According to the National Highway Transportation Administration (NHTSA), motor vehicle crashes are a leading cause of death for children (DOT, 2012). Child safety seats reduce the risk of death in passenger cars by 71% for infants, and by 54% for toddlers ages 1 to 4 years (NHTSA, 2009). Booster seats have been shown to reduce the risk of serious injury in motor vehicle crashes (Macy, 2011). The American Academy of Pediatrics and NHTSA recommend booster seats for children from the time they outgrow their forward-facing car seat until they reach a height of 57 inches or 4 feet 9 inches (Macy 2012, Durbin 2011).
There is strong evidence that child safety seat laws, safety seat distribution and education programs, community-wide education and enforcement campaigns, and incentive-plus-education programs are effective in increasing child safety seat use (Zara, 2001).
- U.S. Department of Transportation, National Highway Traffic Safety Administration. Motor Vehicle Traffic Crashes as a Leading Cause of Death in the United States, 2008 and 2009. May 2012. DOT HS 811 620.
- Zara S, Sleet DA, Thompson RS, Sosin DM, Bolen JC, Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase the use of child safety seats. American Journal of Preventive Medicine 2001:21(4S),31-47.7.
- US Department of Transportation, National Highway Traffic Safety Administration NHTSA, Traffic Safety Facts 2008: Children. Washington (DC); NHTSA; 2009.
- Macy ML, Clark SJ, Freed GL, Butchart AT, Singer DC, Sasson C, Meurer WJ and Davis MM. Carpooling and booster seats: A national survey of parents. Pediatrics 2012;129:290-298.
- Durbin DR and Committee on Injury, Violence and Poison Prevention. Pediatrics 2011;127:e1050-e1066.
Give Kids a Boost
Texas law requires all children younger than 8 years of age, unless they are taller than 4 feet 9 inches, to ride in appropriate child safety seats used according to manufacturer’s instructions.
With funding from the Texas Department of Transportation (TXDOT), the Injury Prevention Center of Greater Dallas (IPC) developed Give Kids a Boost - a school-based project that focuses on the education and enforcement of child occupant safety practices. The goal of the project is to increase properly restrained booster seat use among children 4-7 years of age in selected elementary schools in Dallas. Give Kids a Boost is currently in its third year.
The Give Kids a Boost project was developed and implemented utilizing the results from focus groups and recommendations from the National Highway Traffic Safety Administration (NHTSA) on effective strategies to improve child occupant restraint use.To ensure the project is culturally-competent, community-integrated, and sustainable, the project includes training teachers, parents, safety advocates and community leaders as booster seat educators, using the train-the-trainer model.
The intervention phase of the project includes: 1) train-the-trainer sessions with teachers and parent leaders; 2) parent presentations 3) tailored communication to parents; 4) distribution of child passenger safety fact sheets; 5) information about car seat inspection stations, and 6) enforcement of the Texas child passenger safety law.
Teachers (Pre-K – 3rd grade), and parent volunteers are trained on child occupant safety specifically among children 4-7 years of age. Trained parent volunteers become “safety leaders” for their school, serving as health educators and providing booster seat safety presentations at PTA meetings and other school meetings.
Trained parent leaders provide child occupant safety presentations to parents of booster-age children during Parent-Teacher Association (PTA) meetings, and other meetings. Parent educators share recommendations and child passenger safety information at school-based meetings, such as Parents Advocating for Student Excellence (PASE), a parent advocate program; AVANCE, a parent leadership program, and the Head Start program.
The tailored messaging and activities includes: 1) letters signed by the student’s teacher notifying the parent of the schools participation in the Give Kids a Boost child occupant safety project; 2) an activity at the school to measure each student’s height and collect age and weight; 3) notes from the teacher sent home to the parents with their child’s height measurement and a recommendation for booster seat use as well as information on where to find a free car seat inspection, and 4) one-on-one time to discuss child occupant safety and related resources during parent/teacher conferences. All tailored communication is sent home to parents through the student’s class folder.
Distribution of Fact Sheets
Several fact sheets are distributed as part of the Give Kids a Boost project. The fact sheets are sent home biweekly in the student’s class folder. They cover topics such as the two types of booster seats, Texas booster seat law, the 5-step test to help determine when to graduate a child from a booster seat to a seat belt, NHTSA’s car seat recommendations for children, and proper booster seat use recommendations.
Car Seat Inspection Stations
During the Give Kids a Boost project, project schools may host a car seat inspection station for parents.
High visibility enforcement of child restraint laws is one of the strategies identified by the NHTSA to improve compliance with existing child passenger safety laws. Law enforcement officers present information about the Texas law and occupant safety to the parents of children attending Give Kids a Boost project schools. In addition, they provide enhanced enforcement of the Texas law.
The IPC conducts observational surveys of child occupant restraint use in the pre-intervention and post-intervention time periods to determine whether there is a change in booster seat use among children 4-7 years of age following the implementation of the Give Kids a Boost project. Observations are conducted at project and comparison schools during the same time period during the school year. Students are observed in vehicles as they arrive at school during the morning hours at school drop-off areas.
The IPC has successfully implemented and evaluated the Give Kids a Boost project since 2012. The results show that in schools that received the intervention, booster seat use increased significantly, from 6.6% to 18.2%. Child occupants were nearly 3 times more likely to use booster seats after the intervention (P<0.0001), whereas child occupants at schools that did not receive the intervention did not show a significant increase.
- Department of Transportation (US), National Highway Traffic Safety Administration (NHTSA), Traffic Safety Facts 2009 Data: Children. DOT HS 811 387
- U.S. Department of Transportation, National Highway Traffic Safety Administration. Identifying Strategies to Improve the Effectiveness of Booster Seat Laws. May 2008. Report no. DOT HS 810969.
To promote the use of age-appropriate, correctly installed child safety seats, the IPC conducts child passenger safety fitting stations in high-risk areas of Dallas. At fitting stations, parents/guardians are able to obtain educational information and hands-on training on installing child passenger safety seats correctly. If a child safety seat has been recalled or is no longer appropriate for the child’s age and weight, then a child safety seat is provided and installed by the IPC. To be eligible to receive a free child safety seat inspection, parents/guardians are required to bring the child safety seat and child to the appointment.
National Child Passenger Safety Certification Training Program
Since 2008, the IPC has conducted the National Child Passenger Safety Certification Training Program. The national CPS technician certification course is 32 hours and combines classroom instruction, hands-on work with car seats and vehicles, and a community safety seat checkup event, where students demonstrate proper use and installation of child restraints and safety belts and then teach these skills to parents. Successful completion of the course certifies the individual as a CPS technician for two years. Individuals must recertify during the two-year period. One of the requirements to recertify is to obtain a minimum of 6 hours of CPS technical continuing education units, which must be earned and reported during the current two-year certification cycle.
For information about future dates of the National Child Passenger Safety Certification Training Program and continuing education classes offered by the IPC, please visit our Training page.