Car seat distribution & education programs

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Retired Strategy

Retired strategies are no longer updated.

Date last updated

Car seat distribution programs provide parents with car seats (i.e., infant, convertible, and booster seats) free of charge, via loan, or low cost rental1. These programs often include efforts to teach parents how to correctly install and use car seats2. Programs are generally targeted to low income parents of infants and young children and can be implemented through hospitals, clinics, insurance companies, community organizations, and home visitation.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased use of car seats

What does the research say about effectiveness?

There is strong evidence that car seat distribution and education programs increase car seat use1, 3, 4 and correct use of car seats1, 4.

Distribution of free booster seats combined with education has also been shown to increase the use of booster seats among children 4 to 8 years old3. Car seat distribution programs are effective for rural, urban, and suburban populations and for low and high income populations2. Such programs also appear to increase car seat use in tribal communities5.

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

Federal funding for car seat distribution and education programs was authorized under the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users6. The National Highway Traffic Safety Administration funds states through the Highway Safety Grant to assist car seat distribution7, 8.

Several states also provide free or low cost car seats to low income families through their state department of health. The Ohio Buckles Buckeyes program and the Safe Riders distribution and education program in Texas, for example, provide free car seats to eligible low income families; families are required to attend an educational class on proper use and installation before they receive seats9, 10. The child safety seat distribution program in South Dakota11, and the car seat loan program in Pennsylvania12 are other examples. California offers various free distribution, low cost purchase, and loan programs by county13.


* Journal subscription may be required for access.

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

2 Zaza 2001 - Zaza S, Sleet DA, Thompson RS, Sosin DM, Bolen JC, Task Force on Community Preventive Services. Reviews of evidence regarding interventions to increase use of child safety seats. American Journal of Preventive Medicine. 2001;21(4 Suppl):31–47.

3 Cochrane-Ehiri 2006 - Ehiri JE, Ejere HOD, Magnussen L, et al. Interventions for promoting booster seat use in four to eight year olds travelling in motor vehicles. Cochrane Database Systematic Reviews. 2006;(1):CD004334.

4 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.

5 Billie 2016 - Billie H, Crump CE, Letourneau RJ, West BA. Child safety and booster seat use in five tribal communities, 2010-2014. Journal of Safety Research. 2016;59:113-117.

6 SAFETEA-LU - U.S. Department of Transportation (U.S. DOT), Federal Highway Administration (FHWA). Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users legislation and programs (SAFETEA-LU).

7 NHTSA-HSG - National Highway Traffic Safety Administration (NHTSA). Highway Safety Grant funding guidance (HSG).

8 US DOT-Child safety seat - U.S. Department of Transportation (U.S. DOT). Child passenger safety laws, child safety seat distribution programs, education and enhanced enforcement.

9 ODH-OBB - Ohio Department of Health (ODH). Child passenger safety: The Ohio Buckles Buckeyes (OBB) program.

10 TDSHS-CSS - Texas Department of State Health Services (TDSHS). Safe Riders child safety seat distribution and education programs (CSS).

11 SDDSS-Child safety seat - South Dakota Department of Social Services (SDDSS). Child safety seat distribution program.

12 TIPP-Car seat loan - Traffic Injury Prevention Project (TIPP). Car seat loan programs.

13 CAOTS-Car seats - California Office of Traffic Safety (CAOTS). Who's got car seats? Directory.