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694 Implementation science: evidence-based car seat education for parents
  1. Mikiko Oono1,2,
  2. Koji Kiamura1,2,
  3. Yoshifumi Nishida1,2,
  4. Tatsuhiro Yamanaka1,2,3
  1. 1National Institute of Advanced Industrial Science and Technology, Japan
  2. 2Safe Kids Japan, Japan
  3. 3Ryokuen Children’s Clinic, Japan


Background According to an annual joint report from Japan Automobile Federation and National Police Agency, Japan, about 40 percent (40%) of children under age 6 do not properly use car seats in 2015. Reasons of not using it include parents’ emotional opinions such as “I feel sad when a baby resisted staying in a car seat and cried” or “It will be safe if a fellow passenger can tightly hold a baby” and parent’s misunderstandings such as “the death rate is not different whether or not a baby is in a car seat” or “It is not absolutely necessary to use a car seat if we do not go a long way.” The purpose of this study was to reveal predisposing factors for using a car seat, and by taking them into account, we developed an effective education tool for parents.

Methods We conducted two online surveys from parents aged between 20 and 49 who drove a car with a child at least once a week. The survey respondents were recruited nationwide. The first survey was conducted in November 2013 to find the frequency of car seat use, the type of actions parents usually take when a child resisted staying in a car seat, and the effectiveness of crash test video in increasing parental perceptions of injury severity and self-efficacy. Wilcoxon signed-rank test and Kolmogorov-Smirnov test were used to determine its effectiveness. The second online survey was conducted in February 2014 to find out a specific period of time for a child not to resist staying in a car seat. Based on the results from these two surveys, we developed an animated video and evaluated its effectiveness.

Results One thousand eight people participated in the first survey. When asked the frequency the respondent’s child uses a car seat, 69% said “all the time” and 5% said “rarely use”. About 30% reported that they let their child out of a car seat when the child resisted staying. Over 30% said that there are some times when their child sat in a car seat without using safety belts. Finally, we found that crash test videos were effective in increasing parent’s perceived severity of injury and self-efficacy. In the second survey, 1002 parents took the survey, and we found that the older the age of children were, the less their frequency of using a car seat. Especially, 25% of the respondents whose child were over 4 said that the frequency of car seat use was less than half.

Conclusion Based on the results from these surveys, we developed an animated video that showed you the consequences of car crash on a child when not using a car seat properly.

  • Car seat
  • Parents education
  • Animated video
  • Behaviour change

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