The George Institute for Global Health, The University of Sydney, Level 7, 341 George Street, Sydney, NSW 2000, Australia.
Accid Anal Prev. 2013 Jan;50:984-91. doi: 10.1016/j.aap.2012.08.002. Epub 2012 Aug 24.
Child restraints protect a young child against injury in crashes but best practice child restraint use is low in Australia, particularly among lower socio-economic groups. We investigated factors associated with restraint use to inform the development of education and distribution programmes to support new Australian legislation on child passengers among families in low socio-economic areas of metropolitan Sydney. We interviewed a parent or carer of 1160 children aged 2-5 years enrolled at one of 28 early childhood centres in low socio-economic areas of urban Sydney. Appropriate child restraint use was defined as a forward facing child restraint (FFCR) for 2-3 year olds and a FFCR or booster seat for children aged 4 years or more. Predictors of self-reported appropriate use were explored using logistic regression. Analysis was conducted on one child from each family in the target age range (2-5 years): 586 (51%) were male and the mean age was 3.5 (Standard Deviation 0.8) years. There were 432 (45%) families with annual income below $60,000, 248 (22%) spoke a language other than English at home and 360 (33%) had 3 or more children. Fifty-four percent of carers indicated that their 2-3 year old children travelled in a FFCR. Inappropriate use among children in this age group was more likely when the carer was <36 years (odds ratio (OR) 1.62, 95% confidence interval (CI) 1.08-2.45), in families with ≥3 children (OR 1.64, 95% CI 1.10-2.44) and when the carer believed that a booster seat was just as safe as a FFCR (OR 2.98, 2.05-4.32). Eight-eight percent of carers of 4-5 year olds reported use of a booster seat or FFCR. Non-use was associated with low household income (OR 3.10, 95% CI 1.67-5.75), in families with ≥3 children (OR 2.03, 95% CI 1.09-3.76) and families where a language other than English is spoken at home (OR 2.39, 95% CI 1.10-5.21). Non-English speaking families had less awareness of the new law and poorer knowledge of safety benefits of child restraints. They also had lower household incomes and more concerns about cost of child restraints and booster seats. These findings can inform development of interventions to promote best practice child restraint use, which will reach non-English speaking families in this region. They also confirm the importance of economic and logistic barriers to best practice child restraint use.
儿童约束系统可在碰撞中保护幼儿免受伤害，但在澳大利亚，最佳的儿童约束系统使用实践水平较低，尤其是在社会经济较低的群体中。我们调查了与约束系统使用相关的因素，以为新的澳大利亚儿童乘客法规在悉尼大都市的社会经济较低地区的家庭中制定教育和分配计划提供信息。我们采访了 28 家位于悉尼市区社会经济较低地区的早期儿童中心的 1160 名 2-5 岁儿童的父母或看护人。适当的儿童约束系统使用被定义为 2-3 岁的前向式儿童约束系统 (FFCR) 和 4 岁或以上的 FFCR 或增高座椅。使用逻辑回归探索了自我报告的适当使用的预测因素。对目标年龄范围内（2-5 岁）的每个家庭的一个孩子进行了分析：586 名（51%）为男性，平均年龄为 3.5 岁（标准差为 0.8 岁）。有 432 个家庭（45%）的年收入低于 60,000 澳元，248 个家庭（22%）在家中说英语以外的语言，360 个家庭（33%）有 3 个或更多孩子。54%的看护人表示，他们 2-3 岁的孩子乘坐 FFCR。当看护人年龄<36 岁（优势比 (OR) 1.62，95%置信区间 (CI) 1.08-2.45），家庭中有≥3 个孩子（OR 1.64，95% CI 1.10-2.44），并且看护人认为增高座椅与 FFCR 一样安全（OR 2.98，2.05-4.32）时，该年龄段的儿童使用不当的可能性更大。88%的 4-5 岁儿童的看护人报告使用了增高座椅或 FFCR。低家庭收入（OR 3.10，95% CI 1.67-5.75）、家庭中有≥3 个孩子（OR 2.03，95% CI 1.09-3.76）和在家中说英语以外语言的家庭（OR 2.39，95% CI 1.10-5.21）与非使用相关。非英语家庭对新法律的认识较低，对儿童约束系统安全益处的了解较差。他们的家庭收入也较低，对儿童约束系统和增高座椅的费用更为担忧。这些发现可以为促进最佳实践儿童约束系统使用的干预措施的制定提供信息，这些干预措施将覆盖该地区的非英语家庭。它们还证实了最佳实践儿童约束系统使用的经济和物流障碍的重要性。
