1. Child Occupant Restraint Use Campaign and Reasons for Non-use on a Southwestern Native American Reservation IHS IP Program Development Fellowship 2005 Stephen R. Piontkowski June 8, 2006

2. Overview Background Methods Results Discussion Conclusions/Recommendations

3. Background MVCs 2 nd leading cause of injury and injury death <8.5% child safety seats use (2005) Few local tribal programs distribute child safety seats to parents of infants and children 3-5 years of age A need remained for child occupant protection

4. Background Project Goals: Increase child safety seat use by 20% among children enrolled at a local child care center Identify barriers to child occupant restraint use

5. Methods – Child Care Center Observational surveys Staff training Parent training

6. Methods – Child Care Center Student training –Buckle Bear Child safety seat distribution

7. Methods – Barriers to Use Focus groups and key informant interviews –determine knowledge and attitudes associated with child occupant restraint use –determine potential effective methods of marketing the importance of child occupant restraint use

8. Results – Child Care Center 15 staff attended SNAP 12 staff trained to conduct observation surveys & Buckle Bear 9 parents trained in class 17 seats distributed

10. Results – Barriers to Use Two focus groups –Parents/childcare providers –1 group met at night and 1 during noon hr –12 participants (1 male, 8 parents, 4 grandparents) –21-62 years old

11. Results – Barriers to Use Key informant interviews –13 informants –PD, EMS, Tribal Council (5), school district administration, housing office, Head Start, WIC, Health Education, PHN –In their current positions 2-24 years –Interviews lasted 10-35 minutes

12. Results – Barriers to Use Barriers to child occupant restraint use Lack of enforcement of the child safety seat law If I got a ticket, I would have gotten a car seat. I think we need better examples, even our own Tribal Police, there is no enforcement. Publics lack of understanding of the importance of child safety seats [people are] lazy. To me it seems like they dont care attitude…lets get in and go…they dont see the importance in it

13. Results – Barriers to Use Knowledge and Attitudes –Buckling up keeps children safe from injury and under control (not a distraction to driver) –Kids should ride in the back seat –Not sure what the law is or if there is one –Knew where to obtain child car seats and information from local programs

14. Results – Barriers to Use Potential marketing methods –More classes (when cited for violation, pre- natal) –Personal experiences from local people –Messages from children –Incentives for use –More car seat clinics/checkpoints –Show car seat videos in public places

15. Discussion Attitudes at the Child Care Center demonstrated what was being stated in the focus groups and key informant interviews… –Child safety seats are not viewed as important because people do not understand the consequences of unrestrained passengers in a motor vehicle crash

16. Conclusions/Recommendations Continue the child safety seat intervention at the Child Care Center –Include components that ensure the Centers cooperation and detailed involvement in the project (e.g. written agreement that details the roles and responsibilities of each group involved)

17. Conclusions/Recommendations Make the existing child occupant restraint law more stringent Increase enforcement of that law Develop an enhanced public awareness campaign on the importance of child occupant restraint use Ensure the provision child safety seats is sustained

19. Acknowledgements Gordon Tsatoke Kenny Hicks Jon Peabody Christine Reede Gilbert Patino Larry Berger David Wallace

20. Child Occupant Restraint Use Campaign and Reasons for Non-use on a Southwestern Native American Reservation IHS IP Program Development Fellowship 2005 Stephen R. Piontkowski June 8, 2006