PURPOSE: To investigate the changes and underlying mechanisms in parents' safety awareness and the use of child safety seats after the mandatory legislation in Shanghai city, China. METHODS: This study was carried out by Shanghai Key Laboratory of Environment and Children's Health using a multi-stage, simple random sampling method. Volunteers with children aged 0-12 months were recruited. Child safety seats were sent to each volunteer's family. Telephone encounters and/or on-site visits were used to collect data from parents using a phased survey on children's safety during car use. RESULTS: Among all respondents, 91.2% had heard of motor vehicle accidents involving children, and 97.2% could describe the appropriate use of a safety seat to minimize the risk of child injury in a collision. Among 1078 families with newborns, awareness of child safety seats was 91.9%. There were 86% patients aware that new laws and regulations have been released regarding the use of child safety seats, and 98.5% of them plan to comply with the new laws. Moreover, 61% patients think that taxis should be routinely equipped with child safety seats. CONCLUSION The parents in Shanghai obtained a high level of awareness of children's traffic safety after the introduction of child safety seats legislation, and had a positive experience related to the use of child safety seats. Taxi may be an important area of focus for implementation of child traffic safety. Traffic safety laws and regulations with further impact should be continuously studied.
Accidents, Traffic ; legislation & jurisprudence ; prevention & control ; Automobiles ; Awareness ; Child Health ; legislation & jurisprudence ; Child Restraint Systems ; Child, Preschool ; China ; Humans ; Infant ; Parents ; psychology ; Safety ; legislation & jurisprudence

PURPOSE: Child safety seats (CSS) are critical for the protection of children, in case of motor vehicle accidents. Although the national legislation mandates that all newborns must be placed in an appropriately installed CSS during transportation, people often do not perceive the importance of CSS and do not use it as recommended. The purpose of this survey was to understand the use of CSS for the safe transport of newborns from hospital to home. METHODS: We interviewed parents of newborn infants, using a structured questionnaire, at the time of their discharge from Cheil General Hospital & Women’s Health Care Center, between May 2014 and July 2014. RESULTS: A total of 403 participants were interviewed. The rate of CSS use was only 14.9%. Overall, 76.4% of the families interviewed were not aware about the recommendations on CSS use for newborns when travelling in a car. The provision of education on using CSS significantly influenced their rate of use. Parents who were educated about mounting the CSS in a car used it more as compared with others (25.7% vs. 12.2%) (P=0.002). Furthermore, if parents had heard about the importance or necessity of CSS, they used it more than others did (19.5% vs. 10.6%, P=0.032). CONCLUSION: Despite the legal regulation, most parents transport their newborn infants without a CSS while traveling from hospital to their home. The rate of CSS use was influenced by parental education and their knowledge about its necessity. Education programs for parents must be reinforced to increase the CSS use.
Child Restraint Systems* ; Child* ; Delivery of Health Care ; Education ; Hospitals, General ; Humans ; Infant, Newborn* ; Motor Vehicles ; Parents ; Seat Belts ; Transportation*

PURPOSE: The use of proper safety restraint systems by children is vital for the reduction of traffic accident-related injury and death. This study evaluated the rates of use of safety restraint systems and front seats by Korean children. METHODS: Based on data from the National Health and Nutrition Examination Survey from 2008 to 2015, I investigated the frequencies of safety restraint systems and front seat use by children under six and 12 years of age, respectively. RESULTS: The percentage of respondents who said they always use safety restraint systems increased from 17.7% in 2008 to 45.0% in 2015. The rate of children who did not use the front seats at all was 47.3 % in 2008 compared to 33.4% in 2015. Multivariate logistic regression analysis showed a decrease in safety-restraint-system use as age increased (odds ratio, 0.63; 95% confidence interval [CI], 0.51–0.77). The use rate of front-passenger seat belts by the mother is significantly correlated with the safety-restraint- system use rate by children (odds ratio, 2.14; 95% CI, 1.12–4.06). CONCLUSION: Although the rate of safety-restraint-system use for children is increasing annually, it remains low. Additionally, the use rate of front passenger seats for children is high. To reduce the rates of injury and death of children from traffic accidents, it is necessary to educate on the appropriate use of safety restraint systems according to age and body size and to develop stronger regulations.
Accidents, Traffic ; Body Size ; Child Restraint Systems ; Child* ; Humans ; Korea* ; Logistic Models ; Mothers ; Nutrition Surveys* ; Seat Belts ; Social Control, Formal ; Surveys and Questionnaires

PURPOSE: To determine the effects of pre-discharge education for the correct use of child occupant restraints (CORs). METHODS: Between January and August 2012, education for the correct use of CORs was provided to parents at the time of discharge of their newborns from our neonatal intensive care unit. A cross-sectional survey using self-report questionnaires or telephone interviews was conducted when the children were 6 to 12 months of age, and the acquired data were compared with data from a control group. RESULTS: The overall percentage of children using CORs was 73.4% for the COR educated group and 69.9% for the control group. However, the percentage of children who correctly used CORs was 42.2% for COR educated group and 44.3% for the control group. There was no statistically significant difference in parental awareness and perception of the correct use of CORs between the two groups. CONCLUSION: The correct use rate of CORs in our community is still low, and no difference in the correct use of CORs was observed between parents who were educated before discharge of their newborns and those who were not. Therefore, an alternative strategy, such as a strong enforcement program, is needed to increase the correct use of CORs.
Child Restraint Systems ; Child* ; Cross-Sectional Studies ; Education* ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; Interviews as Topic ; Parents ; Surveys and Questionnaires