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Predicting parents' use of booster seats
  1. Beth S Bruce1,
  2. Anne W Snowdon2,
  3. Charles Cunningham3,
  4. Carolyn L Cramm4,
  5. Krista Whittle5,
  6. Heather Correale6,
  7. Melanie Barwick7,
  8. Caroline Piotrowski8,
  9. Lynne Warda9,
  10. Jessie Harrold1
  1. 1Faculty of Health Professions, Dalhousie University, Halifax, Canada
  2. 2Odette School of Business, University of Windsor, Windsor, Canada
  3. 3Faculty of Health Sciences, McMaster University, Hamilton, Canada
  4. 4School of Nursing, Dalhousie University, Halifax, Canada
  5. 5School of Health and Human Performance, Dalhousie University, Halifax, Canada
  6. 6School of Nursing, University of Northern British Columbia, British Columbia, Canada
  7. 7The Hospital for Sick Children, Toronto, Canada
  8. 8Department of Family Social Sciences, University of Manitoba, Winnipeg, Canada
  9. 9Department of Pediatrics, University of Manitoba, Winnipeg, Canada
  1. Correspondence to Dr Beth Bruce, Faculty of Health Professions, Dalhousie University, 5968 College Street, Halifax, NS B3H 4R2, Canada; bsbruce{at}


Objective To examine the simultaneous contribution of multiple factors associated with parents' use of booster seats.

Methods Using the theory of planned behaviour framework, constructs of the theory were tested for usefulness in predicting self-reported intent and behaviour with respect to parents' use of booster seats. Through the use of structural equation modelling, the study demonstrated the most significant predictors of the intent to use a booster seat and reported use of booster seats in a Canadian sample (n=1480) of parents of school-aged children, 4–9 years.

Results The strongest predictors of intent to use booster seats were attitudes (benefits of booster seat use) and second, subjective norms (perceived booster seat use in the community). Parent barriers were inversely associated with intent and use of booster seats and child barriers with use. Intent and norms had the greatest effect on use, both positive and equally influential. The final model explains 30% of the variance in booster seat use.

Conclusion Messages that address the benefit to the child in preventing injury could be beneficial if spread more diversely, establishing a social norm. Legislation, enforcement and local policy could positively influence the perceived culture that supports and expects booster seat use for school-aged children.

  • Behavioural
  • child
  • passenger
  • public health
  • restraint

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  • Funding The funding was provided by the AUTO21 Network Centre of Excellence.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval This study was conducted with the approval of Dalhousie University.

  • Provenance and peer review Not commissioned; externally peer reviewed.