An Emergency Department Intervention to Increase Booster Seat Use for Lower Socioeconomic Families

Authors

  • Michael A. Gittelman MD,

    Corresponding author
    1. Divisions of Emergency Medicine (MAG, WJP) and Trauma Services (SL), Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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  • Wendy J. Pomerantz MD, MS,

    1. Divisions of Emergency Medicine (MAG, WJP) and Trauma Services (SL), Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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  • Susan Laurence

    1. Divisions of Emergency Medicine (MAG, WJP) and Trauma Services (SL), Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML# 2008, Cincinnati, OH 45229. Fax: 513-636-7967; e-mail: gittm1@cchmc.org

Abstract

Objectives: To evaluate the effectiveness of booster seat education within an emergency department (ED) setting for families residing in lower socioeconomic neighborhoods.

Methods: This was a prospective, randomized study of families with children aged 4 to 7 years and weighing 40 to 80 lb who presented to a pediatric ED without a booster seat and resided in lower socioeconomic communities. Subjects were randomly assigned to one of three groups: 1) received standard discharge instructions, 2) received five-minute booster seat training, and 3) received five-minute booster seat training and free booster seat with installation. Automobile restraint practices were obtained initially and by telephone at one month.

Results: A total of 225 children were enrolled. Before randomization in the study, 79.6% of parents reported that their child was usually positioned in the car with a lap/shoulder belt and 13.3% with a lap belt alone. Some parents (16.4%) had never heard of a booster seat, and 44.9% believed a lap belt was sufficient restraint. A total of 147 parents (65.3%) were contacted for follow-up at one month. Only one parent (1.3%) in the control group and four parents (5.3%) in the education group purchased and used a booster seat after their ED visit, while 55 parents (98.2%) in the education and installation group reported using the booster seat; 42 (75.0%) of these parents reported using the seat 100% of the time.

Conclusions: Education in a pediatric ED did not convince parents to purchase and use booster seats; however, the combination of education with installation significantly increased booster seat use in this population.

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