Child restraint seat use behavior and attitude among Japanese mothers

OBJECTIVES: The purpose of the study was to assess associations between child restraint seat use and attitudes among Japanese mothers. MATERIALS AND METHODS: Mothers whose children were under 6 years of age were recruited through 11 kindergartens located in Kanagawa prefecture, Japan. Questions were developed based on the Health Belief Model and the Theory of Reasoned Action. Past use and future intentions to use, perceived risk of injury, knowledge of safety, attitudes toward use, subjective norms, and safety values related to safety seats were asked. RESULTS: A total of 552 complete questionnaires was obtained. Of 500 car owning households, 54.2% used child restraint seats inconsistently on short drives, and 36.4% did so on long drives. Three variables were associated with inconsistent use on short drives: frequent child resistance to sitting in a restraint seat; mothers' feeling hassled by child restraint seat use; and, mothers' agreement with the lack of need to use a restraint seat when another adult is in a car. Two variables were associated with inconsistent use on long drives: lower subjective norm of husband and frequent child resistance. CONCLUSIONS: In-car environmental modification and parent education need to be considered to increase child restraint seat use among Japanese households.