https://cadeirasauto.fundacionmapfre.org/infantis/images/review-evidence-regarding-child-safety-seat_tcm727-93772.pdf

Reviews of evidence regarding interventions to increase use of child safety seats.

Accident prevention. Presentation of a model placing emphasis on human, structural and cultural factors

Unintentional injury is the leading cause of death for children and adolescents between the ages of 1 and 18 in the United States, accounting for more deaths than the next 20 causes of mortality combined. It is estimated that pediatric injury accounts for more than $50 billion in annual losses from medical care costs, future wages, and quality of life. Despite these numbers, much remains to be learned about the behavioral risks for pediatric unintentional injury. This article reviews behavioral risk factors for pediatric unintentional injury risk, with a particular focus on four broad areas. First, we discuss the effects of demographic risk factors, including gender, socioeconomic status, and ethnicity. Second, we present information about child-specific risk factors, including temperament, personality, psychopathology, and cognitive development. Third, we discuss the influence of parents and other primary caregivers on childhood injury risk, with a particular focus on the effects of supervision and parenting quality and style. Finally, we discuss the role of peers on child injury risk. We conclude with a discussion of the ways in which the material reviewed has been translated into injury prevention techniques, with a focus on how pediatricians might use knowledge about etiological risk to prioritize safety counseling topics. We also present thoughts on four priorities for future research: injury risk in diverse nations and cultures; developmental effects of injury; the influence of multiple risk factors together on injury risk; and translation of knowledge about risk for injury into intervention and prevention techniques.

Pediatric unintentional injury: Behavioral risk factors and implications for prevention

• Though bicycle head trauma is a significant cause of mortality and morbidity, much of which can be mitigated by wearing protective helmets, in 1986, few schoolchildren in the area of Seattle, Wash, were observed to wear helmets. We describe the mechanics of a multifaceted campaign undertaken to alter this situation, involving a coalition of health, bicycle, and helmet industry organizations. These were the major objectives: (1) to convince parents that riding bicycles without helmets is hazardous, (2) to lower the price of helmets to more affordable levels, and (3) to overcome the reluctance of children to wear helmets. The campaign was successful; the sales of one brand of a youth helmet in the Seattle area rose from 1500 to 22 000 over a 3-year period, and the observed helmet usage rate among school-age children increased from 5% to 16% compared with a rise of only 1% to 3% in a control community, Portland, Ore. (AJDC. 1990;144:727-731)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=peds&articleId=515201&pdfFileName=archpedi_144_6_033.pdf

The Seattle children's bicycle helmet campaign.

This paper addresses issues and research needs in the domain of behavior modification for injury control. Although much of the discussion focuses on traffic safety, the concepts and principles are applicable to all areas of injury control (e.g. on the job and in the home). Field research that has increased safety belt use is reviewed briefly to illustrate a tripartite classification of injury control factors (i.e. environmental, individual, or behavioral variables), and to introduce a heuristic framework for categorizing and evaluating behavior change strategies. A multiple intervention level hierarchy depicts a progressive segmentation of the target population as more effective (and costly) interventions are implemented; and a taxonomy of 24 behavior change techniques includes a scoring system for predicting short and long term effects of intervention programs. It is presumed that more risk-prone individuals require higher-level interventions, which are those that provide specific response information and extrinsic controls, while also eliciting active participant involvement, social support, and perceptions of autonomy. Although extrinsic controls increase the immediate impact of an intervention program, these techniques may jeopardize response maintenance when the program is withdrawn.

/pdf/a-conceptual-framework-for-developing-and-evaluating-3744jj699k.pdf

A conceptual framework for developing and evaluating behavior change interventions for injury control

Rewarding Parents for Their Children's Use of Safety Seats

Virtually all children are at risk for injury and death as passengers in moving vehicles. Between 70% to 90% of the injury and death could be reduced or prevented if children were restrained in safety seats. However, studies show that only a minority of children are properly protected. Numerous efforts have been made to increase the number of children riding in car safety seats. This article reviews and synthesizes the various attempts to motivate safety seat usage by examining the literature on (1) informational and educational programs; (2) safety seat loaner programs; (3) state laws requiring seat usage; (4) behavioral improvement emphasis programs; (5) reward-based programs; and (6) passive prevention approaches through airbags. No one approach appears to be the solution to the complex problem of motivating the preventive behavior of acquiring and consistently using safety seats. Recommendations are forwarded for: (1) developing and determining the best techniques for which settings through comparative research; (2) utilizing a developmental perspective in identifying when and what interventions are needed; and (3) implementing creative and comprehensive programs in communities.

Preventing Death and Injury in Childhood: A Synthesis of Child Safety Seat Efforts

This paper examines the development of stopping sight distance (SSD) methodology over the past 75 years. Publications between 1914 and 1940 show that sight distance became increasingly important, but that it was not thoroughly understood. The emphasis during this period was on letting drivers see other vehicles in sufficient time to take evasive action. This concept changed drastically with the 1940 publication of AASHO's classic methodology, which made specific reference to objects, eye heights, and driver perception and reaction times. Evidence shows that the new procedures were gradually assimilated into the design process. Since 1940, emphasis has been on fine tuning the methodology by modifying its parameters. The paper discusses the prominent factors affecting SSD and traces their development over the past 75 years. The sensitivity of stopping sight distance to changes in the key parameters is examined. Characteristics and weaknesses of the methodology are discussed through a review of the recent technical literature. Five potential problems with the current AASHTO policies are discussed. Conclusions are drawn regarding the appropriateness of the current methodology and several specific recommendations are offered for additional research on this important topic.

Stopping sight distance: can we see where we now stand?

The conception, development, and adoption of early AASHO highway design criteria are documented. Examining the early efforts states used to select a design vehicle and develop horizontal curve design criteria illustrates why AASHO's leadership was necessary. AASHO's slow and somewhat haphazard criteria development, and the disparity from state to state, demonstrated the need for a national consensus in highway design parameters. AASHO's role in providing these criteria is outlined through its initial development of policy booklets, followed by its 1954 publication of the landmark Blue Book. The processes by which nine states adopted the AASHO guidance are briefly reviewed. In several cases, the AASHO policy was embraced immediately, and in others it was accepted slowly as states clung to their independent design processes and only gradually updated their design criteria. A few simple conclusions are drawn about the development and adoption process, particularly as it may relate to tomorrow's highway design criteria.

Development and Adoption of Early AASHO Design Criteria

This synthesis will be of interest to highway administrators, safety officials, design engineers, traffic engineers, and analysts who are concerned with improving highway safety Severity indices, which serve as indicators of the expected injury consequences of a crash, are an integral part of the analysis of proposed roadside safety improvements Severity indices that have been developed by many states and research agencies are described, as are the issues associated with developing the values, and applying and evaluating the indices The history of severity indices, the issues associated with estimating accident severity and associated costs, and the range of indices that have been developed are described This publication of the Transportation Research Board also discusses the relationship of accident severity indices with the American Association of State Highway and Transportation Officials (AASHTO) Roadside Design Guide and the Federal Highway Administration (FHWA) ROADSIDE computer program While research since the 1960s has sought to quantify severity indices for a range of object types and impact conditions, there remains a wide variation in the values from which analysts may choose when performing cost effectiveness evaluations

D S Turner

Papers

Rewarding Parents for Their Children's Use of Safety Seats

Preventing Death and Injury in Childhood: A Synthesis of Child Safety Seat Efforts

Stopping sight distance: can we see where we now stand?

Development and Adoption of Early AASHO Design Criteria

Severity indices for roadside features