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Increases in best practice child restraint use among children aged 2–5 years in low socioeconomic areas after introduction of mandatory child restraint laws in NSW Australia
  1. J Brown1,
  2. L Keay2,
  3. K Hunter2,
  4. L Bilston1,
  5. J Simpson3,
  6. R Ivers2
  1. 1Neuroscience Research Australia
  2. 2The George Institute for Global Health
  3. 3School of Public Health, The University of Sydney


    Background In 2009 the Australian Road Rules were modified to specify use of age-appropriate restraints for children up to 7 years. Implementation of the new laws was expected to increase optimal restraint use, but international studies have reported little or no effect of legislation in low income and minority groups.

    Aims/Objectives/Purpose To compare restraint practices in children aged 2–5 years in low socioeconomic areas of NSW before and after introduction of legislation specifying age-appropriate restraint use.

    Methods Direct observations of children aged 2–5 years at sites within low socioeconomic areas were used to assess restraint practices. A pre-legislation sample was drawn from a 2008 cross-sectional observation survey (n=106) and post-legislation data were collected in 2010 from control sites in a cluster randomised trial (n=360). Logistic regression was used to compare restraint practices adjusting for variations in demographic distributions between the samples.

    Results/Outcome Age-appropriate restraint use increased from 41% to 73%, and correct use from 34% to 47% in the post-legislation sample. After controlling for child's age, parental education, income and language spoken at home, the odds of children in the post-legislation sample being appropriately restrained were 2.2 times greater (95% CI 1.4 to 3.6) and the odds of them being correctly restrained were 1.6 times greater (95% CI 1.0 to 2.7) than children in the pre-legislation sample.

    Significance/Contribution to the Field While there appears to have been an improvement in child restraint practices in low income populations following implementation of laws mandating age-appropriate restraint, the results indicate a need for further interventions to increase the number of children optimally restrained.

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