Background Injuries are the leading cause of death among First Nations in Canada from 1 to 44 years, Health Canada 2001. The Ontario First Nation population was 175 178 within 133 First Nation communities in 2008. Ontario First Nations identified Motor Vehicle Collisions, Violence including Suicide and Falls, as injury issues and recommended priorities in education, training and research. An Injury Prevention Initiative was established to address issues, implement priorities and develop an Ontario First Nation Injury Prevention Strategy and Action Plan. It is coordinated by the Chiefs in Ontario. The issue of Motor vehicle collisions among Ontario First Nations included concerns about the reported low use of child car restraints. Few interventions to improve restraint use have been implemented and evaluated.

Objective The objective of the Ontario First Nations Child Car Restraint Project was to promote child passenger safety and evaluate interventions in five communities.

Methods Prior to community based child passenger safety interventions, participants were asked about their knowledge and behaviours related to the use of child car restraints. They then participated in interventions and answered the same questions after the interventions.

Results The results reported knowledge increased significantly and a variation in the improvement by community, by gender and by education level. About half of the participants showed no improvement or had decreased scores.

Conclusion Community-based interventions can improve knowledge and reported behaviour, but not all participants benefit equally. Interventions will need to be community based, culturally specific and targeted to population needs to improve success.