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Motor Vehicle Injury – Child Safety Seats: Community-Wide Information and Enhanced Enforcement Campaigns


What the CPSTF Found

About The Systematic Review

The CPSTF finding is based on evidence from a systematic review of 4 studies (search period through March 1998).

The review was conducted on behalf of the CPSTF by scientists from CDC’s Division of Unintentional Injury Prevention with input from a team of specialists in systematic review methods and experts in research, practice and policy related to motor vehicle injury prevention.

Summary of Results

Detailed results from the systematic review are available in the published evidence review pdf icon [PDF - 2.44 MB].

The systematic review included 4 studies.

Summary of Economic Evidence

An economic review of this intervention did not find any relevant studies.


Results should be applicable to variety of settings and populations in the United States, including those of mixed socioeconomic status.

Evidence Gaps

The CPSTF identified several areas that have limited information. Additional research and evaluation could help answer the following questions and fill remaining gaps in the evidence base. (What are evidence gaps?)

  • Is the intervention likely to either increase or reduce misuse of child safety seats?
  • What is the role of community-wide or individual education in facilitating the effectiveness of other interventions (e.g., legislation, loaner programs)?
  • Are interventions equally effective in all populations within a state (e.g., racial and ethnic minorities, high- and low-income populations, or behavior change-resistant populations)?
  • How must the content and methods of the educational components of interventions be altered to work in different populations?
  • Are these interventions effective in populations that already have high baseline safety seat use rates?
  • Do programs targeted at parents of infants improve the rate at which parents buy or use child safety seats for children older than 1 year?
  • What are intervention costs?
  • Are interventions cost-saving?
  • What is the return on investment?

Study Characteristics

  • Included studies evaluated campaigns that provided information on the importance and correct use of child safety seats through paid advertisements, public service announcements, commentaries by community leaders on local television and radio programs, newspaper articles and editorials, displays of safety seats in public locations, and direct mailings.
  • In three studies conducted in states with existing child safety seat laws, enhanced enforcement components included institution of checkpoints, assignment of law enforcement officers dedicated to enforcing the safety seat use law, and alternative penalties instead of citations (e.g., informational warnings or vouchers to waive fines if the driver purchases a safety seat).
  • Settings included cities, suburbs, and states.
  • Design and implementation of campaigns involved numerous community organizations and government agencies such as public safety and public health offices, schools, advocacy organizations, and parent groups.


Zaza S, Sleet DA, Elder RW, Shults RA, Dellinger A, Thompson RS. Response to letter to the editor. American Journal of Preventive Medicine. 2002;22:330-1.

Sleet DA. Evidence based injury prevention: guidance for community action. In: Australian Third National Conference on Injury Prevention and Control. Australian Third National Conference on Injury Prevention and Control. Brisbane, Queensland, Australia; 1999.