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Original Contribution
February 19, 2003

Use of Child Booster Seats in Motor Vehicles Following a Community Campaign: A Controlled Trial

Author Affiliations

Author Affiliations: Departments of Pediatrics (Drs Ebel and Rivara) and Epidemiology (Drs Koepsell and Rivara), and Harborview Injury Prevention and Research Center (Drs Ebel, Koepsell, and Rivara), University of Washington, Seattle; and Children's Hospital and Regional Medical Center, Seattle, Wash (Ms Bennett).

JAMA. 2003;289(7):879-884. doi:10.1001/jama.289.7.879

Context Once children have outgrown car seats, booster seats protect from injury better than lap and shoulder belts alone. However, the majority of children aged 4 to 8 years use only an adult seat belt.

Objective To evaluate the effectiveness of a multifaceted community booster seat campaign in increasing observed booster seat use among child passengers in motor vehicles.

Design Prospective, nonrandomized, controlled community intervention trial.

Setting and Participants The campaign was initiated in 4 communities in the greater Seattle, Wash, area between January 2000 and March 2001. Eight communities in Portland, Ore, and Spokane, Wash, served as control sites. We observed 3609 booster-eligible children (those aged 4-8 years and weighing 18-36 kg [40-80 lb]).

Main Outcome Measure Observed booster seat use 15 months after the start of the campaign.

Results Before the campaign began, 13.3% of eligible children in the intervention communities and 17.3% in the control communities were using booster seats, adjusting for child age, driver seat belt use, and sex of driver. Fifteen months after the start of the campaign, adjusted booster seat use had increased to 26.1% in the intervention communities and 20.2% in the control communities (P = .008 for the difference in time trends between intervention and control communities).

Conclusion These data suggest that a multifaceted community education campaign can significantly increase the use of child booster seats.