{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T12:45:09Z","timestamp":1776689109497,"version":"3.51.2"},"reference-count":14,"publisher":"BMJ","issue":"2","funder":[{"name":"Australian Research Council Discovery Project","award":["DP170103517"],"award-info":[{"award-number":["DP170103517"]}]},{"name":"NSW Centre for Road Safety","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]},{"DOI":"10.13039\/501100000925","name":"NHMRC","doi-asserted-by":"crossref","award":["Investigator Fellowship"],"award-info":[{"award-number":["Investigator Fellowship"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Inj Prev"],"accepted":{"date-parts":[[2023,10,13]]},"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>Optimal child passenger protection requires use of a restraint designed for the age\/size of the child (appropriate use) that is used in the way the manufacturer intended (correct use).This study aimed to determine child restraint practices approximately 10 years after introduction of legislation requiring correct use of age-appropriate restraints for all children aged up to 7 years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A stratified cluster sample was constructed to collect observational data from children aged 0\u201312 years across the Greater Sydney region of New South Wales (NSW). Methods replicated those used in a similar 2008 study. Population weighted estimates for restraint practices were generated, and logistic regression used to examine associations between restraint type, and child age with correct use accounting for the complex sample.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Almost all children were appropriately restrained (99.3%, 95%\u2009CI 98.4% to 100%). However, less than half were correctly restrained (no error=27.3%, 95%\u2009CI 10.8% to 43.8%, no serious error=43.8%, 95%\u2009CI 35.0% to 52.7%). For any error, the odds of error decreased by 39% per year of age (OR 0.61, 95% CI 0.46 to 0.81) and for serious error by 25% per year (OR 0.75, 95%\u2009CI 0.60 to 0.93).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The findings demonstrate high levels of appropriate restraint use among children across metropolitan Sydney approximately 10 years after introduction of legislation requiring age-appropriate restraint use until age 7, however, errors in the way restraints remain common.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Implications for public health<\/jats:title>\n                  <jats:p>Given the negative impact incorrect use has on crash protection, continuing high rates of incorrect use may reduce effectiveness of legislative change on injury reduction.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/ip-2023-044994","type":"journal-article","created":{"date-parts":[[2023,11,24]],"date-time":"2023-11-24T13:20:29Z","timestamp":1700832029000},"page":"100-107","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Updated population-level estimates of child restraint practices among children aged 0\u201312 years in Australia, 10 years after introduction of age-appropriate restraint use legislation"],"prefix":"10.1136","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7284-0127","authenticated-orcid":false,"given":"Julie","family":"Brown","sequence":"first","affiliation":[{"name":"The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia"},{"name":"School of Population Health, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bianca","family":"Albanese","sequence":"additional","affiliation":[{"name":"Neuroscience Research Australia, Randwick, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Ho","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Elkington","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sjaan","family":"Koppel","sequence":"additional","affiliation":[{"name":"Monash University Accident Research Centre, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Judith L","family":"Charlton","sequence":"additional","affiliation":[{"name":"Monash University Accident Research Centre, Clayton, Victoria, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3144-4507","authenticated-orcid":false,"given":"Jake","family":"Olivier","sequence":"additional","affiliation":[{"name":"School of Mathematics and Statistics, UNSW, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa","family":"Keay","sequence":"additional","affiliation":[{"name":"The George Institute for Global Health, UNSW Sydney, Newtown, New South Wales, Australia"},{"name":"School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lynne E","family":"Bilston","sequence":"additional","affiliation":[{"name":"Neuroscience Research Australia, Randwick, New South Wales, Australia"},{"name":"Neuroscience Research Australia, Randwick, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,11,24]]},"reference":[{"key":"2025092506283570000_30.2.100.1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.160.6.617"},{"key":"2025092506283570000_30.2.100.2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-1171"},{"key":"2025092506283570000_30.2.100.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2006.00870.x"},{"key":"2025092506283570000_30.2.100.4","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1080\/15389588.2016.1203427","article-title":"Rating child passenger safety laws relative to best practice recommendations for occupant protection","volume":"18","author":"Klinich","year":"2017","journal-title":"Traffic Inj Prev"},{"key":"2025092506283570000_30.2.100.5","doi-asserted-by":"publisher","DOI":"10.1136\/injuryprev-2021-044196"},{"key":"2025092506283570000_30.2.100.6","first-page":"37","article-title":"Child occupant protection in Australia","volume":"23","author":"Brown","year":"2012","journal-title":"J Australas Coll Road Saf"},{"key":"2025092506283570000_30.2.100.7","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1016\/j.aap.2010.07.006","article-title":"Population-level estimates of child restraint practices among children aged 0\u201312 years in NSW, Australia","volume":"42","author":"Brown","year":"2010","journal-title":"Accid Anal Prev"},{"key":"2025092506283570000_30.2.100.8","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12070"},{"key":"2025092506283570000_30.2.100.9","doi-asserted-by":"publisher","DOI":"10.1080\/15389588.2012.700746"},{"key":"2025092506283570000_30.2.100.10","doi-asserted-by":"crossref","unstructured":"Korn EL , Graubard BI . Analysis of health surveys. New York: Wiley, 1999.","DOI":"10.1002\/9781118032619"},{"key":"2025092506283570000_30.2.100.11","unstructured":"Lohr S . Sampling: design and analysis. Pacific Grove: Duxbury Press, 1999."},{"key":"2025092506283570000_30.2.100.12","unstructured":"Greenwell NK . Results of the national child restraint use special study. (report no. DOT HS 812 142). Washington, DC National Highway Traffic Safety Administration; 2015."},{"key":"2025092506283570000_30.2.100.13","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph19031524","article-title":"Can age or height define appropriate thresholds for transition to adult seat belts? An analysis of observed seat belt fit in children aged 7-12 years","volume":"19","author":"Parab","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2025092506283570000_30.2.100.14","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17041147","article-title":"Restraint factors and child passenger deaths in New South Wales, Australia","volume":"17","author":"Whyte","year":"2020","journal-title":"Int J Environ Res Public Health"}],"container-title":["Injury Prevention"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/ip-2023-044994","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T13:28:44Z","timestamp":1758806924000},"score":1,"resource":{"primary":{"URL":"https:\/\/injuryprevention.bmj.com\/lookup\/doi\/10.1136\/ip-2023-044994"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,24]]},"references-count":14,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,3,20]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/ip-2023-044994"],"URL":"https:\/\/doi.org\/10.1136\/ip-2023-044994","relation":{},"ISSN":["1353-8047","1475-5785"],"issn-type":[{"value":"1353-8047","type":"print"},{"value":"1475-5785","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,24]]}}}