Booster Seat Use in an Inner-City Day Care Center Population

Abstract

Objective. To determine use and knowledge of belt positioning booster seats by drivers transporting children from day care centers in the central city of Milwaukee, Wisconsin.

Methods. A prospective, direct observational, community-based, exploratory study was undertaken in May 2005. Eighteen day care centers in urban Milwaukee that met the predetermined criteria, including > 10 children ages 4–8 enrolled, were invited to participate. Volunteer observers, including Spanish-speaking members, from community organizations were trained in proper placement by certified car seat technicians. Teams visited sites, completed a standardized survey form with drivers who agreed to participate, and observed the type and placement of restraint in which each child was placed.

Results. Of 841 children observed, 283 were determined to be booster-seat eligible. Only 21% were in the appropriate restraint. Latino, African American, and older children were significantly less likely than white and younger children to be appropriately restrained. Appropriate restraint use was more frequent among those living in the proper ZIP codes with higher median incomes.

Conclusions. This is the first observational study of booster seat use in this Milwaukee population with appropriate restraint use varying widely from reported state and national data. The low rates of appropriate booster seat use, particularly by Latino and African American caregivers and those living in low-income neighborhoods, in this large metropolitan center supports the need for further study and targeted interventions.

Keywords:

• Injury Prevention
• Booster Seat
• Behavior Traffic Participants
• Race and Socioeconomic Differences

ACKNOWLEDGMENTS

The authors would like to thank the Medical College of Wisconsin (MCW) Healthier Wisconsin Partnership Program and the MCW Department of Pediatrics for funding this research; the Milwaukee Urban League and SAFE KIDS Southeast Wisconsin for their essential community partnership; the MCW Injury Research Center for statistical and evaluation support; as well as the numerous volunteers, day care centers, and parents who allowed this research to take place. Chris McLaughlin provided editorial assistance.