Car seat education & enforcement campaigns

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  
Decision Makers
Retired Strategy

Retired strategies are no longer updated.

Date last updated

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 citations1. 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 use2. These efforts generally complement existing car seat laws and often emphasize the importance of booster seat use3.

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 community-wide information and enhanced enforcement campaigns increase car seat use for younger children and older children in booster seats2, 3, 4, 5, 6. Such campaigns are effective in a variety of populations and settings2.

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 enforcement3.

How could this strategy impact health disparities? This strategy is rated 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 old7

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 programs8.


* Journal subscription may be required for access.

1 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.

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

3 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, D.C.: National Highway Traffic Safety Administration (NHTSA), U.S. Department of Transportation (U.S. DOT); 2013.

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

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

7 LawAtlas-Child car seat - LawAtlas. Child car safety seat laws map.

8 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.