 Official Population List. Available at: http://www.municipalaffairs.alberta.ca/documents/ms/2006pop.pdf (Accessed July 18, 2016).

    Google Scholar 

  17. Levy PS, Lemeshow S. Sampling of Populations, Textbook and Solutions Manual: Methods and Applications (Wiley Series in Survey Methodology), 3rd ed. Hoboken, NJ: John Wiley & Sons, Inc., 2003.

    Google Scholar 

  18. Hosmer DW, Lemeshow S. Applied Logistic Regression, 2nd ed. New York, NY: Wiley, 2000.

    Book  Google Scholar 

  19. Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source Code Biol Med 2008;16;3:17. doi: 10.1186/1751-0473-3-17.

    Article  Google Scholar 

  20. Rivara FP, Bennett E, Crispin B, Kruger K, Ebel B, Sarewitz A. Booster seats for child passengers: Lessons for increasing their use. Inj Prev 2001;7(3):210–13. PMID: 11565986. doi: 10.1136/ip.7.3.210.

    Article  CAS  Google Scholar 

  21. Koppel S, Charlton JL, Fitzharris M, Congiu M, Fildes B. Factors associated with the premature graduation of children into seatbelts. Accid Anal Prev 2008;40(2):657–66. PMID: 18329418. doi: 10.1016/j.aap.2007.09.005.

    Article  Google Scholar 

  22. Macy ML, Freed GL. Child passenger safety practices in the U.S.: Disparities in light of updated recommendations. Am J Prev Med 2012;43(3):272–81. PMID: 22898120. doi: 10.1016/j.amepre.2012.05.023.

    Article  Google Scholar 

  23. Yanchar NL, Kirkland SA, LeBlanc JC, Langille DB. Discrepancies between knowledge and practice of childhood motor vehicle occupant safety in Nova Scotia–A population-based study. Accid Anal Prev 2012;45:326–33. PMID: 22269516. doi: 10.1016/j.aap.2011.07.020.

    Article  Google Scholar 

  24. Yanchar NL, Young JB, Langille DB. Knowledge and practice of childhood motor vehicle restraint use in Nova Scotia: Phase II. Accid Anal Prev 2015;74:150–56. PMID: 25463955. doi: 10.1016/j.aap.2014.09.029.

    Article  Google Scholar 

  25. Bruce BS, Snowdon AW, Cunningham C, Cramm CL, Whittle K, Correale H, et al. Predicting parents’ use of booster seats. Inj Prev 2011;17(5):313–18. PMID: 21415070. doi: 10.1136/ip.2010.029181.

    Article  Google Scholar 

  26. Margolis LH, Wagenaar AC, Molnar LJ. Use and misuse of automobile child restraint devices. Am J Dis Child 1992;146(3):361–66.

    CAS  PubMed  Google Scholar 

  27. Macy ML, Freed GL, Reed MP. Child passenger restraints in relation to other second-row passengers: An analysis of the 2007–2009 national survey of the use of booster seats. Traffic Inj Prev 2013;14(2):209–14. PMID: 23343031. doi: 10.1080/15389588.2012.700748.

    Article  Google Scholar 

  28. Henretig FM, Durbin DR, Kalian MJ, Winston FK. Grandparents driving grandchildren: An evaluation of child passenger safety and injuries. Pediatrics 2011;128(2):289–95. PMID: 21768311. doi: 10.1542/peds.2011-0046.

    Article  Google Scholar 

  29. Armstrong RA. When to use the Bonferroni correction. Ophthalmic Physiol Opt 2014;34(5):502–8. PMID: 24697967. doi: 10.1111/opo.l2131.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Public Health, University of Alberta, 4075 Research Transition Facility, Edmonton, AB, T6C 2R3, Canada

    Richard P. Golonka MSc, Brian H. Rowe MD, MSc & Don Voaklander PhD, BPE

  2. Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada

    Bonnie M. Dobbs PhD

  3. Department of Emergency Medicine, University of Alberta, Edmonton, AB, Canada

    Brian H. Rowe MD, MSc

Authors
  1. Richard P. Golonka MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Bonnie M. Dobbs PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brian H. Rowe MD, MSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Don Voaklander PhD, BPE
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Don Voaklander PhD, BPE.

Additional information

Conflict of Interest: None to declare.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Golonka, R.P., Dobbs, B.M., Rowe, B.H. et al. Prevalence and predictors of booster seat use in Alberta, Canada. Can J Public Health 107, e155–e160 (2016). https://doi.org/10.17269/cjph.107.5254

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.17269/cjph.107.5254

Key words

Mots clés

Search

Navigation