Ride Safe: A Child Passenger Safety Program for American Indian/Alaska Native Children

• Published in: Maternal and child health journal Vol. 12; no. Suppl 1; pp. 55 - 63
• Main Authors: Letourneau, Robert J., Crump, Carolyn E., Bowling, J. Michael, Kuklinski, Diana M., Allen, Christopher W.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-07-2008; Springer Nature B.V
• Subjects: Adolescent; Automobile Driving - statistics & numerical data; Child; Child restraints; Child, Preschool; Children & youth; Childrens health; Confidence Intervals; Data collection; Education; Families & family life; Female; Focus Groups; Gynecology; Head Start project; Health services; Health Status Disparities; Humans; Indians, North American - statistics & numerical data; Infant; Infant, Newborn; Injury prevention; Inuits - statistics & numerical data; Law enforcement; Logistic Models; Male; Maternal and Child Health; Medicine; Medicine & Public Health; Motor vehicles; Native children & youth; Native North Americans; Odds Ratio; Pediatrics; Population Economics; Program Development; Program Evaluation; Public Health; Safety; Safety - statistics & numerical data; Safety programs; Seat Belts - statistics & numerical data; Sociology; Success; Training; United States; United States Indian Health Service; Vehicles; Young Adult; United States; United States > US; Alaska; American Indian/Alaska Native; Implementation and evaluation; Child passenger safety; Program development; Health disparities
• ISSN: 1092-7875; 1573-6628
• DOI: 10.1007/s10995-008-0332-6

Background
In American Indian/Alaska Native (AI/AN) communities, child safety seat (CSS) use rates are much lower than in non-native communities. To reduce this disparity, Indian Health Service (IHS) staff developed, pilot-tested, and implemented Ride Safe, which provided education, training, and child safety seats for children aged 3–5 participating in Tribal Head Start Centers.
Methods
Focus groups, key informant interviews, and technical review guided program development and implementation. Progress reports and child safety seat use observations, conducted at the beginning and end of three program years (Fall 2003 to Spring 2006), assessed program reach and impact. To examine CSS use, we used three multiple logistic regressions, including a conservative intent to treat analysis.
Results
Ride Safe reached approximately 3,500 children and their families at 14 sites in six states, providing over 1,700 parents/family members with educational activities, 2,916 child safety seats, and child passenger safety (CPS) technician certification training for 78 Tribal staff. Children were 2.5 times (OR = 2.55,
p
 < .01) as likely to be observed in child safety seats comparing Rounds 1 and 2 data, with the most conservative model showing that the odds of being observed restrained were 74% higher (OR = 1.74, 
p
 = <.01) after implementation of the program.
Conclusions
The Ride Safe Program effectively increased child safety seat use in AI/AN communities, however, observed use rates ranging from 30% to 71% remain well below the 2006 all US rate of 93%. Results from CSS educational and distribution/installation programs such as Ride Safe should be considered in light of the need to increase distribution programs and enhance enforcement activities in AI/AN communities, thereby reducing the disparity in AI/AN motor vehicle injuries and death.