Use of child booster seats in motor vehicles following a community campaign

Once children have outgrown car seats, booster seats protect from injury better than lap and shoulder belts alone. However, the majority of children aged 4 to 8 years use only an adult seat belt. The objective of this study was to evaluate the effectiveness of a multifaceted community booster seat campaign in increasing observed booster seat use among child passengers in motor vehicles. This was a prospective, nonrandomized, controlled community intervention trial. The campaign was initiated in 4 communities in the greater Seattle, Washington, area between January 2000 and March 2001. Eight communities in Portland, Oregon, and Spokane, Washington, served as control sites. The authors observed 3609 booster-eligible children (those aged 4-8 years and weighing 18-36 kg [40-80 lb]). The main outcome measure was observed booster seat use 15 months after the start of the campaign. Results show that before the campaign began, 13.3% of eligible children in the intervention communities and 17.3% in the control communities were using booster seats, adjusting for child age, driver seat belt use, and sex of driver. Fifteen months after the start of the campaign, adjusted booster seat use had increased to 26.1% in the intervention communities and 20.2% in the control communities. In conclusion, these data suggest that a multifaceted community education campaign can significantly increase the use of child booster seats.