Background: Motor vehicle crashes are the leading cause of unintentional death and disability among children 4 years to 12 years of age in the United States. Despite the high risk of injury from motor vehicle crashes in this age group, parental awareness and child passenger safety programs in particular may lack focus on this age group.
Methods: This is a retrospective cross-sectional analysis of child passenger safety seat checklist forms from two Safe Kids coalitions in Michigan (2013) to identify restraint type upon arrival to car seat inspections. Other variables were included if the coalition provided a new child safety seat and if the child had a sibling who underwent a car seat inspection. χ statistics were used to compare change in restraint use on arrival and at departure, the proportion of children attending a car seat inspection event by age, the age category of children by site, the proportion of children with siblings also undergoing a car seat inspection by age, and the distribution of a new child safety seat by age.
Results: Data were available from 1,316 Safe Kids Huron Valley and 3,215 Safe Kids Greater Grand Rapids car seat inspections. Just 10.8% of the total seats inspected were booster seats. Child safety seats for infant and young children were more commonly inspected (rear-facing carrier [40.3%], rear-facing convertible [10.2%], and forward-facing [19.3%] car seats). Few children at inspections used a seat belt only (5.4%) or had no restraint (13.8%). Children 4 years and older were found to be in a suboptimal restraint at least 30% of the time.
Conclusion: Low proportions of parents use car seat inspections for children in the booster seat age group. The proportion of children departing the inspection in a more protective restraint increased with increasing age. This highlights an area of weakness in child passenger safety programs and signals an opportunity to strengthen efforts on The Booster Age Child.
Level of evidence: Epidemiologic/prognostic study, level III.