Abstract
Objective
We modified the Child Safety Seat (CSS) Hassles Scale to characterize CSS hassles
in a diverse population and test for associations between hassles and caregiver-reported
child passenger safety behaviors.
Methods
Secondary analysis of a 2-site survey of caregivers seeking emergency care for their
≤10-year-old child in 2015. Caregivers answered questions regarding CSS hassles, child
passenger safety behaviors, and demographics. Size-appropriate restraint use was defined
by the American Academy of Pediatrics (AAP) 2011 Guidelines for Child Passenger Safety.
We tested for associations between the number of hassles and adherence to AAP guidelines
(including the consistent use of a size-appropriate CSS, travel in a back seat, and
never traveling unrestrained).
Results
There were 238 caregivers included in analyses. Overall, caregivers endorsed a median
of 5 hassles (interquartile range 2, 8). Half (50.8%) of caregivers endorsed child
passenger safety behaviors that were nonadherent to AAP guidelines. Compared with
caregivers reporting no hassles, there was an increased odds of not adhering to AAP
child passenger safety guidelines for each additional hassle reported (adjusted odds
ratio [aOR] 1.11; 95% confidence interval [CI] 1.03, 1.19). In addition, a higher
number of hassles was associated with the inconsistent use of a size-appropriate CSS
(aOR 1.15; 95% CI 1.06, 1.25) and as sometimes traveling unrestrained (aOR 1.13; 95%
CI 1.03, 1.23).
Conclusions
Caregivers who reported more CSS hassles were more likely to report behaviors that
were not adherent to AAP guidelines. Addressing CSS hassles may provide solutions
for nonadherence of AAP child passenger safety guidelines.
Keywords
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Article info
Publication history
Published online: February 09, 2021
Accepted:
February 5,
2021
Received:
July 21,
2020
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2021 by Academic Pediatric Association
