County Health Rankings & Roadmaps, A Healthier Nation, County by County

The County Health Rankings models and measures

Our Approach

The County Health Rankings model of population health

What can I do?

Action Center

Explore guides and tools for improving health.

What Works for Health

Explore programs and policies that work!

What can I learn from others?

Reports

Key findings from the last four years of County Health Rankings and other national reports.

County-by-County Blog

Project updates, commentaries, events and news about health across the nation from the County Health Rankings & Roadmaps team.

Car seat education & enforcement campaigns

Evidence Rating

Scientifically Supported

Health Factors

Decision Makers

Community-wide information and enhanced enforcement campaigns combine targeted information about the importance of car seat use (i.e., infant, convertible, and booster seat use), proper use, and existing laws with enforcement strategies such as checkpoints, dedicated law enforcement officials, or alternatives to citations (Zaza 2001). Public information and education campaigns can include mass media efforts, distribution of educational material, officer visits to schools and child care centers, and other publicity about correct car seat use (CG-Motor vehicle injury). These efforts generally complement existing car seat laws and often emphasize the importance of booster seat use (NHTSA-Goodwin 2013).

Expected Beneficial Outcomes (Rated)

  • Increased use of car seats

Evidence of Effectiveness

There is strong evidence that community-wide information and enhanced enforcement campaigns increase car seat use for younger children and older children in booster seats (CG-Motor vehicle injury, Towner 2001, NHTSA-Goodwin 2013, , NHTSA-Decina 2008). Such campaigns are effective in a variety of populations and settings (CG-Motor vehicle injury).

Support from top law enforcement management, funding dedicated to enforcement, and enforcement methods focused specifically on car seat laws have been shown to be the most effective approaches to these campaigns. Variation in the interpretation of existing state car seat laws can be challenges to enforcement (NHTSA-Goodwin 2013).

Impact on Disparities

No impact on disparities likely

Implementation Examples

As of May 2015, only 12 states require a rear-facing car seat for children less than one year old and six states require a forward-facing car seat for children one to three years old (LawAtlas-Child car seat). 

Delaware, New Jersey, Pennsylvania, and Washington are examples of states with law enforcement agencies that have participated in training activities and publicity events and used a combination of dedicated checkpoints, roving patrols, stationary spots, and dedicated enforcement officials to support community-wide information and enhanced enforcement programs (NHTSA-Decina 2010).

Citations - Evidence

* Journal subscription may be required for access.

CG-Motor vehicle injury - The Guide to Community Preventive Services (The Community Guide). Motor vehicle injury prevention.

Towner 2001 - Towner E, Dowswell T, Mackereth C, Jarvis S. What works in preventing unintentional injuries in children and young adolescents: An updated systematic review. London, UK: Health Development Agency; 2001.

NHTSA-Goodwin 2013 - Goodwin A, Sandt B, Hall W, Thomas L, O’Brien N, Summerlin D. Countermeasures that work: A highway safety countermeasure guide for state highway safety offices, 7th edition. Washington, DC: National Highway Traffic Safety Administration (NHTSA), US Department of Transportation (US DOT); 2013.

Porter 2011* - Porter BE, ed. Handbook of Traffic Psychology. London: Elsevier; 2011.

NHTSA-Decina 2008 - Decina LE, Lococo K, Ashburn W, Hall WB, Rose J. Identifying strategies to improve the effectiveness of booster seat laws. Washington DC: National Highway Traffic Safety Administration (NHTSA); 2008.

Citations - Implementation Examples

* Journal subscription may be required for access.

NHTSA-Decina 2010 - Decina LE, Hall WL, Lococo KH. Booster seat law enforcement: Examples from Delaware, New Jersey, Pennsylvania, and Washington. Chapel Hill: University of North Carolina, Highway Safety Research Center, National Highway Traffic Safety Association (NHTSA); 2010.

LawAtlas-Child car seat - Law Atlas. Child car safety seat laws map.

Date Last Updated

Mar 14, 2016