Factors associated with correct installation of car safety seats: Secondary analyses of data from a national sample

Motor vehicle occupant injury is the leading cause of unintentional injury-related death in children ages 4-14. Proper use of car safety seats can reduce these traffic fatalities by 80%. This study examines characteristics associated with proper installation and use of child safety seats (CSS). This research used secondary SPSS data analyses of a large (37,880 records) database containing individual profiles collected by the National Safe Kids Campaign during child restraint inspection events in 2001-2002. Over 150 variables were collected with 100 of these related to type of restraint system, installation and misuse. Additional composite variables, created for this study, provided more details on characteristics of persons/vehicles related to correct CSS installation. Only 12.7% of CSS inspected for correct usage had been properly installed. Inappropriate use of type of CSS based on child size was the most common misuse (up to 49% depending on type of CSS). CSSs were more likely to be installed correctly in vehicles manufactured by companies that emphasize vehicle safety (e.g., Volvo, 15.8%) and in newer vehicles (14.0%). Parents were more likely to have installed the safety seat correctly compared to persons identified as grandparents in their relationship to the child (p<.000). Kolcraft and Britax models of CSS had more correct usage (20.8% and 15.3%, respectively). Urban locations had a lower percent of correct use compared to non-urban (9.6% vs. 11.1%). This study highlights the utility of secondary data analyses of existing databases as tools to better understand causes of injury and to promote injury prevention.