Buckle Up Challenges and Strategies for Hard-To-Reach Groups.

Buckle Up Challenges Buckle Up Challenges and Strategies for and Strategies for

Hard-To-Reach GroupsHard-To-Reach Groups

ModeratorModerator

Susanne Ogaitis-Jones, Susanne Ogaitis-Jones, MSPH, CHES, CPSTMSPH, CHES, CPSTCoordinator, CPS & OP Healthcare ProjectCoordinator, CPS & OP Healthcare Project

Maryland Institute for Maryland Institute for Emergency Medical Services SystemsEmergency Medical Services Systems

This webinar is brought to you by the Maryland Institute for Emergency Medical Services Systems EMSC Program, with

funding from the Maryland Highway Safety Office and Federal traffic safety funds.

Housekeeping DetailsHousekeeping Details• Please put your phones on Please put your phones on MUTEMUTE in order to in order to

minimize background noise, as the presentation is minimize background noise, as the presentation is being recorded so that we can archive the slides and being recorded so that we can archive the slides and audio on our website.audio on our website.

• Please save questions/comments until the end of the Please save questions/comments until the end of the presentation.presentation.

• At the end of the participation, we would be At the end of the participation, we would be grateful if you would complete and send back a grateful if you would complete and send back a brief evaluation form.brief evaluation form.

Today’s SpeakersToday’s Speakers

• Jewel Johnson, CPST/I, Safety AdvocateJewel Johnson, CPST/I, Safety Advocate

• Danitza A. Simpson, Director, Danitza A. Simpson, Director, Adelphi-Langley Park Family Support Center Adelphi-Langley Park Family Support Center

• Moderator: Susanne Ogaitis-Jones, MSPH, Moderator: Susanne Ogaitis-Jones, MSPH, CPST, Coordinator of CPS, MIEMSS CPST, Coordinator of CPS, MIEMSS

National Restraint Use Rates National Restraint Use Rates

National Survey of Use of Booster Seats, National Survey of Use of Booster Seats, National Center for Statistics, NHTSA, 2008National Center for Statistics, NHTSA, 2008

Ages All Afr-Amer Hispanic Asian/n-H

1 – 3 yrs 92 % 74 % 84 % 99 %

4 – 7 yrs 89 % 84 % 82 % 95 %

8 – 12 yrs 85 % 72 % 79% 91 %

Observational survey of 14,000 occupants (7,500 children)

Maryland Restraint Use RatesMaryland Restraint Use RatesSeat Belt Use rate in 2010: 94.2 %Seat Belt Use rate in 2010: 94.2 %

Child Safety Seat Use Rate: approx. 88.3%**Child Safety Seat Use Rate: approx. 88.3%**2010, among children ages 0–9 yrs involved in MVC. National Study Center2010, among children ages 0–9 yrs involved in MVC. National Study Center

Maryland CSS Misuse rate: 74%Maryland CSS Misuse rate: 74%

Use Rates By Sub-Populations ??Use Rates By Sub-Populations ??

• A study of 2002-2006 data from the National A study of 2002-2006 data from the National Trauma Database on car crashes involving Trauma Database on car crashes involving children <16 years showed that less than half of children <16 years showed that less than half of the kids who had injuries were restrained, with the the kids who had injuries were restrained, with the lowest restraint rates among African Americans, lowest restraint rates among African Americans, Hispanics, and Native Americans. Hispanics, and Native Americans.

• ““Race/ethnicity did not affect mortality or length Race/ethnicity did not affect mortality or length of hospital stay, but the use of restraints was of hospital stay, but the use of restraints was associated with a lower injury severity score.” associated with a lower injury severity score.” (Stark 2011) (Stark 2011)

ChallengesChallenges to Buckling Upto Buckling Up

““Child safety seat use is lower among rural Child safety seat use is lower among rural populations and low income families.”populations and low income families.”

NHTSA, ‘Rural & Urban Crashes Comparative Analysis’ 1996.NHTSA, ‘Rural & Urban Crashes Comparative Analysis’ 1996.


Restraint Use in Population Groups: Restraint Use in Population Groups: HispanicsHispanics

Seat belt use rates among adult Hispanic groups Seat belt use rates among adult Hispanic groups varies widely in studies, showing lower, varies widely in studies, showing lower, comparable, and higher use compared to comparable, and higher use compared to non-Hispanic groups.non-Hispanic groups.

Injury Prevention, Dec 2006, 12(6), 421-426.Injury Prevention, Dec 2006, 12(6), 421-426.

““Hispanicity includes 20 Spanish-speaking Hispanicity includes 20 Spanish-speaking nationalities that differ across many dimensions nationalities that differ across many dimensions including immigration history, legal status, including immigration history, legal status, socioeconomic status, shades of skin color and socioeconomic status, shades of skin color and political views. Therefore, cultural and behavioral political views. Therefore, cultural and behavioral differences between Hispanics of different national differences between Hispanics of different national origins might affect prevalence of seat belt use.” origins might affect prevalence of seat belt use.”

Injury Prevention, Dec 2006, 12(6), 421-426Injury Prevention, Dec 2006, 12(6), 421-426..

Restraint Use in Population Groups: Restraint Use in Population Groups: HispanicsHispanics


What are the challenges and strategies What are the challenges and strategies among specific sub-groups in getting among specific sub-groups in getting adults and children buckled up—every adults and children buckled up—every time, in every vehicle, and having the time, in every vehicle, and having the restraints used properly?restraints used properly?

Bucking Up Challenges and Bucking Up Challenges and Strategies in Hard-to-Reach Strategies in Hard-to-Reach

PopulationsPopulations

Jewel Johnson, Traffic Safety Advocate

ChallengesChallenges

Gaining trustGaining trust Bilingual literature Bilingual literature

and educational and educational materialsmaterials

Families migrateFamilies migrate FundingFunding

Give Kids A BoostGive Kids A Boost

Baltimore’s Baltimore’s Give Kids A Give Kids A BoostBoost program is designed to program is designed to link ongoing local childhood link ongoing local childhood immunization efforts with an immunization efforts with an initiative to increase usage of initiative to increase usage of

car booster seats. car booster seats.

Give Kids A Boost!Give Kids A Boost!

Buckle Up ReligiouslyBuckle Up Religiously

Safe Kids Baltimore’s Community Based Safe Kids Baltimore’s Community Based Child Safety Seat InspectionsChild Safety Seat Inspections

• Monthly Baltimore City Fire Monthly Baltimore City Fire Department. Urban and Department. Urban and county residents.county residents.

• Annually: Mt. Washington Annually: Mt. Washington Pediatric Hospital, Giant Food Pediatric Hospital, Giant Food Stores, Churches, and Head Stores, Churches, and Head Start Centers.Start Centers.

Walking and Riding Safely Walking and Riding Safely Train-the-TrainerTrain-the-Trainer

Community Outreach IdeasCommunity Outreach Ideas

Church FestivalsChurch FestivalsBrush, Floss, and Buckle-Brush, Floss, and Buckle-

UpUpBarber ShopsBarber ShopsHair SalonsHair SalonsMallsMalls

THANKS SO MUCH!THANKS SO MUCH!

Buckling Up Challenges and Buckling Up Challenges and Strategies In Hard-to-Reach Strategies In Hard-to-Reach

GroupsGroups

Danitza A. SimpsonDanitza A. Simpson

• Minorities

• Low income families

• Immigrants

• In Latin American = the use of seat belts In Latin American = the use of seat belts are not mandatory. When a woman delivers are not mandatory. When a woman delivers her child she can leave the hospital in a her child she can leave the hospital in a taxi, public transportation, and even in taxi, public transportation, and even in private vehicle without using a car seat or private vehicle without using a car seat or putting on her seat belt.putting on her seat belt.

• Safety seats are sold in the country, but not Safety seats are sold in the country, but not required to be used.required to be used.

• Seat belts are installed in every vehicle sold Seat belts are installed in every vehicle sold in Latin America, but not required to use in Latin America, but not required to use them.them.

• Some use seat belts because they practice Some use seat belts because they practice safety and others because have been told by safety and others because have been told by a relative or friend that in other countries it a relative or friend that in other countries it is a requirement.is a requirement.

• In Latin America owning a car is In Latin America owning a car is considered a luxury that many can’t afford. considered a luxury that many can’t afford.

• Public transportation is more affordable and Public transportation is more affordable and does not require the use of seat belts.does not require the use of seat belts.

• Educate the subgroupsEducate the subgroups

• Promote public announcements in their Promote public announcements in their native languagenative language

• Collaborate with community leaders to Collaborate with community leaders to promote safetypromote safety

• Faith-basedFaith-based

• Local non-profitsLocal non-profits

• Word of mouthWord of mouth

• Local schoolsLocal schools

• Doctor’s officeDoctor’s office

• Community centersCommunity centers

• Community eventsCommunity events

• Health fairsHealth fairs

• County agenciesCounty agencies

• Distribute literature along with someone who Distribute literature along with someone who speaks their language to provide speaks their language to provide interpretation/translation helpsinterpretation/translation helps

• Fund community organizations to distribute car Fund community organizations to distribute car seats at low or no cost to residents and seat seats at low or no cost to residents and seat usage.usage.

• Educate the subgroups of stages of car seats and Educate the subgroups of stages of car seats and why it is important to properly place the child in why it is important to properly place the child in them.them.

• Because our center is located in a needy Because our center is located in a needy population/area of the county, we are forced to population/area of the county, we are forced to apply for grants to sustain our Car Seat Loaner apply for grants to sustain our Car Seat Loaner Program. Program.

• Many of the residents of the county are low-Many of the residents of the county are low-income or have no education beyond 6income or have no education beyond 6 thth grade. grade.

• We are also seeing a rise in Guatemalan We are also seeing a rise in Guatemalan Natives who don’t speak Spanish or English. Natives who don’t speak Spanish or English. In order to communicate we use pictures, sign In order to communicate we use pictures, sign language, and other relatives. language, and other relatives.

• Many of the families don’t see the need for car Many of the families don’t see the need for car seats or putting on a seat belt and are forced to seats or putting on a seat belt and are forced to get one when being discharged from the get one when being discharged from the hospital or are fined when pulled over by hospital or are fined when pulled over by police.police.

• Some borrow from a relative or neighbor Some borrow from a relative or neighbor and others are referred to us.and others are referred to us.

• These families run the risk of using an These families run the risk of using an expired car seat or use it improperly.expired car seat or use it improperly.

• Have on-hands demonstration or videos for Have on-hands demonstration or videos for those who can’t read or write.those who can’t read or write.

• Make literature/materials easy and briefMake literature/materials easy and brief

But most important But most important

educate, educate, educateeducate, , educateeducate..

Thank youThank you!!

Challenges to Buckling UpChallenges to Buckling Up

Kids aren’t buckled up because their parents or guardians aren’t

buckled.

A driver who is buckled up is three times A driver who is buckled up is three times more likely to restrain a child passenger more likely to restrain a child passenger than one who is not buckled. than one who is not buckled. Journal Pediatrics, Vol. 102, No. 3, September 1998Journal Pediatrics, Vol. 102, No. 3, September 1998

Strategies for Buckling UpStrategies for Buckling Up

•2007 study showed safety belt use was higher in states with 2007 study showed safety belt use was higher in states with primary versus secondary enforcement laws, both for overall primary versus secondary enforcement laws, both for overall population numbers and also for each socio-demographic population numbers and also for each socio-demographic characteristic examined: characteristic examined:

safety belt use of 85% in states with primary lawssafety belt use of 85% in states with primary lawssafety belt use of 74% in states with secondary lawssafety belt use of 74% in states with secondary laws

•A 1999 national survey conducted by a leading African A 1999 national survey conducted by a leading African American researcher found that African Americans who live in American researcher found that African Americans who live in primary enforcement states overwhelmingly supported a primary primary enforcement states overwhelmingly supported a primary seat belt law by 3 to 1. Furthermore, 83% reported they always seat belt law by 3 to 1. Furthermore, 83% reported they always wear their safety belts, as opposed to only 66% of the African wear their safety belts, as opposed to only 66% of the African Americans in secondary enforcement states. Americans in secondary enforcement states. (Air Bag & Seat Belt Safety Campaign)(Air Bag & Seat Belt Safety Campaign)

•

Make buckling up a primary enforcement lawMake buckling up a primary enforcement law

In a 2006 study of fatal crashes, seat belt use among In a 2006 study of fatal crashes, seat belt use among Mexican-Americans and Central/South Americans Mexican-Americans and Central/South Americans in in states with primary seat belt laws states with primary seat belt laws was more than 20% was more than 20% higher than among Hispanics in states with higher than among Hispanics in states with secondary laws. secondary laws.


““Enact standard enforcement Enact standard enforcement safety belt laws (primary laws) safety belt laws (primary laws) coupled with a zero tolerance provision for differential coupled with a zero tolerance provision for differential enforcement, particularly based on race.”enforcement, particularly based on race.”

Formal recommendation by Meharry Medical College, a historically black college, 1998:


“ “Primary enforcement laws may have the Primary enforcement laws may have the greatest effect on sociodemographic greatest effect on sociodemographic groups that reported lower levels of groups that reported lower levels of safety belt use.” safety belt use.”

Am J Public Health, 2007, Sept Am J Public Health, 2007, Sept

97(9)97(9)

Safety Belt Enforcement Safety Belt Enforcement (Primary vs. Secondary vs. None) Dec 2010(Primary vs. Secondary vs. None) Dec 2010


Improve access to child safety seatsImprove access to child safety seats

““When low income families do own a car When low income families do own a car seat, 95% of families use it, suggesting seat, 95% of families use it, suggesting strategies to increase availability of free or strategies to increase availability of free or low cost child safety seats might be low cost child safety seats might be effective.” effective.”

Children’s Safety Network; and Robitaille et. Al, 1990, Am J Pub Health Children’s Safety Network; and Robitaille et. Al, 1990, Am J Pub Health


Proper use Proper use of child safety seats and seat belts…of child safety seats and seat belts…

Safety Seat Safety Seat ChecksChecks

Prenatal and Prenatal and Parenting ClassesParenting Classes

Hospital Wellness Hospital Wellness ServicesServices


““Some of the informational sheets are very wordy and Some of the informational sheets are very wordy and detailed, and some of our parents don’t even read in their detailed, and some of our parents don’t even read in their own language.”own language.”

From NICU nurse in a DC-area hospital, May 2012From NICU nurse in a DC-area hospital, May 2012

2003 study found most car safety seat manuals were written at 2003 study found most car safety seat manuals were written at a 10a 10thth grade level, while nearly a quarter of U.S. adults read at grade level, while nearly a quarter of U.S. adults read at or below a 5or below a 5thth grade level and at least 25% read at about an 8 grade level and at least 25% read at about an 8 thth grade level.grade level. Wegner & Girasek. Child, Youth & Envts 23(1), Spring 2003Wegner & Girasek. Child, Youth & Envts 23(1), Spring 2003

Written language barriersWritten language barriers

•More graphicsMore graphics

•Color codingColor coding

•Simple wordsSimple words

•Obvious warningsObvious warnings

•Table of contentsTable of contents

•Cultural Cultural competency/sensitivitycompetency/sensitivity

Strategies for Buckling UpStrategies for Buckling UpNHTSA:NHTSA:

www.safercar.gov/protegidoswww.safercar.gov/protegidos

Non-English Language Resources Non-English Language Resources Available from SafetyBeltSafe U.S.A. Available from SafetyBeltSafe U.S.A.

• Basic brochure (various languages) Basic brochure (various languages) “Keep Your Children “Keep Your Children Safe” Safe” ((low reading level; California and national versions low reading level; California and national versions available) available) Armenian (#119) Cambodian (#150) Chinese (#94) Farsi Armenian (#119) Cambodian (#150) Chinese (#94) Farsi (#183) Korean (#96) Russian (#33) Spanish (#29) Tagalog (#183) Korean (#96) Russian (#33) Spanish (#29) Tagalog (#97) Vietnamese (#121) (#97) Vietnamese (#121)

• Many educational pages available in SpanishMany educational pages available in Spanish

SafetyBeltSafe U.S.A. P.O. Box 553, Altadena, CA 91003 www.carseat.org 310/222-6860, 800/745-SAFE (English), 310/222-6862, 800/747-SANO (Spanish)


Materials Available in Spanish Materials Available in Spanish Through MIEMSS’ CPS Program:Through MIEMSS’ CPS Program:

• Did you Receive a Prescription for Your Child’s Safety? Did you Receive a Prescription for Your Child’s Safety?

• You Score When you Buckle Everyone Every Day!You Score When you Buckle Everyone Every Day!

• Don’t Let It Slide…Always Buckle Right!Don’t Let It Slide…Always Buckle Right!

PostersPosters

HandoutsHandouts

•Child Passenger Safety: Kids Can Live With It! (Safe Kids)Child Passenger Safety: Kids Can Live With It! (Safe Kids)

•Maryland Child Passenger Safety LawsMaryland Child Passenger Safety Laws

•Rx for your child’s safety/Boosters are for big kidsRx for your child’s safety/Boosters are for big kids

Contact: [email protected] or 410-706-8647


mailto:[email protected]

Other challenges or strategies Other challenges or strategies with hard-to-reach groups?with hard-to-reach groups?

Participants, please use your phone at this Participants, please use your phone at this time to offer comments or ask questions time to offer comments or ask questions that might assist all of us. Be sure to that might assist all of us. Be sure to un-mute your phone and speak up!un-mute your phone and speak up!

Thank you for participating today!

Final Instructions:• An evaluation form is available on our website:

http://www.miemss.org/EMSCwww/CPSHome.htm; alternatively, we can email it to call participants.

• Return your completed evaluation along with the contact info page.

• The full presentation with audio will be available on our website in a couple of weeks, in case you wish to re-visit it, or refer a colleague to it.

Buckle Up Challenges and Strategies for Hard-To-Reach Groups.

Documents

higher use

uprestraint use

child safety seat use

children child safety

prevalence of seat belt

hispanicsseat belt use

national center

population groups