Introduction

Protecting children when they ride in motor vehicles is the responsibility of all community members. Nationally, we have done a good job of getting our very young children (from birth through age 3) into child safety seats; however, too many children who are 4 to 8 years of age are still riding unrestrained. Although any type of occupant restraint use is better than riding unprotected, research has shown that the safest way for 4- to 8-year-old children to ride is in a booster seat. (Fifth Report to Congress, Third Report to the President, NHTSA/DOT, March 2003)

During Fiscal Year 2001, the National Highway Traffic Safety Administration (NHTSA) funded pilot and demonstration projects to implement community-based strategies to increase booster seat use for children weighing between 40 and 80 pounds.* These projects examined factors and activities that influence booster seat use. They all involved community-wide campaigns enhanced by a variety of more targeted activities, such as the development of classroom materials for elementary school children and outreach to pediatricians. Project overviews highlighting key project elements, qualitative research findings to consider, and programmatic findings and lessons learned are presented throughout the guide.**

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Using the Guide

This how-to guide, synthesizing the research findings and lessons learned from the demonstration projects, is for all child passenger safety (CPS) and injury control advocates. Resources and other best practices information from CPS and other occupant protection programs round out the guide to provide a broad view and context for the promotion of booster seats. Use this information to:

• Determine how to initiate the promotion of booster seats in your State or community

• Examine factors that can influence the success of your booster seat promotional and outreach efforts

• Decide how to best use available resources to promote booster seat use

• Monitor and evaluate the success of your efforts.

To read about a wide variety of activities that can be adapted to promote booster seat use in your community, view and/or order a copy of NHTSA’s “Fifth Report to Congress, Third Report to the President: The National Initiative for Increasing Seat Belt Use.” You can find it on NHTSA’s web site, www.nhtsa.gov.

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Integrating Booster Seat Use Into Your Child Passenger Safety Program

NHTSA's demonstration projects addressed many of the issues that affect occupant restraint use for all young children. In some instances, the activities and approaches used in the projects are identical to those that have been and continue to be used to promote child safety seats for younger children. Therefore, in addition to providing important information, lessons learned, and best practices for promoting booster seat use, the case studies can be used to expand and enhance current CPS programs.

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NHTSA's National Strategy To Increase Booster Seat Use

Congressional support for booster seats led to a mandate for NHTSA to develop a national strategic plan*** to increase booster seat use among 4- to 8-year-old children. (The plan can be viewed and ordered from NHTSA's web site, www.nhtsa.gov.) The strategic approach of the plan is modeled after NHTSA's Buckle Up America campaign, which uses (1) public-private partnerships, (2) strong laws, (3) active, high-visibility law enforcement, and (4) effective public education to promote the use of safety belts. In many ways, NHTSA's booster seat demonstration projects also use this model. Although the projects do not include specific activities to close the gaps in child restraint laws, they all recognize the critical need for better laws and the benefits of public-private partnerships, enforcement, and public education.

*At the time these projects were funded, the Agency's policy stated that children between 40 and 80 pounds should be secured in a belt-positioning booster seat. The new recommendation to determine readiness for a booster seat is that "all children who have outgrown child safety seats should be properly restrained in booster seats until they are at least 8 years old, unless they are 4 feet 9 inches tall."

**The Additional Reading at the end of the guide identifies other research on child passenger safety and booster seat use.

***Under the 2000 Transportation Recall Enhancement, Accountability, and Documentation (TREAD) Act (Section 14(I), Improving the Safety of Child Restraints—Booster Seat Education Program), Congress mandated that the Department of Transportation develop "…[a] 5-year strategic plan to reduce death and injuries caused by failure to use the appropriate booster seat in the 4 to 8 year old group…"

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