CHILD RESTRAINT - DEVICE USE IN PATIENTS LEAVING A CHILDRENS-HOSPITAL

Objective: To determine the frequency of and factors associated with t he use of child restraint devices (CRDs) in patients leaving an urban children's hospital. Design: Verbally administered survey, followed by observation of CRD use. Setting: Main parking area at an urban childr en's hospital with mandated use of parking attendants. Participants: A convenience sample of 295 parents or guardians who were leaving the h ospital and were accompanied by at least 1 child younger than 48 month s. Results: Eighty percent of the respondents were female; 77% of the respondents were white and 22% were African American. Two hundred thir ty-five (80%) used CRDs. Subjects who were at risk of CRD noncomplianc e included nonwhite individuals (adjusted odds ratio [OR], 6.6; 95% co nfidence interval [CI], 3.0-14.5), those whose primary source of medic al care was from a public clinic (OR, 2.4; 95% CI, 1.1-5.3) or from a specialty clinic (OR, 2.4; 95% CI, 0.8-6.6), and those who were older than 24 months (OR, 8.7; 95% CI, 3.5-21.9). Parental education and inc ome level were not important predictors of CRD compliance controlling for race, primary medical care source, and age. Study participants wer e observed for incorrect CRD use; 30% (30/99) of infants younger than 12 months were incorrectly placed in the forward-facing position, and 23% (54/235) of all CRD users did not use its harness. Conclusions: Pa tients who use public clinics or pediatric subspecialists as their pri mary source of medical care, especially those who are African American s, are at risk of CRD noncompliance. Children's hospitals should take an active role in improving CRD use in these patients.