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December 1996

Child Restraint Device Use in Patients Leaving a Children's Hospital

Author Affiliations

Nia Sipp
From the Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pa (Drs Zempsky and Isaacman); and the Departments of Pediatrics and Epidemiology, Emory University School of Medicine, Atlanta, Ga (Dr Sullivan). Ms Sipp is an undergraduate at Emory University.

Arch Pediatr Adolesc Med. 1996;150(12):1284-1287. doi:10.1001/archpedi.1996.02170370062010

Objective:  To determine the frequency of and factors associated with the use of child restraint devices (CRDs) in patients leaving an urban children's hospital.

Design:  Verbally administered survey, followed by observation of CRD use.

Setting:  Main parking area at an urban children's hospital with mandated use of parking attendants.

Participants:  A convenience sample of 295 parents or guardians who were leaving the hospital and were accompanied by at least 1 child younger than 48 months.

Results:  Eighty percent of the respondents were female; 77% of the respondents were white and 22% were African American. Two hundred thirty-five (80%) used CRDs. Subjects who were at risk of CRD noncompliance included nonwhite individuals (adjusted odds ratio [OR], 6.6; 95% confidence interval [CI], 3.0-14.5), those whose primary source of medical care was from a public clinic (OR, 2.4; 95% CI, 1.1-5.3) or from a specialty clinic (OR, 2.4; 95% CI, 0.8-6.6), and those who were older than 24 months (OR, 8.7; 95% CI, 3.5-21.9). Parental education and income level were not important predictors of CRD compliance controlling for race, primary medical care source, and age. Study participants were observed for incorrect CRD use; 30% (30/99) of infants younger than 12 months were incorrectly placed in the forward-facing position, and 23% (54/235) of all CRD users did not use its harness.

Conclusions:  Patients who use public clinics or pediatric subspecialists as their primary source of medical care, especially those who are African Americans, are at risk of CRD noncompliance. Children's hospitals should take an active role in improving CRD use in these patients.Arch Pediatr Adolesc Med. 1996;150:1284-1287