Prevalence of child restraint system use and parental knowledge of such systems in Mianyang, China

Abstract Background This study investigated the prevalence of restraint system use for children passengers in cars, and it assessed parental knowledge and attitudes about such restraint systems in Mianyang, China. Methods A cross-sectional survey was conducted between December 2021 and January 2022. Hospitals and kindergartens in Mianyang were randomly selected for inclusion and parents with cars were surveyed about whether they owned and used child restraint systems and about their knowledge and attitudes towards such systems. Factors associated with CRS use were explored using binary logistic regression. Results A total of 4,764 questionnaires were distributed to families with children 0–6 years old. Among the 4,455 responses received, 50.8% of families owned child restraint systems, most of which were front-facing child seats (42.0%). Just under half of families (44.4%) reported using a child restraint system at least sometimes, but only 19.6% used one all the time. Possession and use of a child restraint system varied significantly with parental education level, age of the child, place of residence, number of children, family income, travel frequency, and travel distance. Logistic regression showed that frequency of car travel with a child and monthly family income significantly affected CRS use. Most parents (85.2%) wrongly believed that adult seat belts in cars are effective at protecting their children in the event of a crash. The most frequent reason that parents cited for not using a child restraint system was that it would lead children to travel in the car less often. Conclusions Although approximately half the parents in our sample owned a child restraint system, most used them rarely, if at all. Educating parents about the safe ways for children to ride in a car and about safety restraint systems and safety belts may promote the use of restraint systems.