379 - Racial and Ethnic Differences in Knowledge, Behavior, and Community Norms for Transportation and Child Passenger Safety

Poster Number: 379
Publication Number: 379.1414

Background: Road traffic injuries cause roughly 18% of deaths in US children 5-14 years old (yo). Child restraint systems (CRS) mitigate crash-related injury in the first decade of life, yet use of recommended CRS falls to 90% for 1yo and drops below 60% after age 5. Black and Hispanic children are less likely to use recommended CRS and more likely to be fatally injured in a crash. Little is known about child passenger safety within the context of driving behaviors and community norms across racial and ethnic groups.

Objective: To compare child passenger safety knowledge, transportation behaviors and community norms across racial and ethnic groups.

Design/Methods: Secondary analysis of baseline survey responses for the Tiny Cargo, Big Deal/Abróchame Bien, Cuídame Bien trial. Recruitment occurred after an emergency department or urgent care visit for 6mo – 10yo children in Chicago, excluding those >55” tall and visits with critical illness or injury, crash, or social concerns. English or Spanish-speaking adult caregivers who reported CRS use that was not adherent to AAP guidelines or were planning a premature transition to a less protective CRS were eligible. We compared responses to 9 CRS knowledge questions, 10 transportation behaviors, and 10 community norms by self-identified race and ethnicity in 3 categories: Hispanic; non-Hispanic Black; non-Hispanic, Other. Descriptive, Fisher’s exact, and ANOVA statistics were calculated.

Results: 445 responses were analyzed from caregivers who identified as Hispanic (40%), non-Hispanic, Black (15%), and non-Hispanic, Other (45%). 93% were mothers, median age 36 yrs, IQR 32-40, 64% married, 61% bachelor’s degree or higher. 41% of study children were girls, median age 50mo, IQR 24, 68, 37% publicly insured and 34% received food assistance. CRS knowledge differed across racial and ethnic groups (Figure 1): Hispanic mean 3.3, sd 1.7; non-Hispanic, Black 3.1, sd 1.7; non-Hispanic, Other 4.2, sd 1.8 (p < 0.001). Greater percent of Hispanic caregivers reported not using recommended restraints and traveling unrestrained for child and self but less risky driving behaviors (Figure 2). Community norms for 7 of 10 transportation safety varied significantly by race and ethnicity (Figure 3).

Conclusion(s): Transportation behaviors mirror community norms and vary by racial and ethnic groups among caregivers who were not adherent to CRS guidelines. Community-based efforts to enhance the transportation safety of children should be tailored towards specific risk behaviors, such as traveling unrestrained in Hispanic communities and speeding and distracted driving in non-Hispanic communities.