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Implementation and evaluation of a hospital-based infant car restraint program Sax, Ronald Jeffrey

Abstract

The leading cause of death for children under five years of age is motor vehicle accidents. The use of approved car restraints can reduce the mortality incidence by at least 50%, and the morbidity incidence by at least 70%. The current usage rate of car restraints in British Columbia is approximately 50% for infants 6 months of age, falling off to 10% for four year olds. This study was a prospective, before and after design evaluating an in-hospital program to educate new mothers on the benefits of using infant car restraints. The program is intended to be low cost and self-financing and consists of three components: an educational package on infant car restraints is distributed to all new mothers; a videotape presentation is screened daily on the post-partum ward; and infant car restraints are sold at a discount in the hospital gift shop. Two community hospitals in the metropolitan Vancouver area participated in the study. Baseline restraint use at each study site was determined in a preprogram group. After a short interval, the program was introduced and restraint use in the program group was measured. Initial questionnaires were used to determine self-reported restraint use and basic demographic information. Unobtrusive observations by hospital staff were used to verify restraint use. Follow-up mail questionnaires at six weeks post-partum were used to provide additional demographic and socio-economic information. A high response rate to the questionnaires was obtained from this group of new mothers. A substantial bias in self-reporting of restraint use was also found, but this differed between the two hospitals. In hospitals where currently only a minority of mothers use infant restraints, this program may significantly increase restraint usage. Compared to non-users, mothers who used infant restraints tended to be slightly older, better educated, married and less likely to smoke.

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