1. CRICOS No. 00213J Alexia Lennon 10 th National Injury Prevention and Safety Promotion Conference Brisbane November 2011 How effective is the new child restraint legislation in Queensland? A mixed methods evaluation

2. Acknowledgements Queensland Injury Prevention Council Department of Main Roads and Transport, Queensland Colleagues who assisted with this project were Millie Darvell, Colin Edmonston, Lauren Shaw, Kylie Major-Oakley, Sarah Biggs, Angela Watson, Andrea McCrindle, Kim Smith.

3. Overview Background Research interests Design The observational study Parent perspectives Conclusions

4. Background Pre-2010 –restraint types only specified for infants (<12 mo) –no seating position requirements From March 2010 –restraint type specified (0-7 year olds) –rear seating also required Prior to legislation high compliance However, concerns about age- appropriateness

6. Research interests –Are parents complying with the legislation? –Is this the same for urban, regional and rural parents? Indigenous parents? –What difficulties do parents experience in complying? –Do parents understand why the legislation was put in place? –Have there been negative consequences for other organisations or sectors of the community?

7. Design Three cross-sectional studies: –Observations (road-side; vehicles with child passengers) –Parent interviews (non-Indigenous)/focus group (Indigenous) –Stakeholder interviews

8. Study 1: Observations Road side in Brisbane, Sunshine Coast, Mackay, Townsville; high child traffic (schools, shopping areas, major intersections) Included passenger vehicles w rear seat (n = 1922) carrying child passengers (n = 2791); Measures: –Number of child passengers; restraint type (RF, FFCS, Booster seat, H harness, seatbelt) and seating position (front, rear) ; estimation of child age (0-2 y; 3-6 y; 7-12 y) based on seated height

9. Results: observations (1) Majority of vehicles (62%) only 1 child passenger; Around 1/3 (32%) of vehicles had a child in front seat 85% overall (0-12 y) ‘Appropriate’ restraint 22% child passengers were in front seat Restraint type of choice was seatbelt- 53% of children overall; 23% forward-facing child seats; 17% in booster seats

10. Results: observations (2) 51% children estimated as target age (0-6 y) For target-aged children: –73% ‘Appropriate’ restraint –5.5% in front seats For rear seated target-aged children –73% dedicated child restraint; 15% seatbelt; 3.9% unrestrained Target-aged children more likely than older children to be inappropriately restrained χ 2 (2) = 307.83, p<.001, φ c =.33

11. Appropriateness of restraint for 0-6 year olds by location (rear seat only) Inappropriately restrained n (%) Appropriately restrained n (%)N = 1313 Location Brisbane South85 (21.9)303 (78.1) Brisbane North41 (20.6)158 (79.4) Townsville31 (14.6)182 (85.4) Mackay62 (34.6)117(65.4) Sunshine Coast53 (15.9)281 (84.1) χ 2 (4 ) = 31.16, p <.001, φ c =.15

12. Study 2: Parent perspectives Convenience sample, shopping centres in same locations as obs (n = 490 parents of 769 children aged 0-7 y) ; Brief interview (<10 min) –Type of restraint for each child; awareness of change in legislation; ease of compliance; support for changes Indigenous parents (n = 11) focus group, Woorabinda – understanding of new requirements; support for changes in legislation; barriers to compliance

13. Results: parents (1) Non-Indigenous parents: –56% of children reportedly using forward- facing child seats; 31% booster seat; 1% seatbelt –90% children ‘appropriate’ restraint; 85% of parents ‘appropriate’ restraint practices –2-4 year old children significantly more likely to be deemed ‘inappropriately’ restrained ( χ 2 (3) = 38.15, p<.001, φ c =.22)

14. Results: parents (2) Indigenous parents: –Supported the legislation change –Perceived the purpose as to protect children –Identified barriers to compliance: Cost Belief that can’t legally use 2 nd hand restraints Confusion about whether age or weight is most important in selecting restraints Belief that don’t need restraints on short journeys (esp. around town) Retrofitting of anchor points to vehicles difficult (utes) Lack of qualified installers

15. Conclusions Legislation apparently effective both in encouraging more appropriate restraint use and seating position for target-aged children More modest overall effect than desired High parental awareness that requirements have changed Critical ages are still the transition ages Significant barriers to compliance exist for vulnerable groups

16. Questions?