Advertisement

Looking Back on Rear-Facing Car Seats: Surveying US Parents in 2011 and 2013

Published:January 05, 2015DOI:https://doi.org/10.1016/j.acap.2014.10.004

      Abstract

      Objective

      We sought to determine the age at which US parents first turned their child's car seat to face forward and information sources used to make that decision at the time of the release of the 2011 guidelines for child passenger safety and 30 months later.

      Methods

      We administered 2 separate cross-sectional Web-based surveys of nationally representative panels of US parents in May 2011 and November 2013. Survey participation rate was 54% in both years. Parents of children ≤4 years old responded to questions about transitioning from rear-facing to forward-facing car seats (n = 495 in 2011; n = 521 in 2013).

      Results

      In 2011, 33% of parents of 1- to 4-year-old children who had been turned to face forward (n = 409) turned at or before 12 months and 16% turned at 2 years or older. In 2013, 24% of parents of 1- to 4-year-old children who had been turned to face forward (n = 413) turned at or before 12 months and 23% turned at 2 years or older. Car seat packaging and clinicians were the most common information sources. Demographic characteristics associated with turning to face forward at or before 12 months of age in 2011 (parent age, education, household income, rural residence) were not significantly associated with transitioning at or before 12 months in 2013.

      Conclusions

      Delaying the transition to a forward-facing car seat still represents an opportunity to improve passenger safety in the United States. As common sources of information, clinicians may be influential in a parent's decision to turn their child's car seat to face forward.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Academic Pediatrics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bull M.J.
        • Durbin D.R.
        Rear-facing car safety seats: getting the message right.
        Pediatrics. 2008; 121: 619-620
      1. O’Keefe L. New advice: rear-facing car seats safer for children until they are 2. AAP News, April 1, 2009.

        • Henary B.
        • Sherwood C.P.
        • Crandall J.R.
        • et al.
        Car safety seats for children: rear facing for best protection.
        Inj Prev. 2007; 13: 398-402
        • Macy M.L.
        • Freed G.L.
        Child passenger safety practices in the US: disparities in light of updated recommendations.
        Am J Prev Med. 2012; 43: 272-281
        • Pickrell T.M.
        • Ye T.
        Child Restraint Use in 2008—Use of Correct Restraint Types.
        National Center for Statistics and Analysis, National Highway Traffic Safety Administration, Washington, DC2009
        • Pickrell T.M.
        • Ye T.
        The 2009 National Survey of the Use of Booster Seats.
        National Center for Statistics and Analysis, National Highway Traffic Safety Administration, Washington, DC2010
      2. National Highway Traffic Safety Administration. Child safety seat ease of use ratings. Available at: http://www.nhtsa.gov/portal/nhtsa_eou/info.jsp?type=all. Accessed August 25, 2011.

        • O’Neil J.
        • Slaven J.E.
        • Talty J.
        • Bull M.J.
        Are parents following the recommendations for keeping children younger than 2 years rear facing during motor vehicle travel?.
        Inj Prev. 2014; 20: 226-231
        • Pickrell T.M.
        • Ye T.
        The 2011 National Survey of the Use of Booster Seats.
        National Center for Statistics and Analysis, National Highway Traffic Safety Administration, Washington, DC2013
        • Durbin D.R.
        Child passenger safety—policy statement.
        Pediatrics. 2011; 127: 788-793
      3. Dennis JM. Summary of KnowledgePanel design. Available at: http://www.knowledgenetworks.com/ganp/reviewer-info.html. Accessed June 10, 2014.

        • Tarini B.A.
        • Singer D.
        • Clark S.J.
        • Davis M.M.
        Parents’ interest in predictive genetic testing for their children when a disease has no treatment.
        Pediatrics. 2009; 124: e432-e438
        • Dempsey A.F.
        • Singer D.D.
        • Clark S.J.
        • Davis M.M.
        Adolescent preventive health care: what do parents want?.
        J Pediatr. 2009; 155: 689-694.e1
        • Macy M.L.
        • Clark S.J.
        • Freed G.L.
        • et al.
        Carpooling and booster seats: a national survey of parents.
        Pediatrics. 2012; 129: 290-298
        • Freda M.C.
        The readability of American Academy of Pediatrics patient education brochures.
        J Pediatr Health Care. 2005; 19: 151-156
      4. SaferCar.gov; National Highway Traffic Safety Administration. Car seat recommendations for children. Available at: http://www.safercar.gov/parents/RightSeat.htm. Accessed June 10, 2014.

      5. Selecting and using the most appropriate car safety seats for growing children: guidelines for counseling parents.
        Pediatrics. 2002; 109: 550-553
      6. Hagan Jr., J.F. Shaw J.S. Duncan P.M. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents 3rd ed., pocket guide. American Academy of Pediatrics, Elk Grove Village, Ill2008 (Available at:) (Accessed October 28, 2014)
      7. Insurance Institute for Highway Safety. Child restraint laws. Available at: http://www.iihs.org/laws/ChildRestraint.aspx. Accessed December 2, 2013.

        • O’Neil J.
        • Bull M.J.
        • Talty J.
        • Slaven J.E.
        Important child occupant saftety trends, Indiana, between 2005 and 2010.
        Ann Adv Automot Med. 2011; 55: 27-32
      8. Johnson CK. New advice: Tots safest in rear-facing car seats until age 2. NBCNews.com, March 21, 2011. Available at: http://www.nbcnews.com/id/42186101/ns/us_news/t/new-advice-tots-safest-rear-facing-car-seats-until-age/#.VE-2yskZ6ZR. Accessed March 14, 2014.

      9. Emmons S. AAP: Toddlers in rear-facing seat until 2. CNN Health, March 21, 2011. Available at: http://www.cnn.com/2011/HEALTH/03/21/car.seat.guidelines.parenting/. Accessed March 14, 2014.

      10. Szabo L. Children should ride in rear-facing car seats until age 2. USA Today, March 30, 2011. Available at: http://usatoday30.usatoday.com/news/health/wellness/story/2011/03/Children-should-ride-in-rear-facing-car-seats-until-age-2/45099386/1. Accessed March 14, 2014.

        • Wegner M.V.
        • Girasek D.C.
        How readable are child safety seat installation instructions?.
        Pediatrics. 2003; 111: 588-591
        • Decina L.E.
        • Lococo K.H.
        Child restraint system use and misuse in six states.
        Accid Anal Prev. 2005; 37: 583-590
        • Winston F.K.
        • Chen I.G.
        • Smith R.
        • Elliott M.R.
        Parent driver characteristics associated with sub-optimal restraint of child passengers.
        Traffic Inj Prev. 2006; 7: 373-380
        • Macy M.L.
        • Cunningham R.M.
        • Resnicow K.
        • Freed G.L.
        Disparities in age-appropriate child passenger restraint use among children aged 1 to 12 years.
        Pediatrics. 2014; 133: 262-271
        • Pickrell T.M.
        • Ye T.
        Child Restraint Use in 2008—Demographic Results.
        National Center for Statistics and Analysis, National Highway Traffic Safety Administration, Washington, DC2009
        • Winston F.K.
        • Kallan M.J.
        • Elliott M.R.
        • et al.
        Effect of booster seat laws on appropriate restraint use by children 4 to 7 years old involved in crashes.
        Arch Pediatr Adolesc Med. 2007; 161: 270-275
        • Sun K.
        • Bauer M.J.
        • Hardman S.
        Effects of upgraded child restraint law designed to increase booster seat use in New York.
        Pediatrics. 2010; 126: 484-489
      11. Carlsson A, Strandroth J, Bohman K, et al. Review of child car occcupant fatalities in Sweden during six decades. Paper presented at: International Research Council on the Biomechanics of Injury; Gothenburg, Sweden; 2013.

      12. Flegenheimer M. De Blasio looks toward Sweden for road safety. New York Times, May 12, 2014.

      13. Why Sweden has so few road deaths. Economist, February 26, 2014. Available at: http://www.economist.com/blogs/economist-explains/2014/02/economist-explains-16. Accessed May 20, 2014.

        • O’Neil J.
        • Bandy R.
        • Talty J.L.
        • Bull M.J.
        Drivers’ reasons for choosing forward facing car safety seats.
        Clin Pediatr (Phila). 2011; 50: 869-871