Researchers Identify Gaps in Child Passenger Safety Materials

(July, 2002) In the first study of its kind, researchers from EDC's Health and Human Development Programs (HHD) assessed the content, availability, accuracy, and appropriateness of U.S. child passenger safety educational materials for the general public, as well as identified important gaps in these materials. The study "Seated for Safety," was

"Our main goal was to identify the strengths and weaknesses of existing materials; we hope our results will be used to improve the next generation of child passenger safety resources and inform the development of educational materials more broadly," said Julie Ross, a co-author of the study and a project coordinator at HHD's Children's Safety Network, a resource center within the Center for Violence and Injury Prevention.

The project researchers reviewed 401 printed items collected from 101 organizations. A 10 percent sample was evaluated for technical accuracy, cultural appropriateness, and appropriateness for audiences with low-literacy and low-income, and those who transport children with special health care needs. Because no evaluation tool existed to assess educational materials for cultural appropriateness, the researchers developed one.

Among the study's most important findings:

Most of the materials were not appropriately field-tested during their development or evaluated following dissemination.

Most of the materials were written two or more years ago and likely contained factual inaccuracies; child passenger safety recommendations have since changed.

Most of the materials were not available in languages other than English.

Certain topics were rarely addressed, such as guidelines for transporting children with special health care needs or transporting children in vehicles other than standard passenger cars.

Few of the evaluated items addressed the needs of children at highest risk of motor vehicle injury, including those from low-income and non-English-speaking families.

Many of the evaluated items did not contain basic, critical information, such as the importance of rear seating for children 12 and under.

Reading levels of evaluated items were higher than recommended for the general public.

Between 1994 and 1998, 5,500 motor vehicle passengers 12 and under were killed and 660,000 were injured, according to the Centers for Disease Control and Prevention. Contributing factors included inappropriate selection, installation, and use of child restraints; inappropriate "graduation" from child safety seats to seat belts; and improper seating position within the vehicle.

Minority populations, recent immigrants, non-English speakers, people with low income, people with low literacy, and children with special health care needs are at especially high risk of injury as motor vehicle occupants, according to published research. Educational materials that teach parents and other caregivers, particularly those associated with these high-risk groups, how to protect children are an important part of an overall strategy to reduce child motor vehicle deaths and injuries, said Ross. "Organizations and agencies that produce these materials should have them developed and reviewed for technical accuracy by child passenger safety experts, as well as by target audiences for cultural appropriateness," she noted.

According to the report, new materials need to be developed on specific topics, such as guidelines for children with special health care needs and children riding in vehicles other than recent-make cars, such as older cars with lap belts only, pickup trucks, vans, taxicabs, airport shuttles, and buses. And particular attention should be paid to developing and disseminating information in rural areas, said Ross, which have higher motor vehicle crash and death rates than suburban and urban areas. Pickup trucks and other vehicles without standard back seats are common in rural areas.

The EDC researchers recommend new, higher standards for child passenger safety materials, many of which did not appear to have gone through a formal review process. They advise that all future materials be: written at recommended reading levels, developed with input from target audiences, field-tested, available in a variety of languages, and inclusive of issues of concern to specific populations, such as lower-income populations with older cars, those who transport children in pickup trucks, and those who transport children with special health care needs.

"Future research should focus on establishing standards for new educational materials and on developing better strategies for distributing them to high-risk target audiences," said Ross. She noted that the evaluation methods used in the AAA Foundation study could be applied to any educational materials that need to be developed or updated on a regular basis.