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A qualitative approach using the integrative model of behaviour change to identify intervention strategies to increase optimal child restraint practices among culturally and linguistically diverse families in New South Wales
  1. Julie Brown1,
  2. Danielle Burton1,
  3. Stevan Nikolin1,
  4. Philippa Jane Crooks1,
  5. Julie Hatfield2,
  6. Lynne E Bilston1
  1. 1Neuroscience Research Australia, University of New South Wales (UNSW), New South Wales, Australia
  2. 2Transport and Road Safety Research, University of New South Wales (UNSW), New South Wales, Australia
  1. Correspondence to Dr Julie Brown, Cnr Barker St and Easy St, Randwick, NSW 2131, Australia; j.brown{at}


Objectives To qualitatively explore barriers to optimal child restraint use using the integrative behaviour change model in culturally and linguistically diverse (CALD) communities in New South Wales (NSW), Australia.

Methods A semi-structured discussion was used to conduct 11 language specific focus groups in Arabic, Assyrian, Cantonese, Mandarin, Vietnamese and Turkish. Translated transcriptions were analysed using the major concepts of the integrative behaviour change model.

Results Restraint use intent among CALD community carers is related to perceived safety of their children and complying with the law. While most participants appreciated the safety benefits of correct and appropriate use, a minority did not. Child restraint legislation may positively influence social norms, and enforcement appears to increase parental self-efficacy. However, concerns over child comfort may negatively influence both norms and self-efficacy. There are clear deficits in knowledge that may act as barriers as well as confusion over best practice in safely transporting children. Large family size, vehicle size and cost appear to be real environmental constraints in CALD communities.

Conclusion Determinants of intent and deficits in knowledge in this diverse range of CALD communities in NSW Australia are similar to those reported in other qualitative studies regardless of the population studied. This indicates that key messages should be the same regardless of the target population. However, for CALD communities there is a specific need to ensure access to detailed information through appropriate delivery strategies and languages. Furthermore, practical constraints such as cost of restraints and family size may be particularly important in CALD communities.

  • Child restraints
  • safety seats
  • booster seats
  • focus group
  • qualitative
  • behaviour change
  • ethnicity
  • language
  • dissemination
  • equipment
  • restraints
  • engineering
  • spinal cord
  • head injury
  • MVTC
  • standards
  • passenger
  • child

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  • Funding This work was funded by an Australian Research Council Linkage grant with partner funding from the New South Wales Roads and Traffic Authority. LB is funded by an NHMRC Senior Research Fellowship.

  • Competing interests None.

  • Ethics approval University of NSW Human Research Ethics Committee.

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

  • Data sharing statement Any additional data from the study will be used by the authors only for the purposes of developing an education based intervention to increase optimal child restraint practices among children from CALD communities in Australia.