an application of the health belief model to understanding use of child restraint practices
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An application of the Health Belief Model to understanding use of child restraint practices. Melissa Johns Prof. Narelle Haworth & Dr. Alexia Lennon Australian Injury Prevention Network Conference Brisbane 2011. CRICOS No. 00213J. Queensland Legislation. Old legislation: - PowerPoint PPT PresentationTRANSCRIPT
CRICOS No. 00213J
Melissa JohnsProf. Narelle Haworth & Dr. Alexia Lennon
Australian Injury Prevention Network ConferenceBrisbane 2011
An application of the Health Belief Model to understanding use of child restraint practices
Queensland Legislation
• Old legislation:– All passengers must be restrained– Children younger than 12 months in a rear
facing infant restraint• New legislation:
– Different restraints depending on age of child up to 7 years
– Rear seating for children up to 7 years
Aims• Multi-method study including two parts:
– Study One: three sets of observations in two regional areas of Queensland
– Study Two: two sets of parent intercept interviews conducted in Toowoomba, Queensland
• The aim of Study Two is to determine parents’ views, opinions and knowledge of child restraint practices and the Queensland legislative amendment
Study Two Method• Intercept interviews with parents in a shopping centre in
Toowoomba, Queensland.
• 125 parents reporting on 222 children (aged from 0-8 years)• Interviews lasted approximately 10 minutes and included questions
about:– Child restraint type and seating position– Purpose of changes to legislation– Ease (or otherwise) of complying with legislation– Health Belief Model constructs:
• Perceived benefits• Perceived barriers• Perceived susceptibility• Perceived severity• Self efficacy
Health Belief Model• Individual’s behaviour is:
– reason-based– influenced by attitudes, perceptions & beliefs
(Glanz, Lewis & Rimer, 2002)
• Individuals will carry out a health related action if there is a positive expectation that they will avoid a negative health condition by engaging in a recommended action.
• Example: Parents will restrain their children in appropriate child restraints to avoid child injury or death.
Items used to fulfil Health Belief Model constructsPerceived Benefits:•Protect child•Avoid punishment
Perceived Barriers:•Cost•Length of trip•Parents’ trust in retailer•Enough space in car for 3 restraints•Relative safety of child restraint vs adult seatbelts for children•Relative safety of back seat vs front seat for children
Perceived Susceptibility/Severity:•Likelihood of crash•Likelihood of child injury•Severity of child injury
Self efficacy:Parents confidence in:•Choosing•Obtaining•Installing•Ensuring child wearsmost appropriate child restraint
Restraint Practices
• Score of appropriate:─ If all children were seated and restrained
appropriately according to the new legislation
• Score of inappropriate:– If any one child was seated or restrained
inappropriately according to the new legislation
Analysis• Cronbach’s alpha values of scales for
Health Belief Model were low so associations were examined separately
• Univariate logistic regression was used to examine whether parents’ responses to the Health Belief Model constructs were associated with restraint practices
Results• 125 parents, 222 children
• 74.4% parents achieved score of ‘appropriate’
• 25.6% parents achieved score of ‘inappropriate’
• Parent demographic information was recorded:– Age
– Gender
– Income
– Highest level of education
– Family type
• No significant differences were detected between parents with a score of appropriate or inappropriate on the basis of demographic variables
Perceived Benefits• Significantly more likely to achieve a score of ‘appropriate’ if:
− Parents agreed that placing the child in the recommended
child restraint for his/her age would avoid a fine
− Parents agreed that placing the child in the recommended
child restraint for his/her age would avoid demerit points
• Responses to other items (protect child against injury/death)
were not related to the appropriateness of parents’ overall
restraint practices.
Perceived Barriers
• Significantly more likely to achieve score of ‘inappropriate’ if:
− Parents disagreed that child restraints provide better protection
than a seatbelt for children
• Agreement/disagreement with other items (cost of child restraints, length of trip, trust in retailer, having enough space in the back seat of the car for three child restraints, and the relative safety of a child restraint instead of an adult seatbelts for children and the back seat instead of the front seat) was not related to the appropriateness of parents’ overall restraint practices
Perceived Susceptibility/Severity
• Parents’ responses (likelihood of crash, likelihood of child injury, severity of child injury) were not related to appropriateness of overall restraint practices for their children.
Self efficacy
• Significantly more likely to achieve score of ‘appropriate’ if:
− Parents reported that they were completely confident in installing
the restraint
• Responses to other items (confidence in choosing, obtaining and having child wear restraint) were not related to the appropriateness of parents’ overall restraint practices.
Discussion• Perceived difficulties in installing restraint more important
than choosing, obtaining and wearing correct restraint.
• More information and education to understand that child restraints provide better protection seatbelt for children.
• Avoiding fines and demerit points is associated with appropriate restraint practices.
• Perceived susceptibility and severity, including protecting children against injury or death in a crash did not appear to influence parents’ restraint practices.
Acknowledgements:Funding bodies:
RACQARC
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