Booster Seat Promotion Program
Nassau County, New York

Project Type: Multifaceted community outreach, education, and distribution of booster seats to low-income families

State Law at Time of Project Implementation: New York State did not require booster seat use during the time that the project was implemented. New York State's Occupant Restraint Law stipulated that all children younger than age 4 must be restrained in a child safety seat that meets Federal Motor Vehicle Safety Standard 213. Children younger than age 10 riding in the back seat are required to wear safety belts. This law also specifies primary safety belt use enforcement. Legislation has been introduced requiring the use of booster or child safety seats for children who are younger than 7 years of age or weigh less than 70 pounds.

Purpose: To conduct a public education and outreach program with an emphasis on reaching target audiences in low-income areas to increase the use of booster seats in Nassau County, New York.

Primary Audience(s): Healthcare providers, safety and law enforcement personnel, educators, child safety seat retailers, childcare and Head Start personnel, families and children, senior citizens, and private-sector employers

Project Reach: Nassau County, New York

Project Description: This project used a community-based approach with a special emphasis on outreach to intermediaries who could educate their constituents about booster seat use. Various direct and indirect communications strategies were used, including lectures, presentations, workshops, contests, and child safety seat inspection events. The distribution of booster seats and written information on booster seat use through public and private venues was an integral part of the project.

Key Project Elements: Though listed sequentially, implementation of these elements occurred at different times throughout the project:

• Collected questionnaires and surveys from childcare workers, physicians, other healthcare workers, and car rental companies. Observational surveys were conducted of children (4- to 8-year-olds), child passenger injury data were collected, and five focus groups were conducted to test perceptions of booster seat use and nonuse.

• Educated health-related professionals through workshops, lectures, interviews, presentations during grand rounds at hospitals, presentations at professional meetings, and one-on-one meetings.

• Distributed pamphlets, brochures, programming suggestions, and other types of written information on child safety seats to all intermediary groups.

• Conducted a children's booster seat contest through the schools, childcare centers, libraries, and toy stores. Children were asked to observe and record the restraint status of 4- to 8-year-old children in other cars.

• Provided pamphlets to the leading child safety seat retailers and offered CPS training to their employees.

• Facilitated CPS training for police officers.

• Conducted child passenger safety inspection events and established additional county child safety seat fitting stations.

• Conducted extensive media outreach. Gave interviews to local news stations and cable TV programs. Persuaded local newspapers and national and local magazines to include feature articles.

• Distributed booster seats to low-income families.

• Began preliminary work on the creation of a web site to provide countywide injury prevention information and data (done in collaboration with New York State).

Qualitative Research Findings: This project used a variety of qualitative research methods to document project activities. Generalizations based on the study reports are listed below:

Factors influencing target audience (intermediaries) advocacy of booster seat use

• Physicians visited personally by the grant administrator were interested and informed.

• Because law enforcement professionals have their own training programs, they are already receptive to information on CPS and are open to expanding their efforts on CPS promotion.

• Childcare providers and educators who received brochures on child passenger safety demonstrated interest in using the information (multiple followup requests for additional information were received).

Factors that prevented target audience (intermediaries) advocacy of booster seat use

• Many healthcare professionals do not maintain memberships with professional associations; therefore, use of these organizations may be ineffective as vehicles for distribution of information to these audiences.

• Time constraints experienced by healthcare professionals, along with attitudinal resistance (physicians dismissing health-related information from nonphysicians, negative about office solicitors) reduced their level of receptivity for information provided by this project.

• High staff turnover in retail organizations precluded educating all those working with child safety seats.

• Use of contests at schools depended on the principal's interest (usually low). Those contests that were held were labor intensive to organize and promote.

Factors affecting booster seat distribution and use

• Childcare centers serving low- to middle-income families were effective venues for distributing seats and information, as evidenced by their continued use. Conversely, health department clinics were not as successful. The very low-income status of clients and "chaotic" family conditions were cited as negative factors.

Project Evaluation Methods: Attitudinal and observational surveys were used at the outset of the project to establish baseline measures. Evaluation methods employed in this study were primarily process oriented. Numbers of informational briefings given, numbers of brochures distributed, media appearances, and other process measurements were used as appropriate for each type of outreach and audience.

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Key Programmatic Findings and Lessons Learned

• Some physicians and other healthcare professionals will respond only to outreach efforts by "credentialed" individuals. As a result, these groups are more labor intensive to activate as advocates. However, once educated, physicians can become an increasingly important source of child passenger safety information for families of young children.

• Target audiences who already see public safety and/or child advocacy as their responsibility are the most receptive to booster seat advocacy.

• Offering CPS workshops through the local Childcare Council was very effective. Childcare workers needing recertification in New York have a higher incentive to learn about booster seat use.

• Two major interrelated factors influence the effectiveness of organizations that work with low-income families to serve as booster seat advocates. One factor is the nature of their client contact (routine or emergency). The other factor is the organization's ability (sufficient staff and commitment) to follow through with education on the proper use of child safety seats.

• Connections with established community and professional groups (AAA, Childcare Council, Traffic Safety Board) strongly contributed to the success of outreach efforts.

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