O2014: Boosters in a Bag: A Pandemic Innovation

Background: Booster seat education and no-cost distribution are beneficial interventions (Ehrl, 2006). Nearly 40% of children 4-7 years of age were unrestrained or in a seat belt (Vegega, 2019, National Survey Data). California law requires children under 8 years to be properly buckled into a child restraint (CA VEH 27360) and permits children 8 years and older to use a safety belt if it fits properly (CA VEH 27360.5). Between 2018 and 2020, motor vehicle occupant injury was the 4th leading cause of injury death among California children 5-9 years of age. In our previous study No Child Unrestrained: Reaching the Hard To Reach with Booster Seats, at in-person events in low-income communities, we found that no child was properly restrained using our expanded definition of selection, direction, location, installation, harnessing, and proper restraint use all the time in all vehicles in which the child travels. Due to the COVID-19 pandemic in 2020, we developed virtual methods of booster seat education and distribution.

Methods: Our target population was low-income families — ⅔ reported an annual income below the Federal Poverty Line; 85% identified as Hispanic/Latino. A self-guided online 15-minute HIPAA-compliant educational module available in English and Spanish was developed by our Child Passenger Safety Technician Instructor (CPSTI) to educate parents on age/size-appropriate child occupant protection devices, including current state law. Community-based organization staff were trained to identify and refer families needing a booster seat to the module with promotional QR-coded postcards. Organizations were provided boosters in a bag, educational materials, and a liability waiver. A 3-month follow-up electronic survey was conducted.

Results: Three virtual workshops were conducted between June 2021 and December 2021. Eleven organizations participated and set up neighborhood distribution centers. Organizations included family resource centers, school districts, law enforcement, and community-based organizations providing services to children. 125 booster seats were distributed to children 5-11 years. Reasons for needing a booster seat are in Table 1. Eighty percent (100) responded to a 3-month follow-up electronic survey. Nearly 100% (99/100) of children were using the booster seat and stated that the lap/shoulder fit better with the booster seat (98/100). 100% agreed with the statement that children may need to ride in a booster seat until 10-12 years of age, compared to 45% agreeing during the initial assessment on the online module.

Conclusion: Booster Seats In A Bag, using a virtual platform, is a convenient, efficient, and cost-saving method of increasing booster seat usage. Access barriers to attending in-person classes are eliminated. Pandemic lessons learned include the use of online modules for education and post-assessment of a booster seat distribution along with minimal contact pickup. Moreover, this model can be adapted to in-person events instead of traditional classes.