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The rate of child restraint system use among children aged under six years in China

Aims: The child restraint system (CRS) for vehicles is designed to provide specialized protection for children in the event of a crash. The aim of the study was to investigate the rate of CRS use and analyze the factors associated with CRS use among children aged under six years in China, and to provide further insight into developing strategies for promoting public health education. Methods: This is a cross-sectional study. The study sites were 36 primary healthcare institutions in 12 provinces across China, and the participants were 34,503 guardians of children aged 0–6 years. Guardians who owned private cars were included and completed surveys about their experience using CRS. Odds ratios and 95% confidence intervals were calculated using multivariate logistic regression models. Results: The overall rate of CRS use among children aged under six years in China was 17.3%. Multivariate logistic regression analysis revealed that living in an urban area, low age of the child, guardians having higher education and being looked after by parents had a significant positive association with CRS use among children aged under six years. Conclusions: This study confirms that there is a low rate of CRS use among children aged under six years in China, highlighting the considerable need for CRS use education, advocacy and promotion of increasing use.