Ehiri J E, Ejere H O D, Magnussen L, Emusu D, King W, Osberg J S
Department of Maternal & Child Health, School of Public Health, University of Alabama at Birmingham, 1665 University Boulevard, Ryals Building, Birmingham, Alabama 35249-0022, USA.
Cochrane Database Syst Rev. 2006 Jan 25;2006(1):CD004334. doi: 10.1002/14651858.CD004334.pub2.
Public health and traffic safety agencies recommend use of booster seats in motor vehicles for children aged four to eight years, and various interventions have been implemented to increase their use by individuals who transport children in motor vehicles. There is little evidence regarding the effectiveness of these interventions, hence the need to examine what works and what does not.
To assess the effectiveness of interventions intended to increase acquisition and use of booster seats in motor vehicles among four to eight year olds.
We searched the Cochrane Injuries Group's Specialized Register, the Cochrane Central Register of Controlled Trials, MEDLINE (January 1966 to April 2005), EMBASE (1980 to April 2005), LILACS, Transport Research Databases (1988 to April 2005), Australian Transport Index (1976 to April 2005), additional databases and reference lists of relevant articles. We also contacted experts in the field.
We included randomized and controlled before-and-after trials that investigated the effects of interventions to promote booster seat use.
Two authors independently assessed trial quality and extracted data. Study authors were contacted for additional information.
Five studies involving 3,070 individuals met the criteria for inclusion in the meta-analysis. All interventions for promoting use of booster seats among 4 to 8 year olds demonstrated a positive effect (relative risk (RR) 1.43; 95% confidence intervals (CI) 1.05 to 1.96). Incentives combined with education demonstrated a beneficial effect (RR 1.32, 95% CI 1.12 to 1.55; n = 1,898). Distribution of free booster seats combined with education also had a beneficial effect (RR 2.34; 95% CI 1.50 to 3.63; n = 380) as did education-only interventions (RR 1.32; 95% CI 1.16 to 1.49; n = 563). One study which evaluated enforcement of booster seat law met the criteria for inclusion in the meta-analysis, but demonstrated no marked beneficial effect.
AUTHORS' CONCLUSIONS: Available evidence suggests that interventions to increase use of booster seats among children age four to eight years are effective. Combining incentives (booster seat discount coupons or gift certificates) or distribution of free booster seats with education demonstrated marked beneficial outcomes for acquisition and use of booster seats for four to eight year olds. There is some evidence of beneficial effect of legislation on acquisition and use of booster seats but this was mainly from uncontrolled before-and-after studies, which did not meet the criteria for inclusion in the meta-analysis.
公共卫生和交通安全机构建议4至8岁儿童在机动车内使用增高座椅，并且已实施了各种干预措施，以提高驾驶机动车载儿童者对增高座椅的使用率。关于这些干预措施的有效性，几乎没有证据，因此有必要研究哪些措施有效，哪些无效。
评估旨在增加4至8岁儿童在机动车内购置和使用增高座椅的干预措施的有效性。
我们检索了Cochrane伤害组专业注册库、Cochrane对照试验中心注册库、MEDLINE（1966年1月至2005年4月）、EMBASE（1980年至2005年4月）、LILACS、交通研究数据库（1988年至2005年4月）、澳大利亚交通指数（1976年至2005年4月）、其他数据库以及相关文章的参考文献列表。我们还联系了该领域的专家。
我们纳入了调查促进增高座椅使用干预措施效果的随机对照前后试验。
两位作者独立评估试验质量并提取数据。与研究作者联系以获取更多信息。
五项涉及3070人的研究符合纳入荟萃分析的标准。所有促进4至8岁儿童使用增高座椅的干预措施均显示出积极效果（相对危险度（RR）为1.43；95%置信区间（CI）为1.05至1.96）。激励措施与教育相结合显示出有益效果（RR为1.32，95%CI为1.12至1.55；n = 1898）。免费增高座椅发放与教育相结合也有有益效果（RR为2.34；95%CI为1.50至3.63；n = 380），仅教育干预措施同样如此（RR为1.32；95%CI为1.16至1.49；n = 563）。一项评估增高座椅法律执行情况的研究符合纳入荟萃分析的标准，但未显示出明显的有益效果。
现有证据表明，增加4至8岁儿童增高座椅使用率的干预措施是有效的。将激励措施（增高座椅折扣券或礼品券）或免费增高座椅发放与教育相结合，对于4至8岁儿童增高座椅的购置和使用显示出显著的有益结果。有一些证据表明立法对增高座椅的购置和使用有有益影响，但这主要来自非对照的前后研究，不符合纳入荟萃分析的标准。
