Preventing death and injury in childhood: a synthesis of child safety seat efforts.

Virtually all children are at risk for injury and death as passengers in moving vehicles. Between 70% to 90% of the injury and death could be reduced or prevented if children were restrained in safety seats. However, studies show that only a minority of children are properly protected. Numerous efforts have been made to increase the number of children riding in car safety seats. This article reviews and synthesizes the various attempts to motivate safety seat usage by examining the literature on (1) informational and educational programs; (2) safety seat loaner programs; (3) state laws requiring seat usage; (4) behavioral improvement emphasis programs; (5) reward-based programs; and (6) passive prevention approaches through airbags. No one approach appears to be the solution to the complex problem of motivating the preventive behavior of acquiring and consistently using safety seats. Recommendations are forwarded for: (1) developing and determining the best techniques for which settings through comparative research; (2) utilizing a developmental perspective in identifying when and what interventions are needed; and (3) implementing creative and comprehensive programs in communities.