Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #106535

John E. Ehiri, PhD, MPH¹, Bill King, DrPH, MPH², Henry O.D. Ejere, MD, MS³, Donath Emusu, MD, MPH¹, J. Scott Osberg⁴, and Alyson Hazen, BS⁵. (1) Department of Maternal and Child Health, University of Alabama at Birmingham, School of Public Health, 1665 University Boulevard, Ryals Public Health Building, Suite 320, Birmingham, AL 35294-0022, 205-975-7641, jehiri@uab.edu, (2) Department of Pediatrics, University of Alabama at Birmingham, The Children's Hospital of Alabama, The Southeast Child Safety Institute, 1600 Seventh Avenue South, Birmingham, AL 35233, (3) Department of Medicine, Metropolitan Hospital, 1901 1st Avenue, New York, NY 10029, (4) Director of Research, AAA Foundation for Traffic Safety, 1440 New York Avenue, NW, Suite 201, Washington, DC 20005, (5) Health Behavior, University of Alabama at Birmingham, 1665 University Boulevard, Birmingham, AL 35294-0022

The purpose of this presentation is to demonstrate evidence of the effect of various interventions for increasing booster seat use among children aged 4-8 years, riding in cars. Earlier reviews targeted 0-4 year olds, and there is acceptance that a gap in evidence exists for older children for whom use of booster seats is important. Although many interventions claim to increase booster seat use, there is a paucity of evidence on the most effective strategies.

We used the Cochrane systematic review methodology to assess the effect of interventions to increase booster seat use. In this presentation we will describe the various steps used in conducting the review, results and implications for policy and practice.

Published and unpublished reports were obtained and analyzed. Studies were included if they were randomized controlled trials, quasi-experimental studies, or interrupted time series. Two reviewers independently assessed the quality of identified studies, using pre-determined criteria.

Of the 1,350 relevant reports identified, only 5 met the criteria for inclusion in the meta-analysis. Studies were analyzed to determine effect of intervention on: frequency of use, motor vehicle occupant injuries and deaths from motor vehicle crashes among 4-8 year olds. Revman Version 4.2.7 (the Cochrane Collaboration's statistical software) was used to conduct meta-analysis.

Results showed that interventions which combine education with distribution of booster seats or incentives (e.g., discounted coupons) have the greatest positive impact.

Implications of our findings for various advocacy, funding and educational efforts are discussed.

Learning Objectives: At the end of the session, the participant will be able to

• Articulate the procedures for conducting a Cochrane systematic review relevant to child motor vehicle occupant protection.
• Identify various promotional measures for increasing use of booster seats and analyze strategies that have the strongest evidence of effectiveness.
• Apply lessons learned from the presentation in the design of child booster seat promotional interventions, and in educating individuals, communities, and policy makers.

Keywords: Injury Prevention, Evidence Based Practice

Related Web page: aaafts.org/projects/index.cfm?button=Booster

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation