Identifying Strategies to Reduce the Percentage of Unrestrained Young Children

The purpose of this study was to explore the factors that contribute to nonuse of occupant restraints by children 5 through 7 years of age riding in motor vehicles, and to identify strategies to increase restraint use in this age group. The appropriate restraint for most of these children, based on their size, would be booster seats. Research activities conducted for this study were a literature review, discussions with key informants, a brainstorming session with experts, and focus groups with parents and other caregivers. The prevalence of unrestrained children in this age group varied across observation studies identified in the literature review. Key informants, experts in the field, and parents and other caregivers provided many reasons why drivers do not restrain these children. Reasons included low perceived risk (low crash and injury threat), lack of understanding that booster seats prevent injury, ignorance of the booster seat law, the perception that violations of the child restraint law are not enforced, inconvenience, parental permissiveness, and situational factors. Recommendations to increase proper restraint use among 5- through 7-year-olds centered on enforcement, education, and publicity. Enforcement strategies should focus on increasing the perception that the child restraint law is strongly enforced, increasing the penalties for violating the law, and gaining more support from top-management of law enforcement agencies for enforcing the law. Educating law enforcement officers, judges, and prosecutors about the child passenger safety law and the risks involved for unrestrained and inappropriately restrained children are key components of an enforcement strategy. Generating publicity about the enforcement efforts is also important. Education strategies directed at the public should focus on messages that identify the best practices for properly restraining these children, raise parents’ and other caregivers’ perception of risk by demonstrating the potential for injury and death using visuals and testimonials, and clarify the child restraint law in the State. Educational messages may be delivered by health care personnel, teachers, law enforcement officers, and child passenger safety technicians. Messages can also be delivered through radio public service announcements and billboards.