Determinants of child safety seat use among parents in an International Safe Community, Tehran, Iran

Objective: Road traffic accidents are a global issue and serious threat for public health. Children are at high risk of serious injury or death from motor vehicle crashes. Child safety seats (CSSs) can reduce the risk of death and serious injury in children. This study was done to determine the prevalence of child safety seat use in vehicles and the factors influencing their use in a safe society (Tehran, Iran) in 2015.

Methods: In this cross-sectional study, 804 parents with children under 12 years old who owned private cars were questioned in different areas of Tehran. A questionnaire included demographic data, and 2 specific questionnaires were used for families that used a CSS and those did not use a CSS. Univariate and multivariate binary logistic regression analyses were conducted. Crude and adjusted odds ratios (AORs) with 95% confidence intervals (CIs) were calculated. All analyses were carried out using SPSS 21.

Results: The prevalence of child safety seat use was 18.7% and was significantly higher among parents with an income greater than 50 million rials/month, parents who received child safety seat recommendations, parents living in the north of Tehran, and fathers with more driving experience. Age, weight, and height of children were also factors that influenced the use of child safety seats. The most common reasons for parents to use child safety seats was awareness about the benefits of this device and fear of harm to the child, and the most common reasons for nonuse were child intolerance while sitting in the seat and cost.

Conclusion: The prevalence of child safety seat use in Tehran is very low, and most parents are not aware of the importance of child safety seats. Comprehensive programs, including legislation, law enforcement, public education, and publicity to promote the benefits of using CSSs, in Tehran can be an effective step toward increasing the use of child safety devices.