SuSTAInZ - Supporting Successful Transition to Adult belts In Cars: examining effectiveness of optimiZed tools
Background
Optimal crash protection requires the most appropriate restraint for a child’s size. For children <7 years, Australian law dictates the restraint type to be used. For children ≥7 years, parents can choose the restraint that best suits their child, for example using seatbelts or a booster seat. However, current literature suggests that there is confusion about when their children can safely use seatbelts. This stems from the fact that optimal protection from a seatbelt requires a good match between child size and geometry of both the seatbelt and the vehicle seat. Yet there is a wide variation of seatbelt and vehicle seat geometry across different cars. This coupled with intrinsic variations in child size makes it difficult to provide advice using age or height. The result is that many children ≥7 years inappropriately use seatbelts, increasing risk of injury in a crash.
Current best practice advice for parents to make transition decisions is the 5-step test. Our recent study shows that the 5-step test is effective in conveying the knowledge of the 5-step test but did not show a statically significate difference in parents making a corrected safe seatbelt fit determination for their own child. As a result, we have created an Enhanced 5-step test to better address parental capability, motivation and opportunity which are important factors influencing how parents make this transition decision.
In previous studies from our team, using a user-centred approach has increased comprehension of child restraint by almost 30%. These findings indicate user involvement in developing communication tools is key to their effectiveness. Our previous work specific to the transition to adult seatbelt mapped parental decision-making to behavioural drivers, these results have been used to create the Enhanced 5-step test.
Aim
In this project we will pilot test the effectiveness of the Enhanced 5-step test and undertake detailed examination of the task-related decision process. This research will make fundamental contributions to understanding how to communicate with parents to ensure optimized decision-making. It will be the first randomised evaluation of the effectiveness of the Enhanced 5-step test.
Research Methodology
This project uses a 2-arm single-blinded randomised lab-based controlled trial (see Figure 1) that will include the following quantitative and qualitative data collection methods:
- Questionnaires (i. baseline knowledge and demographics, and ii. post-assessment knowledge and acceptability)
- Observed correctness of transition decision (decision-making assessment)
- Analysis of ‘think-aloud’ protocol during decision-making assessment
This methodology has been selected because the decision-making assessment between parents/carers randomly allocated to 'control’ and ‘intervention’ groups will establish whether or not the Enhanced 5-step test advice effectively assists parents/carers to make correct decisions about using adult seatbelts for children compared to parents/carers provided with original 5-step test advice. Furthermore, the think-aloud protocol and post-assessment questionnaires will provide rich data on the cognitive processes underlying participant decision-making, and act as a surrogate method for obtaining user-input into what information parents/carers need when making this decision. The observations will be conducted at the laboratory at NeuRA (Randwick, NSW) or at the C.A.R.E.S Bicycle Safety Centre (Bass Hill, NSW) where we have conducted our previous child car seat trials.
Current Status
As of November 2024, ethics has been approved, the Enhanced 5-step test has been converted to a website platform, and recruitment will begin in December 2024.
