Background: Despite legislation and research evidence supporting the use of childhood vehicle restraints, motor vehicle crashes remain the leading cause of injury, death and disability among Canadian children. Methods: Working in collaboration with trained car seat specialists and police officers, roadside checks were conducted to observe correct use of child restraints. Results: Of the 1323 child vehicle restraints inspected, 99.6% of the children were restrained, 91% were in the correct seat, and 48% of restraints were correctly installed. The seat/restraint types most used incorrectly used were booster seats (31%) and seat belts (53%). The majority of incorrectly installed or fitted seats (55%) were forward facing. Common errors in installation and fit included the seat not being secured tightly enough to the vehicle, incorrect tether strap use, the harness not being tight enough, and/or the chest clip being in the wrong place. Conclusions:The greatest proportion of incorrect seat use was among those children who transitioned to a seat belt too soon. The greatest proportion of installation and fit errors were among forward facing seats. Researchers recommend: 1) targeting parents with older children (ages 3 and above) regarding transitioning too soon from forward facing seats to booster seats, and from booster seats to seat belts; 2) targeting parents with younger children regarding correct installation of rear facing and forward facing seats; 3) collaborating with police officers to review the most common errors and encourage observation at roadside checks; and 4) creating community awareness by way of roadside checks.

Purpose: Misuse and/or lack of booster seat use are often associated with high rates of injury and death among school-aged children. This pilot study examined the efficacy and the potential effectiveness of a booster seat intervention in the classroom. Methods: Two elementary schools participated (randomly assigned as one intervention school and one control school). At the intervention school, a certified car seat specialist and a police officer held an interactive booster seat session. The height and age for each child were recorded. Children received a certificate indicating whether they met the requirements for booster seat use and a postcard with car seat restraint specifications. Children in the control school received a brochure on car seat safety. Pre-and post-intervention self-reports were collected and booster seat use was observed. Results: Observational findings showed a decline in booster seat use at the control school and an increase in use at the intervention school. Self-reports of booster seat use indicated a decline at both schools; however, cell sizes were too small to permit statistical analyses. Conclusion: Anecdotally researchers found the sessions were easy to conduct and were well received by the children and could be easily integrated into programming in schools. Classroom sessions may have the potential to positively influence booster seat use among 6-to 8-year-olds. Keywords: Booster seats; Child passenger safety; Evaluation; School intervention.Motor vehicle collisions are the leading cause of death for Canadian children under the age of 9 years (1). The correct use of child passenger safety seats can reduce a child's risk of mortality from a motor vehicle crash by 74%, while risk of serious injury can be decreased by 67% (2). For elementary school children between the ages of 4 and 8 years, booster seats are reported to be more effective in preventing injury and death than seat belts alone in the event of a collision (3-5). However, despite the safety advantages, the most recent Transport Canada Survey identified school-aged children (4 to 8 years old) as having the lowest rates of correct safety seat use, at less than 40% (6). Self-report surveys revealed that 31% of Canadian families use their booster seats less than 100% of the time, with 52% of these families using them less than 80% of the time (7). A recent observational study in Nova Scotia that reported incorrect restraint use found that those children using only a seat belt constituted the greatest proportion of incorrect restraints (8). Despite prior efforts to inform parents of the injury prevention benefits of booster seat use, there still remains a significant number of inadequately restrained children among the 4-to 8-year age group.The rationale behind the effectiveness of booster seats for young children as compared with seat belts, is that seat belts are designed for an adult body, increasing the risk of injury among children in the event of a crash (9). Booster seats can reduce the risk of injury by 59% when ...