文章基本信息

标题：Evaluation of a Community-Based Intervention to Promote Rear Seating for Children
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作者：Jennifer Greenberg-Seth ; David Hemenway ; Susan S. Gallagher 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：94
期号：6
页码：1009-1013
语种：English
出版社：American Public Health Association
摘要：Objectives. We evaluated the short-term effect of a community-based effort to promote child rear seating in a low-income Hispanic community. Methods. Child seating patterns were observed pre- and postintervention at intersections in 1 intervention and 2 control cities. Brief interviews assessed exposure to program messages. Results. Child rear seating increased from 33% to 49% in the intervention city (P < .0001), which represented a greater increase than that in the control cities (P < .0001). The greatest improvement was observed in relatively higher-income areas. Rear seating was significantly correlated with reported program exposure. Incentives and exposure to the program across multiple channels seemed to have the greatest effect. Conclusions. Independent of legislation, community-based programs incorporating incentives can increase child rear seating. Motor vehicle crashes are the leading cause of death for children younger than 12 years in the United States. In 2000, 680 children in this age group died as occupants in motor vehicle crashes, and more than 200 000 were admitted to emergency rooms for nonfatal motor vehicle occupant injuries. 1 Child rear seating is a simple, effective way of reducing risk for crash injury or fatality in a population. Braver et al. found that among children 12 years and younger, fatality risk was 36% lower for rear-seated compared with front-seated children. 2 The risk reduction resulting from child rear seating was greater among restrained children (38%) and substantially greater in vehicles with passenger airbags (53%). American children continue to ride in the front seat, even though researchers have known for decades that the rear seat is safer in most crash situations 3– 6 and despite warnings from the National Highway Traffic Safety Administration and vehicle manufacturers. From 1985 through 1996, Massachusetts ranked last of all 50 states in the occurrence of rear seating, with 40% of children riding in the front seat. 7 Low-income groups are at increased risk for motor vehicle injury, indicating a need to specifically target this population with injury-prevention strategies. 8 The increased risk of traffic-related injury and death among Hispanic populations has been well documented. 1, 9– 13 Baker et al. reported that Hispanic children aged 5 to 12 years were nearly 3 times as likely to be motor vehicle fatality victims compared with non-Hispanic White children. 10 Legislation is one strategy for changing child seating patterns. In 1997, the National Transportation Safety Board recommended that each state amend its child passenger safety laws to make child rear seating compulsory. 14 To date, 7 states have passed legislation mandating child rear seating. 15 In Rhode Island, a study was conducted to evaluate the effectiveness of new state legislation requiring children aged younger than 6 years be rear-seated. One year after the law was enacted, vehicles with at least 1 child aged younger than 6 years in the front seat declined significantly, from 23% to 16%. 16 A comparison of seating patterns in 3 European cities whose laws mandate child rear seating with seating patterns in 2 American cities without such laws found that the European children were 50%–70% less likely to be seated in the front. 17 Community-based programs offer another potentially effective approach to changing child seating patterns that does not depend on legislation. Community-based approaches have been successfully applied in other areas of injury prevention. 18 However, few community-based child passenger safety interventions have been rigorously evaluated. In 2001, a Centers for Disease Control and Prevention task force concluded that incentive programs coupled with communitywide education were effective in increasing safety-seat use. 19 In a recent evaluation of a community-based program to promote the use of child restraints, Istre et al. found a significant change in child passenger safety behavior. 20 But few controlled interventions in the United States have addressed child seating patterns in motor vehicles, and none have had changing child seating patterns as their primary focus. 21 The goal of “Kids in the Back/Niños Atrás” was to increase the proportion of children aged younger than 12 years seated in the rear of motor vehicles in a predominantly low-income, Hispanic community, while reinforcing the message that all children should be properly restrained by a lap-/shoulder-belt system or child safety restraint device (e.g., infant seat, child safety seat, booster seat). This article evaluates the effect of this low-cost, community-based intervention.