AUT University, School of Public Health and Psychosocial Studies, Auckland, New Zealand.
Accid Anal Prev. 2010 Nov;42(6):2075-81. doi: 10.1016/j.aap.2010.06.020.
Child restraint systems (CRSs) for vehicles are designed to provide protection and prevent or reduce child mortality and morbidity in road traffic accidents. Overall, 90% of children under 5 years of age in New Zealand currently use CRSs. There is considerable regional variability in CRS usage, but little information exists on its ethnic variations or determinants. "Increasing the level of restraint use" is explicitly stated as one of the 13 priorities within the New Zealand Ministry of Transport's new road safety strategy. As such, understanding CRS prevalence, patterns and associates within different communities is essential in realising this priority. Utilising a large birth cohort of Pacific children (n=1376 mothers), this study aimed to report the prevalence of maternal self-reported car seat usage at the 6 weeks, 1-year, and 2 years postpartum measurement waves; car/booster seat usage at the 4 years postpartum measurement wave; and to identify important associates using generalised estimating equation (GEE) models. Car seats were not used by 161 (11.8%) Pacific children at the 6 weeks measurement wave, 71 (5.8%) at 1-year, and 44 (3.8%) at 2 years, while car/booster seats were not used by 139 (13.3%) at the 4 years wave. Multivariable GEE model results revealed that mothers with no formal education, high parity, who smoked tobacco, lower household income, who lacked English language proficiency, and had multiple births were all at higher odds of failing to use car seat/booster seats. Despite differential attrition being noted in mothers over time, a sensitivity analysis using multiple imputation methods yielded similar findings. Targeted initiatives and education programs focusing on these higher risk groups, in particular, is needed to increase uptake and use of CRS thereby decreasing Pacific children's exposure to injury risk. As New Zealand has a large and increasing proportion of Pacific, Maori and Asian people, there is a continuing need to understand cultural factors in traffic safety. Only when culturally appropriate initiatives and education programs have been developed and disseminated that meet the needs of New Zealand's different communities is the national priority likely to be realised.
车辆儿童约束系统（CRS）旨在提供保护，防止或减少道路交通伤害导致的儿童死亡和发病。总体而言，新西兰目前有 90%的 5 岁以下儿童使用 CRS。CRS 的使用存在相当大的地区差异，但关于其种族差异或决定因素的信息很少。“增加约束装置使用率”明确列为新西兰交通部长新道路安全战略的 13 项优先事项之一。因此，了解不同社区内 CRS 的流行程度、模式和相关因素对于实现这一优先事项至关重要。本研究利用太平洋儿童的大型出生队列（n=1376 名母亲），旨在报告产后 6 周、1 年和 2 年测量波次中母亲自我报告的汽车座椅使用率；产后 4 年测量波次中汽车/ booster 座椅使用率；并使用广义估计方程（GEE）模型确定重要的关联因素。在产后 6 周测量波次中，有 161 名（11.8%）太平洋儿童未使用汽车座椅，71 名（5.8%）儿童在产后 1 年时未使用，44 名（3.8%）儿童在产后 2 年时未使用；而在产后 4 年测量波次中，有 139 名（13.3%）儿童未使用汽车/ booster 座椅。多变量 GEE 模型结果显示，未接受正规教育、多胎、吸烟、家庭收入较低、英语水平较差的母亲，以及多胎母亲，未使用汽车座椅/ booster 座椅的可能性更高。尽管随着时间的推移，母亲的差异流失情况明显，但使用多重插补方法进行敏感性分析得出了类似的发现。需要针对这些高风险群体开展有针对性的举措和教育计划，以提高 CRS 的使用率，从而降低太平洋儿童受伤风险。由于新西兰有大量不断增加的太平洋、毛利和亚裔人口，因此需要持续了解交通安全中的文化因素。只有在制定和传播了符合新西兰不同社区需求的文化适宜性举措和教育计划之后，国家的优先事项才有可能实现。
