Unrestrained or improperly restrained infants and children are at risk of crash injuries and, if seated in front, risk injury from inflating airbags. A pilot program to increase child restraint use and rear seating position was conducted in Durham, North Carolina, in conjunction with an ongoing statewide enforcement program. The programs included letters and pamphlets sent to parents, proper restraint use demonstrations, and enforcement checkpoints. Elementary school children additionally attended assemblies emphasizing proper restraint use. Proper use increased substantially at elementary schools (36% to 64%; 49% to 71%) with smaller increases at the daycare centers (71% to 76%; 60% to 75%). Only slight increases occurred in the percentage of children in rear seats. The pilot program indicated that short-term gains can be achieved in proper restraint use and suggest that enforcement is a key ingredient.
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